Biomedical subjects

R Zarcone

Publications and source records attributed to R Zarcone.

At least 37 records · Page 2Linked to original sources

PubMed1998

[Psychological consequences in women with symptomatic HPV infection].

OBJECTIVE: Evaluation of psychological and social aspects of women with diagnosed genital HPV-infection. EXPERIMENTAL DESIGN: A retrospective study of 40 women with a diagnosis of HPV-genital infection has been made. INTERVENTIONS AND MEASURES: A questionnaire for gathering information on social life, sexuality and emotional relationship with the partner was submitted to the patients. RESULTS: There is a high percentage of sexual impairments after diagnosis of HPV-infection. CONCLUSIONS: HPV infections, as many genital pathologies, lead to problems with sexuality as well as hypochondriac fears.

Adult↗

PubMed1998

Time length of negativization of hCG serum values after either surgical or medical treatment of ectopic pregnancy.

OBJECTIVE: The aim of this study was to compare the time length until the human chorionic gonadotropin titer became negative after medical or surgical treatment of ectopic pregnancy. EXPERIMENTAL DESIGN: Prospective, randomized study. PARTECIPANTS AND INTERVENTIONS: We compared time to resolution in 30 cases of tubal pregnancies successfully treated, 15 underwent laparoscopic linear salpingostomy (group 1) and 15 medical treatment with single-ose methotrexate (group 2). The patients of both groups had no meaningful differences of age, gestational age and human chorionic gonadotropin mean values. MEASURES: During the follow-up human chorionic gonadotropin serum values were obtained every two days until the titer was negative. RESULTS: The time to resolution was 33.6 +/- 6.6 days in group 1, 31.5 +/- 7.8 in group 2 with no statistically meaningful differences. CONCLUSION: The data, comparable with results obtained by laparoscopic treatment, suggest that human chorionic gonadotropin value becomes negative independently of type of treatment and residual trophoblast.

Abortifacient Agents, Nonsteroidal↗

PubMed1998

Systemic lupus erythematosus and pregnancy.

In this paper the authors underline the importance of SLE in women, above all those who become pregnant. This review also stresses the importance of an early diagnosis and the need to give correct information to pregnant women regarding the possible risks of pregnancy, both to the maternal organism and to the fetus. The authors also describe the main aspects of diagnosis and the management of this particular type of patient. In conclusion, they affirm that pregnancy should not be avoided categorically, but that it should be carefully planned and, once started, must be scrupulously monitored in view of the deterioration of SLE caused by pregnancy.

Female↗

PubMed1997

A case of malignant melanoma of the vagina during pregnancy: immunological problems.

BACKGROUND: A clinical case of malignant melanoma of the vagina diagnosed during late pregnancy is described. Prompt histological examination showed a malignant melanoma at an early stage. The treatment of choice for malignant melanoma is surgical exicision. At present we are trying to associate immunological and chemotherapeutic treatments with surgical ones. CASE: A 27-year-old primipara was diagnosed with malignant melanoma at 38 weeks' gestation. The patient underwent a cesarean section. Careful evaluation of the immunological characteristics of the patient induced us to treat the melanoma with human leukocyte alpha interferon. The result was an increase in T4 cells with respect to T8 cells, with an enhancement in the ratio of CD4 to CD8. CONCLUSION: The results suggest the immune system plays a major role in the modification and regulation of neoplasias of the genital tract.

Adult↗

PubMed1997

Current etiopathogenetic views in vulvar cancer.

We considered 59 patients, from 19 to 79 years, treated for vulvar neoplastic pathology (32 of 59 had multiple squamous neoplasias of the anogenital region). It appeared that vulvar cancer is a disease of aged women and in particular between sixty and seventy years, while it isn't common under the age of thirty years. It is a hormone-independent pathology. 85% of vulvar malignant tumors is constituted by squamous cell carcinomas. The principal risk factors are: 1) chronic vulvitis (in particular Lichen sclerosus); 2) leucoplachia, 3) immunosuppression, 4) coitus in a young woman with different partners, multiple abortions, 5) HPV infection (mostly HPV type 6 and 16), 6) other genital carcinomas, 7) capacity to activate or not protoncogenes and to produce interferon, 8) tobacco smoking, 9) VIN.

