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Biomedical subjects

A Perino

Publications and source records attributed to A Perino.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Immunologic recurrent abortion: comparison between immunotherapies.

The Authors record the results in a group of patients with immunologic recurrent abortion (IRA) treated with two different immunoprophylaxis regimen. The first one is an active prophylaxis therapy with preparation and administration from donor mononucleates. According to their previous original experience, the Authors started giving high doses of IV-Ig (HD IV-Ig) in a second group of pregnant patients with the same diagnosis of immunologic recurrent abortion (IRA). The results of this not randomized study show better reproductive outcome in the group treated with use of HD IV-Ig.

Abortion, Habitual↗
PubMedDate not supplied

Assessment of blocking activity in patients with at least two consecutive spontaneous abortions.

The activity of the blocking factor (BF) was studied in 88 patients affected by recurrent abortion syndrome (RAS) by means of the determination of lymphocyte proliferation rate (LPR) in one-way mixed maternal-paternal lymphocyte cultures (MLC). Forty patients (45.5%) showed inadequate blocking activity (LPR greater than 80%). Pearson's correlation did not reveal any link between patient age and LPR (m2 = 0.031), or between LPR and number of aborted pregnancy (m20.058). Fifteen of the 88 patients had had only two consecutive abortions, but Pearson's correlation did not result in any particular differences in the link between LPR and number of abortions in this group; we therefore felt perfectly justified in extending the study to these subjects.

Abortion, Habitual↗
PubMedDate not supplied

The use of GnRH agonists depot for the treatment of dysfunctional uterine bleeding.

The Authors report their experience with the use of GnRH analogue (Goserelin) in 35 women with abnormal uterine bleeding due to low-risk hyperplasia of the endometrium. A hysteroscopic and histopathological follow-up was performed at 2 months and 6 months after treatment. The results show a significantly effectiveness of Goserelin in treating dysfunctional uterine bleeding.

Adult↗
PubMedDate not supplied

The pharmacologic therapy of post-cauterization and post-laser vaporization with polydeoxyribonucleotide.

The most widely used ablative techniques in the therapy of benign cervical lesions are physical treatments with cauterization or laser vaporization; these are, however, usually used for the largest or symptomatic lesions. Many Authors suggest, after physical treatment, the use of topical chemotherapy in order to abolish any possible inflammatory reaction. The use of drugs such as polydeoxyribonucleotide (PDRN) 5 mg (POLIDES 5--Farmigea), provided with reepithelialization and anticomplement action, seems to promote a quicker recovery of the cauterized or vaporized zone, avoiding, at the same time, the secondary inflammatory reaction. The Authors have assessed the quality of reepithelialization by means of PDRN 5 mg ovules of the cervical zone which has been previously subjected to laser vaporization or cauterization for benign cervical lesions or CIN I. The trial was performed with two groups of patients: Group A: laser vaporization, 45 patients, 23 of whom treated with PDRN and 22 with placebo. Group B: cauterization, 46 patients, 24 treated with PDRN and 22 with placebo. The treatment with PDRN 5 mg ovules started on the day of physical treatment and continued for twelve days. The examination of the patients, performed before the treatment (TO) included the following tests: bacteriological test; PAP-smear, colposcopic examination with eventual direct biopsy. The first follow-up (T 1) was performed after 14 days and included a Pap-smear, colposcopic examination and microcolpohysteroscopy (MC) carried out in the zone where physical treatment had been performed, in order to obtain a map of the reepithelialization process process.(ABSTRACT TRUNCATED AT 250 WORDS)

Cautery↗
PubMedDate not supplied

Endometrial ablation: principles and technique.

Uterine bleeding may be caused either by benign organic pathology as well as different dysfunctional conditions. Medical treatment with progestins, danazol or GnRH analogues is usually used as the first choice therapy. Where the symptoms persist, hysterectomy is generally proposed; it has been calculated that from 500,000 to 700,000 such operations are performed annually in the United States. The authors review the state of the art of the endometrial ablation as an alternative to hysterectomy and other medical therapy. Endometrial ablation either by means of the YAG-laser or with the resectoscope, would seem to play a role in well-selected cases of dysfunctional uterine bleeding. In the authors opinion a multicenter study on large numbers of patients is needed in order to confirm these preliminary results.

Electrosurgery↗
PubMedDate not supplied

New perspectives for the therapeutic management of recurrent immunological abortion.

Up to now the only effective therapy for recurrent abortion syndrome due to the absence of the so-called blocking-factor has been active immunotherapy with partner or third-party donor mononucleates. The Authors report their in vivo and in vitro experience with high-dose intravenous gammaglobulin (i IV Ig) in order to treat women with recurrent abortion syndrome. In the Authors opinion there are sufficient experimental reasons for continuing this research with IV Ig obtained from multiparous women plasma pools.

Abortion, Habitual↗
PubMedDate not supplied

Immunological problems in the recurrent abortion syndrome.

