Medroxyprogesterone acetate reduces the in vitro production of cytokines and serotonin involved in anorexia/cachexia and emesis by peripheral blood mononuclear cells of cancer patients.

Medroxyprogesterone acetate (MPA) is widely used in oncology both in the treatment of hormone-related cancers and as supportive therapy in anorexia/cachexia syndrome (ACS), but conclusive data are not yet available to explain its anticachectic effect. ACS is characterised by weight loss, changes in metabolism, reduction of appetite, nausea and vomiting. Several cytokines, mainly interleukin (IL)-1, IL-2, IL-6 and tumour necrosis factor alpha (TNF alpha), are involved in the pathogenesis of ACS.

Potentially beneficial cardiovascular effects of melatonin administration in women.

The cardiovascular effects induced by the daytime administration of melatonin (1 mg) were compared to those of placebo in 12 young women. In order to eliminate cardiovascular effects due to fluctuating endogenous sex steroids, all women were taking a fixed dose of monophasic contraceptive pill. In comparison to placebo, the administration of melatonin reduced, within 90 min, the pulsatility index of the internal carotid artery, evaluated by color Doppler ultrasound (P < 0.

An open multicenter study to compare the efficacy of intraperitoneal insemination and intrauterine insemination following multiple follicular development as treatment for unexplained infertility.

Purpose: This multicenter study was carried out to compare the efficacy of intrauterine insemination (IUI) and intraperitoneal insemination (IPI) associated with multiple follicular development as treatment for unexplained infertility.

Method: A total of 205 couples completed the trial. Sixty-seven couples underwent treatment with IPI (group A) and 138 couples underwent treatment with IUI (group B).

Effect of tibolone on glucose and lipid metabolism in postmenopausal women.

The effect of tibolone, a new therapeutic agent for menopause, on glucose and lipid metabolism was investigated in 11 healthy postmenopausal women. At baseline and after 3 months of tibolone administration (2.5 mg/day), glucose metabolism was evaluated in each subject using both an oral glucose tolerance test (75 g) and the minimal model method of a frequently sampled intravenous glucose tolerance test.

The chronic administration of cabergoline normalizes androgen secretion and improves menstrual cyclicity in women with polycystic ovary syndrome.

Objective: To investigate whether the administration of the long-lasting dopaminergic drug, cabergoline, improves endocrine and clinical features of women with polycystic ovary syndrome (PCOS).

Patients: Twenty-nine women participated in the study: 14 women with clinical and endocrinologic features of PCOS and 15 age- and weight-matched normal cycling women. Each subject was assigned randomly to receive either a tablet of cabergoline at the dose of 0.

Tumor markers and transvaginal ultrasonography in the diagnosis of endometrioma.

Objective: To evaluate the accuracy of CA 19.9 plasma levels (with or without CA 125 levels) combined with transvaginal ultrasonography in the differential diagnosis of endometrioma.

Methods: One hundred eighteen consecutive premenopausal nonpregnant women had laparoscopy or laparotomy between November 1994 and November 1995 because of the presence of a persistent adnexal mass.

Salmon calcitonin plus intravaginal estriol: an effective treatment for the menopause.

Objective: Intravaginal estriol (E3) effectively improves postmenopausal genito-urinary disturbances, without stimulating endometrial proliferation. The aim of the present study was to evaluate the effect of intravaginal estriol (E3) plus nasal spray salmon calcitonin (sCT), to improve neurovegetative symptoms and to prevent the decline of bone mineral density (BMD) of postmenopausal women.

Methods: Two hundred and fourteen (214) healthy postmenopausal women were treated for 12 months with: (1) E3 (0.

The screening of tubal abnormalities in the infertile couple.

Purpose: Our goal was to assess, with a prospective study, the role of hysterosalpingo-contrast sonography (HyCoSy) with an echocontrast agent and transvaginal ultrasonography alone in the evaluation of tubal status.

Methods: Thirty patients were included in the study. These patients underwent an initial plain transvaginal ultrasound examination the day before the HyCoSy.

Spontaneous reversibility of bone loss induced by gonadotropin-releasing hormone analog treatment.

