Дисертації з теми "MED/40"
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Aldentorp, Johanna. "Sömnighet hos dagtidsarbetande med vanlig 40-timmarsvecka." Thesis, Stockholm University, Department of Psychology, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-35678.
Повний текст джерелаEtt intressant ämne inom sömnforskningen är sömnighet, vilken ofta mäts med subjektiva skalor som Karolinska Sleepiness Scale (KSS). Då många undersökningar görs på natt- och skiftarbetare, finns lite data för dagtidsarbetande att jämföra med. Syftet med föreliggande uppsats är att ur sömnighetsdata från förmätningen i en studie vid stressforskningsinstitutet, bilda en uppfattning om sömnighetsmönster hos dagtidsarbetande. Sömn- och vakenhetsdagböcker fylldes i av 821 personer under en vecka och resultaten analyserades med variansanalys för upprepade mätningar med inomgruppsfaktorerna veckodag samt tidpunkt och mellangruppsfaktorerna kön, ålder samt sömnlängd. Signifikanta huvudeffekter återfanns av dag, tid, kön och ålder samt interaktionseffekter av dag/tid, tid/ålder samt tid/kön. Resultaten verkar ge en representativ bild över sömnigheten hos dagtidsarbetande med 40-timmarsvecka, och är troligen generaliserbara till andra inom samma grupp så länge inte arbetsuppgifterna är alltför fysiskt eller mentalt krävande, vilket skulle kunna öka sömnigheten.
Simonazzi, Giuliana <1973>. "Il ruolo dell'ecografia prenatale nell'infezione congenita da Citomegalovirus." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2008. http://amsdottorato.unibo.it/970/1/Tesi_Simonazzi_Giuliana.pdf.
Повний текст джерелаSimonazzi, Giuliana <1973>. "Il ruolo dell'ecografia prenatale nell'infezione congenita da Citomegalovirus." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2008. http://amsdottorato.unibo.it/970/.
Повний текст джерелаSegata, Maria <1973>. "Accuratezza nella diagnosi prenatale di malformazione fetale." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2009. http://amsdottorato.unibo.it/2130/1/Segata_Maria_Tesi.pdf.
Повний текст джерелаSegata, Maria <1973>. "Accuratezza nella diagnosi prenatale di malformazione fetale." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2009. http://amsdottorato.unibo.it/2130/.
Повний текст джерелаGandolfi, Colleoni Giulia <1974>. "Anomalie cerebellari fetali: confronto tra ecografia e risonanza magnetica prenatale e follow up a distanza." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2011. http://amsdottorato.unibo.it/3622/1/GANDOLFI_COLLEONI_GIULIA-TESI.pdf.
Повний текст джерелаGandolfi, Colleoni Giulia <1974>. "Anomalie cerebellari fetali: confronto tra ecografia e risonanza magnetica prenatale e follow up a distanza." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2011. http://amsdottorato.unibo.it/3622/.
Повний текст джерелаMarconi, Rebecca <1975>. "Problematiche delle infezioni da CMV in gravidanza: ruolo dell'ecografia." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2011. http://amsdottorato.unibo.it/3827/1/marconi_rebecca_tesi.pdf.pdf.
Повний текст джерелаMarconi, Rebecca <1975>. "Problematiche delle infezioni da CMV in gravidanza: ruolo dell'ecografia." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2011. http://amsdottorato.unibo.it/3827/.
Повний текст джерелаArmillotta, Francesca <1977>. "Effetti della somministrazione di Testosterone in donne." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4511/4/TESI_DOTTORATO.pdf.
