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Selvaggi L, Menegon Tasselli F, Sciaudone G, Kontovounisios C, Cosenza A, Sica GS, Selvaggi F, Pellino G. Shifting paradigms in two common abdominal surgical emergencies during the pandemic. Br J Surg 2021; 108:e127-e128. [PMID: 33793730 DOI: 10.1093/bjs/znaa158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022]
Abstract
During the pandemic there was a reduction in access to the hospital and surgical treatment of appendicitis and cholecystitis at a global level. Some strategies adopted during this challenging time could be applied even after the emergency has been controlled.
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Affiliation(s)
- L Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - F Menegon Tasselli
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - G Sciaudone
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - C Kontovounisios
- Department of Surgery and Cancer, Imperial College, London, UK.,Department of Colorectal Surgery, Royal Marsden Hospital, London, UK.,Department of Colorectal Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK
| | - A Cosenza
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - G S Sica
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | - F Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - G Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy.,Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
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2
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Cormio G, Colamaria A, Loverro G, Pierangeli E, Di Vagno G, De Tommasi A, Selvaggi L. Surgical Resection of a Cerebral Metastasis from Cervical Cancer: Case Report and Review of the Literature. Tumori 2018; 85:65-7. [PMID: 10228501 DOI: 10.1177/030089169908500114] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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 2×3 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.
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Affiliation(s)
- G Cormio
- Department of Obstetrics and Gynecology, University of Bari, Italy
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3
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Selvaggi L, Pasakarnis L, Brunner D, Aegerter CM. Magnetic tweezers optimized to exert high forces over extended distances from the magnet in multicellular systems. Rev Sci Instrum 2018; 89:045106. [PMID: 29716356 DOI: 10.1063/1.5010788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Magnetic tweezers are mainly divided into two classes depending on the ability of applying torque or forces to the magnetic probe. We focused on the second category and designed a device composed by a single electromagnet equipped with a core having a special asymmetric profile to exert forces as large as 230 pN-2.8 μm Dynabeads at distances in excess of 100 μm from the magnetic tip. Compared to existing solutions our magnetic tweezers overcome important limitations, opening new experimental paths for the study of a wide range of materials in a variety of biophysical research settings. We discuss the benefits and drawbacks of different magnet core characteristics, which led us to design the current core profile. To demonstrate the usefulness of our magnetic tweezers, we determined the microrheological properties inside embryos of Drosophila melanogaster during the syncytial stage. Measurements in different locations along the dorsal-ventral axis of the embryos showed little variation, with a slight increase in cytoplasm viscosity at the periphery of the embryos. The mean cytoplasm viscosity we obtain by active force exertion inside the embryos is comparable to that determined passively using high-speed video microrheology.
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Affiliation(s)
- L Selvaggi
- Department of Physics, University of Zurich UZH, Zurich, Switzerland
| | - L Pasakarnis
- Institute of Molecular Life Science IMLS, Zurich, Switzerland
| | - D Brunner
- Institute of Molecular Life Science IMLS, Zurich, Switzerland
| | - C M Aegerter
- Department of Physics, University of Zurich UZH, Zurich, Switzerland
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4
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Resta M, Spagnolo P, Dicuonzo F, Palma M, Florio C, Greco P, D'Addario V, Vimercati A, Selvaggi L, Caruso G, Clemente R. La risonanza magnetica del feto. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140099400700107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
La RM fetale si candida come metodica di approfondimento nella diagnostica per immagini prenatale, dopo il classico approccio ecografico entrato ormai nel depistage di massa delle anomalie fetali. Il ricorso alla RM fetale ha una storia breve ma l'interesse dei vari autori a questa metodica è risultato crescente nell'ultimo decennio. In questo lavoro viene presentata una breve revisione critica dei dati della letteratura con alcune annotazioni sulle diverse soluzioni tecniche proposte. Viene soprattutto discusso il problema legato ai movimenti fetali che tendono a degradare l'immagine RM dando particolare risalto alle manovre eco-guidate di curarizzazione fetale. Vengono quindi riportati i risultati su una casistica di 27 pazienti gravide in epoca gestazionale compresa tra il secondo ed il terzo trimestre, 22 delle quali sottoposte a curarizzazione fetale. In particolare sono presentati i diversi risultati RM in relazione al diverso dosaggio e al diverso agente curaro-simile impiegato e alcuni dettagli tecnici sull'esecuzione della RM fetale. In questa prima parte del nostro lavoro viene infine discussa l'anatomia normale del cervello fetale all'RM.
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Affiliation(s)
| | | | | | | | - C. Florio
- II Settore Radiologia Ospedaliera; Policlinico Università di Bari
| | | | | | | | - L. Selvaggi
- Clinica Ostetrica; Policlinico Università di Bari
| | | | - R. Clemente
- Istituto di Anatomia Patologica; Policlinico Università di Bari
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5
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Resta M, Spagnolo P, Di Cuonzo F, Palma M, Florio C, Greco P, D'Addario V, Vimercati A, Selvaggi L, Caruso G, Clemente R. La risonanza magnetica del feto. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140099400700402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vengono riportati i quadri patologici osservati in 27 RM fetali prenatali e catalogati in sezioni. Nella sezione riguardante l'anencefalia e la microcefalia sono discussi rispettivamente un caso di anencefalia classica, una microcefalia vera di Evrard, una microcefalia semplice associata a malformazioni in altri apparati ed una rara osservazione di iniencefalia. Nella sezione delle oloprosencefalie sono riportate due oloprosencefalie alobari e due oloprosencefalie semilobari. Nella sezione della agenesia del corpo calloso, sono illustrati 5 casi di agenesia totale, 2 casi isolati, e 3 associati ad altre anomalie del sistema nervoso. Una cisti in tensione del setto pellucido è stata arbitrariamente inserita in quest'ultima sezione. Fra i complessi di Dandy-Walker sono enumerate una malformazione classica di Dandy-Walker, 2 Dandy-Walker variant ed una megacisterna magna. Le anomalie di Chiari riscontrate sono state 2 e si riferiscono entrambe ad una condizione a tipo Chiari I, associata ad idrocefalo in un caso, ad agenesia del corpo calloso nell'altro. In un ultima sezione vengono presentati 2 casi di moderata idrocefalia e due casi di cospicua idrocefalia. Vengono infine presentate alcune brevi considerazioni conclusive sulla validità della metodica.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - R. Clemente
- Istituto di Anatomia Patologica; Policlinico, Università di Bari
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6
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Loizzi V, Cormio G, Leone L, Falagario M, Longo S, Resta L, Selvaggi L. A rare case of primary clear-cell adenocarcinoma of the bladder arising from bladder endometriosis. J OBSTET GYNAECOL 2015; 35:758-60. [DOI: 10.3109/01443615.2015.1004526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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7
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Cormio G, Loizzi V, Ceci O, Leone L, Selvaggi L, Bettocchi S. Unsuspected diagnosis of uterine leiomyosarcoma after laparoscopic myomectomy. J OBSTET GYNAECOL 2014; 35:211-2. [PMID: 25057886 DOI: 10.3109/01443615.2014.937332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- G Cormio
- Department of Biomedical Science and Human Oncology, Obstetrics and Gynecology Unit
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8
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Loizzi V, Cormio G, Lobascio PL, Marino F, De Fazio M, Falagario M, Leone L, Difiore G, Scardigno D, Selvaggi L, Altomare DF. Bowel dysfunction following nerve-sparing radical hysterectomy for cervical cancer: a prospective study. Oncology 2014; 86:239-43. [PMID: 24902494 DOI: 10.1159/000362213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 03/10/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To objectively assess anorectal dysfunction following nerve-sparing radical hysterectomy in stage I-II cervical carcinoma patients. MATERIAL AND METHODS Between 2008 and 2012, 21 patients with primary cervical cancer stage FIGO I-II were enrolled in this prospective study. All women underwent nerve-sparing radical hysterectomy. Anorectal manometry was performed preoperatively and 6 months after surgery. A paired Student t test was used to assess the statistical difference between the manometric evaluations. A p value <0.05 was considered statistically significant. RESULTS Twenty-one patients were available for follow-up. Maximal and mean anal resting and squeezing pressures were unaffected by the surgical procedure, rectoanal inhibitory reflex and length of the high anal pressure zone did not change after the operation. The minimal volume to elicit rectal sensation, urge to defecate and maximal tolerable volume did not change significantly in the postoperative period, although they decreased in 2 and increased in 3 patients. In addition, rectal compliance did not change after surgery. Furthermore, no significant differences were found between patients who were or were not treated with adjuvant radiotherapy. CONCLUSIONS Our findings suggest that nerve-sparing radical hysterectomy for cervical cancer does not seem to be associated with long-term anorectal dysfunction. © 2014 S. Karger AG, Basel.
