Effectiveness of Hysteroscopic Techniques for Endometrial Polyp Removal: The Italian Multicenter Trial.

Study Objective: To compare the effectiveness and safety of different techniques of hysteroscopic polypectomy.

Design: Multicenter, prospective observational trial (Canadian Task Force classification II-2).

Setting: Nineteen Italian gynecologic departments (university-affiliated or public hospitals).

Essure Permanent Birth Control, Effectiveness and Safety: An Italian 11-Year Survey.

Study Objective: To describe safety, tolerability, and effectiveness results through a minimum 2-year follow-up of patients who underwent permanent sterilization with the Essure insert.

Design: A retrospective multicenter study (Canadian Task Force classification II2).

Setting: Seven general hospitals and 4 clinical teaching centers in Italy.

Hysteroscopic bipolar surgery: a valuable progress or a technique under investigation?

Purpose Of Review: Bipolar technology was introduced in the hysteroscopy field with resectoscopic loops and electrodes adaptable to mini-hysteroscopes. The use of isotonic saline as a distension medium and the proximity of electrodes reduce the risk of electrolyte imbalance and electrical burns. Delivering an electrosurgical device throughout mini-hysteroscopes avoids cervical dilatation, limiting uterine wall damages.

Uterine tumor resembling ovarian sex cord tumors treated by resectoscopic surgery.

Uterine tumors resembling ovarian sex cord tumors (UTROSCTs) are rare neoplasms of uncertain malignancy, affecting either pre or menopausal women. Only 48 cases of UTROSCTs have been reported and in most patients the diagnosis was made incidentally, after a hysterectomy as a result of the assumption of a leiomyoma. Although no death from progressive disease was reported, locoregional spread or abdominal relapse was detected in some patients.

Outpatient hysteroscopic polypectomy in postmenopausal women: a comparison between mechanical and electrosurgical resection.

Study Objective: Comparison of operating outcomes of office hysteroscopic polypectomy accomplished by mechanical or bipolar electrosurgical instrumentation.

Design: Prospective study (Canadian Task Force classification II-1).

Setting: Public hospital.

Hysteroscopic view in atypical endometrial hyperplasias: A correlation with pathologic findings on hysterectomy specimens.

Study Objective: To evaluate whether hysteroscopic imaging can contribute to decrease the rate of undetected endometrial carcinomas concurrent with atypical hyperplasia diagnosed by endometrial biopsy.

Design: Retrospective study.

Design Classification: Canadian Task Force Classification II-3.

Prospective endometrial assessment of breast cancer patients treated with third generation aromatase inhibitors.

Objective: A prospective evaluation of the effects on endometrium of third generation aromatase inhibitors (AIs), administered as adjuvant up-front therapy or switched therapy in menopausal patients suffering from breast cancer.

Methods: Forty-five patients suffering from estrogen-receptor positive breast cancer were treated with AIs as adjuvant endocrine therapy; 27 patients switched from tamoxifen to AIs (group 1) due to adverse medical events related to tamoxifen intake (22 patients) or to an extended endocrine treatment after 60 months of tamoxifen therapy (5 patients); whereas 18 patients received AIs as up-front adjuvant therapy (group 2). All patients underwent endometrial investigation before the start of AIs therapy and, thereafter, at 12 month intervals.

Pretreatment and prospective assessment of endometrium in menopausal women taking tamoxifen for breast cancer.

Objectives: To estimate the pretreatment incidence of endometrial pathology and to prospectively assess the endometrial morbidity emerging during tamoxifen intake for breast cancer.

Study Design: One-hundred and forty-six menopausal breast cancer patients, candidate to receive tamoxifen underwent endometrial assessment by Transvaginal Ultrasonography (TU) before the start of therapy. A double-layered endometrial stripe measuring more than 4mm indicated hysteroscopy and endometrial biopsy.

Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study.

Objective: To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause.

Subjects: Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms.

Methods: Cross-sectional study with no exclusion criteria.

Histopathologic behavior of endometrial hyperplasia during tamoxifen therapy for breast cancer.

Objective: The purpose of the present study is to prospectively evaluate the effects of tamoxifen on the pathological behavior of endometrial hyperplasias without atypia, diagnosed before the start of adjuvant endocrine therapy, in menopausal patients suffering from breast cancer.

Methods: Twenty-six patients suffering from estrogen-receptor positive breast cancer and candidate to receive adjuvant tamoxifen, were found to be affected by endometrial hyperplasias before the start of endocrine therapy. All women showed a baseline endometrial stripe, measured by transvaginal ultrasonography, thicker than 4 mm and the diagnosis of endometrial hyperplasia was made by hysteroscopy and endometrial biopsy.

Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy.

Objective: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy.

Methods: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.

Accuracy of hysteroscopic diagnosis of endometrial hyperplasia: a retrospective study of 323 patients.

Study Objective: To evaluate the diagnostic accuracy of hysteroscopic view in endometrial hyperplasia.

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Public hospital in northern Italy.

Baseline endometrial assessment before tamoxifen for breast cancer in asymptomatic menopausal women.

Objective: The aim of this study is to estimate the prevalence of endometrial pathology before the start of tamoxifen therapy in menopausal breast cancer patients.

Methods: Ninety-one gynecologically asymptomatic patients, suffering from estrogen receptor-positive breast cancer and scheduled for adjuvant tamoxifen, underwent pretreatment endometrial assessment. In all patients, a transvaginal ultrasonography was carried out; a double-layered endometrial stripe measuring above 4 mm was considered as abnormal.

