Biomedical subjects

P Stentella

Publications and source records attributed to P Stentella.

At least 19 recordsLinked to original sources

PubMed2006

Improvement of uterine artery Doppler velocimetry indices after metroplasty in arcuate uteri.

OBJECTIVE: Our study aimed to evaluate the effect of metroplasty performed in arcuate uteri on uterine artery Doppler velocimetry. STUDY DESIGN: We performed uterine artery Doppler velocimetry transvaginally before and after metroplasty in 36 women with arcuate uteri. Pulsatility indexes (PI) of uterine arteries were calculated and the presence or absence of a protodiastolic notch was evaluated. RESULTS: Comparing Doppler indexes before and after metroplasty, we found that uterine artery impedance improves as assessed by lower mean PI. We observed that PI after intervention was significantly lower compared with indexes before for mean Doppler index evaluations (mean uterine PI pre: 2.07+/-0.61 and post: 1.49+/-0.24 [p<0.03]). No differences were observed as regards bilateral protodiastolic notch absence or presence. A protodiastolic notch was present in 22 out of 36 women before metroplasty (61%), and a notch was observed in 19 out of 36 (52%) after metroplasty. CONCLUSIONS: Our results suggest that, metroplasty, as well as making the uterine cavity wider, leads to better uterine perfusion.

Adult↗

PubMed2006

Regression rate of clinical HPV infection of the lower genital tract during pregnancy after laser CO2 surgery.

The objective of the study was to evaluate the effects of laser CO2 surgery during pregnancy to prevent clinical HPV infection recurrence after delivery and vertical infection. A case-control study was performed on 280 pregnant women affected by clinical HPV infection treated during pregnancy with 256 women treated three months after delivery. Follow-up was performed for a minimum of three colposcopic examinations for two years. Recurrence rates were calculated considering the number of positive findings for at least one colposcopic examination confirmed by biopsy after a negative control in a year. Statistical comparison of rates was performed by chi-squared and Fisher's exact test. Recurrence rates were higher in the women treated in postpartum (p < .01) than in the group treated during gestation (p < .005). Clinical HPV infections treated during the second trimester of pregnancy showed a sensitive decrease in recurrence-rate of infection. Rarity of respiratory papillomatosis makes conclusions inconsistent for the prevention of vertical infection.

Carbon Dioxide↗

PubMed2003

Endoscopic treatment of intrauterine adhesions.

PURPOSE OF INVESTIGATION: The authors investigated the validity of hysteroscopy as a diagnostic and operative technique in cases of intrauterine adhesions. METHODS: 6,680 hysteroscopies were carried out between June 1987 and December 2000 with 201 patients presenting intrauterine adhesions. Only 75 patients underwent resection of the adhesions by hysteroscopy with 94.6% of functional restoration and 93.3% of anatomic resolution. RESULTS: At 2-month follow-up the uterine cavity was completely regular in 70 cases, while in four cases a second surgical treatment was necessary. CONCLUSION: Good anatomic results are obtained after hysteroscopic treatment of intrauterine adhesions, and pregnancy rates vary from 28.7 to 53.6%.

Adult↗

PubMed2001

The prognostic significance of acetowhitening of the vulva and HPV-DNA test. A multicentre study.

Acetowhitening of the vulva has been related to a subclinical human papillomavirus (HPV) infection. No consense has been reached about undertaking -or not- any therapy for these acetowhite changes. We have observed from our clinical experience and in a 10 years observational follow-up, that acetowhitening of the vulva regarding high risk (16-18) and low risk (6-11) HPV groups (as assessed by PCR analysis) significantly decreased; and acetowhitening areas negative to polymerase chain reaction (PCR), significantly increased from 53% (202/382) to 85% (276/325) (P<0.001). Our findings suggest that independently from HPV type and in the absence of cofactors, there is a statistically significant spontaneous remission of these areas.

Adult↗

PubMed1999

Correlation between cervical intraepithelial neoplasia and human papillomavirus male infections: a longitudinal study.

