Search PubMed⌕ Search

Biomedical subjects

L Fedele

Publications and source records attributed to L Fedele.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Risk factors for different histological types of ovarian cancer.

Various histological types of ovarian cancer may develop from different etiological aspects. Data separated by histological subtypes collected in the framework of a large case-control study on ovarian cancer conducted in Italy were analyzed. The cases were women below the age of 75 years, admitted to a network of hospitals in Milan. Cases were grouped into four categories by histological type: mucinous tumor (n = 52), serous tumor (n = 680), endometrioid tumor (n = 41), and other histologies including clear-cell and undifferentiated epithelial tumors (n = 50). Controls were 2758 patients admitted to the same network of hospitals for a wide spectrum of acute, nongynecological, non-hormone-related, non-neoplastic conditions. In comparison with nulliparae, the risk of serous, endometrioid, and other histologies of ovarian cancer tended to be lower in parous women, but the odds ratios (OR) were above unity for mucinous ovarian cancer. Oral contraceptive use was associated with OR lower than unity for serous (OR = 0.7) and endometrioid (OR = 0.8) ovarian cancers but not for mucinous (OR = 1.4) and other histologies (OR = 1.6). Finally, our results on dietary fat intake did not show substantial differences in all histological types of ovarian cancer.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Risk factors for unexplained dyspermia in infertile men: a case-control study.

This study was conducted to analyze risk factors for dyspermia in infertile subjects in a population of men attending outpatient services for infertility in Milan, Northern Italy. Between September 1989 and November 1990 we conducted a case-control study on risk factors for dyspermia. Cases included infertile men with a diagnosis of unexplained dyspermia consecutively observed for the first time during the study period at the Outpatient Service for Infertility of the First Obstetric and Gynecologic Clinic of the University of Milan. Specific work-up was done to exclude the major known or potential causes of dyspermia and infertility in patients and their partners. Two control groups were selected. The first included normospermic men of infertile couples with negative work-up for any disease that might affect fertility, observed in the same outpatient service where cases had been identified. The second control group included fertile men of unknown semen quality who were the partners of women who gave birth at term (> 37 w gestation) to health infants in randomly selected days at the same clinic. In comparison with those who have never smoked, current smokers were at increased risk of dyspermia versus both normospermic men of infertile couples and fertile men of unknown semen quality, and the risk increased with number of cigarettes smoked per day and duration of smoking. The risk of dyspermia increased with the number of cups of coffee drunk per day compared with men drinking no or one cup per day. Likewise, alcohol drinkers were at increased risk and the risk increased with number of drinks/d.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMedDate not supplied

Intra- and extra-pelvic lesions associated with unstable fractures of the pelvic ring.

Fracture of the pelvis is often caused by high-energy trauma, and for this reason it is frequently associated with fractures in other regions, hemorrhages, or severe lesions of the organs. Based on an analysis of the results, obtained by a review of 68 cases of unstable fracture of the pelvis treated at the IIIrd Division of the Rizzoli Orthopaedic Institute between 1980 and 1995, the authors make several suggestions concerning diagnosis and therapy for the evaluation and treatment of these patients.

Adolescent↗
PubMedDate not supplied

[Standards of birth weight in Italy].

The Italian standards of birth weight have been computed using information routinely collected by the Italian Central Institute of Statistics on about 1,200,000 births in the period 1984-1985. Individual records include data on birth weight and main fetal and maternal characteristics and delivery modalities. The crude and smoothed 5th, 10th, 50th, 90th and 95th centiles of weight at birth as function of gestational age according to sex, type of birth, maternal age and parity are presented. Centiles of weight at birth were higher (about 5%) in males than in females in all gestational ages: for example the 50th centile of weight at 40 weeks gestation was 3479 g in males and 3332 g in females. Between the 28th and the 32nd week the 50th centile of birth weight for multiple births grew at a rate similar to that of singletons; but beyond 32 weeks the weight growth in multiple birth was markedly lower than in singleton ones, the median multiple birth weight reaching the 10th centile of singleton at 38 weeks. The values of centiles increased with parity in both sexes and all gestational ages. The difference was however limited: for example with reference to the 50th centile the value for births in women reporting three or more births was about 5% higher than in those reporting no previous birth. Likewise, centiles of weight were higher in older women, but the difference tended to disappear after 36 weeks gestation. This analysis shows from a large national data-set standards of weight at birth from a Southern European population, providing to obstetrics and perinatologists curves of fetal growth more directly representative of the population under their care.

