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1.
Arq. Inst. Biol. (Online) ; 77(2): 355-358, abr.-jun. 2010. graf
Artigo em Português | VETINDEX, LILACS | ID: biblio-1391116

RESUMO

Com o objetivo de verificar o acúmulo de ácido chiquímico em plantas de laranja pêra (Citrus sinensis) num pomar comercial manejado com glifosato, um herbicida sistêmico de amplo espectro, foram coletadas amostras na Fazenda Jequitibá, tradicional no cultivo de citros, situada no Município de Santo Antônio de Posse, SP. O produtor aplicou de forma convencional Roundup® Original a 1.440 g.ha-1 de equivalente ácido (e.a.) do sal de isopropilamino de glifosato em 19/12/ 2006 na entrelinha de 15 plantas, deixando outras cinco como testemunha. A reaplicação de glifosato a 1.260 g.ha-1 de e.a. foi realizada em 2/4/2007. Em ambos os casos, imediatamente antes da aplicação e aos 3, 7, 10, 15, 20 e 35 dias após, foram coletadas 20 folhas de cada planta tanto da área tratada como da não tratada, analisando-se o teor de ácido chiquímico por cromatografia líquida de alta eficiência (CLAE) de forma isocrática após extração por micro-ondas. Os resultados mostraram não ocorrer acúmulo do ácido chiquímico nas plantas de laranja pêra, não havendo diferenças significativas nos teores deste composto entre o material proveniente da área tratada com glifosato e o daquela capinada manualmente.


In order to check the accumulation of shikimic acid in a traditional commercial grove of citrus "Pêra" cultivar (Citrus sinensis) managed for weed control with glyphosate, a systemic herbicide with wide spectrum, samples were collected at Fazenda Jequitibá, in Santo Antonio de Posse County, São Paulo State, Brazil. The producer applied the following treatments of Roundup Original® glyphosate at 1,440 g.ha-1 a.e. of the isopropylamine salt on 19 December 2006 between rows of 15 plants, leaving five others as control. The reapplication of glyphosate at 1,260 g ha-1 was done on 2 April 2007. In both cases, immediately before application and at 3, 7, 10, 15, 20 and 35 days thereafter, 20 leaves from each treated and untreated plants were collected for analysis of the content of shikimic acid by isocratic high performance liquid chromatography (HPLC) assisted with microwave. The results showed no significant differences in levels of shikimic acid between the material from the area treated with glyphosate and that weeded manually.


Assuntos
Ácido Chiquímico/análise , Citrus/parasitologia , Herbicidas , Cromatografia Líquida de Alta Pressão
2.
Minerva Anestesiol ; 68(7-8): 621-5, 2002.
Artigo em Italiano | MEDLINE | ID: mdl-12244294

RESUMO

One of the most frequent anesthesiological manoeuvres is orotracheal intubation (OTI). Many complications can occur during OTI, one of these is the rupture of the trachea (TR) and/or of the bronchi. The aim of this study is to highlight the risk of TR during OTI. Over a period of three years of activity (1997-1999) in the Cardiothoracic Department of Pisa University nine patients we treated, eight of which were women ranging from 35 to 95 years of age. In the majority of the cases clinical signs like subcutaneous emphysema of the face and neck, hemoptysis and dyspnoea, variably combined were present. An X-ray of the thorax carried out on six patients did not permit the diagnosis. Bronchoscopy was the diagnostic examination in all nine patients. Seven cases were treated by senior anaesthesiologists, without stilet and OTI was easy. Predictive elements for difficult intubation were not observed in any case. Only one patient had a voluminous intrathoracic goitre dislocating the trachea. The nine patients were all treated surgically as they were all symptomatic and with important transmural lacerations that caused pneumothorax or pneumomediastinum. The survival percentage in the third month is 100%. Although rare TR must be suspected when clinical signs are present; bronchoscopy is the examination which permits diagnosis and a correct therapy.


