Biomedical subjects
Publications and source records attributed to P Panella.
The Authors first briefly describe the possible histological features of parotid masses, difficult to differentiate only on the basis of clinical signs. They report on imaging techniques for detecting this kind of pathology and suggest the best diagnostic protocol for correct evaluation of parotid masses, because of its great importance in planning optimal surgical management.
In 43 women (average age 49.6 years), and 70 men (average age 55.2 years) with pathology of the genito-urinary apparatus, seroantibodies to Coxsachie virus B were measured using the passive hemoagglutination method and the virus was isolated in the uterine. Viral isolation test was negative in all urine samples tested. Seropositivity for Coxsackie virus was reported in 26 women (60.46%) and in 51 men (72.85%). Positivity to B1 was 37.16% (42 cases), B2 in 38.05% (43 cases), and to B4 in 35.39% (40 cases). 17.69% (20 cases) of patients were seropositive to only one serotype, 17.69% (20 cases) to 5 serotypes, 14.15% (16 cases) to 3 serotypes, 9.73% (11 cases) to 2 serotypes, and 8.84% (10 cases) to 4 serotypes. B1, 2, 3, 4, 5 (25.97%; 20 cases) and B2, 3, 4, 5 (7.79%; 6 cases) were the most frequent associations. Seropositivity to Coxsackie virus was reported in 100% of patients (4 cases) with urethral caruncola, in 84.21% (16 cases out of 19) with cancer of the bladder, in 81.81% with cystitis (9 cases out of 11) and in 80% with prostatitis (8 out of 10 cases). In relation to sex, seropositivity was higher in males in cases of calculosis (75%; 9 cases out of 12 against 28.57%; 2 cases out of 7) and in cystitis (100%; 6 cases against 60%; 3 cases out of 5). Further studies are necessary to determine the clinical significance of serum Coxsackie virus antibodies in patients with urological pathology in the absence of urinary elimination of Coxsackie virus.
The Authors evaluate the efficacy of the intravenous infusion of PGF2 alpha in the induction of abortion in the second trimester of pregnancy with live fetus (Italian Law no. 194/1978). Abortion occurred in 3 out of 11 (27.27%) nulliparous patients, and uterine curettage was necessary in 2 cases. The interval between administration of the drug and the beginning of uterine contractions was 31.42 +/- 14.15 minutes (range 10 to 35 minutes), the duration of infusion was 7.55 +/- 3.64 hours (range 7 to 9.15 hours), the interval between initiation of infusion and delivery was 8.10 +/- 2.60 hours (range 7 to 9.45 hours), and the dose administered was 20.23 +/- 3.75 mg (range 15 to 25 mg). Side effects were reported in 10 cases (90.90%), and in 5 cases these effects were caused by interruption of infusion. Abortion occurred in 7 out of 13 pluriparous patients (53.84%), and uterine curettage was necessary in 4 cases. The interval between administration of the drug and the beginning of uterine contractions was 20 +/- 12.24 minutes (range 20 to 45 minutes), the duration of infusion was 8.26 +/- 0.9 hours (range 3.10 to 16 hours), the interval between initiation of infusion and delivery was 8.40 +/- 0.8 hours (range 3.0 to 9.6 hours), and the dose administered was 19.28 +/- 5.34 mg (range 5 to 25 mg). Side effects were reported in 11 cases (84.61%), and in 6 cases these effects were caused by interruption of infusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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Sexual desire, frequency of coitus, frequency of orgasm, which partner took the first sexual initiative, and the level of sexual satisfaction were studied in 205 women in puerperium in relation to age in the year preceding pregnancy and during pregnancy. It seems evident that sexual desire and the frequency of coitus and orgasm diminish during pregnancy independently of age. The group of younger women (16 to 20 years old) in our study maintained a relatively higher level of sexual activity especially in comparison to older women (36 to 40 years old). The number of women who took the first sexual initiative increased considerably in pregnancy.
