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Biomedical subjects

P De Franciscis

Publications and source records attributed to P De Franciscis.

At least 19 recordsLinked to original sources
PubMed2004

Effects of soy isoflavones on menopausal neurovegetative symptoms.

AIM: Dietary soy supplementation may reduce the incidence of hot flushes in postmenopausal women due to the presence of phytoestrogens in soy foods. The aim of this study was to assess the effects of a 3-month administration of different doses of either oral or transdermal soy isoflavones on climacteric complaints in postmenopausal women. METHODS: Sixty postmenopausal women were assigned randomly to one of the following groups: groups A and B received 50 mg/day or 75 mg/day of oral isoflavones respectively, while groups C and D received 6 mg/day or 12 mg/day of transdermal isoflavones. A control group (group E) was composed of 15 patients that did not receive any treatment. Hot flushes, Kupper-man index and vaginal dryness at baseline and then after 5, 9 and 13 weeks were evaluated. RESULTS: The isoflavone treatment led to a progressive significant (p<0.01) reduction of the number of hot flushes in the groups A, B and D with a dose-related effect in group D. At week 13, the Kupperman index and hot flush score decreased significantly in all the treated groups, while vaginal dryness score was reduced only in group B. CONCLUSION: Our findings suggest that both oral and transdermal soy isoflavones are effective to attenuate slight to moderate menopausal neurovegetative symptoms with a dose-related effect.

Administration, Cutaneous↗
PubMed2001

Effects of different types of hormone replacement therapy on mammographic density.

OBJECTIVES: to evaluate the effects of different types of hormone replacement therapy (HRT) on mammographic density in postmenopausal women. METHODS: In a prospective 1-year study, 121 healthy postmenopausal women were allocated to one of the following five study groups: twenty-six women were treated with continuous transdermal 17beta-estradiol 50 mcg/die plus acetate nomegestrolo 5 mg/die sequentially added for 12 days per month (Group A); 25 women were treated with continuous transdermal 17beta-estradiol 50 mcg/die plus acetate nomegestrolo 2.5 mg/die added every day (Group B); 23 women were treated with continuous transdermal 17beta-estradiol 50 mcg/die (Group C); 24 women were treated with tibolone 2.5 mg/die (Group D); and 23 women not receiving any medication represented the control group (Group E). At the time of recruitment and after 12 months a two-view mammography was performed to evaluate mammographic density 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). RESULTS: After 12 months of HRT, seven out of 20 patients (35%) in group A, nine of 21 patients (42.85%) in group B, four out of 19 patients (21%) in group C and two of 20 patients (10%) in group D, showed an increase in mammographic density. No variation of density was observed at the second mammographic test in the control group. The mammographic density increase which occurred in groups A, B and C was statistically significant (P<0.05) when compared with group E; no statistically significant difference (P=0.49) was found in mammographic density increase between group D and group E. When the different treatment types were compared each other, a statistically significant difference (P=0.04) was found only between the mammographic density increase occurring in groups B and D. CONCLUSIONS: HRT may cause an increase of mammographic density. The frequency of the density increase is related to the type of HRT and a replacement therapy including a progestin, especially in continuous combination with estrogen, leads to more evident mammographic changes. Tibolone does not significantly affect mammographic density.

Administration, Cutaneous↗
PubMed2001

Effects of surgical menopause and estrogen replacement therapy on atrio-ventricular conduction and ventricular repolarization.

OBJECTIVE: To evaluate the effect of surgical menopause and estrogen replacement therapy on atrio-ventricular conduction and ventricular repolarization in women. METHODS: In a prospective, randomized, double-blind, placebo-controlled clinical trial 50 women underwent hystero-salpingo-oophorectomy. Twenty-five women were treated with 50 microg/die of transdermal estradiol and the other 25 were treated with placebo patches. The duration of the treatment was 12 cycles. Before surgery and after 12 cycles of treatment, a standard electrocardiogram was performed to evaluate atrio-ventricular conduction time and cardiac repolarization time. RESULTS: No significant variations in atrio-ventricuar conduction time and cardiac repolarization time were detected between the two groups at entry, nor was there any difference in both groups after 12 cycles of treatment with transdermal estradiol. CONCLUSIONS: Surgical menopause and estrogen replacement therapy do not modify atrio-ventricular conduction and ventricular repolarization in women.

Adult↗
PubMed2001

Effects of a short-term suspension of hormone replacement therapy on mammographic density.

OBJECTIVE: To evaluate the effects of hormone replacement therapy (HRT) and of a short-term suspension of HRT on mammographic density. DESIGN: Prospective clinical study. SETTING: Outpatient menopausal clinic of the Second University of Naples. PATIENT(S): Ninety-seven healthy postmenopausal women. INTERVENTION(S): Thirty-nine menopausal women with intact uterus (group A) were treated with continuous transdermal E(2) plus acetate nomegestrolo sequentially added, 37 women in surgical menopause (group B) were treated with transdermal E(2) continuously administered, and 21 menopausal women did not receive any medication (group C). At the entry and after 12 months, a mammography was performed without suspension of HRT (group A1: 19 women; group B1: 19 women) or after a short-term suspension (group A2: 20 women; group B2: 18 women). MAIN OUTCOME MEASURE(S): Mammographic density evaluated according to a quantitative method. RESULT(S): At the second mammography, seven patients in group A1, four patients in group B1, and one patient in both groups A2 and B2 showed an increase in mammographic density, whereas no mammographic density increase was observed in patients in group C. A statistically significant difference in the mammographic density increase was found between group A1 and group A2; no difference was found between group B1 and B2. CONCLUSION(S): Suspension of HRT for about 3 weeks may reverse mammographic density increase associated with its use.

