@article {10798, title = {Imaging and therapy of ovarian cancer: clinical application of nanoparticles and future perspectives.}, journal = {Theranostics}, volume = {8}, year = {2018}, month = {2018}, pages = {4279-4294}, abstract = {

Despite significant advances in cancer diagnostics and treatment, ovarian cancers (OC) continue to kill more than 150,000 women every year worldwide. Due to the relatively asymptomatic nature and the advanced stage of the disease at the time of diagnosis, OC is the most lethal gynecologic malignancy. The current treatment for advanced OC relies on the synergistic effect of combining surgical cytoreduction and chemotherapy; however, beside the fact that chemotherapy resistance is a major challenge in OC management, new imaging strategies are needed to target microscopic lesions and improve both cytoreductive surgery and patient outcomes. In this context, nanostructured probes are emerging as a new class of medical tool that can simultaneously provide imaging contrast, target tumor cells, and carry a wide range of medicines resulting in better diagnosis and therapeutic precision. Herein we summarize several exemplary efforts in nanomedicine for addressing unmet clinical needs.

}, issn = {1838-7640}, doi = {10.7150/thno.26345}, author = {Di Lorenzo, Giovanni and Ricci, Giuseppe and Severini, Giovanni Maria and Romano, Federico and Biffi, Stefania} } @article {10803, title = {Interstitial Fluid in Gynecologic Tumors and Its Possible Application in the Clinical Practice.}, journal = {Int J Mol Sci}, volume = {19}, year = {2018}, month = {2018 Dec 12}, abstract = {

Gynecologic cancers are an important cause of worldwide mortality. The interstitium consists of solid and fluid phases, situated between the blood vessels and cells. The interstitial fluid (IF), or fluid phase, is an extracellular fluid bathing and surrounding the tissue cells. The TIF (tumor interstitial fluid) is a dynamic fluid rich in lipids, proteins and enzyme-derived substances. The molecules found in the IF may be associated with pathological changes in tissues leading to cancer growth and metastatization. Proteomic techniques have allowed an extensive study of the composition of the TIF as a source of biomarkers for gynecologic cancers. In our review, we analyze the composition of the TIF, its formation process, the sampling methods, the consequences of its accumulation and the proteomic analyses performed, that make TIF valuable for monitoring different types of cancers.

}, keywords = {Biomarkers, Tumor, Biophysical Phenomena, Extracellular Fluid, Female, Genital Neoplasms, Female, Humans, Practice Patterns, Physicians{\textquoteright}, Tumor Microenvironment}, issn = {1422-0067}, doi = {10.3390/ijms19124018}, author = {Ura, Blendi and Di Lorenzo, Giovanni and Romano, Federico and Monasta, Lorenzo and Mirenda, Giuseppe and Scrimin, Federica and Ricci, Giuseppe} } @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 {3629, title = {Risk of Essure microinsert abdominal migration: case report and review of literature.}, journal = {Ther Clin Risk Manag}, volume = {10}, year = {2014}, month = {2014}, pages = {963-8}, abstract = {

PURPOSE: To report a case of Essure microinsert abdominal migration and literature review.

METHODS: A 41-year-old woman was counseled to undergo Essure sterilization. The procedure was hampered by the presence of endometrial cavity adhesions, obscuring left tubal ostium. By using microscissors the adhesions were progressively lysed. Since the procedure had become very painful, the patient required general anesthesia. Once adhesion lysis was completed, the tubal ostium was well visible. Both devices were then easily introduced into the fallopian tubes. At the end of the procedure, five coils were visible on the right side and five coils on the left side, as recommended.

RESULTS: The 3-month hysterosalpingogram follow-up suspected abdominal migration of the left device. Laparoscopy confirmed the device displacement in the left lower abdominal quadrant. Both fallopian tubes and the uterus appeared normal. No signs of perforation were detected. The device was embedded into the omentum, but it was easily removed. Bilateral tubal sterilization was performed by bipolar coagulation.

CONCLUSION: There are only 13 cases, including the present, of Essure abdominal migration in the literature. In most cases, abdominal displacement of the microinsert is asymptomatic and does not induce tissue damage. However, in some cases, it may cause a severe adverse event, requiring major surgery. Therefore, removal of the migrated device should be performed as soon as possible. Moreover, during presterilization counseling, the patient should also be correctly informed about the risk of this rare but relevant complication, as well as about the surgical interventions that could be required to solve it.

}, issn = {1176-6336}, doi = {10.2147/TCRM.S65634}, author = {Ricci, Giuseppe and Restaino, Stefano and Di Lorenzo, Giovanni and Fanfani, Francesco and Scrimin, Federica and Mangino, Francesco P} } @article {1881, title = {Third trimester abdominal circumference, estimated fetal weight and uterine artery doppler for the identification of newborns small and large for gestational age.}, journal = {Eur J Obstet Gynecol Reprod Biol}, volume = {166}, year = {2013}, month = {2013 Feb}, pages = {133-8}, abstract = {

OBJECTIVE: To understand if ultrasound biometric evaluation at 30-32 weeks of gestation is a valuable screening tool for the detection of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) infants at birth in a low risk population.

STUDY DESIGN: We enrolled 1848 pregnant women with singleton pregnancy undergoing routine fetal biometry. We divided the infants into four groups: moderate SGA, severe SGA, moderate LGA and severe LGA. We considered third-trimester estimated fetal weight (EFW), abdominal circumference (AC), EFW centile (EFWc), AC centile (ACc) and compared their prediction toward SGA and LGA to determine which of these parameters was the best estimator for fetal size. Then we took the strongest predictive value and added all history-related and ultrasound factors to run a stepdown multivariate logistic regression. All the variables were then dichotomized and sensitivity models only for statistically significant parameters were calculated.

RESULTS: We identified the following predictive factors for each outcome: for severe SGA: EFWc with p<0.001, uterine artery pulsatility index (UtA PI) with p<0.002. For moderate SGA: EFWc with p<0.001, UtA PI with p<0.004, maternal preeclampsia p<0.002. For moderate and severe LGA: EFWc with p<0.001.

CONCLUSION: We can detect in a low-risk population a group at risk of growth deviations. Adding Doppler velocimetry to 30-32 weeks EFWc improves the specificity (84\%) regarding SGA newborns, maintaining a good sensitivity (71\%), and reducing the population to be re-screened from 27 to 17\%. An ultrasound examination at 34-36 weeks or the clinical assessment of maternal risk factors remain the best tools for LGA newborns.

}, keywords = {Adult, Anthropometry, Birth Weight, Diabetes, Gestational, Female, Fetal Growth Retardation, Fetal Weight, Gestational Age, Humans, Hypertension, Pregnancy-Induced, Infant, Newborn, Infant, Small for Gestational Age, Pregnancy, Pregnancy Trimester, Third, Prospective Studies, Sensitivity and Specificity, Ultrasonography, Prenatal, Uterine Artery}, issn = {1872-7654}, doi = {10.1016/j.ejogrb.2012.10.010}, author = {Di Lorenzo, Giovanni and Monasta, Lorenzo and Ceccarello, Matteo and Cecotti, Vera and D{\textquoteright}Ottavio, Giuseppina} }