The recurrent abortion syndrome has been considered a serious obstetrical problem, since it was not possible to diagnose the causes in over 40% of the cases. Great progress has now been made with the knowledge of the immunological mechanisms involved in the maintenance of pregnancy. The disorders of such immunological mechanisms, both due to auto- or alloimmune problems, are demonstrated in about 40% of the cases of recurrent abortions. The Authors have studied a group of 56 patients with recurrent abortion syndrome in a complex diagnostic work-up involving: 1) The research of an autoimmune cause; 2) The research of the presence of the Blocking-factors by means of one-way mixed lymphocyte cultures; 3) The research of an altered antipaternal lymphocytotoxic activity or of an excessive HLA-sharing. According to the results of the investigations, several forms of therapeutic management have been used: 1) Steroids-aspirin-calcic heparin for Autoimmune cases. 2) Active immunotherapy for the cases due to the lack of blocking factors. 3) Calcic heparin for the altered antipaternal lymphocytotoxic activity. At the moment it is difficult to evaluate the results of pregnancy rate with this type of therapeutic management because of the too short follow-up.

Abortion, Habitual↗
PubMedDate not supplied

Hysteroscopic metroplasty: the role of ultrasound in the diagnosis and monitoring of patients with uterine septa.

52 patients with septate uterus underwent hysteroscopic metroplasty in the Obstetric and Gynecologic Clinic "R" in Palermo. In this group of patients ultrasound examinations were also performed in order to define their role in diagnosis of type of malformations and in monitoring the endoscopic surgical procedure. Preliminary results seem to indicate that real-time ultrasound is a reliable technique for both purposes.

Adult↗
PubMedDate not supplied

Gamete intrafallopian transfer: different routes of transfer.

The Authors report their own experience and results using different approaches to oocyte pick-up and gamete transfer for gamete intrafallopian transfer (GIFT). The overall pregnancy rate of GIFT is 35.86% (66 pregnancies on 184 cases of GIFT). The Protocol I (Laparoscopic oocyte retrieval and gamete transfer) is presently the more used and gives better clinical results (pregnancy rate of 37.7%); in the Author's opinion, the protocols III (echographic pick-up + IVF + laparoscopic delayed zygote intrafallopian transfer (ZIFT), and VII (Laparotomic pick-up and transfer) are interesting complementary techniques for GIFT.

Adult↗
PubMedDate not supplied

Is hysteroscopy of value in the investigation of female infertility?

A prospective multicentre study was designed to ascertain the value of hysteroscopy in the evaluation of female infertility. The study comprises 619 CO2 hysteroscopies in women complaining of infertility. Four hundred and ninety nine examinations (80%) were performed without anaesthesia or cervical dilatation. Twenty eight cases of malformation were diagnosed. Adhesions were found in 68 patients (11%), polypi in 56 (9.1%) and submucous fibroids in 51 (8.2%). Endometrial hyperplasia was diagnosed by hysteroscopy in 67 patients, but there was only 42% histological correlation. Examination of the tubal ostia by hysteroscopy revealed 26 patients (4%) with unilateral tubocornual polyps and one with bilateral polyps. The correlation with hysterosalpingography (HSG) in 185 patients was poor. In 20% where the HSG was reported as normal there were hysteroscopically demonstrable lesions whereas there were false positive findings at HSG in 35% of cases. Hysteroscopy is the only technique which provides an accurate clinical evaluation of the uterine cavity although it does not provide significant information about the cervical canal or fallopian tubes.

Adult↗
PubMedDate not supplied

Treatment of endometrial hyperplasia with levonorgestrel releasing intrauterine devices.

The effectiveness of a new levo-norgestrel releasing intrauterine device is assessed in fourteen patients with histologically confirmed hyperplastic lesions of the endometrial mucosa. The morphologic response of the hyperplastic endometria to the action of the levo-norgestrel in this study explains the regression of the cases so treated.

Adult↗
PubMedDate not supplied

Direct intraperitoneal insemination (DIPI) for the treatment of refractory infertility unrelated to female organic pelvic disease.

344 couples with infertility unrelated to female organic pelvic disease underwent Direct Intraperitoneal Insemination (DIPI) for a total of a 429 DIPI cycles. Pregnancy per couple was 16.5% and per DIPI cycle 13.2%. DIPI was particularly effective in cases of infertility due to cervical mucus insufficiency and unexplained infertility with results respectively of 33.7% and 30.4% per couple and 30.7% and 28.7% per DIPI cycle. On the contrary, the results regarding male subfertility were 12.5% per couple and 10.5% per DIPI cycle. A significant difference was found (X2 A = 16.48, p less than 0.001) between these results and those of the group composed of cases of cervical mucus insufficiency and unexplained infertility. In cases of antisperm iso- and autoimmunization the results were on the whole poor, and were in any case influenced by corticosteroid pretreatment. The Pellet Swim-up Test (PST) proved to be a good prognostic sign for success of DIPI, since a significant difference was found between the PST group greater than or equal to 1.5 X 10(6)/ml (pregnancy per couple was 19.7% and per DIPI cycle 17.2%) and PST group less than 1.5 X 10(6)/ml (pregnancy per couple was 6.8% and per DIPI cycle was 4.5%) (X2 = 11.4. P less than 0.001).

