@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 {1882, title = {Review of the scientific literature on the health of the Roma and Sinti in Italy.}, journal = {Ethn Dis}, volume = {22}, year = {2012}, month = {2012 Summer}, pages = {367-71}, abstract = {

BACKGROUND: Roma and Sinti in Italy are excluded from the rest of society, often live in precarious housing conditions and have poor access to health services. In Italy, the Roma and Sinti minority (.3\% of the overall population) is scarcely represented if compared with other European countries.

METHODS: To establish what is known and how Roma and Sinti health is studied in Italy, we conducted a review of the scientific literature, including articles published between 2000 and 2010, found in Medline, Embase and Web of Science.

RESULTS: We analyzed 15 relevant articles out of 32 references. Four papers describe rare autosomal recessive disorders. Four illustrate outbreaks of measles. The remaining papers describe health conditions suffered by this minority. All but two, however, are based on data collected at health services.

CONCLUSIONS: The lack of prevalence data and analysis of determinants is a detriment to the health of the Roma and Sinti populations in Italy. Participatory research and evidence-based interventions are needed to improve health outcomes and living conditions of the Roma and Sinti people.

}, keywords = {Gypsies, Health Services Accessibility, Health Status, Housing, Humans, Italy, Minority Groups, Prejudice}, issn = {1049-510X}, author = {Monasta, Lorenzo and Erenbourg, Anna and Restaino, Stefano and Lutje, Vittoria and Ronfani, Luca} }