Adolescent↗
PubMedDate not supplied

Enoxacin in the treatment of Chlamydia trachomatis genitourinary infection.

Twenty women with Chlamydia trachomatis genitourinary infection were treated with oral enoxacin 800 mg/day in two divided doses for 12 days starting on day 1 of the menstrual cycle. A physical examination was performed before the start and 28-30 days after the end of the treatment. At the final examination cultures of urethral and endocervical swabs and endometrial samples were negative in all cases, demonstrating that Chlamydia trachomatis infection had been eradicated. No significant results were obtained at serologic evaluation with the indirect immunofluorescence method to show specific IgM, IgG and IgA antibodies. In the four women with subjective symptomatology this was improved by the treatment with enoxacin. Only two patients presented mild side effects (headache, tachycardia, nausea). Enoxacin seems therefore a very effective and well tolerated drug in the treatment of Chlamydia trachomatis genitourinary infection.

Adult↗
PubMedDate not supplied

Simultaneous intra- and extrauterine pregnancy after multiple ovulation induction.

Superovulation was induced by combined treatment with a GnRH analog, hMG and hCG in a 31 years old nulligravida with a diagnosis of unexplained infertility. She developed a mild hyperstimulation syndrome for which she received conservative treatment in hospital, and she was discharged only after we demonstrated a gestation sac in utero with evident fetal heart beat and beta hCG assays were positive. One week later the patient was readmitted urgently with acute abdominal pain. Laparoscopy revealed a left tubal pregnancy with corpus luteum on the right ovary and free blood in the pouch of Douglas. Salpingotomy was therefore performed with dilatation and curettage of the uterine cavity. Histological examination confirmed the presence of contemporary intra- and extrauterine pregnancy. Based on this first communication, a high index of clinical suspicion for an extrauterine pregnancy is warranted in all patients undergoing superovulation even after a pregnancy in utero has been demonstrated.

Adult↗
PubMedDate not supplied

[Determinants of perinatal and infant mortality in Italy 1980-1983].

Determinants of stillbirth, perinatal and infant mortality in Italy have been analyzed using information collected routinely by the Italian Central Institute of Statistics on more than 2,400,000 births and 33,000 infant deaths in the period 1980-1983. Individual records include data on maternal (for example age, education, obstetric history) and fetal (sex, birth weight, gestational week at birth) characteristics. The Italian stillbirth, perinatal and infant (1st-365th day of life) mortality rates were respectively 7.7/1000 births, 16.4/1000 births and 13.5/1000 livebirths for the considered period. Perinatal and infant mortality was impressive in very low birth weight. About 90% of livebirths weighing less than 1000g died within the first year of life, but this percentage decreased to about 45% in babies weighing 1000-1499g. As a whole, low birth weight explained more than 70% of deaths. Further, stillbirth, perinatal and infant mortality rates were higher in male babies, in older women and in higher birth rank. These findings persist, although less markedly, after adjustment for weight. Mortality rates were about 60-70% higher in less educated women. Stillbirth, perinatal and infant mortality rates were 20 to 30% higher in Southern Italy, as compared to the North of the country. This finding was not markedly changed after adjustment for birth weight and maternal age and education, suggesting that socio-economic factors are per se important determinants of perinatal and infant mortality in Italy, and explain in terms of population attributable risk, about 15% of stillbirths or deaths within the first year of life.

Birth Weight↗
PubMedDate not supplied

Serum Ca-125 concentrations in endometriosis.