Assuntos
Intubação Intratraqueal/efeitos adversos , Traqueia/lesões , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Ruptura , Traqueia/diagnóstico por imagem
3.
Eur J Cardiothorac Surg ; 19(5): 570-5, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11343933

RESUMO

OBJECTIVE: We reviewed our overall experience on 163 patients, affected by myasthenia gravis, who underwent thymectomy between 1976 and 1998. A comparison between the oldest series of 72 patients (January 1976-December 1992), referred by various neurologists and operated on through different approaches, and the last 91 patients (January 1993-December 1998), taking part in a strict diagnostic-therapeutical programme, was made. METHODS: Anagraphic data, duration of symptoms, the surgical approach, necessity of respiratory assistance, the hospital stay, histopathological findings, preoperative and postoperative Osserman classification, as well as medications, were globally analyzed and then compared in the two groups. RESULTS: Significant differences in the length of hospitalization (8.7 days vs. 4.2 days; P=0.00001) and in the prolonged intubation rate (18 vs. 0; P<0.000001) were observed in the most recent series. Patients in the pre-operative Osserman stage I and operated on in the second period had a higher complete remission rate at the univariate analysis (P<0.001 and P<0.0001, respectively). At the multivariate analysis the only parameter which affected the outcome was to be operated on in the second period (P<0.01). CONCLUSIONS: Our experience confirms the role of the extended thymectomy in the treatment of myasthenia gravis. Whenever an extended thymectomy was performed through a complete sternotomy it was a quick procedure, with short hospitalization and acceptable cosmetic results. A careful pharmacological control of the myasthenic symptoms and the presence of team-work among neurologist, thoracic surgeon and anaesthesist in the peri-operative setting reduce the incidence of complications and might increase the efficacy of the thymectomy.


Assuntos
Miastenia Gravis/cirurgia , Equipe de Assistência ao Paciente , Timectomia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
4.
J Environ Sci Health B ; 35(3): 297-307, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10808994

RESUMO

The soil oxidative and anaerobic processes, as well as, the microbial biomass were followed during three years in a cotton farm (Tatuí) where the recommended pesticides have been used for several years, and in an experimental field (São Paulo) treated first time with the same pesticides. The oxidative process was monitored by the dehydrogenase (DHA)-activity using triphenyltetrazolium chloride (TTC) as substrate. The anaerobic process was followed by the iron-oxide reduction, and the microbial biomass was estimated by the substrate (glucose)-indiced respiration. Increases in DHA-activity and in the microbial biomass occurred only in the farm soil, with concomitant decreases in iron-reduction. In the experimental field soil, the increases in DHA-activity were followed only by decreases in iron-reduction. Soil characteristics were the determining factor for different biological parameters after pesticide inputs. All the pesticides produced at least one clear but transient effect.


Assuntos
Praguicidas/efeitos adversos , Microbiologia do Solo , Poluentes do Solo/efeitos adversos , Agricultura , Bactérias Anaeróbias/metabolismo , Biomassa , Oxirredução , Oxigênio/metabolismo
5.
J Environ Sci Health B ; 35(1): 51-9, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10693054

RESUMO

This paper reports on the residues of methyl parathion (O,O-dimethyl O-4-nitrophenyl phosphorothioate), trifluralin (alpha, alpha, alpha-trifluoro-2,6-dinitro-N,N-dipropyl-p-toluidine), endosulfan [(1, 4, 5, 6, 7, 7-hexachloro-8, 9, 10-trinorborn-5-en-2, 3-ylenebismethylene) sulfite] and dimethoate (O, O-dimethyl S-methylcarbamoylmethyl phosphorodithioate) in a cotton crop soil. Soil samples (0-15 cm) were collected at different periods from the cotton crop farm and subjected to Soxhlet extraction. The extracted material was analysed after clean-up by a HP5890 II gas chromatograph equipped with a 63Ni electron-capture detector (ECD-63Ni) and fitted with a 25 m x 0.2 mm i.d. fused silica capillary column [Ultra-2 (5% phenylmethyl polysiloxane)]. The recoveries of the pesticide residues from the spiked control soil were determined after Soxhlet extraction and C18 cartridges clean-up by using radiotracer techniques with the corresponding 14C-pesticides. The results show that in the cotton crop soil the pesticide residues under study were present in the range of 0.1 to 0.4 mg.kg-1. Endosulfan was found to be rapidly degraded in the soil and formed a sulfate metabolite.


