Search PubMed⌕ Search

Biomedical subjects

C Nappi

Publications and source records attributed to C Nappi.

At least 127 records · Page 7Linked to original sources
PubMed1987

Domperidone antagonizes bromoergocriptine--induced nausea and vomiting without affecting its inhibition of prolactin secretion in puerperal women.

In the present study, 122 post puerperal women received at random bromoergocriptine, domperidone, bromoergocriptine plus domperidone or placebo treatment. Domperidone started 20-24 h after delivery and given for 10 or 15 days did not antagonize either the decrease in serum PRL induced by bromoergocriptine or the inhibition of lactation. It did suppress nausea and vomiting in the patients. The results are compatible with the idea that domperidone binds with a higher affinity than bromoergocriptine to DA (dopamine) receptors in the area postrema or the stomach. The converse phenomenon occurs at the level of the DA receptors on the PRL- secreting cells of the anterior pituitary gland.

Adult↗
PubMed1987

Effect of a combination of ethinylestradiol and desogestrel in adolescents with oligomenorrhea and ovarian hyperandrogenism.

Nine oligomenorrheic adolescent girls with a clinical and hormonal picture of ovarian hyperandrogenism were treated with a monophasic oral contraceptive (OC) containing 0.03 mg ethinylestradiol (EE) plus 0.150 mg desogestrel (DOG) for six months. The same treatment was administered in eight eumenorrheic adolescents. In both groups the treatment induced a decrease in LH, FSH, androstenedione (delta 4-A), testosterone (T) and dehydroepiandrosterone sulphate (DHEA-S) levels associated with a significant sex-hormone-binding globulin (SHBG) increase. In oligomenorrheic adolescents a marked decrease in both the total ovarian volume and the number of cystic follicles was observed. All parameters, except SHBG and ovarian volume in hyperandrogenic girls, returned to pre-treatment values 3 months after treatment. Subjective improvement of skin problems occurred in six of the nine oligomenorrheic girls. Although temporary, the EE + DOG formulation pill is effective in the treatment of ovarian hyperandrogenism in adolescents. It may also be useful for the prevention of the progressive transformation in the 'classical' and 'irreversible' micropolycystic ovary of adult age.

Adolescent↗
PubMed1987

Opioid regulation of luteinizing hormone in amenorrheic patients after therapy for induction of ovulation.

This study evaluated the activity of central opiate receptors modulating luteinizing hormone (LH) secretion before and during treatment with human menopausal gonadotropin (n = 8) or purified human urinary follicle-stimulating hormone (n = 6) in 14 patients with hypogonadotropic hypogonadism (n = 6) or secondary amenorrhea (n = 8). LH response to saline infusion and naloxone administration (4 mg intravenously) was assessed. As control, 6 normal ovulating women were studied. Before therapy, all amenorrheic patients showed no LH increase after naloxone injection. Gonadotropin treatment restored the naloxone-induced LH response at preovulatory and midluteal phases in ovulating patients with secondary amenorrhea. The same response was present in spontaneously ovulating women but was absent in the hypogonadotropic hypogonad patients, despite the gonadotropin therapy's efficiency. In conclusion, when the alteration of gonadotropin-releasing hormone synthesis and/or release is reversible, the opioid system actively participates in the regulation of the hypothalamus-pituitary-gonadal axis.

Adult↗
PubMed1987

Differences in the opioid control of luteinizing hormone secretion between pathological and iatrogenic hyperprolactinemic states.

The cause of the amenorrhea that occurs in patients with hyperprolactinemia is unknown. The involvement of endogenous opioid peptides in the inhibition of GnRH release as a central factor leading to the hypogonadotropic state has been recently described. This study analyzed the LH response to opiate receptor blockade by naloxone (4 mg, iv) in groups of subjects with amenorrhea due to hyperprolactinemia of different etiologies. Patients presenting with a PRL-secreting pituitary adenoma (n = 7), idiopathic hyperprolactinemia (n = 9), or hyperprolactinemia during pharmacological treatment for schizophrenia (n = 5) were studied. Furthermore, to evaluate whether high circulating PRL levels influence the activity of the opioid system after the menopause, a group of seven postmenopausal subjects was tested before and 1 week after the administration of metoclopramide (10 mg, three times a day), a dopamine receptor antagonist. Normal premenopausal women (n = 6) served as controls. Naloxone significantly increased plasma LH levels in both prolactinoma and idiopathic hyperprolactinemic patients (P less than 0.01 vs. basal and placebo). In neither of those groups was a significant correlation found between the plasma LH response to naloxone and basal plasma PRL levels. In contrast to pathological hyperprolactinemia, blockade of opiate receptors did not significantly change LH secretion in either amenorrheic women with pharmacologically induced hyperprolactinemia or postmenopausal women. These results suggest that the effect of hyperprolactinemia on opioid modulation of LH secretion is related to the nature of the hyperprolactinemic state, supporting the existence of increased opioid inhibition of LH levels in pathological hyperprolactinemia.