Administration, Cutaneous↗
PubMed2000

Effects of hormone replacement therapy on postmenopausal uterine myoma.

OBJECTIVES: To evaluate the effects of sequential continuous hormone replacement therapy (HRT) on myoma size and on pulsatility index (PI) of uterine arteries and to verify the correlation between uterine artery flow impedance and the growth rate of myoma in women receiving HRT. METHODS: In a prospective 1-year study 60 postmenopausal women were enrolled into three study-groups to receive continuous transdermal 17beta-oestradiol 0.05 mg/day plus nomegestrolo acetate 5 mg/day sequentially added: 20 patients (group A) unaffected by uterine myomas, 20 patients (group B) with single asymptomatic myoma <3 cm/14 cm3, 20 patients (group C) with single asymptomatic myoma >3 cm/14 cm3. The changes in myoma volume and in PI were assessed by means of transvaginal ultrasonographic scan every 3 months. The patients with myoma were divided into two subgroups: quiescent myoma (B1, C1) and growing myoma (B2, C2). RESULTS: No significant increase of uterine fibroids volume was found after 1-year HRT (24.14+/-20.02-->28.81+/-30.02 cm3). Six out of eight myomas growing during HRT belonged to group C. The uterine artery basal PI value of group A was significantly higher (P<0.01) than the corresponding PI in group B and C. At 3 months follow-up, uterine artery PI was significantly higher (P<0.01) than the basal value in both group B (1.70+/-0.22-->1.88+/-0.16) and C (1.59+/-0.28-->1.92+/-0.21). The baseline PI values in group B1 and C1 were significantly higher than the baseline values observed in group B2 and C2 (1.76+/-0.17 vs. 1.32+/-0.02, 1.76+/-0.16 vs. 1.24+/-0.08) and significantly lower than those observed in group A (2.39+/-0.47). After 3 months of HRT, the PI values were not significantly higher than the baseline values in groups B1 and C2 (1.76+/-0.17-->1.90+/-0.17; 1.24+/-0.08-->1.74+/-0.16), while they were significantly higher in group C1 (1.76+/-0.16-->2.01+/-0.17). CONCLUSIONS: Sequential continuous HRT does not increase the volume of the uterine myoma. The findings of very low resistance index in the uterine arteries of women with growing myoma may indicate the risk of growth of the neoplasia during HRT. The assessment of PI in the uterine arteries could be helpful in predicting the growth rate of the myomas before starting HRT.

Estradiol↗
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

Bone density in women with endometriosis.

OBJECTIVE: To evaluate the impact of endometriosis on bone metabolism. MATERIALS AND METHODS: We compared bone mineral density and biochemical markers (plasma osteocalcin, bone alkaline phosphatase, fasting urinary hydroxyproline, urinary excretion of cross-linked N-telopeptide of type I collagen) of bone turnover in forty-nine perimenopausal women undergoing laparotomy because of benign gynecologic pathology: in twenty-four of them (group A) endometriosis was diagnosed, the remaining twenty-five represented the control group (group B). Statistical analysis was performed by means of Student "t"-test; significance was set at p < 0.05. RESULTS: Bone density of the lumbar spine (0.898 +/- 0.325 vs 0.940 +/- 0.350) and bone markers failed to show statistically significant differences between the two groups. No significant correlation was observed between any bone density measurement and severity of endometriosis. CONCLUSION: Endometriosis does not seem to induce even in advanced stages, a reduction of bone density.

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↗
PubMed1997

Laparoscopic hysterectomy in a case of male pseudohermaphroditism with persistent Müllerian duct derivatives.

We describe laparoscopic diagnosis and treatment for a case of dysgenetic male pseudohermaphroditism with persistent Mullerian ducts. The patient, a 32 year old man, with a history of surgery for hypospadias and cryptorchidism during childhood, was referred because of anejaculation. He was of short stature, with male external genitalia composed of a small penis and hypoplastic testis (1 ml right, 6 ml left side). Plasma follicle stimulating hormone (FSH) was high (17 mUI/ml), testosterone low (1.9 ng/ml), and his karyotype was 46,XY. Pelvic ultrasound, nuclear magnetic resonance (NMR) and genitography disclosed a uterine-like structure with cavity communicating with the urethra. Laparoscopy and urethrocystoscopy confirmed the presence of a 4 cm uterus, which was removed endoscopically at the same time. A biopsy of the left gonad was also performed. The uterus contained endometrial tissue and was fibrotic. Histology of the left gonad showed spermatocytic arrest. We diagnosed dysgenetic male pseudohermaphroditism. Laparoscopy, in our opinion, is an optimal tool to diagnose and treat abnormal sexual conditions.