Objective: To verify if a 6-month period of hypoestrogenism due to chronic treatment with GnRH analogue (GnRH-a) causes irreversible bone loss in young women.

Design: Controlled clinical study in volunteer women.

Setting: Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy.

The role of endogenous nitric oxide in the response of coronary blood flow to tachycardia.

Background: The role of endogenous nitric oxide as mediator of flow-dependent dilation is well established. However, its role in the adaptation of coronary blood flow to tachycardia is less well defined. This study was designed to determine whether nitric oxide is a mediator in pacing-induced hyperaemia.

Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome.

Objective: Our purpose was to investigate the advantages of laparoscopic myomectomy versus laparotomy.

Study Design: A prospective, randomized trial was performed on 40 women, 22 to 44 years old, undergoing myomectomy. Patients were randomized to have laparoscopy (n=20) or laparotomy (n=20).

Transvaginal ultrasonography combined with CA-125 plasma levels in the diagnosis of endometrioma.

Objective: To assess the role of transvaginal ultrasonography combined with CA-125 plasma levels in the diagnosis of endometrioma.

Design: Prospective study with pathological confirmation of the diagnosis.

Setting: Department of Obstetrics and Gynecology of the University of Cagliari, Italy.

Prevention of de-novo adhesion formation after laparoscopic myomectomy: a randomized trial to evaluate the effectiveness of an oxidized regenerated cellulose absorbable barrier.

To evaluate the effectiveness of the oxidized regenerated cellulose absorbable barrier (Interceed, TC7) in the prevention of de-novo adhesion formation after laparoscopic myomectomy, a prospective and randomized study was performed at the Department of Obstetrics and Gynaecology of the University of Cagliari, Cagliari, Italy. A total of 50 pre-menopausal non-pregnant women, aged 23-42 years, who submitted to laparoscopic myomectomy from January 1993 to June 1994, were randomized to surgery alone (control group, n = 25) or surgery and oxidized regenerated cellulose barrier (Interceed group, n = 25). Neither group received any other treatment for adhesion prevention.

Evidence that an altered prolactin release is consequent to abnormal ovarian activity in polycystic ovary syndrome.

Objective: To investigate whether endogenous dopaminergic activity is impaired in polycystic ovary syndrome (PCOS)-affected women and is normalized by medical ovariectomy.

Patients: Women with PCOS untreated (n = 23) and treated for 3 months with GnRH analogue (GnRH-a) administration (n = 10) and normal cycling young women (n = 23) as controls.

Interventions: Acute blockade of dopaminergic receptors by the IV administration of 5 mg of the dopaminergic receptor blocking agent sulpiride (sulpiride test) was performed 3 to 7 days after the initiation of spontaneous menses in cycling women or medroxyprogesterone acetate-induced menses in PCOS women.

Ovulation induction with gonadotropins as sole treatment in infertile couples with open tubes: a randomized prospective comparison between intrauterine insemination and timed vaginal intercourse.

Objective: To assess if ovulation induction with gonadotropins alone is an appropriate treatment in couples affected by unexplained and mild male factor-related infertility and if the concomitant IUI improves the pregnancy rate (PR).

Design: Prospective and randomized trial.

Setting: Infertility Centre of Department of Obstetrics and Gynecology of the University of Cagliari, Cagliari, Italy.

Treatment of nonendometriotic benign adnexal cysts: a randomized comparison of laparoscopy and laparotomy.

Objective: To compare laparoscopy and laparotomy in the management of benign adnexal cysts, with particular attention to postoperative convalescence.

Methods: Forty premenopausal, nonpregnant women, 18-40 years of age and without acute pelvic symptoms, were scheduled to undergo surgical management of anechoic, unilateral, unilocular, persistent adnexal cysts from January 1993 through June 1994 at the Department of Obstetrics and Gynecology of the University of Cagliari, Cagliari, Italy. After ultrasonographic examination, followed by the completion of 6 months' expectant management with repeat ultrasonographic evaluations, subjects were randomized to undergo operative laparoscopy (n = 20) or laparotomy (n = 20).