Adenoma↗
PubMed1986

Plasma beta-endorphin levels in anovulatory states: changes after treatments for the induction of ovulation.

The goal of this study was to evaluate the effects of menstrual cyclicity on plasma beta-endorphin (beta-EP) levels. For this purpose, beta-EP and cortisol plasma concentrations were measured during the menstrual cycle in healthy control subjects (n = 12), in patients affected by anovulatory syndrome (n = 6), and in amenorrheic patients (n = 8). In the same patients, beta-EP and cortisol were also measured under treatment for the induction of ovulation with pulsatile luteinizing hormone-releasing hormone or human menopausal gonadotropin plus human chorionic gonadotropin administration. In spontaneous and pharmacologically induced ovulatory cycles, a significant preovulatory rise of plasma beta-EP levels was always evident. Constant levels were found in the other periods of ovulatory cycles and in the patients affected by anovulatory syndrome and primary amenorrhea. Cortisol levels did not show any significant change throughout the cycle, either in controls or in patients before or after treatment. This result suggests that when ovulation occurs, plasma beta-EP levels show a relevant rise, the physiologic significance of which remains to be elucidated.

Adult↗
PubMed1985

Breast carcinoma metastasized in ovarian thecoma (a case report).

We describe a patient with breast cancer metastatic to ovarian thecoma. This finding, to the best of our knowledge, has yet to be reported in literature regardless of the fact that there are many gynecological neoplastic associations. Our hypothesis is that this unusual finding is not accidental, but rather benign lesions may be natural resting sites for metastatic disease. An autopsy series is required to elucidate this incidence.

Adult↗
PubMed1985

Increased retraction of fibrin clots by endothelial cells of infants of diabetic mothers.

Cultured endothelial cells (EC) from the umbilical veins of infants of non-diabetic mothers induced retraction of fibrin clots formed by addition of thrombin to cell-free plasma. Fibrin clot retraction activity increased with time, reaching a maximum within 24 hours and was inhibited at 4 degrees C or in the presence of EDTA. This retraction had many characteristics in common with that induced by platelets. EC obtained from the umbilical veins of infants of poorly controlled insulin dependent diabetic mothers (IDDM) showed similar patterns of retraction. However, compared to normals, these cells induced greater retraction. Since the retraction of fibrin clots is thought to promote the exposure of sub-endothelial layers and since such an exposure plays a major role in thrombogenesis, we suggest that retraction of fibrin clot by EC should be taken into account in evaluating pre-thrombotic states.

Cells, Cultured↗
PubMed1983

An uncommon case of gonadoblastoma.

Gonadoblastoma occurs almost entirely in patients with pure mixed gonadal dysgenesis or in male pseudohermaphrodites. A report of a patient with monolateral gonadoblastoma who sought consultation for primary amenorrhea is presented. Telarche and adrenarche occurred spontaneously at age 12. No signs of clitoromegaly or hirsutism were present. Endoscopic examination and biopsy specimens revealed absence of uterus, monolateral gonadoblastoma and controlateral teratoma in normally developed gonads. Serum gonadotrophins, estrogens and progesterone levels showed a biphasic secretion pattern. 46, XX karyotype was found on peripheral blood cells, skin fibroblasts and ovarian tissue.

Adolescent↗
PubMedDate not supplied

Serum leptin levels in postmenopausal women: effects of transdermal hormone replacement therapy.

OBJECTIVE: To evaluate serum leptin levels in postmenopausal women who are receiving hormone replacement therapy (HRT) and postmenopausal women who are not receiving HRT with similar body mass index (BMI) to determine whether estrogens exert effects on leptin secretion. DESIGN: Cross-sectional, prospective study comparing serum leptin levels in premenopausal women, postmenopausal women who were not receiving HRT (group A), and postmenopausal women who were receiving HRT (group B). RESULTS: Serum leptin levels were significantly higher in group A in comparison to group B and control women (15.82 +/- 6.6 ng/ml, 8.14 +/- 4.17 ng/ml, and 10.12 +/- 5.48 ng/ml, respectively; p < 0.05). Total fat mass (FM) was found to be significantly higher in untreated postmenopausal women in comparison to the other two groups (22.66 +/- 2.79 kg vs. 19.14 +/- 3.39 kg vs. 18.98 +/- 3.82 kg; p < 0.05). No significant difference was observed in weight, height, BMI, blood pressure, or glucose levels among the three groups. A linear correlation between BMI and serum leptin levels as well as between total FM and serum leptin levels was observed in all groups. No correlation was found between serum leptin levels and months from menopause and months of HRT. CONCLUSIONS: Our results show that serum leptin is increased in untreated postmenopausal women, possibly as a consequence of the increase in FM, and that HRT reduces serum leptin levels to premenopausal values. These data need further investigation by a broader longitudinal study.

Body Mass Index↗
PubMedDate not supplied

Reproductive endocrine disorders in women with primary generalized epilepsy.

