[The role of Papanicolaou test in gynecologic practice]. / Il ruolo del test di Papanicolaou nella practica ginecologica.

The paper analyses the importance of Papanicolaou's test in gynecological diagnostics and reports an interesting checklist drawn up by the "Istituto Superiore di Sanità" with which all women should be familiar in order to diagnose cervical cancer at an early stage.

[Preliminary study of the use of s. adenosyl methionine in the management of male sterility]. / Studio preliminare sull'impiego della s. adenosil metionina nella sterilità maschile.

In a preliminary study 10 cases of male sterility were treated with 800 mg/day per os of Samyr-Bioresearch over three months. Increased basal motiligy of spermatozoa was observed in 6 out of 10 cases. The results of the study confirm the value and efficacy of SAM in the treatment of male sterility.

[Clinical study of the use of a new tri-phasic pill]. / Studio clinico sull'uso di una nuova pillola trifasica.

The paper reports the results of a study to assess the contraceptive efficacy of a new triphasic pill (Trinovum - Cilag AG). The pill was administered to 50 women aged between 18 and 41 years for 12 months, giving a total of 600 menstrual cycles. Data confirm the value of this pill which ensures excellent contraceptive efficacy and is well tolerated by patients with very few adverse effects.

[Uterine rupture in modern obstetrics]. / La rottura d'utero nella moderna ostetricia.

The paper reports 18 cases of womb rupture observed in the Institute of Gynecology and Obstetrics at the University of Turin from April 1978 to June 1988. Following an analysis of the data relating to the above cases, the paper concludes that in order to reduce the incidence of womb rupture it is important to hospitalize high-risk patients preferably before the start of labour so as to intervent using caesarian section.

[Uterine fibromyoma in pregnancy]. / Fibromiomi uterini in gravidanza.

Data are reported relating to the study of 100 pregnant women, aged between 30 and 49 years old, effected by one or more fibroma nodules on the body of the womb. From an analysis of results, it appears that appropriate obstetric care can significantly reduce the risk of both maternal and fetal complications.

[Thromboembolic disease in obstetrics. Current concepts]. / Malattia tromboembolica in ostetricia. Concezioni attuali.

Thromboembolic disease during pregnancy and confinement is an important cause of mortality and obstetric morbidity. The onset of thromboembolic disease is caused by vascular damage, stasis and hypercoagulability, factors which are all present during gestation. All A. agree that it is of fundamental importance to intervene immediately in cases of active thromboembolic disease, but also to take suitable prophylactic measures to prevent the onset of disease.

[Urinary tract infection during pregnancy]. / Le infezioni delle vie urinarie in gravidanza.

Infections of the urinary tract are particularly frequent in pregnancy (3-10%). Immediate treatment of all symptomatic forms and screening for asymptomatic forms are vital to prevent damage to mother and fetus.

[Hormonal contraception using estroprogestins]. / La contraccezione ormonale mediante estroprogestinici.

Today the estroprogestagen pill is the most valid method of contraception given that its benefits far outweigh its risks. The paper stresses the importance of a thorough anamnestic, clinical and laboratory examination so as to obtain correct and safe steroid contraception. The efficacy and excellent tolerance of the combined method currently make it the most widespread form of oral contraception.

PIP: Oral contraceptive (OCs) of high efficacy containing estroprogestins (EP) were introduced in the 1960's and since then more than 250 million used them. Their benefits include regular menstrual cycles and protection against genital tumors. Dosage seems to be directly related to risks and benefits, therefore new types of low-dose progestins have been developed. Their mechanism of action is based on hypothalamic- hypophysic control, EP suppress the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Their effects are as follows: the cervical mucus becomes more viscous providing a barrier against spermatozoa, regressive (atrophy) modifications and proliferative alterations of the endometrium, and metrorrhagia induced by estrogens and amenorrhea provoked by progestins. The sequential pill requires administration of estrogens in the 1st phase and estroprogestins in the 2nd phase. They minimize physiological and hormonal effects, but the failure rate is 2-3% per woman year. Combined methods of monophasic, biphasic, and triphasic design are used from the 1st to 5th day of menstruation. They block ovulation with a high degree of efficacy, but the stimulating action of EP on the endometrium produces spotting, premature or late metrorrhagia, and amenorrhea. OCs protect against malignant epithelial tumors of the ovaries. It is estimated that 1700 ovarian carcinomas and 2000 endometrial carcinomas are averted each year by the use of the pill in the US. Endometrial cancer risk is halved by EP. 7 epidemiological studies have found no association between the pill and breast cancer, and the risk of benign mammary lesions is also reduced. Accurate anamnesis is mandatory for prescribing safe OCs including screening for coagulation, hepatic function and glycemia tests, and colposcopic examination. Smoking and the pill as well as age under 16 and over 36 increase risks. Nonetheless, the benefits of EP contraceptives outweigh the risks.