@article {10812, title = {Management of endometrial, ovarian and cervical cancer in the elderly: current approach to a challenging condition.}, journal = {Arch Gynecol Obstet}, volume = {299}, year = {2019}, month = {2019 Feb}, pages = {299-315}, abstract = {

PURPOSE: Gynaecological cancer management in older people represents a current challenge. Therefore, in the present paper, we aimed to gather all the evidence reported in the literature concerning gynecological cancers in the elderly, illustrating the state of art and the future perspectives.

METHODS: We searched MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS and Grey literature (Google Scholar; British Library) from January 1952 to May 2017, using the terms "ovarian cancer", "endometrial cancer", "cervical cancer", "gynecological cancers" combined with {\textquoteright}elderly{\textquoteright}, {\textquoteright}cancer{\textquoteright}, {\textquoteright}clinical trial{\textquoteright} and {\textquoteright}geriatric assessment{\textquoteright}.

RESULTS: The search identified 81 citations, of which 65 were potentially relevant after initial evaluation and met the criteria for inclusion and were analyzed. We divided all included studies into three different issue: "Endometrial cancer", "Ovarian cancer" and "Cervical cancer".

CONCLUSIONS: The present literature review shows that, in spite of the higher burden of comorbidities, elderly patients can also benefit from standard treatment to manage their gynecological cancers. It is important to overcome the common habit of undertreating the elderly patients because they are more fragile and with a lower life expectancy than their younger counterpart. Further trials with elderly women are warranted.

}, issn = {1432-0711}, doi = {10.1007/s00404-018-5006-z}, author = {Vitale, Salvatore Giovanni and Capriglione, Stella and Zito, Gabriella and Lopez, Salvatore and Gulino, Ferdinando Antonio and Di Guardo, Federica and Vitagliano, Amerigo and Noventa, Marco and La Rosa, Valentina Lucia and Sapia, Fabrizio and Valenti, Gaetano and Rapisarda, Agnese Maria Chiara and Peterlunger, Isabel and Rossetti, Diego and Lagan{\`a}, Antonio Simone} } @article {10442, title = {Light element distribution in fresh and frozen-thawed human ovarian tissues: a preliminary study.}, journal = {Reprod Biomed Online}, volume = {37}, year = {2018}, month = {2018 08}, pages = {153-162}, abstract = {

RESEARCH QUESTION: Does synchrotron X-ray fluorescence (XRF) provide novel chemical information for the evaluation of human ovarian tissue cryopreservation protocols?

DESIGN: Tissues from five patients undergoing laparoscopic surgery for benign gynaecological conditions were fixed for microscopic analysis either immediately or after cryopreservation. After fixation, fresh and slowly frozen samples were selected by light microscopy and transmission electron microscopy, and subsequently analysed with synchrotron XRF microscopy at different incident energies.

RESULTS: The distributions of elements detected at 7.3 keV (S, P, K, Cl, Fe, and Os) and 1.5 keV (Na and Mg) were related to the changes revealed by light microscopy and transmission electron microscopy analyses. The light elements showed highly informative findings. The S distribution was found to be an indicator of extracellular component changes in the stromal tissues of the freeze-stored samples, further revealed by the transmission electron microscopy analyses. Low-quality follicles, frequent in the freeze-thawed tissues, showed a high Na level in the ooplasm. On the contrary, good-quality follicles were detected by a homogeneous Cl distribution. The occurrence of vacuolated follicles increased after cryopreservation, and the XRF analyses showed that the vacuolar structures contained mainly Cl and Na.

CONCLUSIONS: The study demonstrates that elemental imaging techniques, particularly revealing the distribution of light elements, could be useful in establishing new cryopreservation protocols.

