Risk factors for deep endometriosis: a comparison with pelvic and ovarian endometriosis.

Objective: To assess whether deep endometriosis has different risk factors compared with endometriosis at other sites. In epidemiological terms, this should be the case if deep endometriosis represents a different condition than ovarian and peritoneal endometriosis.

Design: Case-control study.

Results of the SCART study: selection of candidates for cardiac resynchronisation therapy.

Objective: To prospectively determine whether prespecified electrocardiographic, echocardiographic and tissue Doppler imaging (TDI) selection criteria may predict a positive response to cardiac resynchronisation therapy (CRT).

Methods: In this multicentre, prospective, non-randomised study, 96 heart failure patients with New York Heart Association class III-IV symptoms, an ejection fraction of < or =35%, and at least one marker of ventricular dyssynchrony according to prespecified electrocardiographic, echocardiographic or TDI criteria were enrolled. The primary endpoint was an improvement in the clinical composite score at 6 months.

Comparison of the effects of cardiac resynchronization therapy in patients with class II versus class III and IV heart failure (from the InSync/InSync ICD Italian Registry).

Cardiac resynchronization therapy (CRT) is recommended for patients with New York Heart Association (NYHA) class III or IV heart failure and wide QRS complexes. The aim of this study was to compare the effects of CRT in patients in NYHA class II with those in NYHA class III or IV. Nine hundred fifty-two patients (188 in NYHA class II) consecutively implanted with biventricular devices and enrolled in a national observational registry were studied.

Hormonal treatments for adenomyosis.

Like endometriosis and uterine myomas, adenomyosis presents the typical characteristics of oestrogen-dependent diseases. The medical treatment of adenomyosis is based on the hormonal dependency of the disease and its strongly debated similarities with endometriosis. Infact, despite the evident differences between the two conditions, the therapies that treat endometriosis effectively have also been successful for the treatment of adenomyosis.

Evaluation of a new questionnaire for the presurgical diagnosis of bladder endometriosis.

Background: The main objective was to evaluate the diagnostic accuracy of a new questionnaire for the presurgical diagnosis of bladder endometriosis in patients with a high suspicion index for this disease.

Methods: We included all patients of age <40 years undergoing laparoscopy or laparotomy for chronic pelvic pain. We partially modified the American Urologic Association Symptom Index with the aim of identifying bladder endometriosis among 157 women undergoing surgery for chronic pelvic pain.

Radical excision of inguinal endometriosis.

Background: The diagnosis of inguinal endometriosis can be complex, and patients are often first operated by a general surgeon for a hernia. We present five cases of inguinal endometriosis in which primary surgery resulted in recurrence and a second correct procedure resulted in a cure.

Cases: Five patients with inguinal endometriosis, operated between 1996 and 2002, were seen for the recurrence of symptoms.

Use of an endoscopic ultrasound probe for the evaluation of the Müllerian rudiments in patients with Rokitansky syndrome.

Objective: To assess the use of an endoscopic ultrasound probe in the evaluation of the uterine horns in a series of patients who were undergoing laparoscopy for the creation of a neovagina.

Design: Prospective study.

Setting: Department of Obstetrics and Gynecology in a tertiary care and referral center for Rokitansky syndrome.

Laparoscopically assisted uterovestibular anastomosis in patients with uterine cervix atresia and vaginal aplasia.

Objective: To describe the surgical technique and the long-term anatomic and functional results of laparoscopically assisted uterovestibular anastomosis.

Design: Descriptive study.

Setting: Tertiary referral center.

Laparoscopic findings and pelvic anatomy in Mayer-Rokitansky-Küster-Hauser syndrome.

Objective: To describe analytically the anatomic variety and laparoscopic findings observed in patients with Rokitansky syndrome throughout an 11-year span.

Methods: We analyzed the laparoscopic and chart records of 106 consecutive patients who underwent surgery for the creation of a neovagina, according to the modified laparoscopic Vecchietti procedure.

Results: A hypoplastic vagina was observed in 61 women.

Increased cardiovascular events in hypertensive patients with insulin resistance: a 13-year follow-up.

Insulin resistance (IR) is commonly associated with other cardiovascular risk factors and is considered an independent risk factor for cardiovascular disease and events. The hyperinsulinemic euglycemic clamp technique is considered the gold standard for evaluating IR, but this technique is cumbersome and not easily applicable in large studies. Therefore, there are no long-term follow-up published studies on the relationship between IR determined by this technique and cardiovascular outcome.

Insulin resistance, metabolic syndrome and endothelial dysfunction.

The increasing prevalence of obesity and diabetes mellitus in most industrialized countries, including China and India, is reaching epidemic proportions and requires intense studies and interventions. Insulin resistance appears to be the most relevant feature of the metabolic syndrome and is often the precursor of diabetes mellitus. Insulin resistance has been associated with endothelial dysfunction, which is considered the initial step in the process of atherosclerosis.

Atypical extraspinal musculoskeletal tuberculosis in immunocompetent patients: part II, tuberculous myositis, tuberculous bursitis, and tuberculous tenosynovites.

Tuberculosis involving the soft tissue from adjacent bone or joint is well recognized. However, primary tuberculous pyomyositis, tuberculous bursitis, and tuberculous tenosynovitis are rare entities constituting 1% of skeletal tuberculosis. Tuberculous tenosynovitis involves most commonly the tendon sheaths of the hand and wrist, and tuberculous bursitis occurs most commonly around the hip.

Prediction of response to cardiac resynchronization therapy: the selection of candidates for CRT (SCART) study.

Background: The aim of this study was to evaluate the ability of baseline clinical and echocardiographic parameters to predict a positive response to CRT.

