Comparison of facial features in fetuses and newborns following natural delivery with cephalic presentation: a pilot study

BACKGROUND: Malocclusions are usually diagnosed around 3-4 years of age according to specific criteria. The purpose of this protocol is to validate a method to understand how the type of delivery can influence the development of malocclusions. MATERIALS: This pilot study, conducted at the Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico of Milan, evaluated the relationship between the type of delivery, fetal presentation, and the presence of malocclusions in children. The sample included 5 healthy term newborns, all born to healthy mothers with uncomplicated pregnancies by vaginal delivery. Measurements were taken, via ultrasound, at the 37th week of gestation (T0) and on the second day of life (T1), using a craniometer, caliper and goniometer, including head circumference, lower facial angle, frontonasal angle, labial fissure length, and interpupillary distance. CONCLUSION: The results suggest that further research is necessary to better understand the influence of delivery mode and fetal presentation on the development of malocclusions. This study represents an important first step, highlighting the need for larger samples and more in-depth investigation methods to obtain more conclusive results.

[Hysteroscopic evaluation of the endometrium in 63 postmenopausal patients treated with tamoxifen for breast cancer]. / Valutazione isteroscopica dell'endometrio in 63 pazienti in post-menopausa trattate con tamoxifene per carcinoma della mammella.

This retrospective analysis intends to evaluate by histeroscopy the endometrial findings in a group of 63 patients in post-menopausal treated with tamoxifen for breast cancer. Our patients assumed tamoxifen for a different period between 6 and 120 months. Patients have been divided in two groups: I) patients undergoing hysteroscopy because of some clinical symptoms; II) patients who undergoing hysteroscopy as a routine examination. The most important observation of this work is the correlation between the presence of negative endometrium and low risk hyperplasia (LRH) associated to: symptomatology and duration of therapy. In the group of asymptomatic patients the LRH is found only after 3 years of treatment, while in the group of symptomatic patients, LRH is present within the first two years of treatment; beyond this period high risk hyperplasia (HRH) and endometrial carcinoma have been diagnosed. We also observed a higher incidence of endometrial polyps in this population than among the non treated group and among the symptomatic patients. From these data we conclude that hysteroscopy follow-up has to be performed in the group of patients treated with tamoxifen and that it would be necessary to have a hysteroscopy before the beginning of therapy and that this one has to be repeated once a year through the treatment. Obviously the symptomatic patients have to undergo hysteroscopy as soon as possible as a higher incidence of HRH and endometrial carcinoma has been detected in this group of patients.

Clinical stage IIb carcinoma of the uterine cervix: results in 122 patients.

122 patients affected by clinical stage IIb cervical carcinoma were referred to the Radiation Therapy Department and Obstetrics and Gynaecology Department of the University of Florence between 1977 and 1986 for either radiation therapy only (42 patients) or preoperative treatment followed by surgical resection (80 patients). Among the 42 patients receiving radiation therapy only 23 were treated with external beam therapy only (total dose ranging between 50 Gy and 70 Gy at the mid-plane of the pelvis) while 19 received an additional intracavitary boost (total dose ranging between 68 Gy and 98 Gy at Manchester point A). Higher doses of irradiation to point A were correlated with significantly improved survival (65% vs. 18.5%, p = 0.001) and lower incidence of pelvic failure (33% vs 78%). Following preoperative radiation therapy 80 patients underwent radical surgery. Reassessment of the pathologic specimens was possible in all the cases. Disease free survival was not influenced by involvement of parametria, type of surgery or dose to Manchester point A, but rather to nodal status and thickness of the residual tumour in the cervix.

[Erythrocyte zinc-protoporphyrin content in pregnancy]. / La zincoprotoporfirina eritrocitaria nella gravidanza.

The assessment of iron deficiency represents a major aspect of routine laboratory chemico-clinical analysis, but the results provided by traditional hemato-clinical tests (sideremia, transferrinemia, mean cell volume and red blood cell levels) may not prove conclusive. During pregnancy iron deficiency is common and it would be extremely valuable to obtain a precise method of evaluating anemia. The assay of erythrocytic zincoprotoporphyrin (ZNPP) offers further diagnostic possibilities. This study aimed to evaluate the behaviour of ZNPP and other common laboratory indices in pregnant and non-pregnant women in order to assess the value of assaying ZNPP levels. Some common parameters for the study of sideropenic anemia were determined using the methods employed in our laboratory: mean cell volume (MCV), hemoglobin (Hb), sideremia (Fe), ferrinemia and ZNPP in women of child-bearing age. The tests were prescribed for preventive tests prior to the administration of oral contraceptives and/or in pregnant women undergoing control tests. No tests were made to ascertain professional or environmental exposure to lead or its derivatives. Precision was evaluated by calculating the coefficient of variation (CV) for repeated tests. If a detailed analysis is made of the behaviour of some parameters during pregnancy it can be seen that there is a progressive diminution of sideremia and ferritin, accompanied by increased levels of ZNPP. The potentially most characteristic parameters are ferritin and ZNPP which do not have a Gaussian distribution.(ABSTRACT TRUNCATED AT 250 WORDS)

GnRH analogs in gynecological oncology: a review.

Chronic GnRH analogs (GnRH-A) administration has proven to be effective for the control of some hormone-dependent tumors. GnRH-A are now in the standard treatment of prostatic cancer. In the present paper experimental and clinical data on the use of GnRH-A in gynecologic oncology are reviewed in order to identify a possible role in the therapy of breast, endometrial and ovarian cancer. Besides the indirect hormonal effect of GnRH-A, mediated by the suppression of gonadal steroidogenesis, in vitro evidence suggests a direct anti-proliferative action involving autocrine-paracrine regulation of cellular function. In advanced or recurrent breast cancer objective responses were observed in 157 out of 378 premenopausal patients (41%) and in 18 out of 166 postmenopausal women (10%). In ovarian cancer complete and partial responses were observed in 14 out of 121 (11%). At present, data on advanced endometrial carcinoma are limited: only 18 treated patients are reported, of whom 7 responded (38.8%). However, in general, most of the responses observed were transient. Thus, so far, the use of GnRH-A in gynecologic oncology has to be considered for palliation, after the failure of other better understood treatment modalities. The possible use of GnRH-A as an adjuvant is still under investigation.