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Biomedical subjects

G Loverro

Publications and source records attributed to G Loverro.

At least 109 records · Page 6Linked to original sources
PubMed1985

The role of prenatal diagnosis in the perinatal management of urinary tract abnormalities.

The use of ultrasonography is one of the most appropriate and less invasive techniques for the identification of prenatal assessment of urinary tract anomalies. This technique is able to distinguish malformations which are not compatible with life from those which could benefit from appropriate prenatal management treatment in view of a successful outcome after birth. During the past three years, 13 cases of urinary tract anomalies were found and treated. On the basis of our experience, we believe that ultrasonography is especially indicated: to make an early diagnosis of the type of malformation; in the presence of a complex malformation, gives the physician the possibility of showing and explaining to the parents all the aspects involved in reconstructive surgery thus giving them the possibility to decide for abortion or not; to reveal latent malformations: in these cases postnatal treatment may be efficiently programmed. to prepare the mother for early cesarean section, thus avoiding the trauma of vaginal delivery in cases of high risk such as fetuses with hydronephrotic kidneys. Thus, together with more experience in the field of intrauterine microsurgery, the outlook on the future of fetuses with malformations is certainly becoming brighter.

Adult↗
PubMed1983

Analysis of mononuclear cell subsets in pregnancies with intrauterine growth retardation. Evidence of chronic B-lymphocyte activation.

We have examined the mononuclear cell (MC) subpopulations of 5 pregnant women: Three of them had a previous history of IUGR, whereas two were primiparae and presented IUGR at the term of gestation. IUGR was confirmed after delivery in three women. The analysis of MC subsets was performed by rosetting and immunofluorescence techniques; both heterologous antisera specific for human immunoglobulins and monoclonal antibodies specific for T cell antigens and for M1 and Ia-like antigens were used. The three patients with IUGR confirmed at birth presented numbers of circulating lymphoid cells positive for cytoplasmic IgM, IgG and IgA and with morphologic features of plasmablasts or plasma cells at least tenfold higher than in normal pregnant women at the term of gestation. Our data suggest that chronic activation of the lymphoid system occurs in pregnant women with IUGR. Maternal abnormal reactivity to fetal antigens or to undiagnosed chronic infections may be likely explanations for this phenomenon. Further studies are clearly needed to clarify the relationship between B-lymphocyte activation and pregnancy and to examine the hypothesis of an altered balance of the immunoregulatory T lymphocyte subsets in patients with IUGR.

B-Lymphocytes↗
PubMed1982

[Fetal glucose regulation: glycosylated hemoglobin in cord blood].

Glycosylated haemoglobins were assayed at delivery in 64 pregnant women (48 normals and 16 diabetics) in maternal and cord blood with the colorimetric method of Fluckigër and Winter-halter. A good correlation was observed between maternal and funicular glycosylated Hb (r = 0.67, p less than 0.001) in normal subjects; there wasn't any significant correlation in diabetic pregnant; (r = 0.29). Maternal glycosylated haemoglobins were compared to Schlichkrull's M of glycemic cycles in diabetic pregnant all these subjects showed a good glycemic regulation. Colorimetric technique can separate glycosylated haemoglobins from Hb F, and so allows their detection in cord blood. Glycosylated haemoglobin's assay in cord blood at delivery is an index of fetal glycoregulation in the last trimester of pregnancy and it represents a parameter of fetal pancreatic insulin incretion during intrauterine growth.

Blood Glucose↗
PubMed1982

Behaviour of immune complexes and the complement system in normal pregnancy and pre-eclampsia.

