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P Muscatello

Publications and source records attributed to P Muscatello.

11 recordsLinked to original sources
PubMed1992

[Salpingoscopy: a new method for the evaluation of the tubal factors in sterility].

Salpingoscopy is a new endoscopic procedure that allows the direct vision of the tubal mucosa. Therefore, it is able to identify and evaluate intraluminal lesions not detected by hysterosalpingography or laparoscopy. The endoscopic evaluation of the tubal mucosa can predict the possibility of an intrauterine pregnancy or laparoscopic tubal surgery, permitting the selection of patients with the most favourable prognosis. This technique may also have a role in identifying patients at risk for a repeat ectopic pregnancy and patients with silent endosalpingitis.

Endoscopy↗
PubMed1990

Gonadotrophin releasing hormone agonist (buserelin) in the treatment of endometriosis: changes in the extent of the disease and in CA 125 serum levels after 6-month therapy.

Twenty-two women with endometriosis were treated with the luteinizing hormone-releasing hormone (LHRH) agonist buserelin for 6 months. At second-look laparoscopy the mean score of endometriosis had decreased from 23.1 (SD 17.0) to 17.2 (SD 20.2) (P less than 0.05). CA 125 serum levels decreased from 38.4 (SD 32.2) U/ml at diagnosis to 15.5 (SD 7.0) at second look (P less than 0.005). CA 125 levels correlated at diagnosis with total score of endometriosis (P less than 0.05) and with active score of endometriosis (P less than 0.05), but not with the adhesion score. CA 125 levels were not correlated with endometriosis scores at second look laparoscopy, thus suggesting that mechanisms other than the change in the extent of the disease may be involved in the CA 125 decrease during therapy. CA 125 levels may therefore not be a reliable indicator for monitoring the efficacy of LHRH agonist treatment of endometriosis.

Adult↗
PubMed1979

Presence of positive feedback between oestrogen and LH in patients with Klinefelter's syndrome, and Sertoli-cell-only syndrome.

In five adult patients with Klinefelter's syndrome and two with Sertoli-cell-only syndrome, exogenous administration of 17 beta-oestradiol, resulting in a sustained and prolonged elevation of circulating oestrogen levels, had a biphasic effect on LH release. After an initial decrease, a dramatic rise in peripheral levels of LH (positive feedback) was observed in all patients. The timing and magnitude of the induced LH surge was similar to that observed in postmenopausal women after administration of large doses of Ethinyloestradiol. A similar positive feedback effect on the secretion of FSH could not be demonstrated. In two patients with the Sertoli-cell-only syndrome, oestrogen treatment induced marked variations in serum testosterone levels, which appeared to be related to the LH changes. Similar changes were not present in patients with Klinefelter's syndrome, indicating a decrease in the sensitivity of the testicular Leydig cell. These experiments demonstrate that positive feedback between oestrogen and luteinizing hormone is present in the adult human male.

Adult↗
PubMed1975

Enchancement of deficient pituitary response to luteinizing hormone releasing hormone in patients with primary amenorrhea.

Although the absence of pituitary response to the luteinizing hormone releasing hormone (LHRH) test has been considered proof of a lesion primarily localized at the pituitary level, the possibility exists that an absent pituitary response may represent only the effect of a chronic deficiency of hypothalamic secretion. To verify this hypothesis, 4 patients with primary amenorrhea, hypogonadotropic hypogonadism, and deficient or absent responses to a 25 mug LHRH rapid IV test were treated with 400 mug LHRH infused in 7 hours during each of 3 successive days. The finding that patients with deficient LH responses to a rapid LHRH test became normally responsive to a second equivalent test after a slow and prolonged treatment with the decapeptide suggests that, in these patients, besides a lesion at the pituitary level, a primary defect at the hypothalamic or higher centers may also be suspected.

Adolescent↗
PubMed1975

[Gonadotropins].

The clinical usefulness of plasma LH and FSH radioimmunoassays, both in basal and dynamic conditions, is briefly discussed. While occasional LH and FSH determinations may indicate only a serious gonad failure, at least when high values are found, dynamic studies before and after LH-RH i.v. injection may suggest a hypothalamic or pituitary lesion. In this regard the LH-RH test is presented as the most evident demonstration of the utility of gonadotropin radioimmunoassay. Different patterns of response are presented and their correlation with menstrual disorders is discussed in view of different distribution (Tab.1). Moreover, the AA. suggest a primary hypothalamic deficiency in LH-RH in the cases of "deficient" response that, being a constant finding in different days, became a "normal" response after 3 days therapy with LH-RH infusion and returned to basal levels 2 months later. Equally, an "exaggerated" response consistenly found in some patients with secondary amenorrhea, is suspected to be of hypothalamic origin since "normalization" may be obtained after a similar LH-RH treatment.