Assuntos
Monitoramento Ambiental , Gossypium , Inseticidas/análise , Resíduos de Praguicidas/análise , Solo/análise , Dimetoato/análise , Endossulfano/análise , Monitoramento Ambiental/métodos , Gossypium/química , Humanos , Metil Paration/análise , Trifluralina/análise
6.
Eur J Obstet Gynecol Reprod Biol ; 72(2): 169-74, 1997 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9134397

RESUMO

OBJECTIVE: To analyze determinants of pregnancy outcome, among HIV infected and uninfected intravenous drug users. STUDY DESIGN: A total of 315 pregnant current intravenous drug users, IVDU (151 HIV infected and 164 HIV uninfected subjects) were referred to the Center for Pregnant Drug Addicts of the Mangiagalli Clinic, Milan, Italy, for internatal care and delivery between 1985 and 1993. RESULTS: HIV uninfected and infected mothers did not differ significantly according to type of pregnancy, gestational age at childbirth, mode of delivery, pregnancy outcome and newborn weight, height, head circumference, sex and Apgar at 1 and 5 min. Out of 133 children (born to HIV infected mothers) for whom HIV status was available, 20 (15%) were HIV infected or developed AIDS-related signs and symptoms during a 24 months follow-up. The distribution of HIV infected and non infected infants was not significantly different as regards maternal CD4 lymphocyte count, week of gestation at birth, mode of delivery, infant weight, height, head circumference and Apgar at 1 and 5 min. CONCLUSION: Our data show that HIV infected women in the early stages of HIV infection are not at a higher risk of adverse course of pregnancy than HIV uninfected women. Vertical transmission rates were not associated to newborn characteristics.


Assuntos
Infecções por HIV/complicações , Complicações Infecciosas na Gravidez , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Contagem de Linfócito CD4 , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Gravidez , Resultado da Gravidez
7.
Eur J Epidemiol ; 13(8): 925-30, 1997 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9476823

RESUMO

In order to analyze risk factors for dysmenorrhoea, we conducted a case-control study. Cases were 106 women (median age 27 years) with moderate or severe dysmenorrhoea lasting 12 months or more. Controls were 145 women (median age 26 years) without dysmenorrhoea, admitted for routine gynecological examination at the outpatient gynecological services of the same clinic where cases had been identified. In comparison with women reporting short menstrual cycles (every 25 days or less) the relative risk (RR) of dysmenorrhoea was 2.0 and 2.6, respectively, in those reporting their menstrual cycles of 26-30 days and of 31 days or more, and the RR was 3.6 (95% confidence interval (CI): 1.0-13.4) for women reporting totally irregular menstrual cycles. The estimated RRs were, in comparison with women reporting menstrual flows lasting 4 days or less, respectively 2.2 and 1.9 in those reporting menstrual flows lasting 5 and 6 days or more. Fourty-four (58%) cases but only seven (5%) controls reported heavy menstrual flows (RR in comparison with women reporting slight or normal menstrual flow 12.6, 95% CI: 5.0-32.1). As regards dietary factors, no associations emerged between the various food items, with the exception of cheese and eggs, which tended to be more frequently consumed by cases than controls. The results of this study suggest that the risk of dysmenorrhoea is higher in women with irregular, long and heavy menstrual flows. No association emerged between reproductive history and dysmenorrhoea. Likewise, no clear relationship emerged between intake of several dietary factors and risk dysmenorrhoea.