Reduction of adhesion reformation after laparoscopic endometriosis surgery: a randomized trial with an oxidized regenerated cellulose absorbable barrier.

Objective: To evaluate the effectiveness of an oxidized regenerated cellulose absorbable barrier (Interceed [TC7] Absorbable Adhesion Barrier) in the reduction of adhesion reformation after laparoscopic surgery for endometriosis.

Methods: Thirty-two premenopausal nonpregnant women who had severe endometriosis and complete posterior cul-de-sac obliteration and were undergoing laparoscopic surgery were randomly assigned to either surgery alone or surgery and Interceed. None of the subjects received any other treatment for adhesion prevention.

Modulation of anterior pituitary luteinizing hormone response to gonadotropin-releasing hormone by insulin-like growth factor I in vitro.

Objective: To investigate how much insulin-like growth factor I may modulate the LH response to GnRH.

Design: In primary cultures of male rat anterior pituitary cells, the LH response to GnRH (10(-9) M) was evaluated after a 24-hour preincubation with medium alone, IGF-I (1, 5, 10, 15 nM), polyclonal antibody anti-IGF-I (Ab-anti-IGF-I), (1:3,000; 1:10,000), or rabbit serum (1:3,000; 1:10,000) as control.

Main Outcome Measure: Gonadotropin-releasing hormone-induced LH release from primary cultures of male rat anterior pituitary cells.

Melatonin enhances the luteinizing hormone and follicle-stimulating hormone responses to gonadotropin-releasing hormone in the follicular, but not in the luteal, menstrual phase.

Exogenous melatonin enhances LH pulse amplitude and mean LH levels in women during the follicular, but not the luteal, menstrual phase. In this study we investigated whether an increased pituitary response to GnRH is involved in the stimulatory effect of melatonin. Eight normal cycling women were studied on 2 consecutive days during the follicular stage (days 4-6), and eight were studied during the luteal phase (days 19-21) of the menstrual cycle.

Involvement of ovarian factors magnified by pharmacological induction of multiple follicular development (MFD) in the increase in Ca125 occurring during the luteal phase and the first 12 weeks of induced pregnancies.

Objective: To evaluate the relationship of ovarian activity on Ca125 production, we studied whether Ca125 production varies during the menstrual cycle both in normal ovulatory women and in women whose ovarian factors are significantly stimulated by multiple follicular development (MFD). Furthermore, since the first 12 weeks of pregnancy is characterized by the enhancement of corpus luteum function mainly in MFD-induced pregnancies, Ca125 levels were also evaluated in the first quarter of pregnancy both in spontaneous and in MFD-induced pregnancies.

Subjects: Subjects were normal ovulatory women in the late follicular phase (FP) (N = 20) and in the luteal phase (LP) (N = 20), 32 infertile women submitted to MFD with pure FSH, and 40 pregnant women in which pregnancy occurred spontaneously (N = 20) or after induction of MFD (N = 20).

Prolonged opioid blockade does not influence luteinizing hormone modifications of the follicular and luteal menstrual phases.

Although an acute opioid withdrawal markedly modifies LH secretion in the different phases of the menstrual cycle, whether a sustained opioid blockade imbalances spontaneous LH modifications associated with the progression of the follicular or luteal menstrual phases is presently unknown. Accordingly, normal cycling women during either the follicular (n = 14) or luteal (n = 14) menstrual phase, randomly and in double blind fashion, received either placebo (n = 7 for each phase) or 50 mg/day of the oral opioid antagonist naltrexone (n = 7 for each phase). In each subject, LH pulsatility (10-min blood drawing for 8 h) and the pituitary LH response to a 10-micrograms GnRH stimulus were investigated at baseline and on the fifth day of placebo/naltrexone administration.

The role of follicle-stimulating hormone in the depletion of follicular reserve: menopause in a woman with hypogonadotropic hypoestrogenic amenorrhea: a case report.

Objective: To investigate the role of FSH in the depletion of follicular reserve in a human being.

Design: Prospective evaluation of a very rare case.

Setting: Academic research environment.