Повний текст джерелаAs we know, testosterone (T) plays greater role in many different physiological functions. The role of T in women is still largely unknow. Recent data reports an important role of T in modulating female sexual responsed. AIM: The aim of our study was to investigate the effects of T in women on metabolic parameters and body composition and effects of T on vaginal histology, proliferation and innervations. METHODS: 16 ovariectomized FtM subjects recived TU 1000 mg i.m. with placebo or dutasteride. At week 0 and 54 the following measurements were performed: body composition and metabolic parameters. 16 vaginal sampler from 16 FtM subjects treated with T and 16 PrM e 16 M subjects were collected. Morfhology, glycogen content, Ki-67 proliferation, estrogen receptor, innervations, androgen receptor were evaluated. RESULTS: The administration of T in FtM determines a non-significant increase in LDL cholesterol and significant decrease in HDL cholesterol. HOMA are significantly reduced in the group TU-alone and tend to increase in group TU + D. The hematocrit increases significantly. BMI, WHR and fat mass tend to decrease. Lean body mass tend to increase. No significant changes in bone metabolism have been reported. Vaginal samples from FtM showed a loss of normal architecture of the epithelium. T administration resulted in a strong proliferation reduction. Stromal and epithelial ERα and stromal PGP 9.5 exspression was significantly decrease in FtM. ARs were detected in mucosa and stroma. In mucosa AR density decrease with age but non change with T. In stroma, AR density increase con T. CONCLUSIONS: In conclusion, no major adverse effects were reported after T administration. T administration determines changes in histomorphology and reduces proliferation of vaginal epithelium. We found AR expression in epithelium and stroma. T increase AR expression in stroma.
Armillotta, Francesca <1977>. "Effetti della somministrazione di Testosterone in donne." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4511/.
Повний текст джерелаAs we know, testosterone (T) plays greater role in many different physiological functions. The role of T in women is still largely unknow. Recent data reports an important role of T in modulating female sexual responsed. AIM: The aim of our study was to investigate the effects of T in women on metabolic parameters and body composition and effects of T on vaginal histology, proliferation and innervations. METHODS: 16 ovariectomized FtM subjects recived TU 1000 mg i.m. with placebo or dutasteride. At week 0 and 54 the following measurements were performed: body composition and metabolic parameters. 16 vaginal sampler from 16 FtM subjects treated with T and 16 PrM e 16 M subjects were collected. Morfhology, glycogen content, Ki-67 proliferation, estrogen receptor, innervations, androgen receptor were evaluated. RESULTS: The administration of T in FtM determines a non-significant increase in LDL cholesterol and significant decrease in HDL cholesterol. HOMA are significantly reduced in the group TU-alone and tend to increase in group TU + D. The hematocrit increases significantly. BMI, WHR and fat mass tend to decrease. Lean body mass tend to increase. No significant changes in bone metabolism have been reported. Vaginal samples from FtM showed a loss of normal architecture of the epithelium. T administration resulted in a strong proliferation reduction. Stromal and epithelial ERα and stromal PGP 9.5 exspression was significantly decrease in FtM. ARs were detected in mucosa and stroma. In mucosa AR density decrease with age but non change with T. In stroma, AR density increase con T. CONCLUSIONS: In conclusion, no major adverse effects were reported after T administration. T administration determines changes in histomorphology and reduces proliferation of vaginal epithelium. We found AR expression in epithelium and stroma. T increase AR expression in stroma.
Giunchi, Susanna <1965>. "Caratteristiche cliniche ed ecografiche dei Sarcomi Uterini." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4613/1/GIUNCHI_SUSANNA_TESI.pdf.
Повний текст джерелаObjectives: To describe the gray-scale and Color-doppler sonographic features of uterine sarcomas. Methods: consecutive patients with a histological diagnosis of uterine sarcoma were retrospectively recruited from the databases of two gynecologic oncology Departments. The sonographic reports and the digital images were analysed. Results: Forty-nine cases were included in the study: 17 leiomyiosarcoma, 14 endometrial stromal sarcoma and 18 carcinosarcoma. Median age of the patient population was 62 years (range 35-87). Half of the cases presented abnormal uterine bleeding and 20% pelvic pain. 47/49 (96%) lesions appeared as iso-hypoechoic, without cones of shadow. Conclusions: Uterine sarcomas are a heterogeneous group of tumours showing a range of preoperative sonographic aspects depending on the histological subtype. Knowledge of the spectrum of sonographic findings might help in suspecting these malignant tumours at ultrasound. Opposite to the most common benign uterine mesenchimal tumors (leyomiomas), they never show cones of shadow.
