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Biomedical subjects

R Zarcone

Publications and source records attributed to R Zarcone.

At least 19 recordsLinked to original sources
PubMed2004

AGUS and ASCUS: different incidence in pre- and postmenopausal women.

PURPOSE OF INVESTIGATION: The aim of this study was to determine the incidence of AGUS (atypical glandular cells of undetermined significance), ASCUS (atypical squamous cells of undetermined significance) and SIL (squamous intraepithelial lesion) in the cytologic diagnosis in pre- and postmenopausal women. METHODS: We did a retrospective study selecting 183 patients who were screened for cervical pathology. Ninety-six patients were in postmenopausal age. We determined the incidence of cytologic abnormalities defined as ASCUS, SIL, and AGUS in pre- and postmenopausal women. RESULTS: We expected a marked incidence of low-grade SILs in the fertile population, while the postmenopausal group was thought to be affected more by AGUS and ASCUS. We obtained different results. In our population study, premenopausal women presented more AGUS and ASCUS; the two subgroups presented the same incidence of low-grade SILs; postmenopausal women were more affected by high-grade SILs. CONCLUSIONS: The significance of the new categories introduced by the Bethesda System is still uncertain for different authors. As we look to the future new markers that more specifically identify individuals at-risk can be expected.

Adolescent↗
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↗
PubMed2003

Utilisation of hydrogen peroxide in the treatment of recurrent bacterial vaginosis.

AIM: The authors have evaluated the real efficacy of using hydrogen peroxide for previously treated recurrent bacterial vaginosis that is resistant to other forms of treatment. METHODS: The study included 58 women aged between 18 and 42 years old. Vaginal irrigations with 30 ml of hydrogen peroxide (3%) were prescribed in the evening for a week. The follow-up was carried out 3 months after the end of treatment. RESULTS: The results clearly show that the use of hydrogen peroxide in vagina can eliminate the main symptoms of bacterial vaginosis, and in particular the malodorous leucoxanthorrhea in 89% of cases at 3 months after the end of treatment, a result that is comparable to that obtained using metronidazole or clindamycin as a vaginal cream. Moreover, hydrogen peroxide facilitates the restoration of normal vaginal bacterial flora (represented by H202-producing lactobacillus) in 100% of cases and normal acid pH (pH<4.5) in 98% of cases; it also fosters the disappearance of clue cells from vaginal smears and anaerobic pathogenic flora from vaginal secretions in 100% of cases. The amine test became negative in 97.8% of cases. All results underwent statistical analysis and were found to be statistically significant. CONCLUSION: Hydrogen peroxide represents a valid alternative to conventional treatments for recurrent bacterial vaginosis, and associates the absence of collateral effects with low costs, excellent tolerability and real therapeutic efficacy.

Adolescent↗
PubMed2001

[Role of intestinal resection in primary cytoreduction of ovarian cancer].

BACKGROUND: The aim of this study is to define the role of the intestinal removal for the therapy of ovarian cancer in advanced stadium. METHODS: We have examined 247 females with epithelial ovarian cancer in advanced stadium, that had intestinal removal. RESULTS: The survival in the females that had a very good intestinal removal is greatest than in the females that hadn't a very good intestinal removal.

Carcinoma↗
PubMed2001

[Cytoreductive surgery in patients with stage IV ovarian carcinoma].

BACKGROUND: The aim of this study is to evaluate the efficacy of cytoriductive surgical in females with ovarian carcinoma in advanced stadium, and to define the role of this surgical for the survival of females with hepatic metastases. METHODS: This is a retrospective study. 164 females with ovarian cancer in IV stadium was examined. 64 females had hepatic metastasis. All patients had cytoriductive surgical. RESULTS: The survival in the patients without hepatic metastasis was 38 months if the cytoreduction was very good; it was 18.3 months if there is residual disease. The survival in the patients with hepatic metastasis was 50.1 months if the cytoreduction was very good; it was 27 months if there is residual disease. CONCLUSIONS: A very good surgical is very important for the survival of patients with ovarian cancer in advanced stadium. This is true also in the patients with hepatic metastases.