Adult↗

PubMed1997

Therapeutic protocol of vulvar and cervical HPV-infection.

BACKGROUND: The stages of HPV (Human Papilloma Virus) infection are under the control of the immune system, which is inhibited by the virus itself. Thus, at present the treatment of condyloma acuminata is based on the use of interferon (IFN). The aim of the present study was to evaluate immune system activation and clinical response to IFN therapy. In addition, in the most serious cases, medical treatment with IFN was associated with diathermocoagulation (DTC) of persistent warts. The effectiveness of the combined therapy was also assessed. METHODS: 7 women (age range: 16-52) suffering from cervix condylomata were selected for our study. All of them were injected intramuscularly with doses of 3 million UI of IFN-alpha leucocytar every three days for six weeks together with daily applications of alpha-IFN for six weeks. The women that were still ill three months after IFN therapy, were treated with DTC. In one case, another cycle of IFN treatment was necessary. RESULTS: Clinical response to IFN treatment was complete in 46 cases, partial in 20 cases and unsuccessful in 4 cases. After three months of medical therapy, 30 women were treated with DTC. After this therapy, in 21 cases, the warts were resolved. After 24 months the percentage of relapse was 37.9% when only IFN was used, and 4.51% when IFN was combined with DTC. CONCLUSIONS: These data suggest that a successful protocol for the treatment of condyloma acuminata consist of IFN therapy associated with DTC when warts persisted.

Adolescent↗

PubMed1997

Prognostic value of desmoplastic reaction and lymphocytic infiltration in the management of breast cancer.

OBJECTIVE: To ascertain whether the prognostic value of desmoplastic reaction and lymphocytic infiltration are a good prognostic index to estimate survival in breast cancer patients. METHODS: From 1987 to 1994, the authors have evaluated the prognostic value of desmoplastic reaction and lymphocytic infiltration related to rode state in 34 patients with breast cancer. For statistical analysis and comparison of means the "t"-test was used. The significance level was 0.01. RESULTS: The group of patients with abundant desmoplastic reaction shows an overall survival rate lower than the group with poor desmoplastic reaction (p < 0.01) and the survival of the group with abundant desmoplastic reaction was related to lymphnodal status. CONCLUSIONS: Many prognostic factors have been shown during these years, some connected to patient, some connected to neoplasm and others connected to the treatment. Recently many other prognostic factors have been recognized, among which the possible prognostic role of desmoplasia has been carefully valued. Certainly, today the prognostic value of desmoplastic reaction and lymphocytic infiltration cannot take the place of usual prognostic factors in the evaluation of breast cancer patient yet the desmoplastic reaction is a good prognostic index to estimate the survival in these patients.

Adult↗

PubMed1997

Role of ultrasonography in the early diagnosis of ovarian cancer.

BACKGROUND: Malign ovarian carcinomas are the main cause of death from gynaecological cancer. In fact, only in 30% of cases is it diagnosed at an early stage. In our study the possibility of an early diagnosis of the ovarian malignant neoplasia was evaluated. METHODS: One hundred and thirty-nine women with adnexal swelling were subjected to pelvic echography. The sample was selected during routine gynaecological checkups. RESULTS: All the cases showing a mass diameter exceeding 25 mm were classified as positive. Echotomography showed 129 cases of positive ovarian mass with an accurate diagnosis in 92.27%. Integrating the results of echography with those of radioimmunoassay an early diagnosis of ovarian cancer was achieved in 92.53 of the cases. CONCLUSIONS: A routine pelvic examination associated with pelvic echotomography represent an effective protocol for the diagnosis of ovarian cancer at an early stage.

Adult↗

PubMed1997

[Early diagnosis of adenocarcinoma by endometrial cytologic samples].

145 endometrial cytologic samples were taken by Endocyte and they were compared to histologic samples. The diagnostic concordance was 96.55%, proliferative endometrium, secretory endometrium, hyperplastic endometrium and carcinoma were screened and only 2.75% of cases were uncertain. Endometrial cytology is advantageous because Endocyte can be used in the out-clinic without risks for patients.

Adenocarcinoma↗

PubMed1997

A case of failure of tubal sterilization using Pomeroy's technique.