BACKGROUND: Genital HPV infection is one of the most common sexually-transmitted diseases. The aim of the study was to evaluate the correlation between HPV-associated lesions in male partners of women affected by CIN. METHODS: 210 male partners of women affected by CIN were examined in a long-term follow-up (from 5 to 13 years). The diagnosis in females was performed by cytology, colposcopy and histology. Male partners were submitted to clinical examination, peniscopy and biopsy. RESULTS: 111/210 (53%) females had CIN I, 53/210 (25%) and 46/210 (22%) had CIN III. Subclinical lesions were associated with 18%, 28% and 24% of male partners of women with CIN I, CIN II and CIN III, respectively. Clinical lesions were observed in 7% and 10% of sexual partners of women with CIN I and CIN II, respectively. Mixed lesions affected only 3% of sexual partners of women with CIN I. CONCLUSIONS: Our data show that the transmissibility of HPV infection to the male partners of women affected by CIN was easier when there was a lower grade of CIN. In fact, male partners of women with CIN III had a lower percentage (26%) of clinical or subclinical HPV skin lesions.

Female↗

PubMed1998

HPV and intraepithelial neoplasia recurrent lesions of the lower genital tract: assessment of the immune system.

OBJECTIVE: To evaluate the immune state in patients with genital relapse HPV and intraepithelial lesions of the lower genital tract. METHOD: Forty-three patients were selected. Twenty-one were affected by recurrent HPV infection either alone or combined with intraepithelial neoplasia treated by laser surgery, and 22 had been previously-treated and clinically cured without recurrence during a follow-up from 18 to 24 months. The diagnostic protocol included colposcopy with eso- and endocervical cytology histologically confirmed by directed biopsy. Afterwards patients underwent a systemic immunogenic evaluation. RESULTS: NK cell reduction was strictly related to HPV infection associated with intraepithelial lesions; B-lymphocyte reduction was percentually greater in patients affected by HPV alone; activation of R-IL2 increased in a percentage overlapping in the two groups indicating patient reaction to the virus. CONCLUSION: Our study supports the theory that immune response directed against viral antigens is one of the most important effectors in the control of HPV infections and that HPV is the cause of a systemic rather than local lesion.

Adult↗

PubMed1997

Langerhans cell histiocytosis of vulva and cervix in a 19-year-old woman.

Langerhans cell histiocytosis of the female genital tract is a rare disease. A clinical diagnosis is impossible to establish because no typical lesions are found. Immunohistochemistry of bioptic samples is the easier technique to obtain the correct diagnosis. We present a case of a 19-year-old woman with Langerhans cell histiocytosis of mandible and maxilla with subsequent cervical and vulvar histiocytosis.

Adult↗

PubMed1997

Cervical intraepithelial neoplasia and bacterial vaginosis: correlation or risk factor?

Bacterial Vaginosis (B.V.) is a syndrome defined microbiologically where lactobacilli-dominated flora is exchanged with an abundant complex flora dominated by strict and facultative anaerobic bacteria, constituted by gardenerella, micrococci, streptococci and staphylocci. It has been suggested that B.V. could be important in the development of cervical intracpithelial neoplasias, because the abnormal micro flora can produce careinogenic nitrosamines. The aim of this investigation was to evaluate the correlation between CIN and B.V. in 1,008 patients (median age: 28 years, range 17-60) who were divided into two groups: the first group consisted of 504 patients affected by CIN of different degrees, the second of 504 patients without CIN. All patients were submitted to colposcopy, pap-tests, cytology of the cervical canal and microcolpohysteroscopy in the case of lesions invading the cervical canal. The diagnosis of B.V. is based on four criteria: presence of clue cells, pH 4.5, positive amine test and increased vaginal discharge. X2 Pearson analysis was applied for statistical evaluation of the data. Among the 504 patients in the first group (women affected by CIN of different degrees), 180/504 (36%) women presented B.V. Among the second group (504 women without CIN), 248/504 (49%) women presented B.V. The results of our study demonstrate that there is no significant correlation between CIN and B.V. In the first group of patients affected by CIN and B.V., B.V. was present in 36% of the cases, while in the second group of patients not affected by CIN. B.V. was present in 49% of the cases (P < 0.00005).

Adolescent↗

PubMed1997

Prevention of thromboembolic complications in women undergoing gynecologic surgery.

Our objective was to identify those patients particularly at risk of deep vein thrombosis (DVT) before they underwent extensive gynecologic surgery and to control if, a correct diagnostic analysis and a right pre-operative prophylaxis of patients with risk of developing DVT, was enough to improve post-operative prognosis. Of 2704 patients undergoing gynaecological surgery, 74 were pre-operatively considered at risk of developing DVT. Seventy percent of the patients received pre- and postoperative heparin, while 28% of the women received only postoperative heparin. Nonetheless, seven women receiving this prophylaxis developed DVT. The final results of our study demonstrate that there is a close correlation between incidence of DVT and the presence of risk factors. This incidence can be reduced by prophylactic measures such as elastic stockings for the lower legs, early post-operatory mobilization, hematocrit and volemy control, ending with pharmacological therapy with heparin.

