[Survey of the nutritional status and related risk factors in primary school children in two Italian health units]. / Stato nutrizionale dei bambini delle scuole primarie nelle ASL 4 di Terni e 5 di Bari e fattori DI rischio correlati.

During the months of May and June 2007 two prevalence studies were conducted in two local health units in Italy (Terni and Bari). The objectives of the studies were to test methods and procedures to be used in the nutritional surveillance in primary schools; to measure the prevalence of obesity and overweight in children from those schools; and to determine the prevalence of physical activity and sedentary behaviour A total of 1026 children were measured and interviewed. The refusal rate was 17% in Terni and 16% in Bari. In Terni 8% of children were obese, 24% overweight, while in Bari the corresponding values were 11% and 24%. A high prevalence of behavioural risk factors for obesity was registered such as: not eating breakfast, reduced physical activity and sedentary behaviour It was also demonstrated that parents are often unaware that their children were overweight. The results of these surveys were consistent with the high prevalence that has been registered in other studies on Italian children in the third grade. The results showed also the feasibility of surveys in schools on the nutritional situation of children in primary schools, that can be adopted as a tool for a national surveillance.

[Monitoring of postmenopausal women treated with tamoxifen for breast carcinoma]. / Il monitoraggio di donne in post-menopausa in trattamento con tamoxifene per carcinoma mammario.

The aim of this study was to evaluate the usefulness of different diagnostic tools in the screening for endometrial neoplasms in women receiving tamoxifen as adjuvant treatment after surgery for breast cancer. The Authors' experience, while confirming the importance of a very strict and careful follow-up, stresses the higher sensitivity and specificity of diagnostic hysteroscopy.

Bone metabolism changes after transdermal estradiol dose reduction during estrogen replacement therapy: a 1-year prospective study.

Twenty-four surgically menopausal women were randomly allocated to one of two transdermally-administered estrogen replacement therapies (ERT): Group A was administered Estradiol (E2) TTS 0.05 mg/day for 6 months and 0.025 mg/day for the following six months and group B, E2 TTS 0.10 mg/day for the first 6 months and 0.05 mg/day for the following 6 months. For both groups, the treatment regimen was based upon the twice-weekly application of transdermal patches to the lower abdomen for three weeks a month. Serum E2, alkaline phosphatase (AP), osteocalcin (BGP) and urinary hydroxyproline (OHP) excretion levels were measured before the operation, at the beginning of ERT and after 6 and 12 months of treatment. Bone mineral density (BMD) in the distal regions of the forearms was measured by single photon absorptiometry at the start of the study and after 6 and 12 months. In Group A, both mean cortical and trabecular BMD had increased by, respectively, 1.53% and 2.17% after 6 months of therapy; after the second 6 months a significant decrease was observed in both parameters (2.40% and 3.62%, respectively). In Group B, mean cortical and trabecular BMD increased by 1.50% and 2.10%, respectively (significant increase in trabecular bone) after the first 6 months of treatment; after the following 6 months, these values persisted (+0.15 and -0.03%, respectively). Mean AP, OHP and BGP serum levels rose after the operation. In Group A, AP and OHP showed a significant decrease after the first 6 months (-34.90% and -30.90%), followed by an increase at the last evaluation of 22.50% and 35.50%, that reached statistical significance only for OHP.(ABSTRACT TRUNCATED AT 250 WORDS)

Sonohysterography versus hysteroscopy for diagnosing endouterine abnormalities in fertile women.

OBJECTIVES: To evaluate the usefulness of abdominal and vaginal sonohysterography (SHG) (considered both singly and in combination) for the diagnosis of intrauterine abnormalities. METHODS: At the Department of Obstetrics and Gynecology, University of Bari, Italy, the results of the abdominal and vaginal SHG were retrospectively compared with those of conventional transvaginal sonography and hysteroscopy in 35 fertile women in whom a hysteroscopy was indicated. The sensitivity and specificity for the diagnosis of intrauterine abnormalities of both kinds of SHG (considered both singly and in combination), transvaginal sonography and hysteroscopy were compared; the predictive values of abnormal and normal SHG were determined by a 2 x 2 table relating the test results to the patients' abnormalities shown at hysteroscopy. RESULTS: The combination of both abdominal and vaginal SHG had a sensitivity of 95% and a specificity of 100%; the predictive value of an abnormal test was 100% and that of a normal test 94%. CONCLUSIONS: SHG provides a reliable diagnosis of intrauterine abnormalities. However, hysteroscopy and guided biopsies remain the decisive diagnostic test for investigating intrauterine abnormalities.

Hysteroscopy for diagnosis and treatment of endometrial adenocarcinoma precursors. A review of literature.

The guidelines for early detection of adenocarcinoma and its precursors are controversial. Ultrasound, due to its non invasive nature, could represent a useful technique for screening patients at risk but its specificity is low. Endometrial cytology, especially by using new device, is an effective, easy, and inexpensive method for screening asymptomatic women; however, cytologic investigation shows some limits due to the scarce desquamation of endometrial cells and to the difficulty in diagnosing hyperplasia. Blind biopsy can miss the pathology in cases of focal lesions. Dilatation and curettage gives, in most cases, a certain histologic diagnosis but, requiring anesthesia and hospitalization, is not suitable for mass screening; moreover, in cases of focal lesions its sensitivity is low. Microhysteroscopy allows an atraumatic and direct investigation of the uterine cavity and could be used as a routine basis in patients with risk factors for endometrial pathology and signs of hyperestrogenism. In symptomatic patients its employment must be considered necessary for a correct and modern management of these patients. Operative hysteroscopy represents a promising way for treating hyperplastic endometrial lesions without signs of atypia, but its value in comparison with hysterectomy must be confirmed; when atypia is found, hysterectomy is the treatment of choice.