[Antibiotic prophylaxis with cefotaxime in gynecological endoscopy]. / Profilassi antibiotica con cefotaxime nell'endoscopia ginecologica.

It is now well known that even short operations of limited scope lower the body's defences by influencing the immune system. As a result this leads to a change in microbial flora which encourages an increase in the number of Gram-negative, aerobic, anaerobic and enterococcal colonies. In order to prevent infective postoperative complications which might occur after endoscopic surgery, the authors suggest using a series of valuable recommendations which are reported in this paper. Among these the most important is antibiotic prophylaxis which is able to limit the episodes of infection, thus making a positive contribution to the postoperative iter. Cefotaxime was chosen by the authors since this molecule offers both reliable and efficacious prophylaxis as has also been shown by other studies in the obstetrics and gynecological field. The results obtained by this study fully concord with data reported in the literature.

[Hormonal contraception using estroprogestins]. / La contraccezione ormonale mediante estroprogestinici.

Today the estroprogestagen pill is the most valid method of contraception given that its benefits far outweigh its risks. The paper stresses the importance of a thorough anamnestic, clinical and laboratory examination so as to obtain correct and safe steroid contraception. The efficacy and excellent tolerance of the combined method currently make it the most widespread form of oral contraception.

PIP: Oral contraceptive (OCs) of high efficacy containing estroprogestins (EP) were introduced in the 1960's and since then more than 250 million used them. Their benefits include regular menstrual cycles and protection against genital tumors. Dosage seems to be directly related to risks and benefits, therefore new types of low-dose progestins have been developed. Their mechanism of action is based on hypothalamic- hypophysic control, EP suppress the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Their effects are as follows: the cervical mucus becomes more viscous providing a barrier against spermatozoa, regressive (atrophy) modifications and proliferative alterations of the endometrium, and metrorrhagia induced by estrogens and amenorrhea provoked by progestins. The sequential pill requires administration of estrogens in the 1st phase and estroprogestins in the 2nd phase. They minimize physiological and hormonal effects, but the failure rate is 2-3% per woman year. Combined methods of monophasic, biphasic, and triphasic design are used from the 1st to 5th day of menstruation. They block ovulation with a high degree of efficacy, but the stimulating action of EP on the endometrium produces spotting, premature or late metrorrhagia, and amenorrhea. OCs protect against malignant epithelial tumors of the ovaries. It is estimated that 1700 ovarian carcinomas and 2000 endometrial carcinomas are averted each year by the use of the pill in the US. Endometrial cancer risk is halved by EP. 7 epidemiological studies have found no association between the pill and breast cancer, and the risk of benign mammary lesions is also reduced. Accurate anamnesis is mandatory for prescribing safe OCs including screening for coagulation, hepatic function and glycemia tests, and colposcopic examination. Smoking and the pill as well as age under 16 and over 36 increase risks. Nonetheless, the benefits of EP contraceptives outweigh the risks.

[Endoscopic treatment of polycystic ovary syndrome. Preliminary data]. / Trattamento endoscopico della sindrome dell'ovaio policistico. Dati preliminari.

Four women suffering from polycystic ovary syndrome recalcitrant to routine ovulation inducers have been submitted to electro-cauterization and ovarian resection. Hormonal changes after 24 hours and the incidence of ovulatory cycles in the 6 months subsequent to the execution of these surgical techniques are reported.

Production of prostacyclin (PGI2) and thromboxane A2 (TXA2) by vessels draining and not-draining benign and malignant tumours of the breast.

The production of PGI2 (determined by bioassay) and TXB2 (determined by radioimmunoassay) was studied in the supernatant solutions obtained after incubation of vessel rings prepared from veins draining and not draining benign and malignant tumours of the breast. A significant increase (p less than 0.01) was found in the production of PGI2 by vessels draining the malignant tumours as compared to those not draining such tumours or vessels draining benign tumours. The changes in PGI2, and the tendency for TXB2 to be higher in vessels draining malignant tumours, were in the same direction so that they balanced out when the ratio PGI2/TXB2 was calculated: in consequence no significant changes in this ratio were found in malignant tumours as compared to the benign. A significant difference (p less than 0.01) was observed in the ratios of vessels draining tumours:vessels not draining tumours between malignant and benign tumours in relation to the production of PGI2. The present data demonstrate that the production of PGI2 by vessels draining malignant tumours of the breast is different to that obtained with vessels from patients with benign tumours, although the mechanism responsible for this difference is not known.