Fallopian Tubes↗

PubMed1997

[Preliminary diagnostic evaluation of submucosal myoma using operative hysteroscopy].

BACKGROUND AND AIM: The authors aim to underline the importance of preliminary diagnostic evaluation in the treatment of submucous leiomyoma using hysteroscopy. MATERIALS AND METHODS: The study examined 18 patients monitored at the Institute of Obstetrics and Gynecology of "La Sapienza" University of Rome between January and December 1995 in whom it was possible to make a correct definition of the lesion to be treated (number, site, size, etc.) using 3 different diagnostic methods: hysteroscopy (HS), transvaginal scan (TSV) and transvaginal echohysterography (TVHS) The authors focused attention on three different parameters: leiomyoma size, extension (intracavity/intramural portion) and evaluation of the residual leiomyoma, which are essential for optimal endoscopic resection. RESULTS: HS enabled the number, size, site, origin, base, submucous portion and relations with tube operings to be evaluated, but did not allow the myometrial part of the lesion to be examined. CONCLUSIONS: Integration with TSV, even if this does not allow a precise definition of the extension, highlights the size, site, involvement of myometrial structure and relations with the perimetrium, thus allowing the possibility of evaluating the residual myometrium. Compared to the above methods, TVHS highlights the effective extension (namely the submucous/intramural portion) and localization of the neoformation.

Adult↗

PubMed1996

Topic and systemic administration of natural alfa interferon in the treatment of female and male HPV genital infections.

The aim of the study was to evaluate the effectiveness and tolerance of topic and systemic administration of natural alfa-interferon from normal human leukocytes in the treatment of HPV lesions of the lower genital tract. From May 1991 through May 1992, 70 women (mean age = 29; range 16-42) and 51 men (mean age = 28; range 18-48) with histologically proven HPV genital lesions were studied. 43 patients and 32 male partners with subclinical infection underwent cream therapy (4 applications/day for 30 days) composed of natural alfa interferon and containing 1,000,000 IU/gr. 27 women and 19 men affected by florid infection underwent systemic i.m. therapy with natural alfa interferon in doses of 3,000,000 IU on alternate days for 30 days. The percentage of therapeutical success amounted to 55.8% for women and 78.1% for men subjected to topic therapy; for the 27 patients and 19 male partners treated with systemic therapy the final percentages of success were 70.3% respectively. Natural alfa interferon from normal human leucocytes seems to be a drug of good efficacy and tolerance in the treatment of HPV genital pathology.

Adolescent↗

PubMed1995

[Hysteroscopy in septate uterus. Diagnostic and therapeutic features].

Personal experience of diagnostic and operative hysteroscopy of septate uterus is reported. The diagnosis of septate uterus is an integrated diagnosis that makes use of hysterosalpingography, echography, hysteroscopy and laparoscopy. Of 545 hysteroscopies carried out between January and December 1993, 29 evidenced uterine septum, complete in 6 cases, incomplete in the remaining 23. Of the 29 patients, 7 underwent resection of the septum by the hysteroscopic route. No intra or postoperative complications worthy of note were observed. At follow-up after one month, the uterine cavity in 5 patients proved completely regular while in the remaining 2 one case of fundic fibrous synechia and one of small persistent fibrous bridge, of little importance within the context of the cavity, were observed. The purpose of the present paper is to demonstrate the twofold role of hysteroscopy with regard to the septate uterus; is that hysteroscopy is a diagnostic and a precise operative technique that is atraumatic, fast and of low cost.

Adolescent↗

PubMed1995

Cervical intraepithelial neoplasia: carbon dioxide laser vaporization and conization. Our experience.

Between 1984 and 1992, the CO2 laser was used to treat 341 patients affected by CIN of various degrees. On the basis of specific indications these patients underwent vaporization or conization. Two hundred and twenty eight patients underwent vaporization of intraepithelial lesions, 221 (96.92%) of whom were free of disease after one laser treatment, as observed during the subsequent years of follow-up. In 105 out of the 113 patients treated with conization the cone margin was free of disease. One hundred and one (96.19%) of the these 105 patients had no evidence of disease after one year of follow-up. In the remaining 8 (7.07%) cases examination of the cone revealed the presence of invasive carcinoma. The major complication was vaginal discharge observed in 115 (33.72%) patients. The CO2 laser is a very effective therapeutic procedure for the treatment of intraepithelial lesions of the cervix and permits to preserve reproductive function and anatomic integrity.