Assuntos
Dismenorreia/etiologia , Comportamento Alimentar , Ciclo Menstrual , História Reprodutiva , Adulto , Fatores Etários , Estudos de Casos e Controles , Queijo , Intervalos de Confiança , Anticoncepcionais Orais/uso terapêutico , Escolaridade , Ovos , Feminino , Humanos , Itália , Menarca , Menstruação , Análise Multivariada , Fatores de Risco , Fumar , Classe Social , Fatores de Tempo
8.
J Reprod Med ; 41(5): 316-20, 1996 May.
Artigo em Inglês | MEDLINE | ID: mdl-8725755

RESUMO

OBJECTIVE: To evaluate the relationship between smoking and uterine myomas requiring surgery. STUDY DESIGN: We conducted a case-control study in Milan between 1986 and 1992. Cases were 476 patients under 55 years of age with histologically confirmed myomas. Controls were 1,283 women admitted to the hospital for a spectrum of acute, other-than-gynecologic, hormonal or neoplastic conditions (30% trauma, 25% nontraumatic orthopedic conditions, 25% surgical, 20% other miscellaneous). RESULTS: Cases were less frequently current smokers (22%) than controls (32%). In comparison with never smokers, the multivariate relative risk (RR) for myomas was 0.5 (95% confidence interval [CI], 0.4-0.7) in smokers. Ex-smokers were 10% of cases versus 7% of controls (RR 1.2, 95% CI 0.9-1.8). No clear trend in risk was observed with the number of cigarettes smoked per day or duration of smoking and risk of fibroids. The estimated RRs were largely consistent when separate analyses were performed in strata of age and other selected covariates, including indices of body weight. CONCLUSION: Current smoking seems to reduce the risk of myomas.


Assuntos
Leiomioma/epidemiologia , Fumar/efeitos adversos , Neoplasias Uterinas/epidemiologia , Adulto , Envelhecimento/fisiologia , Peso Corporal/fisiologia , Estudos de Casos e Controles , Intervalos de Confiança , Anticoncepcionais Orais , Escolaridade , Feminino , Humanos , Itália/epidemiologia , Leiomioma/etiologia , Leiomioma/fisiopatologia , Pessoa de Meia-Idade , Análise Multivariada , Paridade/fisiologia , Fatores de Risco , Neoplasias Uterinas/etiologia , Neoplasias Uterinas/fisiopatologia
9.
Hum Reprod ; 10(7): 1795-6, 1995 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-8582982

RESUMO

Frequency of recurrence of fibroids after myomectomy has been evaluated in 145 women (median age 38 years, range 21-52) who underwent myomectomy. After surgery all women returned for follow-up visit every 12 months after surgery. Transvaginal ultrasound examination was performed routinely in every patient at 24 and 60 months and at 12, 36 and 48 months if there were any abnormal pelvic findings or suspicious symptomatology. A total of 39 (27%) women gave birth after myomectomy. For the whole series, the cumulative probability of recurrence (CPR) increased constantly during the study period reaching 51% in 5 years. The 5-year CPR decreased with parity after myomectomy, being 55% for women with no childbirth after surgery and 42% (based on 13 recurrences, P < 0.01) for those who gave birth.


Assuntos
Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Paridade , Período Pós-Operatório , Probabilidade , Ultrassonografia
10.
Int J Androl ; 18(3): 137-40, 1995 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-7558376

RESUMO

The association between the wearing of tight underpants and trousers and risk of dyspermia has been analysed using data from a case--control study. Cases included infertile men with a diagnosis of unexplained dyspermia. Normospermic men of infertile couples were eligible as controls. In comparison with men usually wearing loose underpants, the odds ratio (OR) of dyspermia was 1.9 (95% confidence interval, CI, 0.9-4.1) in those wearing tight underpants. Likewise, the OR of dyspermia was 1.6 (95% CI 0.9-3.0) in men reporting usually wearing tight trousers (including jeans), in comparison with those wearing loose trousers.