}, keywords = {Cryopreservation, Female, Humans, Microscopy, Electron, Transmission, Organ Preservation, Ovarian Follicle, Ovary}, issn = {1472-6491}, doi = {10.1016/j.rbmo.2018.04.051}, author = {Pascolo, Lorella and Venturin, Irene and Gianoncelli, Alessandra and Bortul, Roberta and Zito, Gabriella and Giolo, Elena and Salom{\`e}, Murielle and Bedolla, Diana E and Altissimo, Matteo and Zweyer, Marina and Ricci, Giuseppe} } @article {10850, title = {The Role of Oxidative Stress and Membrane Transport Systems during Endometriosis: A Fresh Look at a Busy Corner.}, journal = {Oxid Med Cell Longev}, volume = {2018}, year = {2018}, month = {2018}, pages = {7924021}, abstract = {

Endometriosis is a condition characterized by the presence of endometrial tissue outside the uterine cavity, leading to a chronic inflammatory reaction. It is one of the most widespread gynecological diseases with a 10-15\% prevalence in the general female population, rising up to 30-45\% in patients with infertility. Although it was first described in 1860, its etiology and pathogenesis are still unclear. It is now accepted that inflammation plays a central role in the development and progression of endometriosis. In particular, it is marked by an inflammatory process associated with the overproduction of an array of inflammatory mediators such as prostaglandins, metalloproteinases, cytokines, and chemokines. In addition, the growth and adhesion of endometrial cells in the peritoneal cavity due to reactive oxygen species (ROS) and free radicals lead to disease onset, its ensuing symptoms-among which pain and infertility. The aim of our review is to evaluate the role of oxidative stress and ROS in the pathogenesis of endometriosis and the efficacy of antioxidant therapy in the treatment and mitigation of its symptoms.

}, keywords = {Endometriosis, Female, Humans, Oxidative Stress}, issn = {1942-0994}, doi = {10.1155/2018/7924021}, author = {Vitale, Salvatore Giovanni and Capriglione, Stella and Peterlunger, Isabel and La Rosa, Valentina Lucia and Vitagliano, Amerigo and Noventa, Marco and Valenti, Gaetano and Sapia, Fabrizio and Angioli, Roberto and Lopez, Salvatore and Sarpietro, Giuseppe and Rossetti, Diego and Zito, Gabriella} } @article {10487, title = {Thrombogenesis in Thrombophilic Pregnancy: Evaluation of Low-Molecular-Weight Heparin Prophylaxis.}, journal = {Acta Haematol}, volume = {137}, year = {2017}, month = {2017}, pages = {201-206}, abstract = {

The aim of this study is to investigate thrombogenesis and the hypercoagulable changes in pregnant women affected by thrombophilia who received low-molecular-weight heparin (LWMH) prophylaxis. We included 21 pregnant women affected by thrombophilia treated with LWMH and 20 nontreated normal pregnant women as the control group. The sample group of thrombophilic pregnant women included different conditions (factor V Leiden mutation, protein C deficiency, protein S deficiency, antiphospholipid antibodies syndrome, and combined defects). Three blood samples were collected during pregnancy (i.e., at 16, 20, and 24 weeks) and tested for activated partial thromboplastin time and prothrombin fragment F1 + 2 (F1 + 2); anti-FXa activity was tested only in treated thrombophilic pregnant women. F1 + 2 levels progressively increased during pregnancy in both study groups. However, the F1 + 2 increase in women exposed to heparin prophylaxis was significantly lower than that in normal pregnant women in all 3 measurements carried out during gestation (p < 0.05); a statistically significant inverse correlation between F1 + 2 levels and anti-Xa activity (R = -0.8575, p < 0.05) was observed in treated women during pregnancy. Our findings suggest that F1 + 2 in addition to anti-Xa measurement could be used to adjust LWMH prophylaxis, at least in high-risk pregnant women.