Adolescent↗

PubMed1995

Multiple primary neoplasms. Considerations on 42 cases.

During the years 1977-1993, 2,108 cases of gynecologic primary neoplasms were observed in the Department of Gynecology and Obstetrics of La Sapienza University in Rome. Forty-two cases were multiple primary cancers. Of these, 27 had multiple primary neoplasms involving only gynecologic sites, 15 had a neoplasm involving also another site; 3 patients had triple primary neoplasms. The most frequent neoplasm associations observed in our case series were: breast-ovary; endometrium-ovary; breast-cervix; endometrium-bowel (sigma-colon).

Adult↗

PubMed1994

Management of human papilloma virus vulvo-perineal infection with systemic beta-interferon and thymostimulin in HIV-positive patients.

OBJECTIVES: To evaluate the effect of a combined therapy based on beta-interferon and thymostimulin in HIV-seropositive women with florid vulvoperineal condylomatosis. METHODS: Nineteen HIV-seropositive women affected by HPV florid vulvo-perineal infection were studied. Their ages ranged from 19 to 32 years (mean = 26); all were smokers; 11 (57.89%) were intravenous drug users with a mean period of drug addiction of 5 years. No patient was on AZT therapy. All patients underwent a combined medical therapy based on beta-interferon administration with doses of 3,000,000 IU i.m. daily for 7 days and subsequently on alternate days for 2 weeks associated with the administration of 70 mg i.m. of thymostimulin per day on alternate days for 30 days. RESULTS: Seven (36.84%) patients showed complete recovery at the end of follow-up; 5 (26.31%) patients showed partial recovery and 7 (36.84%) did not respond to therapy. CONCLUSION: A pro-host immunotherapy seems to be indicated in patients affected by immunodeficiency syndrome.

AIDS-Related Opportunistic Infections↗

PubMed1994

Pain evaluation during carbon dioxide laser vaporization for cervical intraepithelial neoplasia: a randomized trial.

63 pts affected by CIN of various degrees were randomly divided into 3 groups in order to evaluate the pain experienced during laser vaporization of the lesion. All pts were premenopausal and ages ranged between 19 and 39 years. 21 pts received Naproxene Sodium (550 mg) 30 minutes before surgery; 21 pts received placebo and 21 pts received no drug. Laser vaporization was performed with a Coherent System 451 CO2 laser with a power setting of 28 W/cm2 and a spot size of 1.8 mm. The severity of pain was assessed by means of a Visual Analogue Scale. The mean VAS value was 19 for the group treated with Naproxene Sodium; the mean VAS value was 20 for the placebo group and 23 for the group which received no pre-operative drug. Analysis of data from the 3 groups showed no statistically significant difference. Analgesia or anaesthesia before laser surgery for CIN is not a necessity.

Adult↗

PubMed1994

Persistent vulvovaginal candidiasis: systemic treatment with oral fluconazole.

52 patients affected by persistent vulvovaginal candidiasis underwent systemic therapy with oral Fluconazole at a dose of 150 mg once a week for 3 weeks. 31 (59.61%) patients were cured at the first control after therapy. Of the remaining 21 patients, 4 (7.69%) were lost at follow-up and 17 (32.69%) underwent a second cycle of systemic therapy with complete recovery confirmed at the further controls. The overall percentage of recoveries was equal to 92.30%. The results suggest that Fluconazole is very effective in mycotic vulvovaginitis with irrelevant side effects.

Administration, Oral↗

PubMed1993

Vulvar and penile HPV lesions: laser surgery and topic anaesthesia.

Treatment of genital warts (HPV lesions) by Laser-surgery was performed in 90 patients and 90 male partners under topical anaesthesia with 1-3 gr EMLA cream and in 45 patients and 45 males (control groups) under 1-2 ml 2% Carbocaine infiltration. EMLA cream was applied to warts 5-18 minutes (median = 7) before operation. Pain from application of anaesthetic and Laser surgery was significantly less (p < .001) in the groups treated by EMLA. Side effects were minimal in the EMLA groups. The results suggest that EMLA cream could be the anaesthetic of choice in Laser surgery of genital warts.

Adolescent↗