With reference to a case of pregnancy of a patient formerly subjected to tubal sterilization using Pomeroy's technique, the authors define the possibility for tubal stumps to recanalise. Despite the low percentage of failure in tubal sterilization using Pomeroy's technique, the authors conclude that it is advisable to make the earliest possible diagnosis of both intrauterine and extrauterine pregnancy on the basis of suspected symptoms in order to, especially for tubal pregnancies, avoid any tubal sterilization.

Female↗

PubMed1997

[Treatment of endometriosis with GnRH analogues].

BACKGROUND: Since a continuous administration of adequate doses of luteinizing hormone-releasing hormones (LHRH) or of an agonist leads to a hypogonadism-like condition, it is possible to use this effect for the treatment of endometriosis. The present study reports the results obtained in the Gynaecology and Obstetrics Institute of the Second University of Naples, with a long-acting formulation of a GnRH analogues (D-Trp6-LHRH) in biodegradable microcapsules, at monthly intervals. MATERIALS AND METHODS: The study was carried out on 40 women with endometriosis diagnosed by laparoscopy or laparotomy. The duration of treatment in patients in stage I-II was of 6 months, in patients in stage III or IV was of 9 months. RESULTS: After 12 months from the end of therapy, 27 patients did not show any sign of endometriosis with ultrasound and clinical examination; 13 patients still showing endometriosis were from III or IV stage. CONCLUSIONS: This long-acting formulation should offer a better approach for chronic treatment.

Adult↗

PubMed1996

Serum and peritoneal CA-125 levels as diagnostic test for endometriosis.

OBJECTIVE: To evaluate the clinical utility of CA-125 in the diagnosis of endometriosis and to compare the sensitivity of the serum and the peritoneal test as indicator of disease. STUDY DESIGN: Peritoneal fluid was obtained at laparoscopy. The quantitative determination of CA-125 in serum and in peritoneal fluid was performed by IRMA-mat CA-125 'two-step method', a two-site immunoradiometric assay, using 35 and 60 U/ml as cutoff. SETTING: Second Department of Gynecology and Obstetrics, Second University of Naples, Italy. PARTICIPANTS: A total of 26 women infertile undergoing diagnostic laparoscopy that exhibited endometriosis in 14 patients, normal pelvis in 12 patients (control group). INTERVENTIONS: None. RESULTS: CA-125 levels in peritoneal fluid were higher than those found in serum and were significantly elevated (P < 0.05), when compared with the control group, both in women with endometriosis stage I-II and stage III-IV. In serum, CA-125 levels increased only in advanced stage of endometriosis. CONCLUSIONS: Levels of CA-125 in peritoneal fluid seem to be a more sensitive indicator of disease than serum levels (0.86 vs. 0.36), especially in early stage endometriosis (0.80 vs. 0.20) which tends to be overlooked by the CA-125 serum test.

Ascitic Fluid↗

PubMed1996

Chemotherapy and cervical cancer: present trends.

A clinical case of cervical carcinoma Stage Ib is described. We treated a 48-year old woman with grade 2 carcinoma, using cisplatin at a dose of 40 mg/mq on the 1st and 4th days, bleomycin at a dose of 15 mg/mq on the 1st and 8th days, and anti-emetic for two cycles. On the basis of the low ratio T4/T8 we also administered along with chemotherapy, alpha natural interferon at a dose of 3,000,000 i.u. three times a week for four weeks. At the end of the chemotherapeutic treatment the lesion was reduced in size and the biopsy was pathognomically of a microinvasive cancer. In spite of the encouraging biopsy results, the patient was submitted to a simple hysterectomy, with random lymphoadenectomy. Today, two years after her treatment, the patient is free of disease. At present there is discussion as to the efficacy of neoadjuvant chemotherapy in the first stages of the neoplasia in relation to conventional treatment, which reserves chemotherapy to stages IV and IVb and to relapses, in the light of both the lesion and the disposability of the patient to treatment and successive follow-up.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1996

[Association of interleukin 2 and interferon alpha in the management of cervical condylomatosis].