Adult↗
PubMed2001

[Meigs' syndrome and "Meigs' pseudo-syndrome." Report of 2 cases].

BACKGROUND: The aim of this study is to investigate similitudis and differences between the Meigs' syndrome and Meigs' pseudosyndrom. The Meigs' syndrome is an uncommon disease that is characterized by benign ovarian tumor, ascites and pleural effusion. The Meigs' pseudosyndrom is a serious disease that is characterized by malignant ovarian tumor, ascites, pleural effusion. METHODS: We have examined two cases: a case of Meigs' syndrome that is characterized by vomit, abdominal pain, ascites, height serum Ca 125 level; a case of Meigs' pseudosyndrom that is characterized by ovarian adenocarcinoma that is diagnosticated owing to ascites and pleural effusion. CONCLUSIONS: This study suggest that the surgical therapy have a very important role for the complete remission of the disease in the Meigs' syndrome and for the remission of ascites and pleural effusion in the Meigs' pseudosyndrom.

Aged↗
PubMed2001

[HPV infection. Clinical features and treatment].

The aspecific and exiguous symptoms and the lacking information are among the reasons of the diffusion of the vulvo-vaginal papillomatosis. We carried out the present study between 1995 and 1999 in the outpatient clinic of cervico-vaginal pathology of the Second University of Naples. 680 patients (aged between 18 and 56 years) underwent vulvoscopic and colposcopic examination. The did not show any relevant symptoms specific for HPV infection. Among the viral strains, HPV-16 and HPV 18 are able to induce a cervical cancer. To eliminate the pathology the primary prevention is necessary: it consist of both an adequate information about the micro-condilomatosis, the role of the activator agent, the modality of the infection, and the annual screening examinations such as pap-test and colposcopy. As first line treatment during secondary prevention, we utilize Roferon A, and perform diathermocoagulation according with the local diffusion and the degree of the disease (mild, moderate, severe). At the end of the therapy with Roferon A we observed that the infective focus was eliminated in about 60% of the cases and, only for moderate and severe micro-condilomatosis a diathermocoagulation was necessary.

Adolescent↗
PubMed2001

[Second-look in ovarian cancer: laparoscopy or laparotomy?].

BACKGROUND: The aim of the present study was to compare the laparoscopic second-look with laparotomic second-look as regards the consistency of diagnosis of residual tumoral disease after first step treatment in patients affected by ovarian cancer, and to evaluate the feasibility of the laparoscopic second-look. METHODS: Twenty-one patients affected by ovarian cancer underwent laparoscopic second-look followed by laparotomic second-look. Six months after the first surgical intervention all the patients showed no contraindications to laparoscopic second-look. All the surgeries were performed with the same procedure: after the introduction of the trocars the lysis of adherences was carried out, the whole abdominal cavity was explored, 18 abdominal-pelvic sites were examined, direct biopsies were performed and samples for the cyto- and histological analysis were obtained. RESULTS: Positive predictive value for laparoscopy was 100% (6 out of 6 cases), while negative predictive value was 84% (2 false negative cases out of 12). The complete abdominal-pelvic examination was possible in 95% of cases with laparotomy while in 41% of cases with laparoscopy, because of post-operative severe adherences. CONCLUSIONS: Laparoscopic second-look has a good consistency as regards the diagnosis of residual tumoral disease, but its feasibility is lower than laparotomy owing to the presence of severe adherences and the high risk of intra- and post-operative compliances.

Female↗
PubMed1998

Effects of hormone replacement therapy on glucose metabolism.