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Affiliation(s)
- V Loizzi
- Department of Biomedical Science and Human Oncology, Obstetrics and Gynecology Unit, IRCCS Bari, Bari, Italy
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9
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Cormio G, Bettocchi S, Ceci O, Nappi L, Di Fazio F, Cacciapuoti C, Selvaggi L. Antimicrobial Prophylaxis in Laparoscopic Gynecologic Surgery: A Prospective Randomized Study Comparing Amoxicillin-Clavulanic Acid with Cefazolin. J Chemother 2013; 15:574-8. [PMID: 14998083 DOI: 10.1179/joc.2003.15.6.574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Numerous studies have been published in recent years about antimicrobial prophylaxis in gynecologic surgery, but the optimal drug and schedule for the different surgical procedures is still a matter of debate. The aim of the present study was to compare two ultra-short term antimicrobial prophylaxis regimens (amoxicillin-clavulanic acid and cefazolin) in preventing infections following laparoscopic gynecologic operations. Three hundred sixty women hospitalized for a laparoscopic gynecologic surgery procedure were included in the study between January 1999, and December 2001. Patients were randomly allocated to receive amoxicillin-clavulanic acid (2.2 g) [Group A] or cefazolin (2 g) [Group B] as a single dose 30 minutes before surgery. Each patient was assessed daily until discharge to evidence febrile status and the presence of infections at the operative site, urinary tract and respiratory tract. In the amoxicillin-clavulanic acid (Group A) and cefazolin (Group B) groups, overall 164 and 172 patients, respectively, were evaluable for prophylactic efficacy at hospital discharge. Infectious complications were infrequent in both groups with febrile morbidity occurring in only one patient (0.6%) in the amoxicillin-clavulanic group. No sign of infections at the surgical site, urinary tract and respiratory tract was observed in either group. No death due to sepsis was recorded. It is concluded that ultra-short term prophylaxis with both amoxicillin-clavulanic acid and cefazolin is safe and effective in elective laparoscopic gynecologic surgery.
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Affiliation(s)
- G Cormio
- Department of General and Specialist Surgical Sciences, Section of Obstetrics and Gynecology, University of Bari, Italy.
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Simsek E, Kilicdag EB, Haydardedeoglu B, Coban G, Iskender C, Simsek SY, Zeyneloglu HB, Glazebrook JE, Stocker LJ, Cheong Y, Di Florio C, Immediata V, Gagliano D, Zumpano A, Tartaglia C, Selvaggi L, Lanzone A, Guido M, Kanmaz G, Kahraman A, Varli B, Cetinkaya E, Taskin S, Ozmen B, Vij P, Cherian TK, Simsek M, Atilgan R, Ozkan ZS, Kavak B, Deveci D, Demirel I, Sapmaz E, Ashraf M, Ghourab G, Abuzeid O, Mitwally MF, Diamond MP, Abuzeid M, Coenders-Tros R, Van Kessel MA, Oosterhuis GJE, Vernooy E, Kuchenbecker WKH, Mol BWJ, Koks C, Al Rabiah H, Karins M, Faghih M, Choussein S, Bailey AP, Srouji SS, Gargiulo AR, Bosteels J, Pelckmans S, Weyers S, Mol BWJ, D'Hooghe T, Jayakrishnan KDK, Baheti BDS, Lee JH, Lee JR, Lee JY, Jee BC, Suh CS, Kim SH, Aboeighait S, Youssef MAF, Hosny AN, Yassin MS, Shokry MA, Gemei S, Sanad A, Esin S, Baser E, Okuyan E, Kucukozkan T. Reproductive surgery. Hum Reprod 2013. [DOI: 10.1093/humrep/det223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Vimercati A, Achilarre MT, Scardapane A, Lorusso F, Ceci O, Mangiatordi G, Angelelli G, Van Herendael B, Selvaggi L, Bettocchi S. Accuracy of transvaginal sonography and contrast-enhanced magnetic resonance-colonography for the presurgical staging of deep infiltrating endometriosis. Ultrasound Obstet Gynecol 2012; 40:592-603. [PMID: 22535651 DOI: 10.1002/uog.11179] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/12/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To investigate the accuracy of transvaginal sonography (TVS) and contrast-enhanced magnetic resonance-colonography (CE-MR-C) for the presurgical assessment of deep infiltrating endometriosis (DIE). METHODS Ninety women were enrolled prospectively for suspicion of DIE. All patients underwent TVS and CE-MR-C, with each operator blinded to the results of the other exam, before laparoscopy. The sites of DIE examined by both imaging techniques were: rectovaginal septum, pouch of Douglas, uterosacral ligaments, vesicouterine pouch, bowel, bladder and vagina. The presence of adhesions and the involvement of adnexa and of a previous abdominal scar, when there was clinical suspicion, were also evaluated. TVS and CE-MR-C findings were compared with laparoscopic and histological results. RESULTS Endometriosis was confirmed by laparoscopy in 95.6% (86/90) of cases. In 82.2% (74/90) of patients there was DIE. The global accuracy for TVS in the detection of DIE was 89.2%, sensitivity was 81.1%, specificity was 94.2%, positive predictive value was 89.6%, negative predictive value was 89.0%, the positive likelihood ratio was 13.9 and the negative likelihood ratio was 0.2. For CE-MR-C, these values were 87.2%, 71.1%, 97.1%, 93.7%, 84.6%, 24.4 and 0.3, respectively. CE-MR-C allowed diagnosis of all cases of bowel involvement; the accuracy for infiltration and stenosis was 100%. The accuracy of TVS for rectosigmoid nodules was 91.1% and that for infiltration was 88.9%. CONCLUSIONS Both TVS and CE-MR-C showed satisfactory results for the presurgical assessment of DIE. TVS appears to be a powerful, simple, feasible, cost-effective tool for preoperative staging of DIE. CE-MR-C is an 'X-ray free' technique, which could be reserved for cases with deep infiltrating rectosigmoid lesions and for the prediction of stenosis and involvement of the upper part of the colon and small intestine.
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Affiliation(s)
- A Vimercati
- Department of Gynecology Obstetrics and Neonatology (DiGON), I Operative Unit of Obstetrics and Gynecology, University of Bari, Bari, Italy
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12
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Ribatti D, Loverro G, Vacca A, Greco P, Vimercati A, Roncali L, Selvaggi L. Correlative study of angiogenesis in endometrial cancer assessed by the color Doppler ultrasound and by the chick embryo chorioallantoic membrane. Int J Oncol 2012; 11:1191-5. [PMID: 21528321 DOI: 10.3892/ijo.11.6.1191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Angiogenesis is required for both tumor growth and progression and the degree of vascularization seems to correlate with prognosis in several human tumors including uterine malignant neoplasms. In this study we have investigated if three Doppler parameters, such as peak systolic velocity (PSV), resistance index (RI) and pulsatily index (PI), measured in patients with endometrial cancer, were correlated to the angiogenic response induced by grafting of bioptic specimens obtained from the same patients onto the chick embryo chorioallantoic membrane (CAM), a useful in vivo model for such an investigation. Results showed that only PSV was directly correlated to the degree of angiogenesis measured by means of the CAM assay. Moreover, these two parameters were also directly correlated to the malignancy grade of the disease.
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Affiliation(s)
- D Ribatti
- UNIV BARI,SCH MED,INST HUMAN ANAT HISTOL & EMBRYOL,I-70124 BARI,ITALY. UNIV BARI,SCH MED,INST OBSTET & GYNECOL,I-70124 BARI,ITALY. UNIV BARI,SCH MED,DEPT BIOMED SCI & HUMAN ONCOL,I-70124 BARI,ITALY
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13
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Moro F, Selvaggi L, Sagnella F, Morciano A, Martinez D, Gangale MF, Ciardulli A, Palla C, Uras ML, De Feo E, Boccia S, Tropea A, Lanzone A, Apa R. Could antispasmodic drug reduce pain during hysterosalpingo-contrast sonography (HyCoSy) in infertile patients? A randomized double-blind clinical trial. Ultrasound Obstet Gynecol 2012; 39:260-265. [PMID: 22223598 DOI: 10.1002/uog.11089] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To assess the effectiveness of an antispasmodic drug, hyoscine-N-butylbromide, in reducing pain during hysterosalpingo-contrast sonography (HyCoSy). METHODS Eight hundred and sixteen patients undergoing HyCoSy were randomized to receive 10 mg hyoscine-N-butylbromide (n = 408) or placebo (n = 408) per os, 30 min before the procedure, in a double-blind randomized controlled trial. Immediately after the procedure, the patient was asked to describe any pain experienced in comparison with pain usually suffered during the menstrual cycle, and the operator assigned a pain score between 0 and 4 as follows: 0 (no reaction or discomfort), 1 (slight pain, less than menstrual pain), 2 (moderate pain, exceeding menstrual cramps but no vasovagal reaction), 3 (vasovagal reaction or pain requiring observation in a hospital) and 4 (vasovagal reaction or pain requiring resuscitation). The primary aim was to estimate the difference in pain score, considered as a categorical value, between the active arm of the trial and the control group. The secondary aim was to evaluate if pain is related to tubal patency. RESULTS There was no difference in pain score between the hyoscine-N-butylbromide group and the placebo group (P = 0.807). There was a negative correlation between pain and tubal patency, regardless of treatment group (P < 0.0001). CONCLUSIONS Administration of 10 mg antispasmodic drug hyoscine-N-butylbromide does not reduce pain in patients undergoing HyCoSy.