}, keywords = {Adult, Anticoagulants, Case-Control Studies, Factor Xa Inhibitors, Female, Heparin, Low-Molecular-Weight, Humans, Nadroparin, Partial Thromboplastin Time, Peptide Fragments, Pilot Projects, Pregnancy, Pregnancy Complications, Hematologic, Prothrombin, Thrombophilia, Thrombosis}, issn = {1421-9662}, doi = {10.1159/000467385}, author = {Simeone, Roberto and Giacomello, Roberta and Bruno, Germano and Parco, Sergio and Maximova, Natalia and Martinelli, Monica and Zito, Gabriella and Luppi, Stefania and Cervi, Gina and Ricci, Giuseppe} } @article {8049, title = {Effect of seminal leukocytes on in vitro fertilization and intracytoplasmic sperm injection outcomes.}, journal = {Fertil Steril}, volume = {104}, year = {2015}, month = {2015 Jul}, pages = {87-93}, abstract = {

OBJECTIVE: To investigate the influence of seminal leukocytes on conventional IVF and intracytoplasmic sperm injection (ICSI) outcomes, using a flow cytometry method.

DESIGN: Prospective study.

SETTING: Tertiary infertility center and research institute.

PATIENT(S): One hundred sixty-four couples undergoing conventional IVF or ICSI.

INTERVENTION(S): Seminal leukocytes were counted by flow cytometry.

MAIN OUTCOME MEASURE(S): Correlation between seminal leukocytes concentration and reproductive outcomes in IVF and ICSI cycles.

RESULT(S): The median number of oocytes retrieved, the fertilization and cleavage rate, the median number and grade of embryos transferred, the median number of good-quality embryos transferred, and the median percentage of good-quality embryos from total embryos transferred, in leukocytospermic and non-leukocytospermic patients were not statistically different after either IVF or ICSI. Similarly, there were no significant differences between the two groups for implantation rate and clinical pregnancy rate. Multivariate logistic regression analysis showed that the reproductive outcomes were not influenced by adjustment for female age, infertility diagnosis, number of previous attempts, treatment protocol (GnRH agonist or antagonist), assisted reproduction procedure (IVF or ICSI), and leukocytospermia. By profiling the proper Poisson regression models, no leukocytospermia cut-off value was able to identify the subjects at risk for oocyte fertilization or embryo cleavage failure.

CONCLUSION(S): Using a flow cytometry method, we demonstrated that leukocytospermia does not significantly influence IVF or ICSI outcomes. The same results were obtained by using lower or higher cut-off values for leukocytospermia (from 0.2 to 2 {\texttimes} 10(6)/mL).

}, keywords = {Adult, Female, Fertilization in Vitro, Flow Cytometry, Humans, Leukocytes, Male, Pregnancy, Pregnancy Rate, Prospective Studies, Semen, Sperm Injections, Intracytoplasmic}, issn = {1556-5653}, doi = {10.1016/j.fertnstert.2015.04.007}, author = {Ricci, Giuseppe and Granzotto, Marilena and Luppi, Stefania and Giolo, Elena and Martinelli, Monica and Zito, Gabriella and Borelli, Massimo} } @article {3628, title = {Medical treatments for endometriosis-associated pelvic pain.}, journal = {Biomed Res Int}, volume = {2014}, year = {2014}, month = {2014}, pages = {191967}, abstract = {

The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

}, keywords = {Endometriosis, Female, Gonadotropin-Releasing Hormone, Histone Deacetylase Inhibitors, Hormone Antagonists, Humans, Pain Management, Pelvic Pain, Progestins}, issn = {2314-6141}, doi = {10.1155/2014/191967}, author = {Zito, Gabriella and Luppi, Stefania and Giolo, Elena and Martinelli, Monica and Venturin, Irene and Di Lorenzo, Giovanni and Ricci, Giuseppe} } @article {1835, title = {Management of the adnexal mass.}, journal = {Obstet Gynecol}, volume = {118}, year = {2011}, month = {2011 Oct}, pages = {956; author reply 956-7}, keywords = {Female, Humans, Ovarian Neoplasms}, issn = {1873-233X}, doi = {10.1097/AOG.0b013e318230dde3}, author = {Ricci, Giuseppe and Zito, Gabriella and Fischer-Tamaro, Leo} }