Methods: We analyzed 6-month data from the first 133 consecutive patients enrolled in a multicenter prospective study. These patients had symptomatic heart failure (HF) refractory to pharmacological therapy (NYHA class II-IV), left ventricular ejection fraction (LVEF) < or =35%, and prespecified electrocardiographic, echocardiographic or tissue Doppler imaging markers of left ventricular (LV) dyssynchrony.

Septums and synechiae: approaches to surgical correction.

If the Müllerian ducts fail to fuse, or, if the wall which is the result of fusion is not adequately resorbed, the result is a spectrum of uterine abnormalities called Müllerian fusion and absorption defects. The impact of these abnormalities on fertility is a subject for debate, but at least a subset seems to have a negative impact on reproductive performance manifesting in recurrent abortion and/or premature labor. Previous surgical interventions required laparotomy, but, with careful application of imaging techniques, a group of patients can be identified with a uterine septum amenable to removal under hysteroscopic direction with little morbidity.

Atypical extraspinal musculoskeletal tuberculosis in immunocompetent patients, a review. Part I: atypical osteoarticular tuberculosis and tuberculous osteomyelitis.

With the resurgence of pulmonary tuberculosis and musculoskeletal tuberculosis in North America and Europe over the last 20 years, the typical pattern of extraspinal musculoskeletal tuberculosis has been changing; presentation of the disease often mimics that of neoplasia. However, certain radiographic features may offer some clues to the more benign nature of the process and its inflammatory and infectious nature. Although the diagnosis of extraspinal musculoskeletal tuberculosis depends largely on clinical context, it is the radiologist's role to guide the imaging workup to initiate the specific treatment as early as possible.

[From research to users: the Worksafe European Project and the IST-Gaslini Prevention and Safety Project].

Objective: The Worksafe Project aims at increasing access to and use of the large amount of data related to the broad sector of health protection of workers and workplace safety recognising the key role of the communication and dissemination of the research results with particular reference to cancer.

Participants: Four scientific institutes: National Institute for Research on Cancer, Genoa (IST); Finnish Institute of Occupational Health (FIOH), Helsinki; Karolinska Institutet (KI), Stockholm; International Agency for Research on Cancer (IARC), Lyon, and two technological partners (Softeco Sismat, Genoa; Fundacion Robotiker, Bilbao).

Results: The creation of the Worksafe portal, a web based infrastructure that allows knowledge sharing on top of a distributed digital data collection and provides web accessed services addressing a broad interested audience including biomedicine companies universities, research institutions, local and national public organisations and private users.

Neovaginal mucosa after Vecchietti's laparoscopic operation for Rokitansky syndrome: structural and ultrastructural study.

Objective: This study was undertaken to evaluate structural and ultrastructural characteristics of the mucosa of neovaginae created by Vecchietti's laparoscopic operation for Rokitansky syndrome.

Study Design: Vaginoscopy and Schiller test were performed 3, 6, and 12 months after the operation in 106 patients. A biopsy specimen of the neovagina obtained 12 to 18 months after surgery in 19 patients was examined by light, scanning electron, and transmission electron microscopy.

Laparoscopic creation of a neovagina with the laparoscopic Vecchietti operation: comparison of two instrument sets.

Objective: To compare safety and effectiveness of two different instrument sets for the laparoscopic Vecchietti operation for the creation of a neovagina.

Design: Descriptive study.

Setting: Tertiary referral center.

Melatonin does not reduce anxiety more than placebo in the elderly undergoing surgery.

Melatonin has been reported to reduce preoperative anxiety. We performed this study to compare preoperative anxiety in elderly patients receiving melatonin (M) or placebo (P). Anxiety was measured in patients aged >65 yr by a numerical rating scale (range, 0-10).

Metabolic risk factors and markers of cardiovascular and renal damage in overweight subjects.

Background: The prevalence of overweight and obesity in the United States has dramatically increased. Obesity clusters with a variety of hemodynamic and metabolic disturbances that increase the risk of cardiovascular disease. In this study we evaluated whether overweight subjects with hypertension also manifest hemodynamic and metabolic abnormalities compared with individuals of normal weight.

Primary periosteal lymphoma--rare and unusual.

We describe a primary periosteal lymphoma that involved only the periosteum without affecting the adjacent medulla or the regional lymph nodes. No other lymphomatous foci were found in either the distant lymph nodes or viscera. This unusual presentation simulates the imaging appearance of surface lesions of bone, namely benign and malignant tumors, and departs from the typical appearance of primary lymphoma of bone.

Medical management of endometriosis.

Current approved medical therapies for endometriosis rely on drugs that suppress ovarian steroids and induce a hypoestrogenic state, which determines the atrophy of the ectopic endometrium. Gonadotropin-releasing hormone analogs such as danazol, progestogens and estrogen-progestin combinations have all proven effective in relieving pain and reducing the extent of endometriotic implants. However, symptoms often recur after discontinuation of therapy and hypoestrogenism-related side effects limit the long-term use of most medications.

Laparoscopic excision of recurrent endometriomas: long-term outcome and comparison with primary surgery.

Objective: To compare the laparoscopic excision of primary versus recurrent ovarian endometriomas.

Design: Descriptive study.

Setting: Tertiary referral center for the treatment of endometriosis.

Thyroid and hypoxic stress in the newt Triturus carnifex.

When specimens of the newt Triturus carnifex, under anaesthesia by submersion in a 0.2% chlorbutol solution for 25 min, are isolated in a respiratory chamber at 18 degrees C containing water with only 1.3 ppm of oxygen, they consume the oxygen completely in about 3 hr, but they can stay alive for many more hours and wake up with no apparent exterior consequences.