A quantitative study of the circulating immune complexes (IC) was carried out on women during normal pregnancy (286) and the post-partum period (20) and women with pre-eclampsia (30). Furthermore, the behaviour of the complement (C) system was followed. Results showed that IC were low in the first trimester of normal pregnancy (25.3%) and decreased in the following trimesters, whereas they were always present in pre-eclampsia. A very significant difference (p less than 0.0001) was seen when we compared the incidence of IC in normal pregnancy at the third trimester and the pre-eclamptic patients. The follow-up study of the IC, carried out on 4 pre-eclamptic women, showed an increase in the IC levels associated with the exacerbation of the pre-eclamptic picture and a decrease after delivery. The study of complement in normal pregnancy showed a decrease in C1-INH, C1s and C1q, whereas C3, C5, C9 and the properdin factor B increased during the following weeks of gestation; CH50 did not vary excepting during the 1st trimester. In the puerperium all values increased. There was no significant difference between the serum levels of the C components in the 3rd trimester of normal pregnancy and pre-eclampsia. High levels of C3d were observed in normal pregnancy at the 3rd trimester and in pre-eclampsia. The study of this split product of C3 showed that there is activation of the C system, but, since the synthesis of the C components is increased, activation could be masked. Alloantibodies and circulating IC could be the factors responsible for this activation in normal pregnancy and in pre-eclampsia, respectively.

Adult↗
PubMed1981

[The prune-belly syndrome. Antenatal diagnosis (author's transl)].

The authors describe an unusual case of the Prune-Belly Syndrome which was diagnosed antenatally using ultra-sound. They note at the same time that the urinary tract dilated very rapidly in the last weeks of pregnancy and that it was pointless to empty the fetal bladder repeatedly.

Adult↗
PubMed1979

[Action of complement in normal pregnancy and gestosis].

Behaviour of the complement system was studied in normal pregnancy, puerperium and in pre-eclampsia. CH50 showed no variations during normal pregnancy, excepting for first trimester, whereas it increased in puerperium. CVFAH50 increased steadily during all trimesters. C1q, C1s and C1-INH progressively decreased, while C3, C5, C9 and C3PA augmented. All values were clearly raised in puerperium. The decreased values of the early classical pathway components could be attributed to "blocking factors" (antibodies or immune-complexes) which could interfere with cellular immunity at fetoplacental level. The other components probably increase because there is a hormone-stimulated raised synthesis and a high turnover. The data obtained from pre-eclampsia did not reveal significant variations as compared to normal third trimester pregnancy, excepting for CVFAH50 which was reduced. This, however, does not exclude the possibility that there is an immunological pathogenesis of the pre-eclampsia, since activation of the C system is not always detectable in circulation.

Adult↗
PubMedDate not supplied

Hysteroscopy does not increase the risk of microscopic extrauterine spread in endometrial carcinoma.

Fluid hysteroscopy has been suspected to cause tumor dissemination in the abdominal cavity in endometrial cancer patients. The aim of our study was to evaluate the incidence of microscopic extrauterine spread according to diagnostic modality (dilatation & curretage, D&C, hysteroscopy, or both) in patients with endometrial carcinoma. A retrospective study was conducted on 147 patients with histologically proven diagnosis of endometrial carcinoma without macroscopic extrauterine disease. Fluid hysteroscopy was performed by using saline solution irrigated at a final flow of 150 ml/min with a intrauterine pressure ranging between 25 and 50 mmHg. Microscopic intraperitoneal disease and positive peritoneal cytology were considered the primary end-points of this analysis. Fifty-two patients (35%) had diagnosis of endometrial cancer made only by D&C, 56 (39%) underwent D&C and then hysteroscopy, and 39 (26%) had only hysteroscopy. Distribution of the patients in this three groups was casual, and clinicopathologic characteristics of the patients in the three groups were similar. Peritoneal cytology was positive in nine patients, 13 had microscopic ovarian metastases, and eight had microscopic involvement of the pelvic peritoneum or of omentum. Neither the presence of positive peritoneal cytology nor the findings of microscopic intraperitoneal dissemination were significantly associated with the diagnostic procedure employed for primary diagnosis (D&C or D&C plus hysteroscopy or hysteroscopy alone). We conclude that fluid hysteroscopy does not increase the risk of microscopic intraperitoneal spread in endometrial cancer patients as compared to D&C.

Adenocarcinoma↗
PubMedDate not supplied

Distant metastases in ovarian carcinoma.