Serum Ca-125 levels were measured in 154 patients undergoing laparoscopy or laparotomy for infertility and/or pelvic pain. Pelvic endometriosis at various stages was observed in 102 of the patients, and 52 had a visually normal pelvis and served as a control group. We found a significantly higher mean serum Ca-125 concentration in the patients with stages III and IV endometriosis compared with the controls (P less than 0.001) whereas in the patients with stages I and II disease the mean antigen level was comparable to that of the control group. Considering its low sensitivity (14.7%) the usefulness of serum Ca-125 measurements as an initial diagnostic test for endometriosis is scanty. On the contrary, because of its elevated specificity (100%), this test may be useful in indicating early surgical exploration of the pelvis in cases of infertility and/or dysmenorrhea which are associated with high values of Ca-125.

Adult↗
PubMedDate not supplied

Laparotomy versus laparoscopy in the surgical treatment of endometriosis: the end of an era?

The Authors compare the efficiency of laparoscopic treatment with laparotomic surgical management of endometriosis. When the disease causes mechanical distortions and adnexal adhesions, there is an obvious explanation for infertility; in these cases laparotomic surgery has so far proved the only treatment to produce significantly valid results. No findings have yet been reported to demonstrate that cytoreduction, either pharmacological, laparoscopic or laparotomic, offers concrete advantages compared with simple observation when the disease is in the early stage.

Endometriosis↗
PubMedDate not supplied

The GnRH agonists in the treatment of uterine leiomyomas.

The observation that fibroids regress after the menopause has led many authors to use GnRH agonists to obtain a reversible state of hypoestrogenism in patients with this tumor. In all the studies performed GnRH agonists have been found effective in inducing a marked regression of fibroids and resolution of the related symptoms. The only serious side effect reported has been a decrease of bone mineral density, which necessarily limits the duration of treatment. Fibroids have been observed to grow back in almost all patients a few months after suspension of treatment, and this limits the indications for the use of GnRH agonist in the treatment of this condition. GnRH agonists are the treatment of choice, however, in inoperable patients and in those with severe anemia, whereas further studies are needed to better define their use in preoperative treatment and in women in perimenopausal age.

Antineoplastic Agents↗
PubMedDate not supplied

[Epidemiology of spontaneous abortion: a review of the literature].

Spontaneous abortion is the commonest complication of pregnancy. Its reported incidence appears to be constant in developed countries but the frequency of subclinical fetal loss is largely unknown. There is a well known relationship between fetal loss and advancing maternal age. Trisomic fetuses occur more commonly in older women and most are aborted but old women are also at greater risk of aborting a chromosomally normal fetus. Recent epidemiological data have demonstrated a significant association between maternal cigarette smoking and spontaneous abortion. A role of gravidity, early age at menarche, alcohol and methylxanthine consumption has been recently claimed, but epidemiological evidence is scanty and largely controversial. The present paper reviews the epidemiological data on spontaneous abortion.

Abortion, Spontaneous↗
PubMedDate not supplied

Communicating uteri: description and classification of a new type.

A case of bicornuate-bicervical communicating uterus with atresia of the right hemicervix is reported. This cannot be included in any of the nine groups of Toaff's classification of uterine malformations proposed in 1984, and should be classified as a new, tenth type.

Adult↗
PubMedDate not supplied

Second-look laparoscopy in the treatment of endometriosis.

The results of second-look laparoscopy were compared with subjective symptomatology and findings at pelvic exploration in 36 patients who had received conservative treatment for endometriosis. In the 14 patients given pharmacologic treatment, second-look laparoscopy demonstrated active endometriosis in 57.1%, whereas pelvic pain was present in 64.3% and gynecologic examination was positive in 28.6%. In the 22 patients who underwent surgery, active endometriosis was detected by second-look laparoscopy in 31.8%, whereas 40.9% reported pelvic pain and pelvic examination was positive in 31.8%. Thus clinical signs and symptoms were unreliable in the diagnosis of endometriosis recurrence, whereas laparoscopy was indispensable. It should be programmed for 6 months from the end of medical treatment and 12 months after surgery; however, if the pain symptomatology recurs, then laparoscopy is performed immediately.

Adult↗