Publications by authors named "Alessandro Favilli"

Article Synopsis
  • Amniotic fluid contains stem cells (AF-SCs) that have potential uses in regenerative medicine for treating various injuries and diseases.
  • When exposed to basic Fibroblast Growth Factor (bFGF), AF-SCs show the ability to survive and migrate in a rat brain model, resembling characteristics of neuronal/glial progenitor cells.
  • The study employs electrophysiological techniques to identify specific potassium currents in AF-SCs and confirms that histamine can influence calcium dynamics and potassium current activation in these cells.
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Objective: To demonstrate the "cold loop technique" for the hysteroscopic treatment of FIGO type 3 myomas.

Design: Step-by-step demonstration of the technique using educative video.

Subject: A 45-year-old infertile patient with repeated oocyte donor IVF failures affected by a FIGO type 3 myoma.

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Objectives: To report the first cases of surgical staging for apparently early-stage endometrial cancer performed using the Versius® next-generation robotic surgical system (Cambridge Medical Robots [CMR] Surgical, Cambridge, UK).

Design: Prospective case series. Participants/Materials: Women who underwent surgical staging, including total hysterectomy, bilateral adnexectomy, and sentinel lymph node (SLN) biopsy, for apparently early-stage endometrial cancer using the Versius® next-generation robotic surgical system (CMR Surgical, Cambridge, UK).

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Ovarian cancer affects thousands of women every year and represents the female cancer with the highest mortality rate. Effectively, it is a severe disease that requires a multidisciplinary approach for optimal treatment. Surgery currently is the cornerstone of its treatment and numerous methods have been analyzed and developed to predict the possibility of obtaining a residual tumor of 0 (RT=0).

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Objective: To evaluate the reproductive outcomes of patients bearing BRCA-1 and BRCA-2 mutations.

Methods: In this retrospective observational cohort study, we assessed data from BRCA-1 and BRCA-2 carriers, analyzing demographics, oncological history, and reproductive outcomes. Statistical analysis compared BRCA-1 and BRCA-2 carriers.

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Article Synopsis
  • Cervical cancer poses a major health risk for younger women, and tools like cold knife (CK) and carbon dioxide (CO) laser conization are used to treat pre-invasive lesions with the intent to cure incidental cervical cancer cases.
  • A study involving 1,270 women showed that CO laser conization had a significantly lower rate of positive margins compared to CK conization (4.3% vs. 13.3%).
  • Both techniques demonstrated similar oncological safety in cases of incidental cervical cancer diagnosis, with no recurrences noted after an average follow-up period of 53 months, and CO laser conization generally proved more effective at achieving clean margins.
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In eutocic labor, the autonomic nervous system is dominated by the parasympathetic system, which ensures optimal blood flow to the uterus and placenta. This study is focused on the detection of the quantitative presence of catecholamine (C) neurofibers in the internal uterine orifice (IUO) and in the lower uterine segment (LUS) of the pregnant uterus, which could play a role in labor and delivery. A total of 102 women were enrolled before their submission to a scheduled cesarean section (CS); patients showed a singleton fetus in a cephalic presentation outside labor.

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Article Synopsis
  • Gestational diabetes mellitus (GDM) is linked to both immediate obstetric issues and long-term cardiovascular risks, but its effects on platelet function have been underexplored compared to type-2 diabetes.
  • The study compared 23 women with GDM to 23 healthy pregnant women, measuring various aspects of platelet reactivity and endothelial function at different stages of pregnancy and postpartum.
  • Results indicated that women with GDM had increased platelet hyperreactivity and activation, especially towards the end of pregnancy, with some abnormalities persisting up to 8 weeks after delivery, along with signs of endothelial dysfunction.
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Background: Endometrial cancer (EC) is the most common gynecological malignancy in both Europe and the USA. Approximately 3-5% of cases occur in women of reproductive age. Fertility-sparing treatment (FST) options are available, but very limited evidence regarding grade 2 (G2) ECs exists in the current literature.

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Objectives: Enhanced recovery after surgery (ERAS) protocols provide well-known benefits in the immediate recovery with a shorter length of stay (LOS) and also in gynecological surgery. However, the impact of ERAS has not been clearly showed yet regarding long-term consequences and health-related quality of life (HRQL). The aim of this study was to investigate the impact of ERAS on HRQL after hysterectomy for endometrial cancer.

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Article Synopsis
  • Hysteroscopy is the best method for diagnosing and treating issues inside the uterus, with new technology allowing for a combined approach called “see and treat.”
  • Diode laser technology is becoming a key technique in this field, and a systematic review was conducted on original studies using this method, focusing on the treatment of 474 patients.
  • The results showed low complication rates (2.7% intraoperative and 0.6% postoperative), indicating that diode laser hysteroscopy is both safe and effective, but more extensive studies are needed for stronger evidence.
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Background: Hysteroscopy represents the gold standard for the diagnosis and treatment of intrauterine pathologies. The advent of the mini-resectoscope heralded a new era in intrauterine surgery, both in inpatient and outpatient settings.

