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Biomedical subjects

L Falsetti

Publications and source records attributed to L Falsetti.

At least 55 records · Page 3Linked to original sources
PubMed1982

Benserazide and nomifensine in the diagnosis of prolactin-secreting pituitary adenomas.

Benserazide, an inhibitor of dopa-decarboxylase, stimulates prolactin (Prl) release in normal women and in puerperae; nomifensine, a dopaminergic drug able to release dopamine and to inhibit its re-uptake at the post-synaptic level, inhibits Prl release in the same subjects. Similar modifications of Prl release are evident in selected cases of non-tumoral hyperprolactinaemia, while neither drug modifies Prl release in patients with a Prl-secreting pituitary adenoma, in patients with 'functional' hyperprolactinaemia and in patients with 'functional' hyperprolactinaemia and in patients with minor abnormalities of sellar tomography. Neither drug modified Prl release in patients with macro- or microadenomas; several patients in the remaining groups failed to respond to one or both tests, the concordance between the two tests averaging 75%. Patients responding to both tests, to one test or to neither test showed progressively higher basal Prl levels. Since benserazide and nomifensine can indicate the presence of a pituitary adenoma earlier than sellar tomography, our results indicate that patients with no Prl response to one or to both tests probably harbour a pituitary adenoma which cannot yet be revealed by sellar tomography.

Adenoma↗
PubMed1981

[Clinical results in the treatment with metergoline in 80 hyperprolactinemic patients].

8 or 12 mg/day methergolin was administered for an average of 8 months to 80 patients with hyperprolactinaemia of tumoural (20 cases), idiopathic (39 cases), and iatrogenic (21 cases) origin. The success of the treatment was apparent in the return of ovulation and the establishment of pregnancy in 80% of patients with microadenoma, and 85% of those with a normal sella turcica.

Adenoma↗
PubMedDate not supplied

Management of hirsutism.

This review reports our own experience with, and literature studies of, the pharmacological management of hirsutism in women with hyperandrogenism (polycystic ovary syndrome) or with normal serum androgen levels and regular ovulatory menstrual cycles (idiopathic hirsutism). Treatment consists of suppressing ovarian or adrenal androgen secretion, or blocking androgen actions in the skin. The major drugs used are gonadotropin-releasing hormone (GnRH) agonists, combined oral contraceptives (COCs), and steroidal (cyproterone acetate and spironolactone) or nonsteroidal (flutamide and finasteride) antiandrogens. GnRH agonists, suppressing the pituitary, decrease androgen and estradiol secretion and improve severe hirsutism. To avoid estrogen deficiency problems, 'add back' therapy with estrogen-progestogen or COCs is advisable. This method of treatment is complicated and expensive, limiting its use to severe forms of ovarian hyperandrogenism with hyperinsulinemia. The third-generation COCs, containing new progestogens or cyproterone, have very restricted effectiveness in the short term (6 cycles), but their long term use (> 12 cycles) cures mild-to-moderate hirsutism and improves severe hirsutism. As well as suppressing gonadotropins and ovarian androgen steroidogenesis, these formulations decrease free testosterone levels and may also decrease adrenal androgen production. In women being treated with antiandrogens, COCs are important to provide control of the menstrual cycle and contraception. Cyproterone, a progestational agent, inhibits gonadotropin secretion and blocks androgen action. It is used in COCs or in a reverse sequential regimen. In the latter, it is very effective in the short term treatment of hirsutism. Spironolactone blocks androgen receptors. Its effectiveness in hirsutism is dosage-dependent: low dosages are less active than other antiandrogens, whereas high dosages (200 mg/day) are very effective at the cost of several adverse effects (particularly dysfunctional uterine bleeding), but the concomitant use of a COC may prevent these. Flutamide is a pure antiandrogen that blocks androgen receptors and inhibits hair growth. It is very effective in treating hirsutism within 6 to 12 months. Dry skin is very frequent during treatment with flutamide, and hepatotoxicity is possible at high dosages. Finasteride, a 5 alpha-reductase type 2 inhibitor, is the least effective antiandrogen, but a dosage of 5 mg/day decreases hirsutism without adverse effects. Pregnancy must be avoided during therapy with antiandrogens because of the possible risk of abnormal development of a male fetus. Antiandrogens, especially flutamide (250 to 500 mg/day) and cyproterone (12.5 to 50 mg/day in a reverse sequential regimen), alone or in association with COCs, seem to be the most effective agents for the treatment of hirsutism.

Adolescent↗
PubMedDate not supplied

Presurgical treatment of uterine fibroids by using gonadotropin-releasing hormone agonists.

Evaluation of clinical intra- and post-operative benefits of pre-myomectomy therapy with a Gonadotropin-Releasing Hormone Agonist (GnRH-A) (Goserelin) in anemic and non-anemic patients suffering from uterine leiomyomas. Evaluation of ultrasound, estradiol (E2) and hematological measurements before and during treatment with a GnRH-a in thirty women with uterine leiomyomas, comparing pre-treated patients operative time, total intraoperative blood loss, blood counts and febrile morbidity with of thirty-five control women. GnRH-A pre-treatment cures, iron-deficiency anemia, significantly reduces myoma and uterine volume (p < 0.01), total intra-operative blood loss (p < 0.001), decreases post-operative febrile morbidity, though it does not reduce operative time. GnRH-A pre-treatment over a period no longer than two months should be suggested in anemic patients suffering from uterine leiomyomas who have to undergo myomectomy.

Anemia↗
PubMedDate not supplied

Conservative surgical treatment in infertile patients with endometriosis.

