[Incidence of thyroid diseases in pregnant women with type I diabetes mellitus]. / Incidenza di tireopatie in donne gravide affette da diabete mellito tipo I.

The interaction between pregnancy, Diabetes Mellitus and thyroid disturbance needs a particular attention. The antithyroid antibodies are more frequent in pregnant women with insulin-dependent diabetes mellitus (IDDM) than in normal pregnant women. Beside, an increased prevalence of subclinic ipotyroidism has been described in pregnant diabetic women. The object of this study is to verify if women with insulin-dependent diabetes mellitus have more probability than normal women to develop a thyroid pathology in pregnancy, in an area with sufficient iodine. Twenty-eight women have been studied: 15 with IDDM, with age 20-37 years, and 13 healthy women, with the same age. Patients were evaluated at the following time-intervals: 9-12 and 18-20 weeks' gestation, at delivery and six months after delivery. Diabetic women followed an insulinic therapy optimized for to reach a good metabolic control. All follow the patients had a thyroid ecography to evaluate thyroid volume and possible presence of nodular formation or others pathologic signs. A blood sample to assay FT3, FT4, TSH, of the antibodies Anti-Thyreoperoxidase (Anti-TPO) and Anti-Thyreoglobulin (Anti-TG). A urine specimen taken to evaluate the iodine excretion. No significant difference was observed between diabetic and normal women, for the values of TSH (p < 0.2), FT4(p < 0.7), FT3(p < 0.6). Instead a significant difference was found between the thyroid volume (p < 0.04), in the diabetic patients versus the normal women, at delivery and six months after delivery. The results of this study underline the importance of the screening of the thyroid function and morphology, in all the pregnant women and, particularly, in the diabetic patients, to find the presence of glandular alterations as early as possible.

[Impact of counseling on the sexual habits and reproductive decisions in HIV-1-positive subjects]. / Ruolo del counselling sulle abitudini sessuali e scelta riproduttiva in soggetti HIV-1 positivi.

BACKGROUND: To assess the results of counselling on sexual behavior and reproductive choices of couples discordant for HIV-1, in South-Eastern Italy. SETTING: University Hospital, Apulia region, South-Eastern Italy. METHODS: In the period March 1985-December 1995, one hundred and forty-four HIV-1 discordant couples were enrolled. They were followed up for a median period of 39 months (range 12-60 months). Behavioural counselling was performed at each visit of the infected case and the sexual partner was periodically tested for HIV-1 antibodies. RESULTS: Sixty percent of couples pursued in unprotected sex intercourse, 30 new infections being diagnosed during the study period (cumulative incidence rate = 21%). In addition, 49 pregnancies in 38 women were recorded. Termination was very seldom the choice of pregnant women. CONCLUSIONS: There is a clear indication for a failure in the counselling process. A change in population characteristics is to be pointed out as the main factor of the results. More appropriate counselling modalities need to be introduced for the different targets of sexual behaviour of our population.

Expression of AgNORs in serous ovarian tumors.

The nosological nature of the borderline ovarian tumor has been investigated by several methodological approaches. The aim of our research was to verify how the study of the nucleolar organizer regions (AgNOR) may offer its contribution on this subject. We studied 18 cases of ovarian serous tumours, respectively 6 benign, 6 borderline and 6 malignant. A separate calculation for clusters (> 1 mu) and total NORs was performed on fifty neoplastic cells chosen at random from every tumour. The findings recorded were the following: 1) the quantity and shape of clusters, dots and total NORs were significantly increasing from benign to borderline to malignant tumours; 2) the number of the dots and total NORs was higher in the case of borderline tumour stage III than in other cases limited to the ovary; 3) the clusters of the poorly differentiated carcinomas were much less numerous than the clusters of those well differentiated; instead the dots and the total NORs were more numerous. These data suggest a correlation between the number of the NORs and the biological activity of the tumours. The borderline serous tumours of the ovary showed a median position between benign and malignant tumours.

Ultrasound diagnosis of heterotopic pregnancy with viable fetuses.

Combined pregnancy is an under-estimated and increasing clinical condition. Its recognition is usually made post-operatively. Ultrasound findings are not specific. Diagnosis is possible only when the cardiac activity of the extrauterine and intrauterine fetus can be detected. In the literature, 18 pre-operative sonographic demonstrations of such cases are reported. A correct echographic assessment can show a definite diagnosis or indicate a diagnostic laparoscopy minimizing maternal morbidity and mortality and improving the prognosis of the intrauterine fetus. In this report, ultrasound diagnostic aspects are discussed.