High prevalence of autoimmune diseases in women with endometriosis: a case-control study.

The immune system seems to be involved in the pathogenesis of endometriosis. Peritoneal chronic inflammation is present and natural killer cells and macrophages abnormalities have been reported in women with the disease. Moreover, a higher production of serum autoantibodies has been found, which could be related to various factors; some still need to be clarified. The correlation between endometriosis and autoimmune diseases is still unclear with few and conflicting available data. The aim of this study was to evaluate the prevalence of autoimmune diseases, as conditions with a possible common pathogenetic factor, in women affected by endometriosis, in order to address future research on its pathogenesis. This retrospective case-control study includes one hundred and forty-eight women with endometriosis and 150 controls. All women were aged between 18 and 45. Informed consent was obtained from all participants of the study. Considered autoimmune diseases include systemic lupus erythematosus (SLE), celiac disease (CD), inflammatory bowel disease (IBD), and autoimmune thyroiditis. Statistical comparison of patients and control group was performed by means of chi-square test or Fisher's exact test as appropriate. Statistical comparison of parametric variable (age) among the groups was performed by t-test for unpaired data. Age was expressed as mean. A value of .05 or less was considered as significant. In the case group, five patients were affected by IBD, while the disease was not observed in the control group (p = .07). SLE was found in eight patients in the case group, while only one was found in the control group (p = .01). Fifteen women in the case group were affected by CD, while the disease was present only in one woman in the control group (p<.0001). A significant correlation was also found between endometriosis and autoimmune thyroiditis: 80 patients with endometriosis had thyroid diseases versus 14 patients in the control group (p<.0001). Our study reports an association between endometriosis and autoimmune disorders, showing a higher prevalence of autoimmune diseases in women affected by endometriosis. These results support a possible autoimmune pathogenesis of endometriosis.

Immune check-point in cervical cancer.

Despite different treatment strategies, locally advanced cervical cancer (CC) persists as one of the most incurable cancers among women worldwide. In fact, this setting of patients are at high risk of persistent and recurrent disease. In recent years, researches have investigated immune check-point inhibitors in hopes of determining improved response to therapy with prolongation of survival. We reviewed the published literature and conference proceedings and presented pivotal trials supporting immune check-point inhibitors use in the treatment of CC.

Threatened abortion and late-pregnancy complications: a case-control study and review of literature.

AIM: Aim of the study was to evaluate the late-pregnancy and perinatal outcomes of patients with threatened miscarriage in the first trimester. METHODS: An observational cohort study was performed on 81 pregnant women. Subjects were divided into two groups: 1) no bleeding; 2) threatened miscarriage. Patients were followed up until delivery and each materno-fetal complication was registered. RESULTS: Threatened miscarriage was associated with increased risk of preterm delivery, placenta previa, pregnancy induced hypertension/preeclampsia (PE), low birth weight (LBW) and neonatal intensive care unit (NICU) admission. There were no significantly differences between the 2 groups with regard to preterm prelabour rupture of membranes (PPROM), CESAREAN section, retained placenta, perinatal death and intrauterine growth restriction (IUGR). About immediate neonatal outcomes, mean birth weights were lower (≈ 200 g) in the study group (group 2), while no significant difference in the APGAR score between the two groups was noted. CONCLUSION: Our study suggests that threatened miscarriage in the first trimester is correlated with an increased incidence of late-pregnancy and perinatal complications and, therefore, these pregnancies should be considered as high risk ones.

[Family planning in adolescents]. / La pianificazione familiare nell'adolescente.

PIP: A mechanistic sexuality has increasingly replaced romantic, affective love-making among adolescent Italians. At age 16, the adolescent Italian normally requests some form of contraceptive, usually oral. The kind of contraceptive eventually preferred depends on the relationship - if it is stable, coitus interruptus is normally practiced. The choice of contraceptive is being complicated by conflicting reports as to the side effects of oral contraceptives: reduced risk of endometriotic cancer and tumors in the ovaries but increased risk of in situ carcinoma being directly connected with intense and varied sexual activity. A mass-media campaign against oral contraceptives and intrauterine devices have resulted in the preferred use of condoms and diaphragms. However, some teenage girls perceive these as creating real and emotional barriers in relationships, and dislike the inconvenient use of spermicides, the risk of ruptured diaphragms. Instead they wish to explore their own and foreign body in a more natural way. The authors disagree with the assertion made by 1 study that abortion is considered a normal means of contraception in the 10% of cases where the barrier method fails. Only a minority of teenage girls are faced with the trauma of abortion. Gynecologists face the dilemma of prescribing adequate contraceptives which either guarantee the least number of voluntary abortions (oral contraceptives) or protect against new epidemiological diseases (condoms, etc.) A personalized form of contraception, matching the profile of the adolescent's background and sex habits is recommended. New contraceptive methods are described which will probably become available around 1995.^ieng

[Typology and etiopathogenesis of breast pain]. / Tipologia ed etiopatogenesi del dolore mammario.

Although mammary pain is the most common reason prompting women to seek breast examination, it is considered to unimportant to be fully investigated and often treatment is extremely superficial. A projected investigation of the natural history of mammary pain through examination of the symptomatology of the commonest forms is considered to be necessary for accurate diagnosis, itself indispensable for effective treatment.