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1.
Clin Infect Dis ; 76(3): 513-520, 2023 02 08.
Article in English | MEDLINE | ID: mdl-35717635

ABSTRACT

BACKGROUND: Human cytomegalovirus (HCMV) is the leading infectious cause of congenital disabilities. We designed a prospective study to investigate the rate, outcome, and risk factors of congenital CMV (cCMV) infection in neonates born to immune women, and the potential need and effectiveness of hygiene recommendations in this population. METHODS: The study was composed of 2 sequential parts: an epidemiology (part 1) and a prevention (part 2) study. Performance of part 2 depended upon a cCMV rate >0.4%. Women enrolled in part 1 did not receive hygiene recommendations. Newborns were screened by HCMV DNA testing in saliva and cCMV was confirmed by urine testing. RESULTS: Saliva swabs were positive for HCMV DNA in 45/9661 newborns and cCMV was confirmed in 18 cases. The rate of cCMV was .19% (95% confidence interval [CI]: .11-.29%), and 3 out of 18 infants with cCMV had symptoms of CMV at birth. Age, nationality, occupation, and contact with children were similar between mothers of infected and noninfected newborns. Twin pregnancy (odds ratio [OR]: 7.2; 95% CI: 1.7-32.2; P = .037) and maternal medical conditions (OR: 3.9; 95% CI: 1.5-10.1; P = .003) appeared associated with cCMV. Given the rate of cCMV was lower than expected, the prevention part of the study was cancelled. CONCLUSIONS: Newborns from women with preconception immunity have a low rate of cCMV, which appears to be mostly due to reactivation of the latent virus. Therefore, serological screening in childbearing age would be pivotal to identify HCMV-seropositive women, whose newborns have a low risk of cCMV. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov (NCT03973359).


Subject(s)
Cytomegalovirus Infections , Pregnancy Complications, Infectious , Infant , Pregnancy , Infant, Newborn , Humans , Female , Child , Prospective Studies , Prevalence , Cytomegalovirus Infections/epidemiology , Cytomegalovirus Infections/prevention & control , Cytomegalovirus Infections/diagnosis , Cytomegalovirus/genetics , Risk Factors
2.
Gynecol Endocrinol ; 36(8): 723-727, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32065005

ABSTRACT

Studies have been published on the efficacy of Dienogest in the management of pain symptoms in endometriosis. Nonetheless, few data are available on the reducing effect on endometrioma's size. The aim of the study was to evaluate if Dienogest could determine significant changes in size, as well as in symptoms. In this prospective observational study, patients were enrolled with pain symptoms and at least one endometrioma diagnosed via TV-US. The volume of the endometrioma and pain symptoms was measured according to the LxDxWx0.5233 formula and VAS, respectively. Dienogest 2 mg was administered daily. Follow-up visits were scheduled after 6 and 12 months of treatment to assess changes in patients' symptoms and endometrioma's volume. Seventy patients were enrolled, 63 patients completed a 6-month treatment. The reduction of the mean volume after 6 months was 66.71%. Fifty-eight patients completed the 12 month-treatment. The reduction of the mean volume after 12 months was 76.19%. Dysmenorrhea showed a 74.05% reduction after 6 months and a 96.55% reduction after 12 months. Patients reported a reduction in dyspareunia and chronic pelvic pain of 42.71% and 48.91% after 6 months and 51.93% and 59.96% after 12 months, respectively. Dienogest leads to a statistically significant reduction of endometrioma's volume and pain symptoms.


Subject(s)
Endometriosis/drug therapy , Endometriosis/pathology , Nandrolone/analogs & derivatives , Peritoneal Diseases/drug therapy , Peritoneal Diseases/pathology , Adult , Dysmenorrhea/drug therapy , Dysmenorrhea/etiology , Dysmenorrhea/pathology , Dyspareunia/drug therapy , Dyspareunia/etiology , Dyspareunia/pathology , Endometriosis/complications , Endometrium/drug effects , Endometrium/pathology , Female , Humans , Italy , Middle Aged , Nandrolone/pharmacology , Nandrolone/therapeutic use , Organ Size/drug effects , Pelvic Pain/drug therapy , Pelvic Pain/etiology , Pelvic Pain/pathology , Peritoneal Diseases/complications , Prospective Studies , Severity of Illness Index , Treatment Outcome , Young Adult
3.
J Minim Invasive Gynecol ; 23(4): 476-88, 2016.
Article in English | MEDLINE | ID: mdl-26772777

ABSTRACT

A panel of experts in the field of endometriosis expressed their opinions on management options in a 28-year-old patient, attempting pregnancy for 1 year, with severe cyclic pelvic pain and with clinical examination and imaging techniques suggestive of adenomyosis. Many questions this paradigmatic patient may pose to the clinician are addressed, and all clinical scenarios are discussed. A decision algorithm derived from this discussion is also proposed.


Subject(s)
Adenomyosis/diagnosis , Endometriosis/diagnosis , Pregnancy Complications/diagnosis , Adenomyosis/therapy , Adult , Algorithms , Clinical Decision-Making , Endometriosis/therapy , Female , Humans , Hysteroscopy/methods , Magnetic Resonance Imaging , Multimodal Imaging , Needs Assessment , Physical Examination/methods , Preconception Care/methods , Pregnancy , Ultrasonography
4.
J Obstet Gynaecol Res ; 41(11): 1773-8, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26420658

ABSTRACT

AIM: The long-term effects of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral ovarian endometriomas were evaluated. METHODS: A total of 22 patients undergoing laparoscopic cystectomy for unilateral endometrioma (n = 10) and bilateral endometriomas (n = 12) were included in the study. RESULT(S): Serum anti-Müllerian hormone (AMH) levels significantly decreased from the baseline value (3.98 ± 3.27 ng/mL) one (1.67 ± 1.56 ng/mL), three (2.01 ± 1.70 ng/mL), and six months (2.43 ± 2.39 ng/mL) postoperatively. There was no difference between preoperative and 12 month postoperative AMH levels (4.01 ± 3.39 ng/mL) (P > 0.05). Patients with bilateral endometriomas had a significantly higher rate of decline in AMH levels 12 months after surgery than patients with monolateral endometriomas (P = 0.035), but in both groups there was no difference in AMH levels at one and 12 months postoperatively (P > 0.05). CONCLUSION(S): AMH levels temporarily decreased after laparoscopic cystectomy for ovarian endometriomas, with complete recovery of preoperative AMH values at 12 months postoperatively. This pattern was equal in patients with bilateral and unilateral ovarian involvement. Patients with bilateral cysts have higher rates of decline of AMH levels compared to patients with unilateral affection.


Subject(s)
Anti-Mullerian Hormone/blood , Endometriosis/surgery , Gynecologic Surgical Procedures/adverse effects , Laparoscopy/adverse effects , Ovarian Diseases/surgery , Ovarian Reserve/physiology , Adult , Endometriosis/blood , Female , Humans , Ovarian Diseases/blood
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