Outpatient hysteroscopic polypectomy in 237 patients: feasibility of a one-stop "see-and-treat" procedure.

Study Objective: To evaluate the feasibility of a "see-and-treat" office polyp resection, using a 5-mm sheathed operative hysteroscope.

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Public hospital.

Hysteroscopically targeted biopsies compared with blind samplings in endometrial assessment of menopausal women taking tamoxifen for breast cancer.

Study Objective: To determine the validity of tissue sampling accomplished by hysteroscopically targeted or blind biopsies in the assessment of endometrial morbidity associated with tamoxifen treatment.

Design: Retrospective, unrandomized study (Canadian Task Force classification II-2).

Setting: Public hospital.

Saline infusion sonography and office hysteroscopy to assess endometrial morbidity associated with tamoxifen intake.

Objective: The objective of this study was to compare office feasibility, patient acceptance, and diagnostic accuracy of hysteroscopy (HYS) and saline infusion sonography (SIS) in breast cancer patients taking tamoxifen.

Methods: Sixty-six asymptomatic postmenopausal women on tamoxifen for breast cancer underwent SIS, followed by outpatient HYS with endometrial biopsy. In all women an endometrial stripe over 4 mm was previously measured by transvaginal ultrasonography (TU).

Hysteroscopic assessment of menopausal breast-cancer patients taking tamoxifen; there is a bias from the mode of endometrial sampling in estimating endometrial morbidity?

The aim of this study is to evaluate the accuracy of hysteroscopy in detecting tamoxifen-associated endometrial morbidity. Ninety-eight menopausal breast cancer patients taking tamoxifen underwent hysteroscopy because of an endometrial thickness above 4mm measured by Transvaginal Ultrasonography. Thirty-one women recorded uterine bleeding while 67 were asymptomatic.

Prognostic significance of hysteroscopic imaging in endometrioid endometrial adenocarcinoma.

Objective: The aim of this study was to relate hysteroscopic features of endometrioid endometrial adenocarcinoma to stage, grade and overall survival.

Methods: Sixty women with endometrioid adenocarcinoma underwent laparotomy and staging according to current FIGO classification. Before surgery hysteroscopy was performed in all patients to establish the morphology of neoplasia, the extent of endometrial lining involvement, and endocervical spreading.

Accuracy of hysteroscopy in predicting histopathology of endometrium in 1500 women.

Study Objective: To estimate the accuracy of hysteroscopy in predicting endometrial histopathology.

Design: Retrospective analysis (Canadian Task Force classification II-2).

Setting: Public hospital.

Hysteroscopy and transvaginal ultrasonography in postmenopausal women with uterine bleeding.

Objective: To evaluate the accuracy of hysteroscopy and transvaginal ultrasonography (TU), based on a histopathological report from endometrial specimens, in diagnosing endometrial pathology in menopausal women with uterine bleeding.

Methods: Four-hundred and nineteen postmenopausal women with uterine bleeding underwent TU, hysteroscopy and endometrial biopsy. Hysteroscopic and sonographic findings have been evaluated on the basis of the final diagnosis established by histologic examination.

Simultaneous laparoscopic cholecystectomy and laparoscopically assisted vaginal hysteroadnexectomy.

As a consequence of the wide applications of operative laparoscopy and thoracoscopy, simultaneous surgical procedures have been carried out endoscopically. We report a 51-year-old woman treated by simultaneous laparoscopic cholecystectomy and celioscopically assisted vaginal hysteroadnexectomy for hydropic calculous gallbladder, uterine myomas, and bilateral ovarian policystosis. These procedures were carried out using six abdominal trocar sites, and the gallbladder was removed through the colpotomic access.

Risk factors for respiratory distress syndrome in the newborn. A multicenter Italian survey. Study Group for Lung Maturity of the Italian Society of Perinatal Medicine.

Risk factors for respiratory distress syndrome (RDS) in the newborn have been evaluated using data from a large survey conducted between 1980 and 1989 in selected periods in eleven perinatal units placed in five Italian regions. A total of 1624 liveborn infants consecutively delivered at the collaborating centers, at delivery 26-37 weeks gestational age and without clinically evident congenital anomalies were included in the survey. All the newborns were followed up to the 28th day of life.

Effect of peritoneal fluid on sperm motility and velocity distribution using objective measurements.

The aim of this study was to analyze in vitro the effect(s) of peritoneal fluid (PF) on sperm motility. Seventy PFs obtained during laparoscopy were tested on motile-rich sperm suspensions. Proportion of motile sperm and velocity distribution were evaluated by multiple-exposure photography technique.

Antenatal prevention of respiratory distress syndrome; a multicentre survey.

Obstetric and neonatal data were collected on 934 preterm deliveries in 11 Italian centres in 1980, 1985 and 1986. Therapeutic regimens for prevention of respiratory distress syndrome (RDS) were applied in 42% of the cases in 1980, 32% in 1985 and 42% in 1986. Prevention was made in most cases with corticosteroids, although their use fell progressively from 94% in 1980 to 74% in 1986.

Measurement of fetal surfactant production by fluorescence polarization of amniotic fluid in complicated pregnancies.

The results are presented of fluorescence polarization as a method for measurement of surfactant production in 159 specimens of amniotic fluid collected from pregnant women with diabetes, hypertension, Rh immunization, premature rupture of membranes (for more than 48 h prior to delivery) and intrauterine growth retardation (IUGR). The predictability of the development of respiratory distress syndrome has been assessed by this assay. Its specificity, sensitivity and overall accuracy were similar to the lecithin/sphingomyelin (L/S) ratio.