Assuntos
Vestuário/efeitos adversos , Oligospermia/etiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas , Estudos de Casos e Controles , Café , Intervalos de Confiança , Humanos , Masculino , Razão de Chances , Oligospermia/epidemiologia , Fatores de Risco , Fumar
12.
Hum Reprod ; 9(10): 1950-3, 1994 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7844232

RESUMO

The objective of this study was to assess the association between alcohol drinking before and during pregnancy and the risk of spontaneous abortion using data from a case-control study conducted in Milan, Italy. A total of 462 women (median age 30 years) were admitted for spontaneous abortion (within the 12th week of gestation) to a network of obstetrics departments in the greater Milan area. Of these, 148 (32%) were between the fourth and the eighth week of gestation and 314 (68%) between the ninth and the 12th week. A control group was made up of 814 women (median age 29 years) who gave birth at term (> 37 weeks gestation) to healthy infants (Apgar 5th minute > or = 8, weight > or = 3000 g) on randomly selected days at the same hospitals where cases had been identified. A total of 212 cases (46%) and 355 controls (47%) reported alcohol drinking before conception. Considering non-drinkers as the reference category, the relative risks (RR) of spontaneous abortion were 1.2 [95% confidence interval (CI), 0.9-1.6] and 0.8 (95% CI, 0.6-1.1), respectively, in drinkers of one to seven and more than seven drinks per week before conception. No association emerged between the duration of alcohol drinking and the risk of spontaneous abortion. A total of 166 cases (35.9%) and 263 (32.3%) controls reported any alcohol drinking during the first trimester of pregnancy. The corresponding relative risk was 1.1 (95% CI, 0.9-1.4) and no relationship emerged between the number of drinks per week and the risk of abortion.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Aborto Espontâneo/etiologia , Consumo de Bebidas Alcoólicas , Adulto , Cerveja , Estudos de Casos e Controles , Feminino , Humanos , Itália , Análise Multivariada , Gravidez , Primeiro Trimestre da Gravidez , Fatores de Risco , Fumar , Vinho
13.
Hum Reprod ; 9(7): 1333-6, 1994 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7962443

RESUMO

The reproductive prognosis of 115 women desiring pregnancy who underwent surgery for ectopic pregnancy between 1985 and 1990 at the Clinica Luigi Mangiagalli, was analysed after a median follow-up period of 26 months (range 2-83). Probability of reproductive events was assessed by a product-limit model. Women who underwent surgery for ectopic pregnancy had a 54% probability of becoming pregnant (cumulative pregnancy rate, CPR), and a 36% probability of giving birth to a child (cumulative livebirth rate, CLB) during the 3 years after surgery. These percentages dropped with history of previous ectopic pregnancy (respectively 33%, P = 0.07, and 7%, P < 0.05). Increasing age at surgery and presence of adhesions in the contra-lateral tube seemed to be associated with poor reproductive prognosis (CPR = 40% and CLB = 12% for women aged > or = 35 years and CPR = 37% and CLB = 20% in women with adhesions in the contralateral tube), but these findings were not statistically significant. No association emerged between fertility and parity or type of surgery. The recurrence rate of ectopic pregnancy was 20%. No significant association emerged between recurrence of ectopic pregnancy and age, history of previous pregnancy, history of previous ectopic pregnancy, non-intact contra-lateral tube and salpingotomy.