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Affiliation(s)
- F Moro
- Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy.
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14
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Cormio G, Carriero C, Loizzi V, Gissi F, Leone L, Putignano G, Resta L, Selvaggi L. "Intestinal-type" mucinous adenocarcinoma of the vulva: a report of two cases. EUR J GYNAECOL ONCOL 2012; 33:433-435. [PMID: 23091907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND "Intestinal-type" mucinous carcinoma of the vulva is extremely rare with very few cases reported in the literature. CASE REPORT The authors report two patients who had diagnosis of intestinal-type mucinous adenocarcinoma of the vulva after excisional biopsy. In both cases, restaging was perfomed with total body computed tomography (CT) scan, gastroscopy, and colonoscopy that showed no other site of disease. A radical vulvectomy with bilateral systematic inguinal lymphadenectomy was performed, and in both cases no residual disease was found. A patient developed metastatic (liver, bone marrow) colonic cancer 36 months after primary surgery, received multiple lines of chemotherapy, and died of disseminated disease 18 months after diagnosis. The other patient was found to have dysplastic polyp in the sigmoid colon, and is alive without disease at 39 months after primary diagnosis. CONCLUSION Intestinal-type mucinous carcinoma of the vulva has a poor prognosis. Strict endoscopic follow-up of the colon is mandatory in such cases, considering the high propensity of associated gastrointestinal (GI) tumors.
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Affiliation(s)
- G Cormio
- Department of Gynecology, Gynecologic Oncology Unit, Obstetrics and Neonatology (DIGON), University of Bari, Bari, Italy
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Karasu Y, Dilbaz B, Demir B, Dilbaz S, Secilmis Kerimoglu O, Ercan CM, Keskin U, Korkmaz C, Duru NK, Ergun A, de Zuniga I, Horton M, Oubina A, Scotti L, Abramovich D, Pascuali N, Tesone M, Parborell F, Bouzas N, Yang XH, Chen SL, Chen X, Ye DS, Zheng HY, Nyboe Andersen A, Lauritsen MP, Thuesen LL, Khodadadi M, Shivabasavaiah S, Mozafari R, Ansari Z, Hamdine O, Broekmans F, Eijkemans MJC, Cohlen BJ, Verhoeff A, van Dop PA, Bernardus RE, Lambalk CB, Oosterhuis GJE, Holleboom C, van den Dool-Maasland GC, Verburg HJ, van der Heijden PFM, Blankhart A, Fauser BCJM, Laven JSE, Macklon NS, Agudo D, Lopez C, Alonso M, Huguet E, Bronet F, Garcia-Velasco JA, Requena A, Gonzalez Comadran M, Checa MA, Duran M, Fabregues F, Carreras R, Ersahin A, Kahraman S, Kavrut M, Gorgen B, Acet M, Dokuzeylul N, Aybar F, Lim SY, Park JC, Bae JG, Kim JI, Rhee JH, Mahran A, Abdelmeged A, El-Adawy A, Eissa M, Darne J, Shaw RW, Amer SA, Dai A, Yan G, He Q, Hu Y, Sun H, Ferrero H, Gomez R, Garcia-Pascual CM, Simon C, Gaytan F, Pellicer A, Garcia Pascual CM, Zimmermann RC, Ferrero H, Simon C, Pellicer A, Gomez R, Madani T, Mohammadi Yeganeh L, Khodabakhshi SH, Akhoond MR, Hasani F, Monzo C, Haouzi D, Assou S, Dechaud H, Hamamah S, Amer S, Mahran M, Eissa M, Darne J, Shaw R, Lan V, Nhu G, Tuong H, Mahmoud Youssef MA, Aboulfoutouh I, Al-inany H, Van Der Veen F, Van Wely M, Zhang Q, Fang T, Wu S, Zhang L, Wang B, Li X, Yan G, Sun H, Hu Y, He Q, Ding L, Day A, Wang B, Yan G, Hu Y, Sun H, Zhang L, Fang T, Zhang Q, Wu S, Yan G, Sun H, Hu Y, Fulford B, Boivin J, Alanbay I, Ercan CM, Sakinci M, Coksuer H, Ozturk M, Tapan S, Chung CK, Chung Y, Seo S, Aksoy S, Yakin K, Caliskan S, Salar Z, Ata B, Urman B, Devroey P, Pellicer A, Nyboe Andersen A, Arce JC, Harrison K, Irving J, Osborn J, Harrison M, Fusi F, Arnoldi M, Cappato M, Galbignani E, Galimberti A, Zanga L, Frigerio L, Taghavi SA, Ashrafi M, Karimian L, Mehdizadeh M, Joghataie M, Aflatoonian R, Xu B, Cui YG, Gao LL, Diao FY, Li M, Liu XQ, Liu JY, Jiang F, Li M, Cui YG, Diao FY, Liu JY, Jee BC, Yi G, Kim JY, Suh CS, Kim SH, Liu S, Cui YG, Liu JY, Cai LB, Liu JJ, Ma X, Geenen E, Bots RSGM, Smeenk JMJ, Chang E, Lee W, Seok H, Kim Y, Han J, Yoon T, Lazaros L, Xita N, Zikopoulos K, Makrydimas G, Kaponis A, Sofikitis N, Stefos T, Hatzi E, Georgiou I, Atilgan R, Kumbak B, Sahin L, Ozkan ZS, Simsek M, Sapmaz E, Karacan M, Alwaeely FA, Cebi Z, Berberoglugil M, Ulug M, Camlibel T, Kavrut M, Kahraman S, Ersahin A, Acet M, Yelke H, Kamalak Z, Carlioglu A, Akdeniz D, Uysal S, Inegol Gumus I, Ozturk Turhan N, Regan S, Yovich J, Stanger J, Almahbobi G, Kara M, Aydin T, Turktekin N, Youssef M, Aboulfoutouh I, Al-Inany H, van der Veen F, van Wely M, Hart R, Doherty D, Frederiksen H, Keelan J, Pennell C, Newnham J, Skakkebaek N, Main K, Salem HT, Ismail AA, Viola M, Siebert TI, Steyn DW, Kruger TF, Robin G, Dewailly D, Thomas P, Leroy M, Lefebvre C, soudan B, Pigny P, Decanter C, ElPrince M, Wang F, Zhu Y, Huang H, Valdez Morales F, Vital Reyes V, Mendoza Rodriguez A, Gamboa Dominguez A, Cerbon M, Aizpurua J, Ramos B, Luehr B, Moragues I, Rogel S, Cil AP, Guler ZB, Kisa U, Albu A, Radian S, Grigorescu F, Albu D, Fica S, Al Boghdady L, Ghanem ME, Hassan M, Helal AS, Ozdogan S, Ozdegirmenci O, Dilbaz S, Demir B, Cinar O, Dilbaz B, Goktolga U, Seeber B, Tsybulyak I, Bottcher B, Grubinger T, Czech T, Wildt L, Wojcik J, Howles CM, Destenaves B, Arriagada P, Tavmergen E, Sahin G, Akdogan A, Levi R, Goker ENT, Thuesen LL, Loft A, Smitz J, Nyboe Andersen A, Ricciardi L, Di Florio C, Busacca M, Gagliano D, Immediata V, Selvaggi L, Romualdi D, Guido M, Bouhanna P, Salama S, Kamoud Z, Torre A, Paillusson B, Fuchs F, Bailly M, Wainer R, Tagliaferri V, Busacca M, Gagliano D, Di Florio C, Tartaglia C, Cirella E, Romualdi D, Guido M, Aflatoonian A, Eftekhar M, Mohammadian F, Yousefnejad F, De Cicco S, Gagliano D, Busacca M, Di Florio C, Immediata V, Campagna G, Romualdi D, Guido M, Depalo R, Lippolis C, Vacca M, Nardelli C, Selvaggi L, Cavallini A, Panic T, Mitulovic G, Franz M, Sator K, Tschugguel W, Pietrowski D, Hildebrandt T, Cupisti S, Giltay EJ, Gooren LJ, Oppelt PG, Hackl J, Reissmann C, Schulze C, Heusinger K, Attig M, Hoffmann I, Beckmann MW, Dittrich R, Mueller A, Sharma S, Singh S, Chakravarty A, Sarkar A, Rajani S, Chakravarty BN, Dilbaz S, Ozturk E, Ozdegirmenci O, Demir B, Isikoglu S, Kul S, Dilbaz B, Cinar O, Goktolga U, Eftekhar M, Aflatoonian A, Mohammadian F, Broekmans F, Hillensjo T, Witjes H, Elbers J, Mannaerts B, Gordon K, Krasnopolskaya K, Galaktionova A, Gorskaya O, Kabanova D, Venturella R, Morelli M, Mocciaro R, Capasso S, Cappiello F, Zullo F, Monterde M, Gomez R, Marzal A, Vega O, Rubio-Rubio JM, Diaz-Garcia C, Pellicer A, Gordon K, Kolibianakis E, Griesinger G, Yding Andersen C, Witjes H, Mannaerts B, Ocal P, Guralp O, Aydogan B, Irez T, Cetin M, Senol H, Erol N, Yding Andersen C, Kolibianakis E, Devroey P, Witjes H, Mannaerts B, Gordon K, Griesinger G, Rombauts