In the period 1985-1988 23 infertile patients with pelvic endometriosis underwent conservative surgery with microsurgical technique. 8.7% (only 2 women) of the patients were in 2nd stage, 43.5% in 3rd stage and 47.8% in 4th stage of the American Fertility Society classification (1985). Associated pathology was found in 52.2% of the patients. Surgical techniques and results are presented. We obtained 13 (56.5%) full term pregnancies. The postoperative birth rate was 50% in 2nd stage, 80% in 3rd stage and 36.4% in 4th stage. Associated pathology was present in 69.2% of pregnant patients. Ten women (43.5) did not conceive: 10% were at 2nd, 20% at 3rd and 70% at 4th stage. Associated disease was present in 30% of women that did not become pregnant.

Adult↗
PubMedDate not supplied

Ovarian hyperstimulation syndrome (OHS): a case of severe OHS.

A 26 year old patient, who underwent an ovulation stimulation therapy (Clomiphene /UH-FSH), monitored only by ultrasound presented a severe Ovarian Hyperstimulation Syndrome (OHS). beta-HCG values confirmed conception, that outcame in an abortion. During an ovulation stimulation therapy, patient's management with the ultrasound examination, is often inadequate and it's moreover necessary to determine the 17 beta E2 levels.

Abortion, Spontaneous↗
PubMedDate not supplied

Polycystic ovary syndrome: long-term evolution.

A study was made of the long-term evolution of 64 women with PCO in order to identify the clinical and/or endocrine alterations that may modify the prognosis of each case. The patients were divided into two groups: Group A, where at the conclusion of the observation period disorders were present, and Group B, where they were not. A comparison between the clinical and endocrine data obtained from the two groups at the first observation showed only one significant difference, concerning the time of onset of menstrual irregularities; these coincided with the menarche in only 57.6% of the cases in Group A, but in 94.7% of those in Group B.

Adult↗
PubMedDate not supplied

Uterine fibromyoma and sterility: role of myomectomy.

The role of abdominal myomectomy with regard to surgical technique, subsequent conception and term pregnancy was evaluated. Of 30 patients undergoing myomectomy 13 conceived and 10 had a good pregnancy. It should be noted that 10 of 30 patients considered in this study had a leiomyomas associated disease, representing another cause of infertility. Thus, a preoperative evaluation of the reproductive capability of the couple would allow a selection of patients who are to undergo myomectomy resulting in a better pregnancy rate. In the present series, the ages of the patients and the size of the leiomyomas did not significantly influence the pregnancy rate. The most important correlation with subsequent fertility was the duration of infertility prior to myomectomy. The general principles of reproductive microsurgery should be kept in mind when performing myomectomy.

Adult↗
PubMedDate not supplied

Clinical, endocrine, roentgenographic, and immune characterization of hyperprolactinemic women.

Seventy-one hyperprolactinemic women were analyzed for medical history, gonadotropin and ovarian hormonal levels, and prolactin (PRL) responsiveness to benserazide. Sellar tomography was then performed on a yearly basis for 3 years in all women, computerized coronal and sagittal tomography in 54 of them. Under basal conditions, 30 women had roentgenographic evidence of pituitary adenoma; at the end of the follow-up period, such evidence was seen in 44. Amenorrhea, steady PRL levels, a low LH/FSH ratio, a longer duration of the disease, and low serum progesterone levels were more common in women with a final diagnosis of pituitary adenoma than in those with a persistently normal sella. The benserazide test for PRL release had yielded abnormal results since the beginning in all the 44 women with final roentgenographic evidence of pituitary adenoma, and in about half of the patients with persistently normal aspect of the sella; autoantibodies towards the pituitary gland, the thyroid gland, and gastric parietal cells were found in 3, 2, and 3 patients, respectively. No autoantibodies towards the adrenal gland or the islets of Langerhans were ever found in any cases. These data show that a fair proportion of hyperprolactinemic women have a (micro)adenoma, which becomes apparent over a relatively short period of time. Amenorrhea and steadily raised PRL levels are more common in these women. The benserazide test seems to be adequate for predicting which women will eventually develop a roentgenographically detectable adenoma. Autoimmunity does not seem to be involved in the pathogenesis of hyperprolactinemia and/or pituitary adenoma.

Adenoma↗
PubMedDate not supplied

A new association of ethinylestradiol (0.035 mg) cyproterone acetate (2 mg) in the therapy of polycystic ovary syndrome.

The authors treated 28 patients with polycystic ovary syndrome (PCOS) with the new preparation SH B 209 AE consisting of 0.035 mg of ethinylestradiol and 2 mg of cyproterone acetate (EE + CPA) throughout 12 months. From the analysis of the endocrine and clinical modifications induced by the drug along with the negligible incidence of side effects the conclusion can be drawn that this new estro-progestational association is indicated in the therapy of PCOS.

Acne Vulgaris↗
PubMedDate not supplied

Endocrine and clinical results in administering lisuride for inhibiting lactation.

Lisuride is a potent direct Dopamine agonist and has an effective Prolactin-lowering effect. 64 post-partum women have been divided in two groups: 44 patients with personal reasons to inhibit lactation and 20 patients normally breast-feeding, as control group. The inhibition of lactation has been carried out with Lisuride using 3 X 0.2 mg daily over 10 days, starting within 24-28 hours from delivery. In all the patients we have dosed Prolactin (PRL), LH, FSH, 17-beta Estradiol (E2) in basal conditions (1st day after delivery) and on the 5th and 10th day of assumption of the drug. At the 10th day-control the inhibition of lactation, without symptoms, has been obtained in 39 out of 44 patients treated (86.3%). It is clear how, in comparison with the control group, Lisuride leads to a rapid fall of PRL and seems to promote an earlier restoration of hypothalamus-pituitary-ovary axis, as is shown by the behaviour of gonadotropin and estradiol.

Adult↗