Distant metastases are unusual at presentation and during the course of ovarian carcinoma. The aim of the present study was to determine the incidence and prognostic factors of distant metastases consistent with stage IV disease in ovarian cancer patients. A retrospective chart review was conducted on 162 patients with epithelial ovarian carcinoma treated at our Unit between 1991 and 2000. Pertinent clinical information, pathologic data, treatment, and prognostic factors for survival following documentation of distant metastatic disease were collected. The significance of the association between metastatic status and various clinical variables was assessed using the standard chi-square test. Survival time was calculated from the time of diagnosis of ovarian cancer and from the time of diagnosis of the distant metastases. A logistic regression procedure was used to estimate the odds of metastatic status given the presence of certain clinical variables. A total of 67 metastatic sites were diagnosed in 50 patients. Thirteen patients (8%) had distant metastatic disease at the time of diagnosis, 37 patients (22%) had distant metastases at the time of recurrent of progressive disease. Site of metastases were: liver, 21; pleura, 11; lung, 8; central nervous system and skin, 7 each; extra-abdominal lymph nodes and spleen, 5 each; bone, 2; and breast, 1. Significant risk factors for the development of distant metastases were stage, grade, and lymph node involvement. Median interval time between diagnosis of ovarian cancer and documentation of metastatic disease was 44 months (range 3-105), and at the time of diagnosis of distant disease, 36 of 50 patients (72%) had other sites of disease (intra-abdominal or extra-abdominal). Median survival from diagnosis of distant disease was 12 months (range 1-58). In univariate analysis performance status (P = 0.03), the presence of other sites of disease (P = 0.04) and interval time between diagnosis of ovarian cancer and documentation of distant metases (P = 0.03) were the only factors significantly associated with survival. Long interval time remained significant for prognosis in multivariate analysis also (P = 0.04). Distant metastasis consistent with stage IV disease is a late complication that occurs in about one third of ovarian cancer patients. Prognosis after documentation of distant metastases is poor. We conclude the most important prognostic factor associated with survival is the interval time between diagnosis of ovarian cancer and documentation of distant metastases.

Carcinoma↗
PubMedDate not supplied

Chemoradiation: A new approach for the treatment of cervical cancer.

Despite advances in screening, cervical cancer remains a major health problem worldwide. In an effort to improve loco-regional control, both neoadjuvant and chemoradiation have been trialed. Recently, five randomized clinical trials performed by the Gynecologic Oncology Group, the Radiation Therapy Oncology Group and the Southwest Oncology Group have demonstrated a significant advantage both in progression-free and overall survival when cisplatin-based chemotherapy was administered during radiation for advanced stages of cervical cancer. Based on the results of these trials, the US National Cancer Institute released a Clinical Announcement supporting the concurrent use of cisplatin-based chemotherapy with radiation therapy for high-risk early stage and locally advanced stage cervical cancer. Subsequently, an additional prospective randomized trial performed by the National Cancer Institute of Canada was not able to show benefit with the use of chemoradiation compared with radiation alone for patients with locally advanced stage cervical cancer. This article will analyze these six clinical trials in order to determine the role of chemoradiation in the management of patients with cervical cancer. Furthermore, as anemia is one of the most powerful prognostic factors in patients with cervical cancer, we propose to evaluate the relationship between a decreased level of hemoglobin and treatment outcome.

Antineoplastic Agents↗
PubMedDate not supplied

Receptorial and mitochondrial apoptotic pathways in normal and neoplastic human endometrium.

Under normal conditions, in human endometrium, apoptotic and antiapoptotic factors play an important role in tissue homeostasis. Abnormalities of apoptosis, a process implicated in several events in the reproductive organs, may contribute to neoplastic transformation. The present study aimed to investigate the involvement of both the receptorial and the mitochondrial pathways of apoptosis in normal endometrium and in endometrial carcinoma, by measuring caspase-3 and caspase-8 activities and cytosolic cytochrome c levels. Twelve endometrial carcinomas and nine normal endometrial specimens (four in mild proliferative phase, five in late secretory phase) were included in this study. Cytosolic fractions, obtained by differential centrifugation of tissue homogenates, were analyzed for caspase-3 and caspase-8 activities, as well as for cytochrome c content. Caspase-8 activity in normal secretory phase endometrium was higher than that in the proliferative phase and in the endometrial carcinoma. Moreover, higher cytochrome c levels were detected in endometrial carcinoma with respect to normal secretive endometrium. No significant differences were found in caspase-3 activity between normal and pathologic endometrium. The results obtained suggest that in normal endometrium, apoptosis takes place through the activation of both receptorial and mitochondrial pathways. Defects in both these pathways may contribute to the development of endometrial carcinoma.