L, Van Kuijk J, Mannaerts B, Montagut J, Nogueira D, Porcu G, Chomier M, Giorgetti C, Nicollet B, Degoy J, Lehert P, Alviggi C, De Rosa P, Vallone R, Picarelli S, Coppola M, Conforti A, Strina I, Di Carlo C, De Placido G, Hackl J, Cupisti S, Haeberle L, Schulze C, Hildebrandt T, Oppelt PG, Reissmann C, Heusinger K, Attig M, Hoffmann I, Dittrich R, Beckmann MW, Mueller A, Akdogan A, Demirtas O, Sahin G, Tavmergen E, Goker ENT, Fatemi H, Shapiro BS, Griesinger G, Witjes H, Gordon K, Mannaerts BM, Chimote MN, Mehta BN, Chimote NN, Nath NM, Chimote NM, Karia S, Bonifacio M, Bowman M, McArthur S, Jung J, Cho S, Choi Y, Lee B, Seo S, Lee KH, Kim CH, Kwon SK, Kim SH, Kang BM, Jung KS, Basios G, Trakakis E, Hatziagelaki E, Vaggopoulos V, Tsiavou A, Panagopoulos P, Chrelias C, Kassanos D, Sarhan A, Elsamanoudy A, Harira M, Dogan S, Bozdag G, Esinler I, Polat M, Yarali H. REPRODUCTIVE ENDOCRINOLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Loizzi V, Cormio G, Nestola D, Falagario M, Surgo A, Camporeale A, Putignano G, Selvaggi L. Prognostic factors and outcomes in 28 cases of uterine leiomyosarcoma. Oncology 2011; 81:91-7. [PMID: 21968290 DOI: 10.1159/000331679] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 07/28/2011] [Indexed: 01/07/2023]
Abstract
OBJECTIVES It was the aim of this study to evaluate clinicopathological characteristics and prognostic factors of uterine leiomyosarcomas (LMS). METHODS Twenty-eight patients with uterine LMS were evaluated in this retrospective study. Their features and survival were analyzed by Kaplan-Meier and log-rank tests. RESULTS The median age of the patients was 52 years (range 25-74). Nine patients had a disease with a mitotic count <10/10 high-power fields. Twenty-one patients presented with stage I disease, 1 with stage II and 6 with stage IV. Twelve patients underwent total hysterectomy and bilateral salpingo-oophorectomy, 2 simple hysterectomy, 5 myomectomy and 9 more comprehensive surgical treatments. Adjuvant chemotherapy was administered to 16 patients, whereas chemoradiation was given only to 2 patients. Fifty percent presented with recurrence of the disease. The median overall survival was 46 months. Age, mitotic count, type of surgery, adjuvant therapy, recurrence and clinical response to chemotherapy were not found to affect survival, while the menopausal status and FIGO (International Federation of Gynecology and Obstetrics) stage were found to be prognostic factors. CONCLUSION In our series, the menopausal state and FIGO stage were found to be prognostic factors related to survival.
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Affiliation(s)
- V Loizzi
- Department of Gynecology, Obstetrics and Neonatology, University of Bari, Bari, Italy.
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Caccavo D, Pellegrino NM, Totaro I, Vacca MP, Selvaggi L, Depalo R. Anti-laminin-1 antibodies in sera and follicular fluid of women with endometriosis undergoing in vitro fertilization. Int J Immunopathol Pharmacol 2011; 24:481-8. [PMID: 21658322 DOI: 10.1177/039463201102400221] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is increasing evidence that autoimmune phenomena, including auto-antibody production, may affect fertility in women with endometriosis. The aims of this study are to evaluate anti-laminin-1 antibody (aLN-1) presence in sera and in follicular fluids (FF) of women with endometriosis undergoing IVF and its impact on oocyte maturation and IVF outcome. aLN-1 were measured by a home-made enzyme linked immunosorbent assay in sera and FF obtained from 35 infertile women with endometriosis and in sera from 50 fertile controls and 27 infertile women without endometriosis (IWWE). aLN-1 serum levels were significantly higher in women with endometriosis in comparison with both fertile controls and IWWE (P<0.001 and P<0.05, respectively) and a positive correlation was found between serum- and FF-aLN-1 (r=0.47, P=0.004). According to the cut-off (mean+3 SD of fertile controls), 31% of women with endometriosis were aLN-1 positive. Metaphase II oocyte counts showed inverse correlation with FF-aLN-1 levels (r=-0.549, P=0.0006). Ongoing pregnancy (i.e pregnancy progressing beyond the 12th week of gestation) occurred in 4/11 aLN-1 positive patients and in 7/24 aLN-1 negative with no significant difference (P=0.7). In conclusion, our results highlight that aLN-1 are increased in women with endometriosis and their presence in FF may affect oocyte maturation leading to a reduced fertility. However, aLN-1 seem to have no effect on IVF outcome.
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Affiliation(s)
- D Caccavo
- Department of Clinical Medicine, Immunology and Infectious Diseases, University of Bari Aldo Moro, Bari, Italy.
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Cormio G, Loizzi V, Gissi F, Camporeale A, De Mitri P, Leone L, Putignano G, Selvaggi L. Long-term topotecan therapy in recurrent or persistent ovarian cancer. EUR J GYNAECOL ONCOL 2011; 32:153-155. [PMID: 21614902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The objective of this study was to evaluate feasibility, safety and clinical outcome of long-term therapy with topotecan (Hycamtin) in recurrent or persistent ovarian cancer. PATIENTS AND METHODS A retrospective chart review was conducted on all patients treated with topotecan (TPT) at the Department of Obstetrics and Gynecology, University of Bari, Italy between 1999 and 2007. Pertinent clinicopathologic information, response and toxicity following treatment with TPT were collected. TPT was given at a dosage ranging between 1.5 and 1.0 mg/m2 every three to four weeks. All patients were evaluated for toxicity acording to the CTC and response according to the RECIST response criteria. Time to progression (TTP) was calculated from initiation of TPT treatment and start of the next chemotherapy regimen. RESULTS A total of 30 patients received TPT for at least eight cycles for recurrent ovarian (22), fallopian tube (3) or primary peritoneal carcinoma (5). A total of 432 cycles of chemotherapy were given, with an average of 14.4 cycles per patient (range 8-22). Dose reduction was necessary in 20 patients (66%). About half of the patients required blood transfusions and growth factors. Non hematologic toxicity was mild and manageable. Responses were observed in 16/30 patients (53%), the remaining having SD. Median time to treatment progression was 28 months (range 9-88). CONCLUSION Long-term treatment with topotecan in recurrent/persistent ovarian cancer is feasible with limited evidence of cumulative toxicity. The results of this retrospective analysis suggest a potential role for late response and survival benefit for those patients without disease progression who continue topotecan therapy beyond six cycles of treatment.
