[''Isolated'' single umbilical artery: incidence, cytogenetic abnormalities, malformation and perinatal outcome]. / Arteria ombelicale singola "isolata": incidenza, anomalie citogenetiche, malformazioni ed outcome perinatale.

AIM: The aim of the study was to 1) evaluate the gestational age at diagnosis and the incidence of single umbilical artery in an unselected population of 3750 pregnant women; 2) identify its association with malformations and/or karyotype aberrations in pre/postnatal age; 3) evaluate the fetal-neonatal outcome; 4) investigate the likelihood that a fetus might be affected by a cytogenetic abnormality even in presence of an apparently ''isolated'' single umbilical artery. METHODS: Transabdominal ultrasound of the umbilical vessels and histological confirmation at birth. In presence of single umbilical artery an accurate prenatal ultrasound assessment, karyotyping (pre/postnatal), and clinical follow-up after birth were performed. RESULTS: The incidence of single umbilical artery in our population resulted 1.07% (40/3750), being ''isolated'' in 40% of cases. The diagnosis of chromosomal aberration associated with single umbilical artery was made in 6 cases (15%), while structural fetal abnormalities in absence of causal chromosomal anomalies were present in 9 cases (22.5%), with syndromic patterns in 3 of them. In 2 cases with chromosomal anomalies the single umbilical artery was apparently ''isolated'' at the ultrasound examination between the 17th and the 22nd week of gestation. Excluding 4 terminations of pregnancy, the perinatal mortality percentage resulted 25% (9/36); similarly, fetal growth retardation was present in 25% of cases (9/36). CONCLUSIONS: The incidence of single umbilical artery in our population confirms that this fetal vascular anomaly is frequently identified in pregnancy. In the light of our cases and data in the literature it is evident that diligent surveillance in prenatal age and accurate clinical follow-up after birth are mandatory when a single umbilical artery has been diagnosed. Finally, the possibility, even if rare, that even when the single umbilical artery is apparently ''isolated'', a chromosomal aberration might be present (1/24 of our ''isolated'' cases) should be considered when addressing correct counselling to the couples.

[Role of interleukin-1-alpha and growth factors in postmenopausal osteoporosis]. / Ruolo di interleuchina-1-alpha e dei fattori di crescita nell'osteoporosi postmenopausale.

This study aims to verify the changes occurring in factors such as interleukin alfa-1 (IL1-alpha) and growth factor (GF1) during surgical menopause, with or without hormone replacement therapy. Forty patients, who underwent hysterectomy, entered this perspective and longitudinal study: in ten out of these forty patients the ovaries were preserved. The remaining thirty patients, whose ovaries were removed, were randomly given either estrogen or estro-progestin therapy or no therapy at all. The IL1-alpha and IGF1 levels, taken a year before, were compared with the levels obtained prior to surgery. No changes in IGF1 levels were observed in women who underwent oophorectomy without further treatment and in those women whose ovaries were preserved. A non significant reduction of IGF1 levels was observed in women treated with estrogens. A significant reduction (p < 0.007) was observed, instead, when estro-progestin administration was employed. No changes of IL1-alpha levels were observed when the ovaries were preserved. This monokyne significantly increased in women who underwent oophorectomy and were not treated. Treatment with estrogens or estro-progestin caused a significant reduction of the IL1-alpha levels (p < 0.0005) (p < 0.0009). These data strongly suggested that chronic or acute estrogenic deprivation does not play a significant role on the circulating IGF1 levels and, consequently, also on GH levels. This significant decrease in IGF1 levels with the addition of EP, in association with an increase of osteocalcin, suggested an active role of osteoblasts during administration. The increase of interleukin 1-alpha, after oophorectomy, was considered to play an important role in menopause osteoporosis.(ABSTRACT TRUNCATED AT 250 WORDS)