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Biomedical subjects

A Perino

Publications and source records attributed to A Perino.

At least 19 recordsLinked to original sources
PubMed2006

Identification of the macromolecular complex responsible for PI3Kgamma-dependent regulation of cAMP levels.

PI3Kgamma is a phosphoinositide 3-kinase characterized by both lipid and protein kinase activity. It is activated by G-protein-coupled receptors and is predominantly expressed in leucocytes; in addition, recent work showed its presence in the heart and its involvement in regulating cardiac functions. In this tissue, PI3Kgamma acts as a negative modulator of contractility, by decreasing cAMP concentration through a kinase-independent mechanism. Indeed, whereas PI3Kgamma-deficient mice show an abnormal cAMP elevation, cAMP levels in knock-in mouse mutants, expressing a kinase-dead PI3Kgamma, are comparable with wild-type controls. PI3Kgamma regulates cardiac cAMP homoeostasis by forming a macromolecular complex containing PDE3B (phosphodiesterase 3B). In this complex, PI3Kgamma could regulate PDE3B activity through protein kinase A, a PDE activator.

Animals↗
PubMed2004

Recombinant human LH supplementation versus recombinant human FSH (rFSH) step-up protocol during controlled ovarian stimulation in normogonadotrophic women with initial inadequate ovarian response to rFSH. A multicentre, prospective, randomized controlled trial.

BACKGROUND: In approximately 12-14% of young normogonadotrophic women treated with a depot GnRH agonist long protocol, the initial ovarian response to recombinant human FSH (rFSH) can be suboptimal. We have tested the hypothesis that these women may benefit from recombinant human LH (rLH) supplementation in a multicentre, prospective, randomized trial compared with patients treated with an rFSH step-up protocol. METHODS: A total of 260 young normogonadotrophic women undergoing controlled ovarian stimulation with a GnRH agonist long protocol for IVF/ICSI were enrolled. The starting dose of rFSH was 225 IU. One hundred and thirty patients with serum estradiol levels <180 pg/ml and with at least six follicles with a mean diameter >5 mm but none >10 mm on both day 5 and day 8 of stimulation were randomly allocated to two groups. From the eighth day of stimulation, women in group A (n=65) received 150 IU of rLH in addition to rFSH, while those in group B (n=65) had an increase of 150 IU in the daily dose of rFSH (step-up protocol). One hundred and thirty normally responding women continued monotherapy with rFSH and served as a further control population (group C). RESULTS: The mean number of cumulus-oocyte complexes retrieved in group A (9.0+/-4.3) was significantly higher (P<0.01) compared with group B (rFSH 6.1+/-2.6) but significantly lower compared with group C (10.49+/-3.7, P<0.05). Implantation and pregnancy rates were significantly lower (P<0.05) in the rFSH step-up group (10.5 and 29.3% respectively) when compared with normal responders (18.1 and 47.3% respectively). CONCLUSIONS: rLH supplementation is more effective than increasing the dose of rFSH in terms of ovarian outcome in patients with an initial inadequate ovarian response to rFSH alone.

Adolescent↗
PubMed2004

IVIG in APS pregnancy.

For more than two decades, the intravenous administration of high doses of IgG pooled from the plasma of healthy donors (immune globulin therapy, also known as 'IVIG') has benefited patients with a variety of autoimmune disorders. A potential therapeutic role of IVIG in the prevention of thrombosis and of miscarriages in antiphospholipid syndrome (APS) has been postulated. Multicenter randomized controlled trials attempted to define the role of IVIG in preventing pregnancy complications in APS indicate that simple anticoagulation could not be completely satisfactory, and certain patient subgroups might take advantage of IVIG therapy alone or in combination with heparin.

Abortion, Habitual↗
PubMed1999

Total laparoscopic hysterectomy versus total abdominal hysterectomy: an assessment of the learning curve in a prospective randomized study.

The present randomized study was undertaken in order to compare the short-term results between total laparoscopic hysterectomy and abdominal hysterectomy in a centre with experience in laparoscopic surgery. From January 1997 to September 1998 inclusive, 102 women aged 44-71 years were randomly assigned to either total laparoscopic hysterectomy (n = 51 patients) or abdominal hysterectomy (n = 51 patients). The patients' demographic characteristics were similar in both groups. Average intra-operative blood loss was lower in laparoscopic hysterectomy than in abdominal hysterectomy (P </= 0. 001). The average time employed for laparoscopic hysterectomy was 104.1 +/- 26.98 min; according to the learning curve experienced in this study, the range was 72-163 min and the results after the plateau was reached showed no statistical difference between laparoscopic and abdominal operating times. The mean length of hospital stay was 2.38 +/- 0.30 days in the laparoscopic hysterectomy group versus 6.23 +/- 1.85 days in the abdominal hysterectomy group (P </= 0.001). In conclusion, this study shows that total laparoscopic hysterectomy can be effectively performed within reasonable time limits, provided that operators are experienced surgeons in operative laparoscopy and that operating times are comparable with those of abdominal hysterectomy.