Amenorrhea↗
PubMedDate not supplied

Effects of estrogen on the release of gonadotropins and prolactin in male pseudohermaphrodites.

Three adult patients with male pseudohermaphroditism were given 15 microgram/kg body weight of 17 beta-estradiol im daily (at 08:00 hours) for 12-15 days and circulating levels of gonadotropins, prolactin and estradiol were determined by radioimmunoassay before and during the steriod course. All patients had elevated gonadotropin levels prior to starting on estradiol. During estrogen treatment all patients demonstrated suppression of FSH and LH with a subsequent rise in LH (positive feedback) while estrogen levels remained elevated. A similar positive feedback effect on the secretion of FSH could not be demonstrated. In two patients, who had never received estrogen treatment prior to this study, estradiol induced a significant elevation of serum prolactin levels within 24 h and levels remained higher than basal values for the rest of the estrogen treatment period. In the third patient, who had been previously treated with estrogen, serum prolactin levels did not change significantly during estrogen treatment. This study was afforded evidence for the presence in humans of an estrogen mediated LH release concomitant with an augmented prolactin secretion.

Adolescent↗
PubMedDate not supplied

Incidence of genital tuberculosis in infertile patients submitted to diagnostic laparoscopy: recent experience in an Italian university hospital.

The incidence of genital tuberculosis is decreasing in industrialized countries. The authors report their experience in 254 patients with primary or secondary infertility. Out of 101 patients with a tubal factor of infertility, two patients were diagnosed as having tuberculosis by both endometrial biopsy and endometrial culture. In a third patient, even in the presence of laparoscopic findings suggesting genital tuberculosis Mycobacterium tuberculosis was isolated only from the urine.

Adult↗
PubMedDate not supplied

Perlaparoscopic salpingoscopy in the evaluation of the tubal factor in infertile women.

Endoscopic evaluation of tubal mucosa during tubal reconstructive microsurgery has been shown to be an important prognostic factor in predicting the probability of a subsequent intrauterine pregnancy. Recent reports have described the use of this technique during laparoscopy in order to evaluate the tubal factor in infertility. We report our experience with this new diagnostic procedure. We utilized a flexible fiberscope with an outer diameter of 3.8 mm for endotracheal intubation. The fiberscope was passed through the operating channel of the laparoscope in order to evaluate the tubal mucosa in patients with primary and secondary infertility associated with tubes patent at the distal end. We encountered abnormalities of the infundibulum or of the ampullary mucosa in 24% of the tubes considered normal at HSG and in 27% of the tubes judged normal at laparoscopy. On the contrary, 44% of the tubes with abnormalities at HSG and 58% of the tubes with abnormalities at laparoscopy presented normal mucosa at salpingoscopy. Our results, in addition to those published in the literature, demonstrate that salpingoscopy is an important and valuable diagnostic procedure for an accurate evaluation of infertile patients. With this technique it is also possible to select patients with a favorable prognosis for tubal microsurgery.

Endoscopes↗
PubMedDate not supplied

Salpingoscopy in patients with endometriosis-associated infertility.

Endoscopic evaluation of the tubal mucosa has been shown to be an important prognostic factor in predicting the probability of a subsequent intrauterine pregnancy. A recent classification of the tubal mucosa lesions allows uniformity of evaluation, permitting comparison of results in prospective studies. It has been suggested that endometriosis may be associated with intratubal abnormalities. In this prospective study we evaluated 35 patients with endometriosis-associated infertility. No intraluminal abnormalities were found, and all the patients that subsequently conceived had an intrauterine pregnancy.

Adult↗
PubMedDate not supplied

Absorbable versus non-absorbable sutures in ovarian microsurgery: experimental results in the rabbit model.

Microsurgery has been shown to reduce the risk of adhesion formation when compared to conventional surgery in cases of benign ovarian pathology. However, the microsurgeons have contrasting opinions concerning the use of absorbable versus non-absorbable suture materials. In the present study we compared nylon versus vicryl sutures for ovarian surgery using the rabbit as an experimental model. No differences were found in terms not only of post-operative adhesions but also in terms of post-operative reproductive outcome for the sutures analyzed.

Animals↗