We aimed to assess the prevalence of and factors associated with anti- severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positivity in a large population of adult volunteers from five ...administrative departments of the Liguria and Lombardia regions. A total of 3609 individuals were included in this analysis. Participants were tested for anti-SARS-CoV-2 antibodies Immunoglobulin G (IgG) and M (IgM) class antibodies at three private laboratories (Istituto Diganostico Varelli, Medical Center, and Casa della Salute di Genova). Demographic data, occupational or private exposure to SARS-CoV-2-infected patients, and prior medical history consistent with SARS-CoV-2 infection were collected according to a preplanned analysis. The overall seroprevalence of anti-SARS-CoV-2 antibodies (IgG and/or IgM) was 11.0% 398/3609; confidence interval (CI) 10.0%–12.1%. Seroprevalence was higher in female inmates than in male inmates (12.5% vs. 9.2%, respectively, p = 0.002), with the highest rate observed among adults aged >55 years (13.2%). A generalized estimating equations model showed that the main risk factors associated with SARS-CoV-2 seroprevalence were the following: an occupational exposure to the virus Odd ratio (OR) = 2.36; 95% CI 1.59–3.50, p = 0.001, being a long-term care facility resident (OR = 4.53; 95% CI 3.19–6.45, p = 0.001), and reporting previous symptoms of influenza-like illness (OR = 4.86; 95% CI 3.75–6.30, p = 0.001) or loss of sense of smell or taste (OR = 41.00; 95% CI 18.94–88.71, p = 0.001). In conclusion, we found a high prevalence (11.0%) of SARS-CoV-2 infection that is significantly associated with residing in long-term care facilities or occupational exposure to the virus. These findings warrant further investigation into SARS-CoV-2 antibody prevalence among the Italian population.
To evaluate the efficacy of goserelin versus a low-dose cyclic oral contraceptive (OC) in improving pelvic pain in women with endometriosis and to compare recurrence of symptoms during follow-up.
...Open-label, randomized trial.
University hospital endometriosis center.
Fifty-seven women with moderate or severe pelvic pain and laparoscopically diagnosed endometriosis.
Six-month treatment with goserelin depot (n=29) or a low-dose cyclic OC (n=28) followed by 6-month follow-up.
Variation in severity of symptoms during treatment and at the end of follow-up as shown by a linear analog scale and a verbal rating scale.
At 6months of treatment, a significant reduction in deep dyspareunia was observed in both groups, with goserelin superior to the OC at linear analog scale assessment. Nonmenstrual pain was diminished on both scales without differences between treatments. Women taking the OC experienced a significant reduction in dysmenorrhea. At the end of follow-up, symptoms reappeared without differences in severity between the groups.
Low-dose cyclic OCs may be a valuable alternative for the treatment of dysmenorrhea and nonmenstrual pain associated with endometriosis. Symptoms recurred in most subjects 6months after drug withdrawal.
Endometriosis and ovarian cancer Vercellini, P; Parazzini, F; Bolis, G ...
American journal of obstetrics and gynecology,
07/1993, Letnik:
169, Številka:
1
Journal Article
Recenzirano
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.
In six women with a preoperative diagnosis of incarcerated hernia, surgical exploration of the groin revealed inguinal endometriosis and no hernia. The affected structure was always the ...extraperitoneal portion of the round ligament. Six of the seven lesions were on the right. Intraperitoneal endometriosis was demonstrated in all patients. Catamenial pain was the pathognomonic symptom in the differential diagnosis of the inguinal mass. Gynecologists and surgeons should bear in mind the possibility that endometriosis may be the cause of symptoms of a suspected incarcerated inguinal hernia. Should this disease be detected at inguinal exploration, a laparoscopy is indicated during the same operation.
The visual diagnosis of endometrioma at laparotomy in 245 women operated on for ovarian cysts demonstrated a sensitivity of 97%, specificity of 95%, positive and negative predictive value of 98% and ...94%, respectively, and overall accuracy of 96%. Because the visual detection of endometriomas is remarkably accurate, ovarian biopsy, although desirable in some cases, would seem dispensable for a correct laparoscopic diagnosis and staging of the disease.
Objective. To investigate the effect of gonadotropin releasing hormone agonist (goserelin) treatment before hysterectomy for leiomyomata-associated menorrhagia.
Design. Prospective, comparative, ...nonrandomized study.
Setting. A teaching hospital of Milano University.
Patients. Anemic women requiring hysterectomy for myoma-associated menorrhagia.
Intervention. Six months' preoperative goserelin treatment (41 cases) or immediate surgery (92 controls).
Main outcome measures. Abdominal/vaginal hysterectomy rate, number of transfusions, operating time, blood loss, complications, febrile morbidity, and days in hospital.
Results. In the goserelin group mean hemoglobin rose (8.5 versus 13.3 g/dl) and mean uterine volume decreased (528 versus 251 ml). At preoperative pelvic exploration abdominal hysterectomy was indicated in 22 (54%) cases and 74 (80%) controls and vaginal hysterectomy in 19 (46%) and 18 (20%) (relative risk 3.6, 95% confidence interval 1.6 to 7.7; p = 0.001). No case required a transfusion whereas 51% of controls needed a total of 127 packed red cell units.
Conclusions. In anemic women with menorrhagia and leiomyomas, gonadotropin releasing hormone agonist treatment before hysterectomy limited transfusion requirements and increased the vaginal procedure rate.
Conservative surgery for severe endometriosis in infertile women is one of the most challenging situations for the pelvic surgeon. The second half of the 1980s saw an increase in the supporters of ...laparoscopic treatment even for more extensive disease. Two opposing factions were thus created: traditional gynecologic surgeons who accuse endoscopists of imprudence and technical inadequacy and enthusiastic supporters of operative laparoscopy who consider laparotomy obsolete and its associated morbidity needlessly high for the patient and health service. In the present review of the literature data we analyze laparotomy and laparoscopy techniques and compare the postoperative results in terms of reproductive success in an attempt to clarify whether conservative endoscopic treatment of severe endometriosis is only an inappropriate proposal with no future or whether, due to its efficacy, it will eventually limit interventions via laparotomy to exceptional circumstances.
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