OBJECTIVE: To evaluate the relationship between hormone replacement therapy and glucose metabolism, and the possible role played by the administration route. DESIGN: Prospective randomized study. MATERIALS AND METHODS: Eighty-four patients in either surgical or spontaneous menopause were randomly allocated into four groups: 15 patients in surgical menopause were treated with estrogens alone administered transdermically (17 beta-estradiol, 50 micrograms/day); 15 patients in surgical menopause were treated with oral conjugated equine estrogens (0.625 mg/day); 18 patients in spontaneous menopause were treated with transdermic estrogens plus oral progestagen (17 beta-estradiol 50 micrograms/day, acetate medroxyprogestogen 10 mg/day for 12 days per month); 16 patients in spontaneous menopause were treated with oral conjugated equine estrogens (0.625 mg/day) plus oral progestagen (10 mg/day for 12 days per month). Twenty patients not given any medication represented the control group. Before starting the trial and after six months of therapy, glucose and insulin levels before and after an oral glucose loading test were evaluated. Data analysis was performed by means of Student's "t"-test, ANOVA was used to compare mean levels between the groups. Significance was set at p < 0.005. RESULTS: Dosages made after 6 months of therapy showed comparable basal glucose levels in all the studied group, while basal insuline levels in patients taking estrogen alone were lower (76.88 +/- 23.66 vs 95.91 +/- 24.57 in group 1, 80 +/- 13.34 vs 96.91 +/- 18.97 in group 2) than pretreatment values. No significant difference in glucose levels was found after glucose load in the four groups. CONCLUSION. Women treated with estrogen alone have a tendency to a lower insulin response, which could indicate a greater insulin sensitivity. This effect seems to be more evident in transdermic administration than with oral administration. The addition of progestagen seems to wane the increase in insulin sensitivity induced by estrogens.

Administration, Cutaneous↗
PubMed1998

Preoperative GnRH analogue in hysteroscopic metroplasty.

OBJECTIVE: To evaluate the effectiveness of Gonadotropin-Releasing Hormone analogue when administered preoperatively in hysteroscopic metroplasty. DESIGN: Prospective, comparative study. PATIENTS AND MAIN OUTCOME MEASURES: Sixty patients undergoing hysteroscopic metroplasty for septate uterus who were randomly allocated to pretreatment with two injections monthly of Gonadotropin-Releasing Hormone analogue or to no pretreatment. To assess the outcome of surgery three parameters were used: operative time (minutes), fluid adsorption (ml) and intraoperative bleeding. RESULTS: No significant differences in the operating time (21.9 vs 22.9 min), fluid adsorption (395 ml, range 200-550 vs 515 ml, range 250-650), intraoperative bleeding and failure rate were found between pretreated patients and controls. CONCLUSIONS: Preoperative treatment with Gonadotropin-Releasing Hormone analogue showed no advantage in hysteroscopic treatment of mullerian defects, but only an improvement, not statistically significant, in term of reduced operative time and fluid adsorption.

Adult↗
PubMed1998

Tubal patency after laparoscopic treatment of ectopic pregnancy.

OBJECTIVE: To evaluate operative course, tubal patency and reproductive performance after laparoscopic treatment of ectopic pregnancy in relation to initial human chorionic gonadotropin (hCG) values and to the kind of operation. DESIGN: Retrospective study. PATIENTS: Fourty-five patients affected by ectopic pregnancies: thirty-two treated with laparoscopic linear salpingotomy subvided into two groups depending on the hCG serum values < 10,000 mUl/ml (twenty patients: group 1) or > 10,000 mUl/ml (twelve patients Group 2), thirteen patients (Group 3) undergoing laparoscopic salpingectomy. Hysterosalpingographic examination was performed two or three months after surgery. MAIN OUTCOME MEASURES: Operative time, major surgical complications, tubal patency and pregnancy rate after surgery. RESULTS: Operative time was significantly (p < 0.05) lower in both group 1 and 3 (22.5 +/- 3.2 and 19.1 +/- 6.3, respectively) than in group 2 (39.4 +/- 5.6). Bilateral patent tubes were observed in eighteen cases of group 1 (90%) and eight cases of group 2 (60%). No statistically significant differences were found between the pregnancy rate of both group 1 (8/18) and 2 (3/8) and of group 3 (3/11). CONCLUSIONS: Reproductive outcome is similar in both conservative and destructive laparoscopic management of ectopic pregnancy: furthermore it shows a trend of improvement, not statistically significant, in conservative treatment.

Chorionic Gonadotropin↗
PubMed1998

[Authors' experience with medical therapy of herpes genitalis in pregnancy].