Adult↗
PubMed1998

Hysteroscopic metroplasty.

STUDY OBJECTIVE: To evaluate 10 years' experience with hysteroscopic treatment of septate uterus in Italy. DESIGN: Multicenter retrospective study conducted from January 1988 to March 1997 (Canadian Task Force classification II-2). SETTING: Twelve Italian centers for minimally invasive therapy. PATIENTS: Women (total 973) with hysteroscopically diagnosed septate uterus. INTERVENTIONS: Hysteroscopic metroplasty performed with scissors, resectoscope, or neodymium:yttrium-aluminum-garnet laser. MEASUREMENTS AND MAIN RESULTS: Data on indications for hysteroscopic metroplasty, details of patient management from pretreatment to follow-up, and pregnancy course and delivery were collected by questionnaire. Main indications were two or more abortions and primary infertility. Most procedures were performed with the resectoscope, followed by scissors and laser. Few minor complications occurred. Pregnancy rates were good. CONCLUSION: Hysteroscopy is safe and effective treatment of septate uterus in terms of both pregnancy rate and outcome.

Adult↗
PubMed1998

Pidotimod in the management of vulvar papillomatosis: double-blind clinical trial versus placebo.

To investigate whether the immune system improvement induced by pidotimod increases the rate of spontaneous disappearance of vulvar papillomatous lesions, a multicenter, double-blind, placebo-controlled, randomized clinical trial was performed. Forty-nine patients (23 in the pidotimod group and 26 in the placebo group) with first diagnosis of vulvar papillomatosis as shown by clinical and histological findings underwent 90-day treatment with oral 800-mg pidotimod once a day or identical placebo. The main outcome measure was the difference between vulvar papillomatous infected area before and after treatment judged by the following: complete regression (complete disappearance of all papillomatous lesions); partial regression (a decrease of at least 75% of the infected area); no response (a decrease of less than 75% of the infected area or new viral lesions not present at baseline). Forty patients completed the trial according to the study protocol and were entered in the "per protocol" analysis of efficacy. Complete regression was observed in 12 of 18 patients (66.7%) receiving pidotimod compared with 7 of 22 patients (31.8%) receiving placebo. The total infected surface area at the end of treatment was 10.1 +/- 18.5 mm2 (mean +/- SD) in the pidotimod arm and 198.3 +/- 399.2 mm2 in the placebo arm (p < 0.05 between treatment). Notwithstanding the fact that better results were obtained in the pidotimod group, more data are needed to confirm our encouraging results.

Administration, Oral↗
PubMed1997

Short-term therapy for recurrent abortion using intravenous immunoglobulins: results of a double-blind placebo-controlled Italian study.

It is still unclear whether i.v. immunoglobulins (Ig) can facilitate the reproductive prognosis of women who have suffered recurrent pregnancy loss. We report the results of a multicentre placebo-controlled study on the effect of Ig administration on pregnancy outcome in 46 women who had suffered at least three recurrent miscarriages. All were screened to exclude chromosomal or Müllerian abnormalities, the presence of antinuclear antibodies, lupus anticoagulant (LA) or elevated titres of anticardiolipin antibodies which may have revealed an underlying autoimmune problem. To avoid a selection bias towards ongoing pregnancies, i.v. Ig or placebo were administered between weeks 5 and 7 of gestation for 2 consecutive days as soon as each woman knew she was pregnant and before embryonic heart activity could be detected. A further infusion was administered at week 8 when ultrasonography confirmed an ongoing embryonic development. In all, 68% of the women who received Ig went to term versus 79% of those who received a placebo (not significant), with no significant differences in the pregnancy course or the perinatal outcome. These results suggest either that women with recurrent miscarriages who have no recognized cause of pregnancy loss have a good reproductive prognosis without any treatment or that the emotional care associated with the administration of a placebo can indirectly facilitate the progression of pregnancy.

Abortion, Habitual↗
PubMed1996

Laparoscopic-ultrasonographic combined technique for the creation of a neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome.

