Steroidi sessuali e reattivita' vascolare

Dottorato di ricerca in scienze ginecologiche ed ostetriche. A.a. 1994-95. Relatore Piero Capetta. Coordinatore Marco MassobrioConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome; Biblioteca Nazionale Centrale - P.za Cavalleggeri, 1, Florence / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

Compressive suture of the lower uterine segment for the treatment of postpartum hemorrhage due to complete placenta previa : a preliminary study

Aim: To assess the efficacy of a uterine compression suture technique in controlling hemorrhage after removal of complete placenta previa during cesarean section. Methods: This prospective study was performed in a tertiary referral hospital and included 18 patients with postpartum hemorrhage following removal of complete placenta previa during elective cesarean section. All 18 patients underwent bilateral anteroposterior compression suture of the lower uterine segment. All patients were followed postpartum for evaluation of uterine cavity and menstrual cycles. Results: Anteroposterior compressive suture of the lower uterine segment achieved immediate complete hemostasis in all 18 patients. No surgical complication was observed. All patients recovered normal menstrual cycles. Normal patency of the uterine cavity was documented with sonohysterography in all patients at the 6-month follow-up visit. Conclusions: This quick and simple suture technique seems to be effective in stopping hemorrhage following complete placenta previa removal during cesarean section. Normal patency of the uterine cavity seems not to be impaired at medium-term follow-up

Effect of soy-derived isoflavones on hot flashes, endometrial thickness, and the pulsatility index of the uterine and cerebral arteries

This study was conducted to identify clinical factors that are predictive of treatment choice for pelvic organ prolapse. One hundred forty-six women diagnosed with pelvic organ prolapse were educated about their condition and possible treatments before being offered one of three different treatment choices: expectant management (any choice other than pessary or surgery, including pelvic muscle exercises), pessary, or surgery

Randomized Dose-Ranging Trial of Tamoxifen at Low Doses in Hormone Replacement Therapy Users

The combination of hormone replacement therapy (HRT) and low-dose tamoxifen may retain the benefits while reducing the risks of either agent. We assessed the optimal biologic dose and schedule of tamoxifen in HRT users using surrogate end point biomarkers and menopausal symptoms. SUBJECTS AND METHODS: Two hundred ten current or de novo HRT users were randomly assigned to one of the following four arms: tamoxifen 1 mg/day and placebo/week, placebo/day and tamoxifen 10 mg/week, tamoxifen 5 mg/day and placebo/week, or both placebos for 12 months. The primary end point was the change of plasma insulinlike growth factor 1 (IGF-I) through 12 months, and secondary end points were IGF-I/IGF binding protein-3 (IGFBP-3) ratio, fibrinogen, antithrombin III, C reactive protein, C-telopeptide, mammographic percent density, and endometrial thickness. Endometrial proliferation was assessed by Pipelle biopsy in superficial, deep glandular, and stromal compartments after 12 months. RESULTS: Compared with placebo, IGF-I declined in all tamoxifen arms (P = .005), with a greater change on 5 mg/day (P = .019 v 10 mg/week or 1 mg/day). Tamoxifen increased IGFBP-3 and lowered antithrombin-III, C reactive protein, and mammographic density, with greater effects of 5 mg/day. Tamoxifen increased endometrial thickness but not Ki-67 expression, which was lower on 5 mg/day among the three doses. Menopausal symptoms were not significantly worsened by tamoxifen. CONCLUSION: Doses of tamoxifen < or = 5 mg/day modulate favorably biomarkers of breast carcinogenesis and cardiovascular risk in HRT users with no increase of endometrial proliferation and menopausal symptoms. A dose of 5 mg/day was the most effective and has been selected for a phase III trial in HRT users