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Affiliation(s)
- G Cormio
- Gynecologic Oncology Unit, Department of Gynecology, Obstetrics and Neonatology (DIGON), University of Bari, Bari, Italy
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Jiang Y, Zhao J, Hua M, Zhen X, Yan G, Hu Y, Sun H, Selvaggi L, Zannoni GF, Tagliaferri V, De Cicco S, Vellone VG, Romualdi D, Lanzone A, Guido M, Fassbender A, Vodolazkaia AV, Bossuyt XB, Kyama MK, Meuleman CM, Peeraer KP, Tomassetti CT, D'Hooghe TM, Lumini A, Nanni L, Manna C, Pappalardo S, Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A, Manna C, Crescenzi F, Farrag A, Sallam HN, Zou L, Ding G, Zhang R, Sheng J, Huang H, von Kleinsorgen C, Wilson T, Thiel-Moder U, Ebert AD, Reinfandt M, Papadopolous T, Melo AS, Rodrigues JK, Dib LA, Andrade AZ, Donabela FC, Ferriani RA, Navarro PA, Tocci A, Royo P, Lucchini C, Ramos P, Alcazar JL, Habara T, Terada S, Yoshioka N, Hayashi N, Haouzi D, Assou S, Monzo C, Anahory T, Dechaud H, De Vos J, Hamamah S, Gonzalez-Ramos R, Rojas C, Rocco J, Poch A, Sovino H, Kohen P, Munoz A, Devoto L, Aygen MA, Atakul T, Oner G, Ozgun MT, Sahin Y, Ozturk F, Li R, Qiao J, Zhylkova I, Feskov A, Feskova I, Somova O, Chumakova N, Bontekoe S, Blake D, Heineman MJ, Williams EC, Johnson NP, Motta A, Colaci D, Horton M, Faut M, Bisioli C, Kopcow L, de Zuniga I, Wiener-Megnazi Z, Khaytov M, Lahav - Baratz S, Shiloh H, Koifman M, Oslander R, Dirnfeld M, Sundqvist J, Andersson KL, Scarselli G, Gemzell-Danielsson K, Lalitkumar PGL, Tokushige N, Markham R, Crossett B, Ahn S, Nelaturi V, Khan A, Fraser IS, Van Vaerenbergh I, Fatemi HM, Blockeel C, Van Lommel L, In't Veld P, Schuit F, Kolibianakis EM, Devroey P, Bourgain C, Sugino N, Tamura I, Lee R, Maekawa R, Gelbaya T, Gordts S, D'Hooghe TN, Gergolet M, Nardo LG, Yu H, Wang H, Huang H, Lee C, Soong Y, Kremenska Y, Masliy Y, Goncharova Y, Kremenskoy M, Veselovskyy V, Zukin V, Sudoma I, Delgado-Rosas F, Gomez R, Tamarit S, Abad A, Simon C, Pellicer A, Racicot M, Dean NL, Antaki R, Menard S, Kadoch IJ, Garcia-Guzman R, Cabrera Romero L, Hernandez J, Palumbo A, Marshall E, Lowry J, Maybin JA, Collins F, Critchley HOD, Saunders PTK, Chaudhury K, Jana SK, Banerjee P, Mukherjee S, Chakravarty BN, Allegra A, Marino A, Lama A, Santoro A, Agueli C, Mazzola S, Volpes A, Delvoux B, de Graaff AA, D'Hooghe TM, Kyama CM, Dunselman GAJ, Romano A, Caccavo D, Pellegrino NM, Totaro I, Panzarino M, Nardelli C, Depalo R, Flores R, Montanana V, Monzo A, Polo P, Garcia-Gimeno T, Cabo A, Rubio JM, Pellicer A, de Graaff AA, Dunselman GAJ, Beets GL, van Lankveld JJ, Kim HY, Lee BS, Cho SH, Choi YS, Seo SK, Lee KE, Yang HI, Abubakirov A, Vacheyshvili T, Krechetova L, Ziganshina M, Demura T, Nazarenko T, Fulop I, Rucz A, Herczegh SZ, Ujvari A, Takacs SZ, Szakonyi T, Lopez - Muniz A, Zamora L, Serra O, Guix C, Lopez-Teijon M, Benadiva C, Alvarez JG, Goudakou M, Karkanaki A, Kalogeraki A, Mataliotakis I, Kalogiannidis I, Prapas I, Hosie M, Thomson KJ, Penny CB, Thomson KJ, Penny C, Hosie MJ, McKinnon B, Klaeser B, Bersinger N, Mueller MD, Horcajadas JA, Martinez-Conejero JA, Montesinos M, Morgan M, Fortuno S, Simon C, Pellicer A, Yi KW, Shin JH, Park HT, Kim T, Kim SH, Hur JY, Chan RWS, Chan YY, Ng EHY, Yeung WSB, Santulli P, Borghese B, Chopin N, Marcellin L, de Ziegler D, Chapron C, Elnashar A, Badawy A, Mosbah A, Tzioras S, Polyzos NP, Messini CI, Papanikolaou EG, Valachis A, Patavoukas E, Mauri D, Badawy A, Messinis IE, Acar N, Hirota Y, Tranguch S, Daikoku T, Burnum KE, Xie H, Kodama A, Osuga Y, Ustunel I, Friedman DB, Caprioli RM, Dey SK, Mitra A, Sahu R, Pal M, Bhattachrayya AK, Bhattachrya J, Ferrero S, Remorgida V, Rollandi GA, Biscaldi E, Cho S, Choi YS, Kim HY, Seo SK, Yang HI, Lee KE, Shin JH, Lee BS, Arena E, Morando A, Remorgida V, Ferrero S, Tomazevic T, Ban-Frangez H, Virant-Klun I, Verdenik I, Pozlep B, Vrtacnik-Bokal E, Valenzano Menada M, Biscaldi E, Remorgida V, Morotti M, Venturini PL, Rollandi GA, Ferrero S, Dimitriadis E, Salamonsen LA, Hannan N, O'Connor O, Rombauts L, Stoikos C, Mahmoudi M, Shaikh A, Mousavifar N, Rastin M, Baharara J, Tabasi N, Takemura Y, Fujimoto A, Osuga Y, Tsutsumi R, Ooi N, Yano T, Taketani Y, Karkanaki A, Goudakou M, Kalogiannidis I, Panagiotidis I, Prapas Y, Zhang D, Lv PP, Ding GL, Zhang RJ, Zou LB, Xu GF, Gao HJ, Zhu YM, Sheng JZ, Huang HF, Martinez-Conejero JA, Labarta E, Alama P, Pellicer A, Horcajadas JA, Bosch E. Posters * Endometriosis, Endometrium and Implantation. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cormio A, Guerra F, Cormio G, Cantatore P, Selvaggi L, Gadaleta M. 103 MtDNA content in the progression of endometrial pathology from normal endometrium to hyperplasia to type I endometrial carcinoma. Mitochondrion 2010. [DOI: 10.1016/j.mito.2009.12.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cormio G, Loizzi V, Carriero C, Putignano G, Selvaggi L. Spleen involvement in women with ovarian cancer. EUR J GYNAECOL ONCOL 2009; 30:384-386. [PMID: 19761127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aim of this study was to determine the prognostic factors of spleen metastases in ovarian cancer. A retrospective chart review was conducted and ten patients with spleen metastases were evaluated. Eight were Stage III, one Stage I and one Stage IV. One patient had a spleen metastasis at the time of ovarian cancer diagnosis, whereas, the remaining patients 23.4+12 months after ovarian cancer diagnosis. Spleen involvement is a late complication that rarely occurs in ovarian cancer and confers a poor prognosis. The interval time between ovarian cancer diagnosis and appereance of spleen involvement is the most important prognostic factor.
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Affiliation(s)
- G Cormio
- Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, University of Bari, Bari, Italy
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Cormio G, Loizzi V, Carriero C, Scardigno D, Putignano G, Selvaggi L. Conservative management of uterine leiomyosarcoma: report of a failure. EUR J GYNAECOL ONCOL 2009; 30:206-207. [PMID: 19480257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Conservative management of uterine leiomyosarcoma has rarely been reported in the literature. CASE REPORT A 26-year-old woman was diagnosed with uterine leiomyosarcoma after resection of a 11 cm uterine mass. Conservative management was proposed, demolitive surgery was not performed and the patient received four courses of chemotherapy. Four months after completion of chemotherapy the patient developed a local recurrence and died of disease 48 months after the primary diagnosis. CONCLUSION Reporting a failure after conservative management of uterine leiomyosarcoma is important in order to try to evaluate correct indications for fertility-sparing surgery.
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Affiliation(s)
- G Cormio
- Department of Obstetrics and Gynaecology and Neonatology, University of Bari, Italy
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Cormio G, Loizzi V, Carriero C, Putignano G, Selvaggi L. Is there a role for neoadjuvant chemotherapy in early invasive cervical carcinoma? EUR J GYNAECOL ONCOL 2009; 30:249-254. [PMID: 19697614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The purpose of this study was to determine if a survival advantage may exist from neoadjuvant chemotherapy (NACT) followed by radical surgery in early invasive (Stage IB1 and IIA) cervical carcinoma. METHODS Using information from studies published on the topic of NACT in cervical carcinoma along with baseline control rates of standard treatment and patterns of failure, an estimate of how many patients with early invasive cervical cancer would benefit from this procedure was calculated. RESULTS NACT followed by tailored radical surgery could result in a significant decrease (about 40%) in recurrence rate (13 vs 22%) and ultimately in survival compared to conventional treatment in early invasive cervical cancer. Moreover the introduction of NACT in all patients should result in a 75% decrease of adjuvant radiotherapy (10 vs 40%), and probably in a decrease in surgical and radiation related complications. CONCLUSION A fraction of patients with early invasive cervical cancer (high-risk Stage IB-IIA cervical cancer) could benefit from NACT followed by tailored radical surgery. A randomized controlled trial to test this research question is very difficult due to the large population required. A subset population is identified which may benefit from NACT.