Assuntos
Gravidez Ectópica/cirurgia , Adulto , Fatores Etários , Doenças das Tubas Uterinas/complicações , Feminino , Humanos , Gravidez , Resultado da Gravidez , Gravidez Ectópica/complicações , Prognóstico , Recidiva , Aderências Teciduais/complicações
14.
Epidemiology ; 5(4): 469-72, 1994 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7918820

RESUMO

We analyzed the relation between cigarette smoking, alcohol consumption, and risk of dysmenorrhea using data from a case-control study in Milan, Italy. With never-smokers as the reference category, the relative risk (RR) of dysmenorrhea was 1.9 [95% confidence interval (CI) = 0.9-4.4] for women smoking 10-30 cigarettes per day. The risk of dysmenorrhea increased with duration of smoking in women who smoked for less than 10 years (RR = 1.3, 95% CI = 0.6-2.6) and in those who smoked for 10-20 years (RR = 2.8, 95% CI = 1.3-6.2). In comparison with teetotalers, the age-adjusted RR of dysmenorrhea was 0.8 (95% CI = 0.4-1.5) for alcohol drinkers.


Assuntos
Consumo de Bebidas Alcoólicas , Dismenorreia/epidemiologia , Fumar/efeitos adversos , Adolescente , Adulto , Estudos de Casos e Controles , Dismenorreia/etiologia , Feminino , Humanos , Itália/epidemiologia , Fatores de Risco
15.
Placenta ; 15(3): 321-6, 1994 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8066055

RESUMO

Risk factors for placenta praevia have been analysed in a case control study conducted in Milan, Italy. A total of 140 cases of placenta praevia and the two women who delivered healthy babies consecutively after each index case (280 controls) were identified reviewing clinical records of 49,765 registered deliveries at the Clinica Mangiagalli in Milan from 1979 to 1991. An increased relative risk (RR) of per cent confidence interval, CI, 2.3-6.7) and among those with previous abortions (RR = 1.8, 95 per cent CI, 1.2-2.8) or with more than one previous pregnancy (RR = 1.9, 95 per cent CI, 1.1-3.3). A non-significant trend in risk was observed with parity (RR = 1.2 for one and 1.5 for two previous deliveries versus nulliparas) and for caesarean section (RR = 1.2 for one and 2.1 for two previous caesarean deliveries versus no previous caesarean section). No relation emerged with sex of the newborn and multiple pregnancy and risk of placenta praevia. Our study shows that older age and previous abortions are associated with an increased frequency of placenta praevia.


Assuntos
Placenta Prévia/epidemiologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Itália/epidemiologia , Idade Materna , Gravidez , Gravidez de Alto Risco , História Reprodutiva , Fatores de Risco
16.
Contraception ; 49(2): 101-10, 1994 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8143449

RESUMO

Misoprostol is used by women in Brazil in case of unwanted pregnancy to attempt abortion. This paper reports the characteristics, pattern of misoprostol use and opinions of a group of 102 women (median age 25 years, range 16-49 years), from Fortaleza, capital of Ceará state, who had used misoprostol to attempt abortion. Seventy-five percent were women of lower social class, 58% had less than 8 years of education and 46% were never married. Misoprostol was used for the first induced abortion by 65 women. Modal dose was 4 tablets--200 micrograms of misoprostol each--most frequently 2 tablets by oral route and 2 tablets by intravaginal route. This pattern of use was associated with the highest rate of abortion, mainly at 9-12 weeks of amenorrhea. Fifty-five percent of women had no pregnancy test; 41% had 8 weeks or less of amenorrhea. Curettage was performed in 49 of 84 women who reported abortion and in 41 of 43 women who entered the hospital. Infection and uterine perforation were the complications described. Seventy-two percent of women were in favor of legalization of abortion, but 52% were also in favor of the prohibition of misoprostol sales; 66% would not repeat misoprostol use and 53% would not suggest it to a friend. The poorest women were less favorable to misoprostol ban. Despite the current lack of safer alternatives, misoprostol does not seem a satisfactory solution to illegal abortion in Brazil.


