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Biomedical subjects

R Tinelli

Publications and source records attributed to R Tinelli.

At least 19 recordsLinked to original sources
PubMed2006

[First abdominal access in gynecological laparoscopy: which method to utilize?].

The choice of the technique to enter the peritoneal cavity, during a laparoscopy, depends on a lot of variables which hinder a standardized method and, actually, it appears impossible to show, with certainty, the best method to choose for the first abdominal access in gynecological laparoscopy. The preference for one or another technique depends on the operator experience, school and speciality of the surgeon, laparoscopical upgrading and the work environment; many surgical techniques are not yet used due the limits and fears of some surgeons to change the preference in first access approaching and for the lack of operating versatility by a method or another one. A review of the scientific literature, underlines that the major problems during the first laparoscopical abdominal access are two, vascular and intestinal and their percentage is variable. In this paper we describe the large range of methods for open and closed laparoscopy and for direct access, that permit to perform a first abdominal laparoscopical access, and their major possible problems.

Abdominal Wall↗
PubMed2005

[Urinary incontinence in postmenopausal period: clinical and pharmacological treatments].

Urinary incontinence is a common clinical problem in female sex and occurs especially in postmenopausal women; this disease, that represents an economical problem for society, begins in young age, arises in middle age and increases in women more than 65 years old. Studies carried out on etiological factors involved in urinary incontinence show that estrogens enhance the trophism and vascularization of the muscular and fascial support of the pelvic floor, the growth of fibroblasts and the collagen metabolism in the superficial fascia in postmenopausal women. The postmenopausal estrogenic deficit could be related to many urogenital problems, but many researches performed on the effects of estrogens in urogenital postmenopausal homeostasis and of hormonal replacement therapy in postmenopausal incontinent women, did not show conclusive findings; for this reason, even if many authors attributed to menopause a role of major risk factor for incontinence, a direct correlation has never been confirmed. The treatment of postmenopausal female incontinence may be clinical and pharmacological, and includes a first step therapy (bladder training, biofeedback techniques, electrical pelvic floor stimulation) and a second step therapy (pharmacological therapy, bladder devices and surgical operations). In this review the clinical and pharmacological treatments, their efficacy and their application in incontinent postmenopausal women are described.

Biofeedback, Psychology↗
PubMed2004

[Current surgical management in ovarian cancer recurrences].

Ovarian cancer is a tumor with a high trend of recurrence and this occurrence consistently increases the difficulty of the patient cure and reduces the efficacy of current treatments. The role of surgery in persistent or recurrent ovarian cancer is controversial and the type of surgery can be different according to the different stages and invasion of tumor; it can be a debulking surgery followed by chemotherapy (to eradicate the most part of ovarian cancer, leaving a minimal tumoral residue), an interval surgery (for advanced ovarian cancer stage in previously operated patients, followed by 2 or 3 inductive chemotherapy cycles and subsequently a cytoreductive redo surgery) and a cytoreductive secondary surgery, after optimal primary surgical treatment and minimal tumoral recurrence. In some cases it is possible either to perform a debulking surgery during a primary (after the conclusion of primary treatment) or a salvage or palliative surgery (to improve, after an acceptable time period, clinical symptoms in patients with progressive cancer or resistant to treatments). The aims of surgical therapy, to be performed in a patient with ovarian cancer relapse, are to reduce, as much as possible, the tumour size, to increase the quality of life and to increase the survival time; in this review different surgical techniques to be carried out in each case, selected for disease staging, for tumour cells kinetic and for surgical goals, are discussed.

Carcinoma↗
PubMed2003

[Stress urinary incontinence: an overview on actual surgical trends].