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Affiliation(s)
- G Cormio
- Department of Obstetrics and Gynecology, University of Bari, Bari, Italy
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Romualdi D, Costantini B, Selvaggi L, Giuliani M, Cristello F, Macri F, Bompiani A, Lanzone A, Guido M. Metformin improves endothelial function in normoinsulinemic PCOS patients: a new prospective. Hum Reprod 2008; 23:2127-33. [DOI: 10.1093/humrep/den230] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vimercati A, Scioscia M, Panella E, Nardelli C, Coluccia A, Camporeale C, DeCosmo L, Laforgia N, Selvaggi L. Perinatal Risk Factors and Mode of Delivery Correlated to Survival and Psychomotor Disability in Extremely Low Birth Weight Infants. Gynecol Obstet Invest 2008; 66:91-7. [DOI: 10.1159/000127983] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Accepted: 11/06/2007] [Indexed: 11/19/2022]
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Loizzi V, Cormio G, Vicino M, Selvaggi L. Neoadjuvant Chemotherapy: An Alternative Option of Treatment for Locally Advanced Cervical Cancer. Gynecol Obstet Invest 2007; 65:96-103. [PMID: 17878736 DOI: 10.1159/000108600] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2006] [Accepted: 07/11/2007] [Indexed: 11/19/2022]
Abstract
Although the incidence of cervical cancer has declined in both North America and Europe, it still represents the second most common cancer in women and the fifth most common malignancy worldwide. Most patients in the developed countries present with disease either confined to the cervix or with limited extension beyond it. Historically, the standard treatment was usually radiotherapy or radical hysterectomy with node dissection. In 1999, five randomized clinical trials performed by the Gynecologic Oncology Group, the Radiation Therapy Oncology Group and the Southwest Oncology Group have demonstrated a significant outcome advantage when cisplatin-based chemotherapy was administered during radiation in patients with cervical cancer. In the current review, we will analyze the role of neoadjuvant chemotherapy followed by radiotherapy and surgery as an alternative option treatment to the standard chemoradiation for locally advanced cervical cancer (stage Ib2 or larger).
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Affiliation(s)
- V Loizzi
- Division of Gynecology Oncology, Department of Obstetrics Gynecology and Neonatology, University of Bari, Bari, Italy
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Cormio G, Loizzi V, Selvaggi L. Leptomeningeal involvement after remission of brain metastases from ovarian cancer. Int J Gynaecol Obstet 2007; 99:139. [PMID: 17628564 DOI: 10.1016/j.ijgo.2007.04.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Revised: 04/29/2007] [Accepted: 04/30/2007] [Indexed: 11/23/2022]
Affiliation(s)
- G Cormio
- Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.
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Cormio G, Vicino M, Loizzi V, Tangari D, Selvaggi L. Antimicrobial prophylaxis in vaginal gynecologic surgery: a prospective randomized study comparing amoxicillin-clavulanic acid with cefazolin. J Chemother 2007; 19:193-7. [PMID: 17434829 DOI: 10.1179/joc.2007.19.2.193] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The aim of this prospective, randomized study was to compare amoxicillin-clavulanic acid with cefazolin as ultra-short term prophylaxis in vaginal gynecologic surgery. It was conducted at the Department of Obstetrics and Gynecology, University of Bari. Patients were randomly allocated to receive amoxicillin-clavulanic acid (2.2 g) [Group A] or cefazolin (2 g) [Group B] as a single dose 30 minutes before surgery. Each patient was assessed daily until discharge to evidence febrile status and the presence of infections at the operative site, urinary tract and respiratory tract. In the amoxicillin-clavulanic acid (Group A) and cefazolin (Group B) groups, overall 88 and 90 patients, respectively, were evaluable for prophylactic efficacy at hospital discharge. Infectious complications were infrequent in both arms, with febrile morbidity occurring in 4 (4.5%) and 16 (8.9%) patients respectively in the amoxicillin-clavulanic acid and cefazolin groups (p=0.016). Urinary tract infections were higher but not significantly in the amoxicillin-clavulanic acid group (6.8% versus 4.4 %), whereas asymptomatic bacteriuria was detected in 2.2% of the patients in both groups. There was no respiratory tract infection or septic death in either group. It is concluded that ultra-short term prophylaxis with both amoxicillin-clavulanic acid and cefazolin is safe and effective in elective vaginal gynecologic surgery.
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Affiliation(s)
- G Cormio
- Sezione de Ginecologia A, Dipartimento di Scienze Chirurgiche Generali e Specialistische, Università degli studi di Bari, Bari, Italy. n.cormio@
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Belosi C, Selvaggi L, Apa R, Guido M, Romualdi D, Fulghesu AM, Lanzone A. Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma? Hum Reprod 2006; 21:3108-15. [PMID: 17053004 DOI: 10.1093/humrep/del306] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The clinical heterogeneity of polycystic ovary syndrome (PCOS) is mirrored by the unceasing debate on the most appropriate diagnostic criteria. METHODS AND RESULTS To highlight differences and inconsistencies between NIH and ESHRE/ASRM criteria, we applied them to 375 patients with oligo/amenorrhoea and signs of hyperandrogenism. Among them, we identified 273 women with PCOS according to NIH, whereas up to 345 patients fulfilled ESHRE/ASRM criteria. The 72 patients, constituting the gap between the two classifications, exhibited a lower expression of clinical signs compared with the 273 patients matching both criteria. To the whole group, we then applied the ESHRE/ASRM criteria modified to include an easily reproducible ultrasound examination of the ovarian stroma (UCSC criteria). In this way, we identified 30 women who were healthy according to all criteria, 37 affected by PCOS according only to the ESHRE/ASRM Consensus, 35 affected according only to the UCSC and ESHRE/ASRM criteria and 273 who were considered to have PCOS by all criteria. These groups showed a progressively increasing expression of PCOS features. CONCLUSION In the grey area between NIH and ESHRE/ASRM classifications, UCSC criteria could identify a subgroup of women, missed by NIH criteria, with more pronounced stigmas than those identified by ESHRE/ASRM criteria alone, and who may profit more from a targeted therapy.
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Affiliation(s)
- C Belosi
- ISI, Istituto Scientifico Internazionale Paolo VI, Rome, Italy
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Cormio G, Martino R, Loizzi V, Resta L, Selvaggi L. A rare case of choroidal metastasis presented after conservative management of endometrial cancer. Int J Gynecol Cancer 2006; 16:2044-8. [PMID: 17177844 DOI: 10.1111/j.1525-1438.2006.00730.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Hematogenous dissemination from endometrial cancer is quite rare. We report a 31-year-old woman who developed choroidal metastasis following conservative management of early-stage endometrial carcinoma. She had received kidney transplantation and was taking steroids and cyclosporine. Three years after hysterectomy for persistent endometrial carcinoma, she developed multiple metastatic disease (to both lungs and right pelvis), and while on treatment with paclitaxel and carboplatin, she complained of a rapid visual deterioration. Ophthalmologic evaluation revealed a metastatic choroidal tumor associated with multiple central nervous system metastases. The patient refused further treatment and died 1 month after diagnosis of choroidal involvement. In conclusion, this is the first reported case of choroidal metastasis from endometrial cancer and highlights the need to consider immunosuppressive treatment as an absolute contraindication to conservative fertility-sparing treatment in gynecological malignancies.
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Affiliation(s)
- G Cormio
- Department of Obstetrics and Gynaecology and Ophthalmology, University of Bari, Bari, Italy.
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Fulghesu AM, Angioni S, Belosi C, Apa R, Selvaggi L, Ciampelli M, Iuculano A, Melis GB, Lanzone A. Pituitary-ovarian response to the gonadotrophin-releasing hormone-agonist test in anovulatory patients with polycystic ovary syndrome: predictive role of ovarian stroma. Clin Endocrinol (Oxf) 2006; 65:396-401. [PMID: 16918963 DOI: 10.1111/j.1365-2265.2006.02611.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the influence of ovarian stroma on basal and poststimulus androgen secretion in patients affected by secondary amenorrhoea and polycystic ovaries (PCO) at ultrasound (US). DESIGN Prospective study. PATIENTS Fifty-one patients with PCO selected from a group of 72 normal weight women aged 20-25 years affected by secondary amenorrhoea and 10 normal ovulatory controls. METHODS All subjects underwent US to evaluate volume, area, stromal area and stromal/total area ratio of both ovaries. Plasma levels of gonadotrophins, oestradiol (E2) and androgens were measured before and 24 h after GnRH-a injection. 60 min after stimulus LH and FSH were also assayed. RESULTS Thirty patients had increased ovarian stroma (IS) and 21 patients normal ovarian stroma (NS). Significantly higher LH levels characterized the IS group, both basally and after GnRH-a stimulation compared with NS and controls (P < 0.01). Baseline levels of androstenedione, testosterone and 17-OHprogesterone (17-OHP) were significantly higher in IS group. Moreover, 17-OHP hyper-response to GnRH-a was demonstrated in IS group in comparison to NS and control groups (P < 0.005). CONCLUSIONS Stroma evaluation may be of use in discriminating between different pathogenic factors in secondary amenorrhoea. This criterion may be applied to support the correct diagnosis of polycystic ovary syndrome (PCOS). Indeed, in line with the most recently proposed guidelines, patients affected by multifollicular ovaries could be classified as PCOS. The possibility of taking into account more than one US criterion or of carefully reanalysing the significance of increased stroma volume should be considered.