Between 1982 and 1984 330 women in postmenopause for at least one year were admitted to the First Clinic of Obstetrics and Gynecology, Catania University Medical School, Catania, Italy, with a frequency of 10.04% of gynecological admissions. The most frequent pathologies were metrorrhagia (32.72%; 108 cases) from an atrophic endometrium or glandular hyperplasia of the endometrium, vaginoperineal lacerations with cystorectocoele with or without urinary incontinence (10.90%; 36 cases), cancer (11.21%; 37 cases) and ovarian cystoma (11.21%; 37 cases), uterine prolapse (9.30%; 31 cases), and endometrial polyps (9.09%; 30 cases). Uterine fibromyoma (3.93%; 13 cases) and carcinoma of the portio (3.93%; 13 cases) were among the rare pathologies. Uterine pathologies were the most prevalent (68.78%; 227 cases), followed by ovarian (15.15%; 50 cases), pathology of involving the pelvic and perineal containment (10.90%; 36 cases), vulvar pathology (2.72%; 6 cases), and vaginal pathology (1.51%; 5 cases). Malignant neoplastic pathology was reported in 25.45% of cases (84 cases) consisting only of uterine cancer (47.61%; 40 cases) and ovarian cancer (45.23%; 38 cases). In comparison with the study performed by Cetroni in 1952 one notes a net reduction in the frequency of uterine prolapse (by about three times), and a smaller reduction in cancer of the uterine cervix with a slight increase in cervical polyps, endometrial cancer, and above all in metrorrhagia from atrophic endometrium or glandular hyperplasia of the endometrium.
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Twelve patients aged between 25 and 48 years with parity ranging from 2 to 4 were treated for rectovaginal fistula at the First Clinic of Obstetrics and Gynecology, Catania University Medical School, Catania, Italy from 1965 to 1985. In all patients the rectovaginal fistula was in the inferior third of the vagina and of maximum diameter of 5 cm. Therapy consisted of surgical correction in 9 patients with transformation of the fistula into a complete perineal tear cutting the bridge of healthy tissue under the fistula. Follow-up period varying from 2 to 16 years showed no recurrence.
113 patients aged between 16 and 41 underwent conservative surgery of the ovary between 1965 and 1984 in the First Clinic of Obstetrics and Gynecology, Catania University Medical School, Catania, Italy. The frequency of conservative surgery of the ovary was 0.55% of total gynecological admissions. Indications for surgery were sterility due to postinflammatory adherence in 14.15% (16 cases), in 34.51% (39 cases) ovarian polycystosis after failure of medical therapy with ovulation inducers, in 46.92% (53 cases) pelvic tumor, and in 4.42% (5 cases) hemorrhage of the corpus luteum (4 cases) or ovarian pregnancy (1 case). In 53 cases of enucleation of ovarian tumor the most frequent pathology was serous cyst (41.50%; 22 cases), followed by dermoid cysts (33.96%; 18 cases), cyst caused by endometriosis (18.86%; 10 cases). Luteinic cysts were more rare (3.77%; 2 cases), and in only 1 case was there ovarian cystadenoma (1.88%). Postoperative course was febrile in 7.96% (9 cases) of patients. There were no cases of mortality.
Between 1965 and 1985 28 patients aged between 10 and 18 years (average age 16.3 years) were treated for pelvic tumor, with a frequency of 0.13% of gynecological admissions. Ovarian tumor was the most frequent type (21 cases), followed by paraovarian tumor (5 cases), and uterine tumor (2 cases), 21 of pelvic tumor were neoplastic of which 18 benign. Among the ovarian neoplasias the most prevalent was cystadenoma (9 cases), followed by dermoid tumors (7 cases).
The authors report their studies of 39 lymphoscintigraphies performed on patients with breast cancer. They point out that interpretation of scintigraphic imaging must take into account the morphologic variations of the lymph nodes of the internal mammary chains (i.e. single central chain, single central lymph node) and the morphological difference in the symmetry of lymph nodes considered non-pathologic to avoid false positives. The authors retain that lack of visualization of a chain, conspicuous increase in size of a lymph node, asymmetry of pathologic development, or reduced uptake by one or more lymph nodes of the internal mammary chains must be interpreted as a sign of metastatic spread. The authors recommend lymphoscintigraphy as an effective technique in the screening of breast cancer patients for staging, follow-up, restaging, and planning of radiotherapy.