Assuntos
Aborto Induzido , Misoprostol , Administração Oral , Adolescente , Adulto , Fatores Etários , Brasil , Escolaridade , Feminino , Humanos , Estado Civil , Pessoa de Meia-Idade , Misoprostol/administração & dosagem , Misoprostol/efeitos adversos , Gravidez , Fatores Socioeconômicos , Vagina
17.
Eur J Cancer ; 30A(12): 1764-8, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7880602

RESUMO

Response to a second-line weekly cisplatin chemotherapy in ovarian cancer previously treated with cisplatin- or carboplatin-based regimens was analysed in a clinical series observed between 1984 and 1991. Women who achieved pathological complete response or pathological optimal partial remission after first-line cisplatin- or carboplatin-based regimens were treated at recurrence or progression, occurring at least 4 months after first-line treatment, with second-line chemotherapy. A total of 72 women were included in the analysis. Second-line chemotherapy regimens were: cisplatin 1 mg/kg weekly for seven courses plus epirubicin 70 mg/m2 intravenously (i.v.) every 3 weeks for three courses (28 subjects), cisplatin 1 mg/kg plus etoposide 90 mg/m2 i.v. weekly for a total of seven courses (11 subjects) and cisplatin 1 mg/kg weekly for nine courses plus carboplatin 250 mg/m2 every 3 weeks for three courses (33 subjects). Of the 72 women, 22 (31%, 14 clinical, 8 pathological) had a complete response and 28 (39%), a partial response (24 clinical, 4 pathological). The 24-month cumulative survival probability was 63% in women with complete response, 32% in those who had partial response, but all the 22 non-responders died within 24 months from diagnosis of recurrence (log rank test P < 0.05). The frequency of complete response and partial response increased with the interval between first diagnosis and recurrence: among the 33 women who had recurrent disease to < 18 months from first diagnosis, complete response or partial response was obtained in 20 (61%) subjects, this figure was 67% (14 out of 21 women) among subjects who had recurrent disease between 18 and < 36 months from first diagnosis and 89% (16/18) among those who had recurrence > or = 36 months. In comparison with women who had recurrence 4- < 18 months from first diagnosis, the OR of response was 1.3 (95% CI 0.4-4.1) for those who had recurrence between 18 and < 36 and 5.2 (95% CI 1.1-24.3) for those who had recurrence > or = 36 months from surgery (chi 1(2) trend p < 0.05). Survival rate after the end of second line chemotherapy for women who relapsed 4- < 18 months, 18- < 36 or 36 months or more after surgery were, respectively, 24, 20 and 67% (log rank test, P < 0.05). Age at first diagnosis, histology, stage, and grading of the disease at first diagnosis and site of recurrence were not associated with response to second-line therapy.


Assuntos
Carboplatina/uso terapêutico , Cisplatino/uso terapêutico , Neoplasias Ovarianas/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/administração & dosagem , Intervalo Livre de Doença , Esquema de Medicação , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Neoplasias Ovarianas/mortalidade , Prognóstico
18.
J Epidemiol Community Health ; 47(4): 265-8, 1993 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8228759

RESUMO

STUDY OBJECTIVE: The aim was to obtain quantitative information from published data on the potential association between video display terminal (VDT) use during pregnancy and the outcome. DESIGN: Results of nine published case-control studies (or cohort studies analysed as case-control) on the relation between VDT exposure during pregnancy and the outcome were sought by reviewing reference lists in relevant reports and by conducting manual and computer searches of the reports published in English. MEASUREMENTS AND MAIN RESULTS: The nine reviewed reports included information on about 9000 cases of spontaneous miscarriages, 1500 of low birth weight, 2000 of congenital malformation, and 50,000 controls. The results of these studies on each outcome of pregnancy examined were reduced to a single 2 x 2 table (cases/controls--exposed/unexposed). Pooled odds ratio (OR) estimates were computed separately for miscarriage, low birth weight, and congenital malformation. Seven studies analysed the relation between VDT exposure in pregnancy and the risk of miscarriage: the estimates' crude OR of spontaneous abortion ranged from 0.9-1.2 and the pooled OR was 1.0 (95% confidence interval (CI) 0.9, 1.0). No consistent evidence of increasing risk with duration of exposure to VDT was found. Two studies analysed the relation between VDT use and risk of having a low birth weight infant: the OR estimates in the individual studies were 1.0 and 1.1. Likewise, no relation emerged from the five studies providing information on congenital malformations and VDT use: the pooled OR was 1.0 (95% CI 0.9, 1.2). No specific malformation pattern emerged. CONCLUSIONS: This meta-analysis provides reassuring evidence on the absence of any major risk of adverse pregnancy outcome as a result of exposure to a VDT. With the number of cases reviewed, it was possible to exclude excess risk of 20% for spontaneous abortion, low birth weight, and congenital malformations.