Objectives: To evaluate the effectiveness, safety, and feasibility of the mini-resectoscope for the treatment of intrauterine pathologies.

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Article Synopsis
  • Uterine leiomyomas (ULs) are common non-cancerous tumors in women, but how they affect fertility is still not well understood.
  • A new classification system from 2008 helps categorize these fibroids better, especially focusing on a special type called "type 3 UL" that can cause more problems for women trying to get pregnant.
  • This review aims to explain how type 3 ULs can affect fertility and explore ways to treat them better, since there's not much solid information available right now.
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Importance: Previous reviews have shown that a history of cesarean section (CS) is associated with a worse in vitro fertilization (IVF) prognosis. To date, whether the decline in the IVF chances of success should be attributed to the CS procedure itself or to the presence of isthmocele remains to be clarified.

Objective: To summarize the available evidence regarding the impact of isthmocele on IVF outcomes.

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The ever-increasing technological advancement in the (ultra)high-performance liquid chromatography tandem (high-resolution) mass spectrometry platforms have largely contributed to steeply intensify the interest towards lipidomics research. However, mass spectrometers alone are unable to distinguish between enantiomers. This obstacle is especially evident in the case of glycerolipids analysis due the prochiral nature of glycerol.

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Objective: To summarize evidence from randomized controlled trials (RCTs) on the effectiveness of virtual reality technology (VRT), as used by patients, for reducing pain during outpatient hysteroscopy.

Data Sources: Electronic databases and clinical registers were searched until June 21, 2023. The review protocol was registered in PROSPERO before the data extraction (CRD42023434340).

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The latest classification from the Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) has reclassified type 3 myomas, changing their classification from intramural to submucosal. While hysteroscopic myomectomy is considered the gold standard treatment for patients experiencing symptoms from submucosal myomas, there are currently no specific guidelines available for managing type 3 myomas, and the optimal surgical approach remains uncertain. The search for suitable articles published in English was carried out using the following databases (PROSPERO ID CRD42023418602): MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), Health Technology Assessment Database, Web of Science and search register.

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Background: Knowledge of vascular anatomy and its possible variations is essential for performing embolization or revascularization procedures and complex surgery in the pelvis. The obturator artery (OA) is a branch of the anterior division of the internal iliac artery (IIA), and it has the highest frequency of variation among branches of the internal iliac artery. Possible anomalies of the origin of the obturator artery (OA) should be known when performing pelvic and groin surgery, where its control or ligation may be required.

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The COVID-19 pandemic posed a significant challenge for clinicians in managing pregnant women, who were at high risk of virus transmission and severe illness. While the WHO declared in May 2023 that COVID-19 is no longer a public health emergency, it emphasized that it remains a global health threat. Despite the success of vaccines, the possibility of new pandemic waves due to viral mutations should be considered.

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Article Synopsis
  • Study investigates the relationship between urinary levels of S100B and Tau proteins in infants and future neurodevelopmental outcomes, particularly in those born preterm or with intrauterine growth restriction (IUGR).
  • Results show that higher levels of S100B and lower levels of Tau in these infants correlate with poorer cognitive and motor skills by age two, though their relation to brain volume is weak.
  • The findings suggest that monitoring urinary levels of S100B and Tau, alongside brain growth indicators, could help identify infants at risk for delayed neurodevelopment.
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: Diagnostic hysteroscopy is the gold standard in the diagnosis of intrauterine pathology and is becoming an essential tool in the daily practice of gynecology. Training programs for physicians are necessary to ensure adequate preparation and learning curve before approaching patients. The aim of this study was to describe the "Arbor Vitae" method for training in diagnostic hysteroscopy and to test its impact on the knowledge and skills of trainees using a customized questionnaire.

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Background: The effect of FIGO (the International Federation of Gynecology & Obstetrics) type 3 myomas on in vitro fertilization (IVF) is uncertain.

Objectives: To evaluate whether FIGO type 3 myomas affect IVF outcomes, through a systematic review and meta-analysis (CRD42022379700).

Search Strategy: Electronic databases were searched until November 15, 2022.

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Human papillomavirus (HPV) infection is one the most common sexually transmitted infections worldwide. In most cases, the infection is temporary and asymptomatic; however, when persistent, it may lead to lesions that can evolve into cancer in both women and men. Nowadays, prophylactic vaccination is the primary preventive strategy for HPV infections, but vaccines do not cover all types of HPV strains.

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