The Authors studied the frequency of Cesarean section in relation to deliveries in the last trimester of pregnancy, the frequency of repetitive Cesarean section, age and parity of the patients, indication for cesarean section, week of delivery, and perinatal and maternal morbidity and mortality at the First Clinic of Obstetrics and Gynecology, University of Catania, Catania, Italy, from 1972 to 1974 and from 1983 to 1985. The frequency of Cesarean section has increased from 12.07% (735 cases out 6,086 deliveries) to 16.89% (837 cases out of 4,955 deliveries). There was a decrease in frequency of repetitive Cesarean section from 30.47% (224 cases) to 27.95% (234 cases) and in perinatal mortality rate from 4.35% (32 cases out of 735) to 3.19% (27 cases out of 845 newborn). There were no cases of maternal death, while the most common cause of maternal morbidity was uterine atonia. From 1972 to 1974 mechanical causes were the most frequent indication for Cesarean section (28.16% -207 cases), while from 1983 to 1985 previous hysterotomy (32.73% -274 cases) was the main indications for Cesarean section.
Correlation between parity and sexual behavior during pregnancy was studied in 106 pluriparous and 69 primiparous patients. Sexual desire, frequency of coitus, frequency of orgasm, which partner initiated sexual activity, and level of sexual satisfaction were analyzed in the year before pregnancy and during pregnancy. Sexual desire, frequency of coitus, and sexual satisfaction were qualitatively equal in both groups. The frequency of coitus in particular decreased progressively in the three trimesters of pregnancy and more evidently in the pluriparous. The partner who initiated sexual activity most frequently was the male in the pluriparous group.
The Authors report a case of fecal peritonitis caused by perforating appendicitis in a patient in the 16th week of pregnancy. Appendectomy was performed and the patient successfully delivered a normal sibling weighing 2850 grams in the 37th week.
Between 1965 and 1985 59 paraovarian cystic tumors, were treated at the First Clinic of Obstetrics and Gynecology, Catania University, Catania (Italy). In 45.76% of cases (27 cases) the cyst was localized on the right and in 40.67% (24 cases) on the left parametrium, bilaterally in 6.77% (4 cases) and multiple on the same side in 6.77% (4 cases). In 91.52% (54 cases) the patients were in fertile age and 8.48% (5 cases) were in menopause. The dimensions of the cysts varied between 2 and 20 cms, with higher incidence between 6 and 10 cms (49.16%). In 1.69% there was benign neoplastic degeneration (1 case of cystadenoma). In 6.77% (4 cases) there were no symptoms, while pelvic pain and menstrual disorders occurred in 57.62% (34 cases) and 35.59% (21 cases) of cases respectively. In 5.08% (3 cases) there was torsion of the cyst. Enucleation of the cyst was performed in 44.06% (26 cases), and in the other cases therapy was adopted according to the patient's age, parity, associated gynecological pathology and neoplastic degeneration.
From 1965 to 1984, 105 cases of ovarian dermoid cysts have been diagnosed and treated at the First Clinic of Obstetrics and Gynecology, Catania University, Catania, Italy. The patients were aged between 9 and 70 years, with a higher frequency of dermoid cysts between 26 and 30 years (21.91%, 23 cases). In 0.95% (1 case) the patient was premenarchal, 84.76% (89 cases) in fertile age, and in 14.29 (15 cases) in menopause. 35.22% (37 cases) were nulliparous with an average of 31 years, and 64.76% (68 cases) pluriparous with an average age of 38.9 years. In 4.76% (5 cases) the patients had already been treated for dermoid cysts. The asymptomatic form occurred in 13.33% (14 cases), while in 9.52% (10 cases) of cases there was torsion of the cyst. In 89.53% (95 cases) the cyst was monolateral, double in the same ovary in 0.95% (1 cases), and bilateral in 9.52% (10 cases). Epithelial cancerous degeneration occurred in 1.95% of cases (2 cases). In 11.43% (12 cases) enucleation of the cyst was performed while in the other cases therapy was chosen in relation to age, parity, and associated gynecological pathology of the patients. The Authors compare their data with that in literature.
From January 1978 to July 1983 22 patients have recovered from eclampsia in the Obstetrics and Gynecology Department - Vitt. Emanuele II Hospital - Catania University. 64% of the patients had hypertension in pregnancy combined with edema in 92.85% of the cases (13 cases) and with proteinuria in 18% of the cases (4 cases). Eclampsia manifested itself before labour in 28.57% (6 cases), during labour in 19.05% (4 cases), in postpartum in 19.05% (4 cases) and in the successive three days after delivery in 33.33% (7 cases). Perinatal death rate was 11.28% and in all the cases it was due to intrauterine fetal death. In 22 patients treated there was a case of acute pulmonary edema and a case of maternal death.