OBJECTIVE: To create a neovagina using a combined laparoscopic and ultrasonographic technique in Mayer-Rokitansky-Kuster-Hauser syndrome by modification of Vecchietti's operation. DESIGN: Case report. SETTING: Division of Physiopathology of Reproduction, University of Palermo, Palermo, Italy. MAIN OUTCOME MEASURE(S): The advancement of the needle from the pseudohymen, through the vesicorectal space using a triple contrast ultrasonographic technique. RESULT(S): The ultrasonographic scanning guides the accurate transit from external genitalia to the peritoneal cavity. CONCLUSION(S): This original approach allowed a safe and rapid creation of a neovagina in a case of Mayer-Rokitansky-Kuster-Hauser syndrome.

Abnormalities, Multiple↗
PubMed1996

Treatment with a gonadotrophin releasing hormone agonist before endometrial resection: a multicentre, randomised controlled trial.

OBJECTIVES: To ascertain whether treatment with a gonadotrophin releasing hormone agonist before endometrial resection reduces absorption of distension fluid and operating time and facilitates the procedure. DESIGN: A multicentre, prospective, randomised controlled study. PARTICIPANTS: Seventy-one premenopausal women with established menorrhagia. INTERVENTIONS: Eight weeks of goserelin depot treatment before endometrial resection of immediate surgery in the early proliferative phase of the cycle. MAIN OUTCOME MEASURES: Irrigation fluid deficit, operating time and degree or difficulty of the procedure. RESULTS: After randomisation eight women withdrew from the study, leaving 33 women in the goserelin arm and 30 in the immediate surgery arm. Mean (SD) operating time was 15.1 (9.0) min in the goserelin group versus 16.9 (9.5) min in the controls; mean difference + 1.8 min, 95% CI, -2.9 to + 6.4. Mean (SD) distension medium deficit was, respectively, 422 (287) ml versus 564 (291 ml); mean difference + 142 ml, 95% CI -4 to + 288. The goserelin effect was restricted to the 29 women with adenomyosis as the mean (SD) fluid deficit was considerably less in the 19 treated women than in the 10 controls (299 (206) ml versus 597 (135) ml; mean difference + 298 ml, 95% CI + 149 to + 447). The surgeons classified the intraoperative difficulties as none in 6, minimal in 20, moderate in 7, and severe in no cases in the goserelin group; corresponding figures in the group without pretreatment were 2, 14, 13, and 1. CONCLUSIONS: Goserelin administration before endometrial resection may reduce absorption of fluid at surgery in women with adenomyosis and may facilitate intrauterine operating conditions.

Absorption↗
PubMed1996

[The role of heparin sulfate in the treatment of pregnant women with circulatory deficiency syndrome].

The syndrome from circulatory maternal, precocious and belated deficit could influence the appearance of a vast range of obstetric incluted pathology: recurrent abortions, delays of increase, pre-eclampsia, fetal and neonatal dead. The principal biochemical implicated mechanism has represented from alteration of equilibrium trombossano prostaciclina with adjunct vasoconstriction and uterum-placental hypoperfusion. In this study the authors have estimated the efficacy and the compliance of the heparan sulfate in 30 pregnant patients to risk for vascular pathology. In all these cases, the rational to the use the heparan sulfate had represented from the necessity to associate a therapy anteplatelet with associate an fibrinolitic activity. The percent of pregnancies with alive and vital fetuses was of the 90%; the collateral effects have been inconsiderable. The authors retain useful effect randomize checked studies to evaluate further the real results this therapy.

Abortion, Spontaneous↗
PubMed1995

Computerized colposcopy: results of a pilot study and analysis of its clinical relevance.

OBJECTIVE: To evaluate the clinical usefulness of a computer based system that stores and analyzes high-resolution digital colposcopic images. METHODS: Three hundred patients referred to our institutions for evaluation of abnormal cervical cytology underwent colposcopy with development of digital images. The first 70 patients were used to standardize the system. The images obtained from 188 evaluable patients were analyzed and scored by software according to internationally recognized colposcopic criteria. The results were compared with traditional colposcopic diagnoses and with corresponding histology results using kappa statistics for inter-observer agreement and McNemar test for significance. RESULTS: The exact concordance rate between computer-aided impressions and histology (85.1%, kappa = 0.77) was significantly higher (P < .001) than that observed between traditional colposcopic findings and histology (66%, kappa = 0.40). The computer-assisted colposcopy was much more accurate than traditional colposcopy in diagnosing high-grade lesions (91.2 versus 61.8% of exact concordance, P < .001) as well as normal histology (74.1 versus 34.5%, P < .001), but not significantly different when evaluating low-grade lesions (89.6 versus 86.5%). CONCLUSION: The integration of computer imaging and colposcopy can improve the colposcopic diagnostic accuracy. An inexperienced colposcopist may benefit from computerized support to obtain the most appropriate histologic specimen, and eventually access to distant consultation via modem or through on-line services. An additional advantage is the ability to develop a space-saving permanent record of digitized images readily available to review a patient's cervical history or perform effective programs of quality control in colposcopy.