Aged↗
PubMedDate not supplied

A case of Sertoli-Leydig cell tumor in a postmenopausal woman.

Sertoli-Leydig cell tumor belongs to the group of sex cord-stromal tumors of the ovary. These neoplasms account for less than 0.5% of all ovarian tumors and are more often encountered in young women between the ages of 20 and 30 years who usually become virilized. We described an unusual case of Sertoli-Leydig cell tumor in a postmenopausal women who presented with a solid right pelvic mass, a large amount of ascites, and laboratory tests revealing an elevated CA125, all suggesting a pelvic malignancy. Although five similar cases of postmenopausal women with Sertoli-Leydig cell tumor of ovary have been reported in the literature, we believe that this is an useful addition to the literature.

Aged↗
PubMedDate not supplied

Surgical resection of a cerebral metastasis from cervical cancer: case report and review of the literature.

AIMS AND BACKGROUND: Central nervous system metastasis from cervical carcinoma is uncommon. CASE REPORT: We report the case of a 51-year-old woman who developed a solitary cerebral metastasis 29 months after radical hysterectomy with pelvic lymphadenectomy for a stage IB, grade III cervical cancer. The patient suddenly complained of headache, confusion and dizziness; she was submitted to emergency surgical resection of a 2 x 3 cm metastasis in the right frontal lobe. The postoperative course was uneventful and she completely recovered from her neurological deficit. Following surgery the patient underwent careful restaging. Massive bilateral involvement of the pelvic wall was diagnosed, and the patient received three courses of cisplatin-based chemotherapy. She developed liver and lung metastases and died 10 months later of progressive disseminated disease, without, however, any sign of recurrent or persistent cerebral involvement. CONCLUSION: Neurosurgical resection should be considered in cervical cancer patients with solitary brain metastasis in the absence of systemic disease.

Brain Neoplasms↗
PubMedDate not supplied

[Fetal hydrops caused by cardiac failure in utero: description of 2 cases and pathogenetic considerations].

Two cases of congestive heart failure in utero with fetal hydrops are reported. The diagnosis was made during pregnancy by means of echography. Cardiac failure, derived from supraventricular tachycardia not associated with structural anomalies of the heart, was observed in one of the patients. By digoxin administration and vagal stimulation the rhythm reverted to sinus, one hour after birth. In the second case fetal echography showed a fetus with serious bradycardia (45/min.) and ascites. On the bases of a median located and symmetric liver and of a complex heart malformation a diagnosis of "isomeric syndrome" was supposed. One hour after vaginal delivery, the newborn dead and autopsy confirmed a left isomeric syndrome with polisplenia and complex congenital cardiopathy (left ventricle and mitral hypoplasy, double outlet right ventricle, pulmonary stenosis, anomalous systemic and pulmonary venous return).

Edema↗
PubMedDate not supplied

Diagnosis of endometrial hyperplasia in women with abnormal uterine bleeding.

BACKGROUND: Reliability of hysteroscopy in diagnosing endometrial hyperplasia in women with abnormal uterine bleeding. METHODS: Out of 105 patients with abnormal uterine bleeding 47 showed structural abnormalities. Comparative analysis between hysteroscopic and histological results in 58 women without gross abnormalities has been performed in order to verify sensitivity and specificity of hysteroscopy in the diagnosis of endometrial hyperplasia. RESULTS: Specificity of hysteroscopy in diagnosing endometrial hyperplasia was 84.7% while sensitivity resulted to be 80%. CONCLUSIONS: Women with abnormal uterine bleeding and normal uterine cavity has a low rate (3.4%) of false negative endometrial hyperplasia. On the contrary findings of endometrial hyperplasia at hysteroscopy has a high incidence of false positive (25.8%). In conclusion, abnormal uterine bleeding could cause an increased thickness in endometrium, appearing as hyperplasia on hysteroscopic examination.

Adult↗