[The use of electrosurgery in the treatment of extra-cervical genital condylomatosis]. / L'impiego dell'elettrochirurgia nel trattamento della condilomatosi genitale extra-cervicale.

BACKGROUND AND AIMS: The aim of this study was to evaluate the therapeutic efficacy of electrosurgery in the treatment of HPV correlated extra-cervical genital lesions. METHODS: A group of 78 patients with clinical or colposcopic, histologically ascertained vulvar or perineal condylomatosis were enrolled consecutively between March 1994 and July 1995 at the Cervico-Vaginal and Vulvar Pathology Unit of the Obstetrics and Gynecology Clinic at Tor Vergata University, Rome. All patients underwent physical treatment with a radiofrequency electrosurgical knife using exclusively cutting current. In addition to patient compliance, the following parameters were evaluated: length of surgery and recovery times, collateral effects and possible long-term results; a colposcopic and, if necessary, bioptic follow-up was also performed at 3, 6 and 12 months after treatment. RESULTS: Seven out of the group of 68 patients with subclinical condylomatosis presented histologically documented recidivation during the course of follow-up. In the discussion the authors evaluate the positive results obtained using this method and, based on the physical principle underlying electroradiosurgery, they suggest using the term electrosurgical vaporisation for destructive electrotherapy using a cutting current, which is suited to the physical mechanism with which this current acts.

Efficacy of CO2 laser surgery in treating squamous intraepithelial lesions. An analysis of clinical and virologic results.

This paper reports the clinical and virologic results of CO2 laser treatment for squamous intraepithelial lesions in 154 patients. On the basis of cervical canal involvement, vaporization or conization was performed. Failure rates following the first and second treatments were 4.5% and 0%, respectively. However, human papillomavirus persistence in several women with completely normal follow-up suggests that one of the possible mechanisms of failure could be reexposure of the healing area to a viral reservoir within the "normal" epithelium.

[Hysteroscopic evaluation of endometrial ultrasonic anomalies in asymptomatic postmenopausal patients. Preliminary results]. / Valutazione isteroscopica di anomalie ecografiche dell'ecopattern endometriale in pazienti asintomatiche in postmenopausa. Risultati preliminari.

A group of 248 asymptomatic postmenopausal patients was evaluated using transvaginal echography. Thirty-five patients with endometrial echopatterns which were larger than 8 mm and/or irregular then underwent hysteroscopy and endometrial biopsy. Results show that 31.4% of cases in which there was a thickening of the endometrial echopattern correspond to the presence of polyp, myoma, synechia with atrophic endometrium. In conclusion, the Authors affirm the inappropriateness of the term "endometrial echopattern" in menopause, since this term should be reserved to describe the typical appearance of the endometrium during the reproductive phase. They stress that ultrasonography can reveal anomalies of the internal echostructure of the womb but that further tests (e.g. hysteroscopy, biopsy) are required to diagnose their nature.

Role of endocervical curettage in the diagnostic workup of preinvasive cervical lesions.

The aim of the present study was to evaluate the clinical value of endocervical curettage in the diagnostic workup of patients with colposcopically suspect lesions, by correlating the findings of colposcopically directed biopsy with the results of endocervical curettage in patients with both satisfactory and unsatisfactory colposcopic examination. Our results (positive curettage findings in 55.6% of the patients with unsatisfactory colposcopy and in 16.7% of the patients with satisfactory colposcopy) indicate that endocervical curettage could be a useful guide to correct management.

[Medical treatment of pelvic inflammatory disease. A clinical study on the therapeutic effectiveness of piperacillin + erythromycin and of piperacillin + clindamycin + gentamycin]. / Trattamento medico della malattia infiammatoria pelvica. Studio clinico sull'efficacia terapeutica di piperacillina + eritromicina e di piperacillina + clindamicina + gentamicina.

The aim of the present clinical study was to evaluate the therapeutic effectiveness of two different antibiotic combinations (piperacillin + erythromycin and piperacillin + clindamycin + gentamycin) in the medical treatment of patients with pelvic inflammatory disease, respectively at the II and III stage. The findings confirm the therapeutic value and the low toxicity of both pharmacological regimens.

[Hormonodependence and hormonosensibility of the gynecological neoplasias. III. The breast carcinoma]. / Ormonodipendenza e ormonosensibilita delle neoplasie ginecologiche. Nota III. Il carcinoma della mammella.

PIP: The pathogenesis of breast cancer is Extensive tests isolate 3 distinct factors: genetic, hormonal and viral. Thus, the risk factor is increased 2-3 times by hereditary predisposition whereas (bilateral) ovariectomy, blocking production of ovarian hormones, reduces the risk by 10 times. Childbirth reduces the risk in reverse proportion to its frequency; however, less protection is afforded if not accompanied by lactation. Nulliparity was recognized as a risk factor in 1926, but recent studies have proven less conclusive. Also included as risk factors are the intake of fatty nutrients and obesity. Further indications include older age at 1st pregnancy, menstrual disorders, and a prolonged reproductive life as a result of precocious menarche and/or delayed menopause. The longer menopause is delayed, the greater the premenopausal period characterized by hyperestrinization, anovulation, and a modest production of progesterone. Metabolism of estrogens oriented towards more active metabolites compounds the risk factors. It has been impossible to verify an etiologic connection between estrogenic preparations administered during post-menopause and breast cancer. Oral contraceptives, in general, do not seem to pose any risk. A connection between prolactin and cancer has been demonstrated in rodents, but not in humans. Antiprolactin pharmaceuticals are capable of inducing regression of neoplasia, indicating a plausible, however unproven, active role of prolactin. Progesterone acting as an antiestrogen reduces the levels of cytoplasmic receptors, thus probably acting protectively. Basically, two approaches are possible for endocrine treatment of metastasized breast carcinoma: ablative surgery based on hormone deprivation (ovariectomy, suprarenalectomy, hypophysectomy) or additive therapy based on hormonal interference (estrogens, androgens, progestins, antiestrogens).^ieng