Stress urinary female incontinence (IUS) is an unpleasant symptom describing a loss of urine during physical exertion; genuine stress incontinence (GSI) is a socially unacceptable, involuntary loss of urine in absence of detrusor activity from the urethra associated with sudden cough or strain. The incidence of IUS is less than 10% in reproductive-age women but may approach 10-20% in postmenopausal women. The IUS pathophysiology is connected with two specific mechanisms: the urethral-bladder sliding out of anatomical area involves the normal system of endobladder/intraabdominal pressures, with a loss of urine; the second mechanism involves the damaged urethral sphincteric function, with a reduction of the urethral closure pressure and a urinary loss after minimal physical stimulation. The IUS medical therapy is troublesome and often inefficient, and the only approved effective measures are the surgical procedures, actually reserved for cases of unsuccessful medical therapy; surgical treatments can be classified according to the access as: vaginal, abdominal, associated and complex. They intend to reposition the urethral-bladder sliding in its normal intra-abdominal position, to allow equal transmission of increased intraabdominal pressure to the bladder and the proximal urethra. In the scientific literature there are more than one hundred surgical procedures for IUS correction, but the IUS surgical approach is anyway the actual gold standard therapy.

Adult↗
PubMed2003

[Depression, menopause and hormonal replacement therapy (HRT)].

The ovarian failure and the termination of reproductive female functions could influence the mental neurotransmission and the cognitive activity of menopausal women; female menopausal brain, one of the favorite estrogens target, could suffer of a negative homeostasis modification, affecting the daily behavior. So, neurotransmissive degeneration could expose aged women to some psychological disturbances, some of these frequently associated to hypoestrogenic hot flushes rise. Many studies showed the estrogen influence on female brain, and tried to explain how the hormonal replacement therapy (HRT), act on mood, life energy and cognitive activities. Although brain estrogenic activity seems to establish a useful role on neuromodulation and on the prevention of some psychopathologies, the conventional administration of HRT, improves the mood and menopausal female well-being, but it does not act on clinically depressed women.

Affect↗
PubMed2003

[Induction of labour: which method to use?].

Induction of labour is a common obstetric instrument to employ when the potential risk to continue a pregnancy is higher than to terminate it. The methods of induction can be pharmacological or mechanical; the choice of the method mainly depends by the cervical ripening, as it is significantly able to influence, according to the type of induction, its final issue. The mechanical methods are: stripping and sweeping of the membranes, hand dilatation of cervix, intrauterine pressure catheters, Laminaria Japonicum, transcervical Foley catheter and amniotomy. To pharmacological methods include some agents such as the prostaglandins (PG), the most common approach to induce a labour, and used above all by vaginal way in patients with unripe cervix. They simulate the natural PG effects at the beginning of delivery and show a great efficiency. There are a lot of PG on the market, but except some of them, as Dinoprostone for PGE2 and Misoprostol for PGE1, no one of them shows the same safety in management of labour. Oxytocin, another inductive method, administered by diluted intravenous infusion, is utilized alone or mainly with other methods when the labour is started or with rupture of the membranes, because it begins or maintains the myometrial contraction.

Abortifacient Agents, Nonsteroidal↗
PubMed2002

[Medical treatment in abnormal uterine bleeding: evaluation of a GnRH therapy versus danazol therapy in perimenopausal women].

BACKGROUND: Dysfunctional uterine bleedings are uterine hemorrhage, frequent in the climacteric period and are a usual gynecologic pathology in ambulatorial controls (10%). METHODS: 60 premenopausal women, have been enrolled, all affected by hyper-polymenorrhea or dysfunctional uterine bleeding; than they were subdivided them into 2 groups; Group I: 30 patients with GnRH analogues treatment (Decapeptyl da 3.75 mg/month, 6 months of therapy); Group II: 30 patients with Danazol treatment (danatrol, 200 mg/daily, 6 months of therapy). Clinical controls were performed by visit, a questionnaire compilation (Kuppermann index) and biochemical examinations, with this frequency: 0, 3, 6 and 9 months. Statistical evaluation was performed by Student "t" test. RESULTS: In both groups, either amenorrohea and symptomatic improvement after 3 months of therapy were observed, without statistical differences; a statistical difference (p>0.01) was assessed in patients compliance, since were observed, without statistical differences a major frequency in collateral effects in II Group, with danazol therapy was observed. The results of this study show that, the limited occurrence of side effects in perimenopausal patients affected by dysfunctional uterine bleeding, treated with GnRH analogues, could affect the choice of pharmacological therapy in favor of these one.