It is known that women suffering from temporal lobe epilepsy may frequently present reproductive endocrine disorders (REDs). We hypothesized that a high occurrence of REDs could be found also in primary generalized epilepsy (PGE), and therefore investigated the hormonal and ovarian echographic profiles in 20 PGE female patients of reproductive age. Fourteen reported normal menstrual cycles, while 6 complained of longstanding menstrual irregularities. All but three patients were receiving antiepileptic drug (AED) therapy. In all subjects, the basal levels of gonadotropins, prolactin, and gonadal steroids were assayed. The response of luteinizing hormone (LH) to gonadotropin-releasing hormone was also investigated and ovarian ultrasonographic findings were evaluated. In five of six patients with menstrual problems (25% of the group), a well-defined RED was diagnosed (polycystic ovarian disease in three cases and hypothalamic ovarian failure in two). The 14 patients with normal menstrual cycles showed an elevation of mean basal follicle-stimulating hormone and prolactin, and a blunting of mean LH response. Our results suggest that a high occurrence of REDs may be found also in PGE. We hypothesize that a neurotransmitter dysfunction might be the common pathogenetic mechanism resulting in both REDs and PGE. The hormonal alterations observed in the patients with normal menstrual cycles seem to support our hypothesis. Previous data seem to rule out a possible AED effect accounting for the hormonal findings observed in our series. However, further studies are needed to confirm our preliminary results.

Adolescent↗
PubMedDate not supplied

[Ovarian drilling in minilaroscopy and local anesthesia in the therapy of polycystic ovarian syndrome].

BACKGROUND: To evaluate the feasibility of ovarian drilling using minilaparoscopy under local anesthesia and to determine its efficacy in the surgical treatment of polycystic ovarian syndrome. METHODS: Prospective randomized study carried out in an out patient service on 62 women affected by PCOS divided into two groups: 32 patients (group A) underwent bilateral ovarian drilling by minilaparoscopy under local anesthesia and 30 patients (group B) underwent bilateral ovarian drilling by traditional laparoscopy under general anesthesia. RESULTS: Operation times were not different between the two groups. Discharge time was significantly lower in group A in comparison to group B. The rate of patients discharged after 2 hours was significantly higher in group A. The need for additional analgesia was lower in group A in comparison to group B. Serum LH, A and T levels were significantly reduced after surgery in both groups. Pregnancy rate after 1-year follow-up was higher, although not significantly in group A. Ovulation and abortion rates were not different between the two groups. CONCLUSIONS: Ovarian drilling in minilaparoscopy under local anesthesia is a new option for gynecologists, allowing similar therapeutical results to those achieved by traditional laparoscopy, but with the benefits of a less invasive technique that can be carried out in an outpatient service without the need for general anesthesia.

Adult↗
PubMedDate not supplied

[Hysteroscopy in the diagnosis of endometrial carcinoma].

OBJECTIVE: To determine the diagnostic value of hysteroscopy in endometrial cancer. METHODS: 216 patients underwent hysteroscopy and endometrial biopsy. A comparison was made between hysteroscopic impression and histological examination. RESULTS: Sensitivity of hysteroscopy for diagnosing of endometrial cancer was 83.33%, specificity was 99.04%, positive predictive value was 71.42% and negative predictive value was 99.52%. CONCLUSION: Hysteroscopy was found to have a very important role in the diagnosis of endometrial cancer.

Biopsy↗
PubMedDate not supplied

[Hysteroscopy in suspected endometrial carcinoma: a comparison among cavity-distention media].

OBJECTIVE: To evaluate satisfaction rate, efficacy and complication rate of carbon dioxide (CO2) vs normal saline as uterine distension medium for outpatient diagnostic hysteroscopy in patients with suspicious endometrial cancer. METHODS: Thirty-eight undergoing outpatient hysteroscopy performed with carbon dioxide (group A) or normal saline (group B). Quality of vision of uterine cavity, procedure time, complications, patient discomfort, satisfaction rate have been evaluated. RESULTS: In group B a significant reduction in abdominal pain, shoulder tip pain and a lower incidence of vasovagal reactions were observed in comparison to group A. In normal saline group we found a higher satisfaction rate and a lower operative time in comparison to the CO2 group. CONCLUSIONS: Uterine distension with normal saline seems to have less adverse effects and is better accepted by patients.

Abdominal Pain↗
PubMedDate not supplied

[Evaluation of endometrial carcinoma using hysteroscopy and transvaginal echography].

OBJECTIVE: To compare transvaginal ultrasound and hysteroscopy in the diagnosis of endometrial cancer in women with postmenopausal bleeding. METHODS: Sixty postmenopausal women with abnormal uterin bleeding underwent to transvaginal ultrasound, hysteroscopy and endometrial biopsy. RESULTS: USG and hysteroscopy demonstrate respectively a sensitivity of 96% and 90%, specificity of 88% and 94%, positive predictive value of 86% and 92% and negative predictive value of 92% and 96% and accuracy of 89% and 94%. CONCLUSIONS: The accuracy of hysteroscopy is significantly higher than transvaginal sonography for the detection of endometrial cancer.

Aged↗