BACKGROUND: Neonatal risk in herpes infections is very high: in the USA it is 1:2,000, in Japan 1:15,000 and in England 1:65,000. These differences seem to be due mostly to the different risk factors associated to the mother infection. The best strategy to cure herpes infection is to examine every patient during pregnancy and to identify the high risk ones. METHODS: In this study, 1,860 pregnant women have been submitted to a colposcopic and cytologic screening for the research of HSV. RESULTS: HSV was found in twenty (1.07%) women. Two groups have been made: the first with 14 HSV positive women at 3-6 months of pregnancy and second with 6 HSV positive women at eight months of pregnancy. Both groups were treated with acyclovir per os. The 14 women of the first group underwent vaginal delivery. The women of the second group underwent cesarean section. Only in 1 case a neonatal infection has been observed.

Acyclovir↗
PubMed1998

[Authors' experience in the treatment of cervical intraepithelial neoplasia].

BACKGROUND: During the last ten years, after the destroying intervention for the treatment of cervical intraepithelial uterine neoplasia (CIN = Cervical Intraepithelial Neoplasia) was abandoned, space has been given to the conservative treatment, both destructive and excisional. In this study, conducted at the Department of Gynaecology and Obstetrics of Eboli Hospital (ASL Salerno 2) in collaboration with the Gynaecological and Obstetrical Department of the Second University of Naples, the authors compared the various therapy techniques of the conservative excisional type, using 5 different methods. METHODS: One hundred and fifty-seven women, all with lesions of the neck of the uterus of varying degrees of severity, underwent the treatment. Cytologic and colposcopical controls (follow-up) were carried out at intervals over a period of time. RESULTS: In 5 of the 95 patients (5.3%) who underwent surgical conisation, the presence of invading carcinoma was noted. Of the 19 women treated with diathermical loop, 3 cases of mature squamous metaplasia, 3 cases of CIN I, 8 cases of CIN II, and 4 cases of CIN III were observed. In the 32 patients treated with laser-therapy a complete recovery, equal to 100% was obtained although with slight margins of under-estimation and over-estimation; the same result was verified in the 3 patients treated with electroresection with high frequency radio waves and in the 8 patients treated with microneedle. CONCLUSIONS: On the basis of these results it is concluded that lasertherapy and electroresection with high frequency radio waves (3.8 MHz) using electrodes with "bands" or with "linears" (microneedle) gave the best results for both the therapeutical advantages with anatomical and functional integrity of the cervix and for economic reasons.

Adult↗
PubMed1998

[Incidence of CIN in HIV-positive women].

BACKGROUND: The aim of this study was to evaluate the incidence of CIN in HIV-seropositive women. METHODS: A group of 23 women with a mean age of 28 years was recluted. Three of them were clinically affected, and 20 were non-AIDS HIV-seropositive. The patients underwent cervical cytology, colposcopically directed biopsy and T-cell studies. In addition, HPV using the in vitro hybridization, was investigated. RESULTS: Eight of 23 patients (24.78%) had CIN. Patients with CIN had significantly lower CD4 cell counts and CD4/CD8 ratios than those without CIN. Patients with AIDS had higher grade lesions than those non-AIDS HIV-sero-positive. CONCLUSIONS: The data obtained suggest that abnormal cervical pathology is common among HIV seropositive women, and so cervical colposcopy should be part of the routine management of HIV-seropositive women.

Adult↗
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

[Diagnosis and therapy of CIN in pregnant women].

BACKGROUND: CIN is the most frequent neoplasm in pregnancy. At present, in Italy, Pap test and colposcopy are not included in routine examinations in prenatal visits. METHODS: In this study, we submitted 560 pregnant women to Pap test during prenatal visits. In case of abnormal or doubtful smears a colposcopy and target biopsy were performed. RESULTS: Of the 560 women studied, 124 had genital bleeding and the other 436 were asymptomatic. Six cases of CIN symptomatic women and 5 cases in the asymptomatic ones. In no cases we thought necessary a therapeutic operation. We limited the therapy to a follow-up. CONCLUSIONS: In our opinion, it is necessary to treat CIN during pregnancy.

Adolescent↗