[Our experience in the diagnosis and treatment of diffuse peritonitis]. / La nostra esperienza nella diagnosi e nel trattamento delle peritoniti diffuse.

Acute diffuse peritonitis is still an unpredictable occurrence that hinders patient's survival and is a severe challenge for the surgeon regarding diagnosis and management. The Authors report their experience on 94 cases of acute diffuse peritonitis due to different causes observed during a period of 10 years. Surgical treatment was mainly based on severity of clinica data and general conditions of the patients. Overall mortality was 6.3%. Modern diagnostic techniques, proper usage of antibiotics and accurate timing of surgical procedure constitute the main factors for un update management of peritonitis.

Vitrification of human spermatozoa without cryoprotectants.

The aim of our study was to investigate the effects of vitrification (cooling rate approximately 10000(C/min) without cryoprotectants on swim-up prepared human spermatozoa in comparison to standard conventional freezing with cryoprotectants. Motility, morphology, rate of viability and acrosome reaction of spermatozoa were evaluated. The described method of cryopreservation of human spermatozoa by direct plunging into liquid nitrogen slush without cryoprotectants was effective and could be recommended for routine IVF.

The prevalence of coeliac disease in infertility.

An increased incidence of reproductive problems, including infertility, miscarriage, low birth weight newborns, and shorter duration of breast-feeding, are known to exist in women with coeliac disease; some of these conditions are improved by a gluten-free diet. We have tried to ascertain the prevalence of coeliac disease in 99 couples who were being evaluated for infertility, compared with the known prevalence of silent disease in the population of Northern Sardinia, in which it is endemic. Of all women, four tested positive for at least two out of three markers: immunoglobulin A (IgA) antigliadin, immunoglobulin (IgG) antigliadin, and anti-endomysium antibodies, and underwent a jejunal biopsy; three had histological evidence of coeliac disease. One male partner was positive for two markers, and had a diagnostic jejunal biopsy. The prevalence of coeliac disease in infertile women seems higher (three out of 99, 3. 03%) in the study group than in the general population (17 out of 1607, 1.06%), and particularly in the subgroup with unexplained infertility (two out of 25, 8%, P < 0.03). Screening for coeliac disease should be part of the diagnostic work-up of infertile women, particularly when no apparent cause can be ascertained after standard evaluation.

Oligomenorrhea treatment by purified FSH using a fixed protocol.

This study is designed to evaluate the effectiveness, safety and tolerability of a low dose of purified FSH administration using a fixed protocol in oligomenorrheic patients not desiring pregnancy. We used a low dose (75 IU/day for 5 days) of purified FSH (Metrodin) in 10 oligomenorrheic patients (aged 18-30) for 25 cycles. The onset of menstruation occurred in 7 patients (70%) and in 19 treatment cycles (76%), the ovulation was verified in 5 of these patients (50%) for 13 cycles (52%). One patient had spotting after the treatment, 2 patients did not have any response. The treatment did not cause side effects and it showed a good tolerability.

The treatment of cervical carcinoma in the Sardinian population.

The epidemiological and clinical characteristics of cervical carcinoma in Sardinia were examined, with particular regard to the low incidence (6.47/100,000 women) of these neoplasias. Postsurgical adjuvant Radiotherapy in the high-risk cases has allowed a constant improvement in therapeutic results, with a low relapse-incidence and a high percentage of survival, especially in first and second stage treated cases.