Assuntos
Terminais de Computador , Campos Eletromagnéticos/efeitos adversos , Exposição Ocupacional , Resultado da Gravidez , Gravidez , Aborto Espontâneo/etiologia , Estudos de Casos e Controles , Anormalidades Congênitas/etiologia , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Fatores de Risco
19.
Am J Obstet Gynecol ; 169(1): 181-2, 1993 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-8392791

RESUMO

In 556 patients undergoing surgery for ovarian cancers the frequency of endometriosis ranged from 3.6% to 5.6% in serous, mucinous, and miscellaneous neoplasms versus 26.3%, 21.1%, and 22.2%, respectively, in endometrioid, clear cell, and mixed subtypes; the differences were statistically significant (chi 2 heterogeneity 50.0, p < 0.001) and consistent in strata of age, parity, menopausal status, and disease stage.


Assuntos
Endometriose/complicações , Neoplasias Ovarianas/complicações , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Adenocarcinoma Mucinoso/complicações , Adenocarcinoma Mucinoso/patologia , Neoplasias do Endométrio/complicações , Neoplasias do Endométrio/patologia , Feminino , Humanos , Itália , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia
20.
Obstet Gynecol ; 81(3): 363-6, 1993 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8437787

RESUMO

OBJECTIVE: To analyze the relation between hysterectomy with or without oophorectomy and the risk of subsequent ovarian cancer. METHODS: We have conducted a case-control study since 1983 in a network of general and university hospitals in the greater Milan area. The cases were 953 women aged less than 75 years with histologically confirmed epithelial ovarian cancer. Women younger than 75 years residing in the same geographic area and admitted for acute conditions to the same network of hospitals where the cases had been identified were eligible as controls. Potential controls were excluded if they had been admitted for gynecologic, hormonal, or neoplastic diseases or had previously undergone bilateral oophorectomy. A total of 2758 controls were interviewed. RESULTS: Fifty-two cases (5.5%) and 215 controls (7.8%) reported a history of hysterectomy, including eight cases and 38 controls who also reported unilateral oophorectomy. In comparison with women with intact uterus and ovaries, the age-adjusted relative risk (RR) was 0.7 in both women who reported hysterectomy alone (95% confidence interval [CI] 0.5-0.9) and in those reporting hysterectomy plus unilateral oophorectomy, though the latter finding was not statistically significant (95% CI 0.3-1.4). The risk of ovarian cancer was inversely related with time from hysterectomy. Compared with women reporting no pelvic surgery, the RR was 0.9 (95% CI 0.4-1.7), 0.7 (0.3-1.6), 0.7 (0.3-1.4), and 0.5 (0.3-0.8), respectively, in women reporting hysterectomy within 4 years or less and 5-9, 10-14, and 15 years or more before interview. CONCLUSION: Hysterectomy approximately halves the risk of ovarian cancer, possibly because of altered ovarian blood flow or the opportunity that hysterectomy provides for examining the ovaries.


Assuntos
Histerectomia , Neoplasias Ovarianas/epidemiologia , Ovariectomia , Adulto , Idoso , Estudos de Casos e Controles , Intervalos de Confiança , Feminino , Humanos , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco , Fatores de Tempo
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