At present the therapy of cervical condylomatosis is based on the use of interferon because the HPV types responsable for condyloma inhibit the immunitary system. But many A. studying the effects of IFN have found that at high concentration it has an immunosuppressive action. The aim of the present study was to evaluate if interleukin-2 associated with IFN is useful in avoiding this negative effect by improving the efficacy of cervical condylomatosis therapy. We treated 25 women suffering from cervical condyloma with increasing doses of IL-2 injected intralesionally and associated with natural alpha-IFN injected intramuscularly. The duration of the whole therapy was six weeks. We evaluated the percentage of inflammatory cells in peripheral blood before and after treatment. The per-cent number of lymphocytes, eosinophils and lymphoblasts was increased by 27%, 88% and 40%, respectively. The clinical response to the therapy was total in 14 cases, partial in 9 cases and unsuccessful in 2 cases. These data suggested that combination therapy with interleukin-2 and alpha-IFN for the treatment of patients with cervix condylomatous is successful.

Adult↗

PubMed1996

[Vulvo-vaginal HPV infection: immunological aspects].

All phases of HPV infection are under the control of the immunitary system which is probably inhibited by the virus itself. We studied 65 patients (range 22-55 year). They presented an HPV vulvovaginal infection not healed after common therapy. The aim of our study was to verify the changes occurring in the immune system during HPV vulvo-vaginal infection. Using the immunohistochemical method we evaluated the number of T4,T8 and NK lymphocytes inside the lesion. Moreover we measured the immunitary cells of the hematic compartment. Inside the lesion we noted a reduction of the immune system in 69.23% of cases, while in the hematic compartment it was reduced only in 6.15% of cases. These data strongly suggested that the evaluation of the immunitary state, before starting therapy, is important in deciding when it would be useful to associate immunostimulating substances at the common treatment of vulvo-vaginal infection.

Adjuvants, Immunologic↗

PubMed1996

[Anencephaly: a still unresolved problem].

The anencephaly is a congenital malformation, characterized by the absence of the cerebral structures and of the skull. In this study we have considered 5 cases of anencephaly, occurred in the decade 1985-1994. All the pregnant women have been interviewed and underwent ultrasonographic evaluation. Four out of 5 pregnant women have voluntarily interrupted pregnancy. In only 1 case, having achieved woman the 40th week of pregnancy, the delivery has been spontaneous: the fetus has died after few hours. The results of this study suggest that, being the anencephaly the most commonly indications for the abortion, would be important to help the women bearers of anencephalic fetuses to consent taking the organs, using them for transplantations on children that necessitate them.

Abortion, Therapeutic↗

PubMed1996

[Folic acid and cervix dysplasia].

The localized folate deficiency, which is sometimes misdiagnosed as cervical dysplasia, because of morphological similarities between the cytologic features of megaloblastosis seen with folate deficiency and the changes associated with dysplasia, could be a component of the dysplastic process. In this study we attempted the effect of oral folic in women with cervical dysplasia. A total of 154 subjects with grade 1 or 2 CIN were randomly assigned either 10 mg of folic acid or a placebo daily for 6 months. Clinical status, human papillomavirus type 16 infection and blood folate levels were monitored at 2 month intervals. After 6-months no significant differences were observed between supplemented and unsupplemented subjects regarding dysplasia status, biopsy results, or prevalence of human papillomavirus type 16 infection. Folate deficiency the initiation of cervical dysplasia, but folic acid supplements do not alter the course of established disease.

Administration, Oral↗

PubMed1996

[Drug treatment in vulvar lichen sclerosus].

This study was made in the Oncologic Gynecology's surgery of the Department of Obstetrics and Gynecology of the University of Naples. We evaluated the efficacy of local therapy with testosterone and progesterone in Vulvar Lichen Sclerosus. We treated 65 women suffering from Vulvar Lichen Sclerosus. In the group of 38 women treated with testosterone, we observed a complete response in 26 cases (68%). In the group of 27 women treated with progesterone we observed a complete response in 18 cases (66.6%). This demonstrates the efficacy of local therapy with testosterone and Progesterone in Vulvar Lichen Sclerosus. The authors believe that medical treatment with topical testosterone and progesterone represents an effective alternative to invasive methods for the care of Vulvar Lichen Sclerosus.

Administration, Topical↗