Adolescent↗
PubMed1995

Endoscopic management of a case of 'complete septate uterus with unilateral haematometra'.

Endoscopy and ultrasound was used to diagnose a 13 year old virgin girl who presented with dysmenorrhoea and suspected right side adnexal tumescence. The girl was found to have a complete septate uterus with non-communicating right hemicavity and haematometra, an exceptional type of Müllerian anomaly. After pretreatment with buserelin, hysteroscopic metroplasty was successfully performed.

Adolescent↗
PubMed1995

Short-term use of Goserelin depot in the treatment of dysfunctional uterine bleeding.

UNLABELLED: STUDY-PLAN: an open study aimed at evaluating the results of a short term therapy (3 months) with Goserelin depot as a medical treatment of premenopausal dysfunctional uterine bleeding. PATIENTS: 60 premenopausal women (aged 36-50) with dysfunctional uterine bleeding, presenting simple endometrial hyperplasia. RESULTS: after the treatment, spontaneous menstrual bleeding recurred in 57/60 patients, while 3/60 (5%) patients remained amenorrheal during the whole period of follow-up, showing a postmenopausal hormonal pattern. In the first post-therapy menstrual cycle all the 57 patients had a bleeding score < 100; patients relapsing during the second, third and fourth cycle were respectively 2/54 (3.7%), 5/48 (10.7%) and 17/38 (44.7%). The fourth post-therapy cycle was delayed 6-9 months after the last injection of Goserelin. Both the mean blood loss and the mean duration of bleeding were significantly reduced in all post-therapy cycles. Eleven patients were anaemic before therapy (Hb < 12 g%); Goserelin treatment resulted in a normalization of the hematological parameters. At the end of treatment a small area of hyperplasia persisted in only 4/60 patients (6.7%). Localised or diffused hyperplasia were found respectively in 5/54 (9.3%) and in 1/54 patients (1.9%) at three months, and in 5/48 (10.4%) and 4/48 (8.3%) at a six-month follow-up. Side effects were infrequent. CONCLUSIONS: the long symptom-free period and the low incidence of side effects indicates Goserelin depot as a valuable medical treatment for dysfunctional uterine bleeding.

Adult↗
PubMed1993

Role of leuprolide acetate depot in hysteroscopic surgery: a controlled study.

OBJECTIVE: To evaluate leuprolide acetate (LA) depot (Enantone Depot, Takeda, Italy) when administered preoperatively in hysteroscopic surgery. DESIGN: Prospective, comparative study. SETTING: University Clinic of Obstetrics and Gynecology. PATIENTS: One hundred ninety-three patients (114 pretreated with LA depot and 79 controls) who underwent hysteroscopic surgery for uterine septa (group A), submucous fibroids (group B), and abnormal uterine bleeding (group C). RESULTS: In groups B and C there was a significant reduction in the operating time, bleeding during the operation, and the amount of distention medium required after LA depot administration, but no significant differences in surgical feasibility or efficacy were found in group A patients after treatment. CONCLUSION: Preoperative treatment with LA depot is effective in making hysteroscopic surgery easier.

Adult↗
PubMed1990

Endometrial carcinoma and its precursors: early detection and treatment.

Endometrial carcinoma is the most frequent genital neoplasia in women. Precursors of this condition include endometrial hyperplasia, particularly when cytologic atypia occurs. Among the frequent early clinical manifestations of endometrial carcinoma is abnormal uterine bleeding that must be differentiated from bleeding associated with benign conditions. Early detection of endometrial carcinoma and its precursors in women at risk is the best prophylactic measure in the final therapeutic outcome. In this review, the accuracy of methods of early diagnosis of endometrial carcinoma and its precursors is assessed, in order to provide early therapy and optimum prognosis. The epidemiology of endometrial carcinoma, as well as the risk factors for the development of this neoplasia, are also reviewed. A histologic classification of endometrial hyperplasia and carcinoma of the endometrium, based on current theories of histopathogenesis, is included.

Biopsy↗