[Use of arginine in intruterine growth retardation (IUGR). Authors' experience]. / Impiego dell'arginina nel ritardo di crescita asimmetrico (IUGR). Nostra esperienza.

BACKGROUND: Asymmetrical intrauterine growth retardation (IUGR) represents a foetal mechanism, consequent to placental insufficiency, due to many factors: genetic, vascular, malformative. At present, no therapy is really efficient. The aim of this study was to evaluate the efficacy, in these pathological conditions, of the use of L-arginine. This amino-acid improves GH-RH incretion, with consequent increase of plasmatic GH influencing somatic growth. L-arginine moreover, is the obligatory precursor for nitric oxide (NO) enzymatic synthesis (Endothelial-derived relaxing factor). NO helps the prolapse of smooth musculature and, consequently, the improvement of placental blood circulation. METHODS: On the basis of the double activity of NO, vasodilatation and GH-RH induction, 43 pregnant women have been treated suffering from IUGR, diagnosed by ultrasonic examination an by evaluation of Doppler velocimetry values, from 30th week of gestation, administering L-arginine (Bioarginina, 6 g per os/day). Periodically, USG and Doppler velocimetry examinations were performed to evalue foetal growth and possible increase of peripheral vessels resistance. RESULTS: 32 patients improved the clinical course of pregnancy: 19 recovered the whole retardation; 9 only one week; 4 had premature delivery after 36 weeks with foetal weight coincident with gestational age. CONCLUSIONS: The positive results suggest the prosecution of clinical studies in order to attempt the achievement of an effective pharmacological treatment of IUGR.

Salivary ferning and the menstrual cycle in women.

The Authors report the data relative to the monitoring of menstrual cycle carried out by the observation of salivary ferning. They compared the usual physical and hormonal parameters of four groups of women with the aspect of the crystallisation of the saliva observed both by normal optical microscope and by a special type of pocket microscope which can be used by women themselves. In conclusion the Authors report a careful examination of the biochemical correlation relating the women's hormonal climate and its salivary constituents.

PIP: In Naples, Italy, clinical researchers observed salivary ferning under the microscope in four groups of women and compared their observations with the usual physical and hormonal parameters of these women. They aimed to determine the scientific reliability of salivary ferning as a method to detect a woman's fertile period or eventual hormonal disorders. The groups included 10 unmarried women aged 18-30 years using natural family planning (NFP), 32 married women aged 22-40 years using NFP, 10 women aged 25-35 years submitted to ovulation induction by clomiphene citrate, and 4 unmarried women aged 22-30 years with menstrual disorders. The researchers compared salivary crystallization using a normal optical microscope and a special type of pocket microscope that the women themselves can use. The pocket microscope yielded an average accuracy of examination in 92% of cases. The researchers hypothesized that estrogens, catecolestrogens, and opioid tone have a positive influence on salivary ferning, a result of optimal proportion of water, salts, and sialomucins. The first data collected relative to salivary ferning should lead to further research. The researchers consider observation of salivary ferning a new technique for determining the fertile period that can be supplemented by other known and experimental methods. This proposed method is safe, practicable, and economical.

Objective and subjective data for fertile period diagnosis in women: comparison of methods.

The Authors have evaluated the reliability of various methods, both natural and biochemical, for the identification of the female ovulatory period in women with regular periods. They compared these methods among themselves and with echographical checking of ovulation. It emerged clearly from the study that the greatest reliability among the natural methods is obtained through the evaluation of the presence of cervical mucus, while among biochemical methods the best results are obtained by a semiquantitative colorimetric test. Brilliant prospects have also been opened by research on saliva.

Echographic aspects of the mixed müllerian tumor of the endometrium.

The Authors report a rare clinical case of mixed müllerian tumor of the endometrium. They propose the possibility of an echographic diagnosis on the basis of a careful examination of the reports indicated in Literature.

Ultrasonic visualization of the endometrial cycle.

The dynamic morphological aspects of the uterine mucosa during the various phases of the endometrial cycle were examined, by using ultrasonographic methods, in 148 patients having regular menstrual cycles and a biphasic basal body temperature. During the proliferative phase, ultrasonographic examinations permitted a visualization of the mucosa in 33%-45% of the cases, respectively in the initial and in the later part of the phase. During the secretory phase, the endometrium was identifiable in 81.4% (initial part) to 90% of the cases (later part of phase). During the menstrual phase, on the other hand, the median echo of the endometrial cavity could never be clearly identified.