Adult↗
PubMed1993

["Aorto-mesenteric compression" syndrome. Report of a case and review of the literature].

The Authors report a case of Wilkie's syndrome recently observed. This unusual observation is suitable for some clinical and therapeutic considerations. X-ray examination and abdominal CT played a decisive role for the diagnosis. Among the large number of operations till now proposed for the management of this syndrome, the Authors preferred the latero-terminal duodeno-jejunum anastomosis. Such intervention, in fact, is easy and quick and allows to preserve a physiological intestinal function.

Adult↗
PubMed1980

[Isolation of a spore fraction of Bacillus sphaericus toxic for larvae of Anopheles].

A lethal fraction for Anopheles stephensi larvae has been isolated from Bacillus sphaericus strain 1593 spores by various methods The best results have been obtained by freezing and thawing which give an extract made in majority of protein with high molecular weight and causing 100% of mortality in 24 hours. Because of its easy extracction and its lack of diaminopimelic acid, the toxic fraction is thought to be located outside the spore coats.

Animals↗
PubMed1976

[Study of a specific polyoside and a group antigen extracted from Leptospira biflexa patoc, patoc I strain].

We extracted from L. biflexa patoc a fraction F, reacting in hemagglutination and ring tests with sera prepared against more than ten different serogroups. This fraction contains mainly a polysaccharide (65 per cent), the role of which was clearly demonstrated in the precipitation reaction with homologous antisera, through periodic oxidation; it also contains lipids (20 per cent) and proteins (10 per cent). We isolated from this fraction F, by Biogel column chromatography, 2 distinct antigens, one, F2, carrying the patoc-type specificity, the other, F 1B, a group specificity shared by many leptospira. These antigens differ not only immunogically, but also in their chemical composition. The type-specific antigen F2 contains mainly a polysaccharide composed of arabinose and glucosamine (possibly an immunodominant sugar). As for the group-specific fraction F 1B, its composition is more complex since lipids and proteins are also found with the polysaccharide. This antigen could therefore be a lipoglycoprotein.

Animals↗
PubMed1970

Influence of Brucella endotoxins on the initiation of antibody-forming spleen cells in mice immunized with sheep red blood cells.

Changes in the formation of antibodies to sheep red blood cells (sRBC) in the presence of Brucella extracts was studied in mice whose spleen cells were assayed by the Jerne procedure. Two strains of female mice were employed. Brucella extracts were prepared: (i) by trichloroacetic acid extraction (LPSN), (ii) by phenol extraction (LPS), and (iii) by hot acetic acid hydrolysis (Ps). B. abortus LPSN and B. melitensis LPSN or LPS, administered with sRBC, stimulated the specific response to sRBC, but only at high doses of endotoxins. B. abortus LPSN and B. melitensis LPSN suppressed nonspecific responses against horse red blood cells (hRBC), in contrast to the typical events following administration of Serratia marcescens endotoxin (or endotoxins from other ubiquitous organisms). In CD-1 mice, B. abortus Ps depressed the specific anti-sRBC response. Attempts to presensitize mice with abortus LPSN resulted in a stimulation of the response to sRBC, but pretreatment with B. melitensis LPSN had an inhibitory effect. When injected alone, Brucella endotoxins activated anti-sRBC antibody-forming cells but not anti-hRBC cells. B. abortus Ps was unable to modify the background number of anti-sRBC cells and inhibited the hRBC response. These data suggest (i) that there exists a "common antigen" between Brucella cells and sRBC and (ii) that the so-called primary response to endotoxins from ubiquitous organisms represents a secondary response to already naturally sensitized animals.

Journal Article↗