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Affiliation(s)
- A M Fulghesu
- Dipartimento Chirurgico Materno-Infantile e di Scienze delle Immagini, Università degli Studi di Cagliari, Cagliari, Italy.
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Hugues JN, Cédrin-Durnerin I, Howles CM, Amram M, Angelini A, Balen A, Barbereau D, Birkhauser M, Boujenah A, De Leo V, De Placido G, Dessole S, Favrin S, Ferrazi E, Gay C, Germond M, Hedon B, Hocke C, Jolly C, Lamarca-Roth E, Lanzone A, Marchand F, Marcolin G, Mascaretti G, Moreau L, Massobrio M, Nappi C, Pardi G, Pennehouat G, Porcu E, Seibert M, Selvaggi L, Thiers D, Venturini P. The use of a decremental dose regimen in patients treated with a chronic low-dose step-up protocol for WHO Group II anovulation: a prospective randomized multicentre study. Hum Reprod 2006; 21:2817-22. [PMID: 16877376 DOI: 10.1093/humrep/del265] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In women with chronic anovulation, the choice of the FSH starting dose and the modality of subsequent dose adjustments are critical in controlling the risk of overstimulation. The aim of this prospective randomized study was to assess the efficacy and safety of a decremental FSH dose regimen applied once the leading follicle was 10-13 mm in diameter in women treated for WHO Group II anovulation according to a chronic low-dose (CLD; 75 IU FSH for 14 days with 37.5 IU increment) step-up protocol. METHODS Two hundred and nine subfertile women were treated with recombinant human FSH (r-hFSH) (Gonal-f) for ovulation induction according to a CLD step-up regimen. When the leading follicle reached a diameter of 10-13 mm, 158 participants were randomized by means of a computer-generated list to receive either the same FSH dose required to achieve the threshold for follicular development (CLD regimen) or half of this FSH dose [sequential (SQ) regimen]. HCG was administered only if not more than three follicles >or=16 mm in diameter were present and/or serum estradiol (E(2)) values were <1200 pg/ml. The primary outcome measure was the number of follicles >or=16 mm in size at the time of hCG administration. RESULTS Clinical characteristics and ovarian parameters at the time of randomization were similar in the two groups. Both CLD and SQ protocols achieved similar follicular growth as regards the total number of follicles and medium-sized or mature follicles (>/=16 mm: 1.5 +/- 0.9 versus 1.4 +/- 0.7, respectively). Furthermore, serum E(2) levels were equivalent in the two groups at the time of hCG administration (441 +/- 360 versus 425 +/- 480 pg/ml for CLD and SQ protocols, respectively). The rate of mono-follicular development was identical as well as the percentage of patients who ovulated and achieved pregnancy. CONCLUSIONS The results show that the CLD step-up regimen for FSH administration is efficacious and safe for promoting mono-follicular ovulation in women with WHO Group II anovulation. This study confirms that maintaining the same FSH starting dose for 14 days before increasing the dose in step-up regimen is critical to adequately control the risk of over-response. Strict application of CLD regimen should be recommended in women with WHO Group II anovulation.
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Affiliation(s)
- J N Hugues
- Reproductive Medicine Unit, Jean Verdier Hospital, University Paris XIII, Paris, France.
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Vimercati A, Scioscia M, Angelici M, Nappi L, Depalo R, Greco P, Selvaggi L. Proposal of a Model for Prevention and Treatment of Congenital Toxoplasmosis. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-923763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Abstract
The purpose of this study was to evaluate the efficacy and toxicity of neoadjuvant chemotherapy in patients with locally advanced cervical cancer. Between 1992 and 2003, all consecutive women with locally advanced cervical cancer receiving neoadjuvant chemotherapy were identified. Sixty-seven patients received neoadjuvant chemotherapy: 34 had stage I disease, 28 had stage II disease, and 5 had stage III disease. Clinical response to neoadjuvant chemotherapy occurred in 61 patients, including six with complete and 55 with partial response; five women showed stable disease and one progressed. After neoadjuvant chemotherapy, 58 women underwent surgery, whereas the remaining nine received radiation. Hematologic toxicity was seen in 14 patients, with most of them consisting in severe anemia. The 5-year survival rate and median survival were 63% and 93 months. In univariate analysis, response to neoadjuvant chemotherapy, treatment after neoadjuvant chemotherapy, cervical stromal invasion >50%, and lymph node involvement were important prognostic factor responsible for survival. Neoadjuvant chemotherapy followed by surgery seems to be tolerated and active in the treatment of locally advanced cervical cancer and might be an alternative choice of therapy to chemoradiation. A prospective randomized trial with a larger number of cases is needed.
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Affiliation(s)
- L Selvaggi
- Department of Obstetrics and Gynecology, University of Bari, Bari, Italy
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Vicino M, Loizzi V, Scardigno D, Selvaggi L. [Polycystic ovary syndrome: from physiopathology to therapy]. Minerva Ginecol 2006; 58:55-67. [PMID: 16498371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Polycystic ovary syndrome (PCOS) is still a complex and heterogeneous disorder that presents a challenge for clinical investigators. It is the most common endocrine and metabolic disorder of reproductive-aged women that presents with varied symptoms such as hyperinsulinemia, anovulatory dysfunction, hirsutism, obesity and elevated incidence of cardiac problems. For these reasons, this syndrome is considered by some physicians as an endocrine and for others as a metabolic syndrome. This article will focus on the disorder of the PCOS. It will be based on an understanding of the physiopathology in order to present therapeutic recommendations.
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Affiliation(s)
- M Vicino
- Dipartimento di Scienze Chirurgiche Generali e Specialistiche, Università degli Studi di Bari, Bari.
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Bettocchi S, Ceci O, Nappi L, Pontrelli G, Pinto L, Costantino A, Selvaggi L. 75. J Minim Invasive Gynecol 2005. [DOI: 10.1016/j.jmig.2005.07.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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38
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Vimercati A, Scioscia M, Vicino M, Selvaggi L. Prenatal Evaluation of an Extremely Rare and Bizarre Case of Cephalothoracopagus Monosymmetros Janiceps Twins. Geburtshilfe Frauenheilkd 2005. [DOI: 10.1055/s-2005-872869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Bettocchi S, Ceci O, Nappi L, Pontrelli G, Pinto L, Costantino A, Selvaggi L. 186. J Minim Invasive Gynecol 2005. [DOI: 10.1016/j.jmig.2005.07.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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40
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Chapple CR, Martinez-Garcia R, Selvaggi L, Toozs-Hobson P, Warnack W, Drogendijk T, Wright DM, Bolodeoku J. A Comparison of the Efficacy and Tolerability of Solifenacin Succinate and Extended Release Tolterodine at Treating Overactive Bladder Syndrome: Results of the STAR Trial. Eur Urol 2005; 48:464-70. [PMID: 15990220 DOI: 10.1016/j.eururo.2005.05.015] [Citation(s) in RCA: 216] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2005] [Accepted: 05/24/2005] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare two new generation antimuscarinics at their recommended doses for treatment of overactive bladder syndrome (OAB). METHODS A prospective, double blind, double-dummy, two-arm, parallel-group, 12-week study was conducted to compare the efficacy and safety of solifenacin 5 or 10 mg and tolterodine extended release (ER) 4 mg once daily in OAB patients. After 4 weeks of treatment patients had the option to request a dose increase but were dummied throughout as approved product labelling only allowed an increase for those on solifenacin. RESULTS Solifenacin, with a flexible dosing regimen, showed greater efficacy to tolterodine in decreasing urgency episodes, incontinence, urge incontinence and pad usage and increasing the volume voided per micturition. More solifenacin treated patients became continent and reported improvements in perception of bladder condition assessments. The majority of side effects were mild to moderate in nature, and discontinuations were comparable and low in both groups. CONCLUSIONS Solifenacin, with a flexible dosing regimen, was found to be superior to tolterodine ER with respect to the majority of the efficacy variables.
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Affiliation(s)
- C R Chapple
- Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Urology Research, South Yorkshire, UK.