Autoimmune Diseases↗
PubMedDate not supplied

Immuno-bead test (IgG-IgA-IBT) in cervical mucus for the diagnosis of antisperm isoimmunization in female infertile patients with negative or doubtful PCT.

57 infertile women belonging to infertile couples with negative or doubtful PCT underwent the following tests: Sperm Cervical Mucus Contacts Test (SCMC-Test), IgG-IgA-Immuno-Bead Test (IgG-IgA-IBT) in cervical mucus, Micro Sperm Immobilizing Test (Micro-SIT) in cervical mucus and Sperm Immobilizing Test (SIT) in serum. Et least one of the tests gave a positive result in 49.1% of the patients examined and there was a significant difference between the SCMC-Test and the IgG-IgA-IBT: the former was positive in 26 out of 45 patients (57.7%), while the latter was positive in 13 cases (28.8%), (chi 2 = 6.48, p less than 0.05). On the other hand, there was no significant difference between the cervical mucus IgG-IgA-IBT, cervical mucus Micro-SIT and serum SIT; these were positive in respectively 14 (24.5%), 18 (31.5%) and 17 (29.8%) in the 57 patients who underwent all the tests at the same time. Three of the four cases with a mildly positive result of the cervical mucus IgG-IgA-IBT, where the beads were located at the tail-tip, showed negative results to all the other tests performed. Cervical mucus IgG-IgA-IBT is therefore a fairly specific method for the determination of antisperm isoantibodies in the cervical mucus as long as the assessment of those cases with low positivity and beads located mainly at the tail-tip is performed carefully. It is advisable in these patients to take into consideration the results of more classical tests such as cervical mucus Micro-SIT.

Adult↗
PubMedDate not supplied

Endoscopic intrauterine resection: principles and technique.

The adaptation of urologic resection techniques in the uterine cavity has made it possible to perform endouterine surgery. This technique also permits a complete histological analysis of all the resected tissues. In the opinion of the Authors this systemic intrauterine resection leads to a complete transformation of gynecologic surgery, since it permits a considerable reduction of the hospitalization and recovery period.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

Indirect immuno-bead test in the seminal plasma and in the serum for the diagnosis of antisperm autoimmunization in male infertile patients.

125 male subjects belonging to infertile couples with negative or doubtful PCT underwent the following tests: IgG MAR Test, seminal TAT, indirect IgG-IgA-IgM-IBT in the seminal plasma, serum TAT, serum SIT, serum IgG-IgA-IgM-IBT. There was no significant difference in the incidence of autoimmunized patients and those resulting from classical testing methods (IgG MAR Test, seminal and serum TAT, serum SIT) (16%), and the results of the indirect IBT in the seminal plasma and in the serum (16.8%). The IBT showed an increase which was not, however, statistically significant in subjects with concomitant local and general autoimmunization, compared to the classical methods, (13.6% in the subjects examined versus 10.4%). There was a statistical significant difference between the results of the indirect IgA-IBT in the seminal plasma and those of the IgG MAR Test, (19 versus 12 positive patients, chi2 = 6.05, p less than 0.05). Furthermore, in 88.2% of the cases with concomitant positivity, the indirect IgA-IBT in the seminal plasma showed higher values than the indirect IgG-IBT in the seminal plasma. There was no significant difference between the results of the classical methods and the serum IBT, whereas both in the semen and in the serum the beads adhered mainly to the tail plus the tail up considering only the nemaspermic portion with the highest relative rate of adhered beads.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Evaluation of sperm immobilizing and sperm agglutinating seric activity in male subjects with or without positive IgG M.A.R.-test belonging to sub-fertile couples with negative or doubtful P.C.T.

In this study we have compared the results of autoagglutination, IgM M.A.R.-test, seric S.I.T. and seric T.A.T. in 75 men with normal seminal parameters belonging to sub-fertile couples in whom the only evident anomaly was the presence of negative or doubtful P.C.T. We compared a tight correlation between IgG M.A.R.-test and autoagglutination (IgG M.A.R.-test clinically positive in 82.8% of subjects with positive spermagglutination); between seric S.I.T. and IgG M.A.R.-test (S.I.T. positive in 58.3% of subjects with IgG M.A.R.-test clinically positive); between seric T.A.T. and IgM M.A.R.-test (T.A.T. positive in 69.4% of subjects with positive IgG M.A.R.-test). Such results proved the reliability of IgG M.A.R.-test as a screening test in the determination of male autoimmunization. Moreover, the possibility that they were the cases in which only the local antisperm activity was shown, underlines the necessity not to limit immunological research to only seric antibody titrations. The analyses of the types of mixed agglutination present in cases of positive IgG M.A.R.-test make us suspect that a quota of the agglutination type emh was due to the impossibility with such type of test to specify adequately the zones of G.R. sperm interaction involved in the formation of mixed agglutinates.

Adult↗