Disorders of Sex Development↗
PubMed1997

In vitro fertilization following laparoscopic ovarian diathermy in patients with polycystic ovarian syndrome.

BACKGROUND: To evaluate the in vitro fertilization outcome in patients with polycystic ovarian syndrome previously treated by laparoscopic ovarian diathermy. METHODS: We designed a prospective study to compare in vitro fertilization stimulation parameters and pregnancy rate for two groups of women with polycystic ovarian syndrome. In the first group, we included 23 patients previously treated by laparoscopic ovarian electrodiathermy (group A), in the second group we included 36 women who did not undergo surgical treatment (group B). All patients underwent the same ovarian hyperstimulation protocol and a standard in vitro fertilization and embryo transfer technique. In a limited number of women (five in group A and eight in group B) we measured the levels of sex steroids in follicular fluid. Statistical analysis was performed by means of chi-square test or Fisher's exact test to compare frequencies and by means of the Student's t-test or ANOVA test to compare means. Significance was set at p < 0.05. RESULTS: In group A we found a significantly higher ongoing pregnancy rate (28.6% in group A vs 7.3% in group B), a significantly lower estradiol peak level (1722.73 +/- 522.24 in group A vs 2314.48 +/- 692.60 in group B), a trend for lower abortion rates and an improvement in the number of patients administered human chorionic gonadotropin than in group B. The levels of estradiol, testosterone and androstenedione in follicular fluid were significantly lower from small to intermediate and to large follicles in group A, while in group B only estradiol and androstenedione were different. Lower levels of androstenedione and testosterone were found in each follicular pool of group A, compared to the respective pool in group B. CONCLUSION: We report a significantly better ongoing pregnancy rate after in vitro fertilization and embryo transfer procedures in women pretreated by means of laparoscopic ovarian electrocautery. These results may be related to lower androgen levels in the follicular fluid.

Adult↗
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

Reproductive outcome after hysteroscopic metroplasty.

OBJECTIVE: To evaluate the reproductive outcome after hysteroscopic metroplasty. STUDY DESIGN: We analysed the reproductive outcome of 69 patients, with different degrees of septate uterus, undergoing hysteroscopic metroplasty in the outpatient infertility clinic of Naples 'Federico II' University. Of the 69 patients, 48 had a history of recurrent abortion while 21 had a primary infertility. In all cases the procedure was performed by means of the resectoscope. RESULTS: In 97.1% of the cases post-operative hysterosalpingogram or hysteroscopic examination showed a normal cavity with a little fundal notch. In two cases, second surgery was needed. Of the 48 patients affected by repeated abortion, 40 became pregnant after the metroplasty whereas, to date, in the infertile group only six out 21 (29.0%) conceived. We observed a total of 46 pregnancies with two sets of twins. Of these, 31 pregnancies (67.4%) were carried to term, five (10.8%) ended in preterm delivery, six (13%) ended in spontaneous abortion and four (8.6%) are in progress. Cervical cerclage was performed on 13 women. Only one (7.6%) woman with cervical cerclage had a preterm delivery, while the preterm delivery rate in women without cerclage was 12.1%. The modality of term pregnancy deliveries was cesarean section in 48% of the cases and vaginal delivery in the 52%. CONCLUSIONS: Our data analysis suggest that the correction of mullerian anomalies does not improve the pregnancy rate, but only the pregnancy outcome of the patients.

Abortion, Habitual↗
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↗
PubMed1990

Chronic administration of imipramine antagonizes deranged circadian rhythm phases in individually housed rats.

The circadian rhythms of hypothalamic serotonin (5HT), tryptophan (TP) and 5-hydroxy-indoleacetic acid (5HIAA), and serum corticosterone were determined in male Wistar rats. The animals underwent a five-week 12:12-hr light/dark cycle conditioning period and were divided into three groups: rats housed four to a cage (group C, control), rats housed individually (group I), and rats housed individually and treated for two weeks with 10 mg/kg/day of imipramine continuously administered by osmotic pumps implanted under the skin (group T). Significant differences were found in the acrophases of 5HT, TP and 5HIAA between group I and group C, and corticosterone mesor was higher in group I than in group C. On the contrary, no differences were observed between group T (individually housed, but given imipramine) and group C. Therefore, chronically administered imipramine antagonizes the circadian changes induced by individual housing.

Animals↗
PubMed1989

Effects of individual housing on circadian rhythms of adult rats.

Circadian rhythms of hypothalamic serotonin (5HT), its precursor tryptophan (TP) and its metabolite 5-hydroxy-indoleacetic acid (5HIAA), and of prolactin and corticosterone circulating hormones were determined in group-housed and in individually-housed male rats, adapted to a 12:12 light/dark cycle. After 5 weeks of individual housing, 5HT peaked later, TP and 5HIAA peaked earlier, and the mesor level of TP and 5HIAA decreased with respect to group-housed animals. Individual housing caused an increase in the corticosterone mesor level, but did not affect amplitude or acrophase. The circadian rhythm of prolactin was unchanged by individual housing.

Animals↗