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Loizzi V, Cormio G, Resta L, Rossi CA, Di Gilio AR, Cuccovillo A, Selvaggi L. Neoadjuvant chemotherapy in advanced ovarian cancer: a case-control study. Int J Gynecol Cancer 2005; 15:217-23. [PMID: 15823102 DOI: 10.1111/j.1525-1438.2005.15206.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to compare the outcome of patients with advanced ovarian carcinoma treated with neoadjuvant chemotherapy (NACT) with those treated conventionally with primary debulking surgery. From 1994 to 2003, all consecutive cases of advanced-stage epithelial ovarian carcinoma treated with NACT at the University of Bari were identified. A well-balanced group of women who underwent primary debulking surgery followed by platinum-based chemotherapy was selected as controls. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors for survival. Thirty women with advanced-stage epithelial ovarian carcinoma were treated with NACT and compared to 30 patients who underwent primary debulking surgery. Patients in the NACT were significantly older and had a poorer performance status compared to the controls. However, no statistical difference was observed in overall disease-specific survival (P= 0.66) and disease-free survival (P= 0.25) between the two groups. Although patients in the NACT group are significantly older and have a poorer performance status, this treatment modality does not compromise survival. Prospective randomized trials comparing NACT to conventional treatment to determine the quality of life and cost/benefit outcomes are now appropriate for women presenting advanced epithelial ovarian cancer.
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Affiliation(s)
- V Loizzi
- Sezione di Ginecologia e Ostetricia A, Dipartimento di Scienze Chirurgiche Generali e Specialistiche, University of Bari, Bari, Italy.
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Loizzi V, Cormio G, Vicino M, Fattizzi N, Bettocchi S, Selvaggi L. Hormone replacement therapy on ovarian and uterine cancer risk and cancer survivors: how shall we do no harm? Int J Gynecol Cancer 2005; 15:420-5. [PMID: 15882164 DOI: 10.1111/j.1525-1438.2005.15303.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This article will focus on the results of the Women's Health Initiative on the effects of hormone replacement therapy on coronary heart disease, stroke, venous thromboembolism, breast cancer, and colorectal cancer. Data from other relevant trials, including the most recent data on ovarian and uterine cancer risk and on gynecologic cancer patients, are also discussed to provide some guidelines on prescribing hormone replacement therapy in clinical practice, particularly in gynecologic cancer survivors.
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Affiliation(s)
- V Loizzi
- Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.
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Di Paola M, Loverro G, Caringella AM, Cormio G, Selvaggi L. Receptorial and mitochondrial apoptotic pathways in normal and neoplastic human endometrium. Int J Gynecol Cancer 2005. [DOI: 10.1136/ijgc-00009577-200505000-00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Loizzi V, Cormio G, Vicino M, Fattizzi N, Bettocchi S, Selvaggi L. Hormone replacement therapy on ovarian and uterine cancer risk and cancer survivors: how shall we do no harm? Int J Gynecol Cancer 2005. [DOI: 10.1136/ijgc-00009577-200505000-00002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This article will focus on the results of the Women's Health Initiative on the effects of hormone replacement therapy on coronary heart disease, stroke, venous thromboembolism, breast cancer, and colorectal cancer. Data from other relevant trials, including the most recent data on ovarian and uterine cancer risk and on gynecologic cancer patients, are also discussed to provide some guidelines on prescribing hormone replacement therapy in clinical practice, particularly in gynecologic cancer survivors.
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Abstract
The purpose of this study was to investigate the clinical features of hepatic metastasis in patients with epithelial ovarian cancer. From 1998 to 2002, all women with hepatic metastasis from ovarian cancer were identified at the University of Bari. Twenty-nine patients identified included one having stage IIC, one stage IIIA, two stage IIIB, 17 stage IIIC, and eight stage IVB. Eight women had hepatic metastasis at the time of the diagnosis of ovarian cancer (group I), 10 patients had hepatic metastasis as first recurrence (group II), and 11 (group III) as a second relapse. The median survival from the time of liver metastasis diagnosis was 19 months in group I patients, 24 months in group II patients, and 10 months in group III patients. No statistical differences in survival were seen among the three groups (P = 0.7). Cell type, performance status at the time of the primary tumor diagnosis, number of hepatic lesions, the presence of other sites of disease at the time of hepatic metastasis, and platinum-based chemotherapy were significantly related to survival. Better performance status, serous cell-type tumor, single hepatic lesion, the absence of other sites of disease, and platinum-based chemotherapy are good prognostic factors.
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Affiliation(s)
- V Loizzi
- Dipartimento Di Scienze Chirurgiche Generali E Specialistiche, Sezione Di Ginecologia E Ostetricia A, University of Bari, Viale J.F. Kennedy 80, 70124 Bari, Italy.
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Greco P, Scioscia M, Vimercati A, Cibelli G, Rossi AC, Nappi L, Selvaggi L. Preinduction Sonographic Measurement of Cervical Length in Post-Term Nulliparous Women with Low Cervical Score: A Pilot Study. Geburtshilfe Frauenheilkd 2005. [DOI: 10.1055/s-2004-830393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Loizzi V, Rossi C, Cormio G, Cazzolla A, Altomare D, Selvaggi L. Clinical features of hepatic metastasis in patients with ovarian cancer. Int J Gynecol Cancer 2005. [DOI: 10.1136/ijgc-00009577-200501000-00005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The purpose of this study was to investigate the clinical features of hepatic metastasis in patients with epithelial ovarian cancer. From 1998 to 2002, all women with hepatic metastasis from ovarian cancer were identified at the University of Bari. Twenty-nine patients identified included one having stage IIC, one stage IIIA, two stage IIIB, 17 stage IIIC, and eight stage IVB. Eight women had hepatic metastasis at the time of the diagnosis of ovarian cancer (group I), 10 patients had hepatic metastasis as first recurrence (group II), and 11 (group III) as a second relapse. The median survival from the time of liver metastasis diagnosis was 19 months in group I patients, 24 months in group II patients, and 10 months in group III patients. No statistical differences in survival were seen among the three groups (P = 0.7). Cell type, performance status at the time of the primary tumor diagnosis, number of hepatic lesions, the presence of other sites of disease at the time of hepatic metastasis, and platinum-based chemotherapy were significantly related to survival. Better performance status, serous cell-type tumor, single hepatic lesion, the absence of other sites of disease, and platinum-based chemotherapy are good prognostic factors.
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Loizzi V, Cormio G, Resta L, Rossi CA, Di Gilio AR, Cuccovillo A, Selvaggi L. Neoadjuvant chemotherapy in advanced ovarian cancer: a case-control study. Int J Gynecol Cancer 2005. [DOI: 10.1136/ijgc-00009577-200503000-00005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The aim of this study was to compare the outcome of patients with advanced ovarian carcinoma treated with neoadjuvant chemotherapy (NACT) with those treated conventionally with primary debulking surgery. From 1994 to 2003, all consecutive cases of advanced-stage epithelial ovarian carcinoma treated with NACT at the University of Bari were identified. A well-balanced group of women who underwent primary debulking surgery followed by platinum-based chemotherapy was selected as controls. Kaplan–Meier and Cox proportional hazards analyses were used to determine the predictors for survival. Thirty women with advanced-stage epithelial ovarian carcinoma were treated with NACT and compared to 30 patients who underwent primary debulking surgery. Patients in the NACT were significantly older and had a poorer performance status compared to the controls. However, no statistical difference was observed in overall disease-specific survival (P = 0.66) and disease-free survival (P = 0.25) between the two groups. Although patients in the NACT group are significantly older and have a poorer performance status, this treatment modality does not compromise survival. Prospective randomized trials comparing NACT to conventional treatment to determine the quality of life and cost/benefit outcomes are now appropriate for women presenting advanced epithelial ovarian cancer.
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Bettocchi S, Nappi L, Ceci O, Santoro A, Selvaggi L, Cormio G, Vimercati A. Treatment of submucosal and partially intramural myomas using the bipolar Versapoint system. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s1074-3804(04)80306-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Loizzi V, Cormio G, Di Vagno G, Resta L, Cazzolla A, Di Gilio A, Cuccovillo A, Selvaggi L. Neoadjuvant chemotherapy for stage III and IV epithelial ovarian cancer: A comparative study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V. Loizzi
- University of Bari, Dept Ob/Gyn, Bari, Italy; University of Bari, Dept of Pathology, Bari, Italy
| | - G. Cormio
- University of Bari, Dept Ob/Gyn, Bari, Italy; University of Bari, Dept of Pathology, Bari, Italy
| | - G. Di Vagno
- University of Bari, Dept Ob/Gyn, Bari, Italy; University of Bari, Dept of Pathology, Bari, Italy
| | - L. Resta
- University of Bari, Dept Ob/Gyn, Bari, Italy; University of Bari, Dept of Pathology, Bari, Italy
| | - A. Cazzolla
- University of Bari, Dept Ob/Gyn, Bari, Italy; University of Bari, Dept of Pathology, Bari, Italy
| | - A. Di Gilio
- University of Bari, Dept Ob/Gyn, Bari, Italy; University of Bari, Dept of Pathology, Bari, Italy
| | - A. Cuccovillo
- University of Bari, Dept Ob/Gyn, Bari, Italy; University of Bari, Dept of Pathology, Bari, Italy
| | - L. Selvaggi
- University of Bari, Dept Ob/Gyn, Bari, Italy; University of Bari, Dept of Pathology, Bari, Italy
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