Giunchi, Susanna <1965>. "Caratteristiche cliniche ed ecografiche dei Sarcomi Uterini." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4613/.
Повний текст джерелаObjectives: To describe the gray-scale and Color-doppler sonographic features of uterine sarcomas. Methods: consecutive patients with a histological diagnosis of uterine sarcoma were retrospectively recruited from the databases of two gynecologic oncology Departments. The sonographic reports and the digital images were analysed. Results: Forty-nine cases were included in the study: 17 leiomyiosarcoma, 14 endometrial stromal sarcoma and 18 carcinosarcoma. Median age of the patient population was 62 years (range 35-87). Half of the cases presented abnormal uterine bleeding and 20% pelvic pain. 47/49 (96%) lesions appeared as iso-hypoechoic, without cones of shadow. Conclusions: Uterine sarcomas are a heterogeneous group of tumours showing a range of preoperative sonographic aspects depending on the histological subtype. Knowledge of the spectrum of sonographic findings might help in suspecting these malignant tumours at ultrasound. Opposite to the most common benign uterine mesenchimal tumors (leyomiomas), they never show cones of shadow.
Marra, Elena <1979>. "Valutazione dell’impiego dei test per la genotipizzazione di HPV e l’espressione degli oncogeni virali nel follow-up di donne conizzate per lesioni cervicali di alto grado nello screening del cervico-carcinoma della Regione Emilia-Romagna." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5572/1/marra_elena_tesi.pdf.
Повний текст джерелаObjective. To evaluate the prevalence of several HPV genotypes in patients with CIN2/3 in Emilia-Romagna, the genotype-specific HPV DNA persistence and the expression of HPV oncogenes E6/E7 during follow-up after conisation, and their role in the prediction of residual disease; to verify the applicability of new molecular diagnostic tests in cervical cancer screening. Methods. Patients with abnormal screening citology treated by conisation (T0) for histologically confirmed CIN2/3 were included. At T0 and at 6, 12, 18 and 24 months of follow-up, in addition to the Pap smear and colposcopy, research and genotyping of HPV DNA of 28 types were performed. In case of positivity to the DNA of the 5 genotypes 16, 18, 31, 33 and/or 45, we proceeded to detect HPV E6/E7 mRNA. Preliminary results. The 95.8% of 168 selected patients were HPV DNA positive at T0. In 60.9% of cases the infections were single (mostly HPV 16 and 31), in 39.1% were multiple. HPV 16 was the most frequent genotype detected (57%). The 94.3% (117/124) of patients positive for 5 genotypes of HPV DNA were mRNA positive. Of the 168 patients 38 dropped out. At 18 months (95% of patients), the persistence of HPV DNA of any genotype was 46%, of HPV DNA of 5 genotypes was 39%, with mRNA expression in 21%. We found recurrent disease (CIN2 +) in 10.8% (14/130) at 18 months. Citology was negative in 4/14 cases, HPV DNA test was positive in all cases, mRNA testing in 11/12 cases. Conclusions: HR-HPV DNA test is more sensitive than cytology, mRNA testing is more specific in identifying a recurrence. Final data will be available after the follow-up planned.
Marra, Elena <1979>. "Valutazione dell’impiego dei test per la genotipizzazione di HPV e l’espressione degli oncogeni virali nel follow-up di donne conizzate per lesioni cervicali di alto grado nello screening del cervico-carcinoma della Regione Emilia-Romagna." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5572/.
Повний текст джерелаObjective. To evaluate the prevalence of several HPV genotypes in patients with CIN2/3 in Emilia-Romagna, the genotype-specific HPV DNA persistence and the expression of HPV oncogenes E6/E7 during follow-up after conisation, and their role in the prediction of residual disease; to verify the applicability of new molecular diagnostic tests in cervical cancer screening. Methods. Patients with abnormal screening citology treated by conisation (T0) for histologically confirmed CIN2/3 were included. At T0 and at 6, 12, 18 and 24 months of follow-up, in addition to the Pap smear and colposcopy, research and genotyping of HPV DNA of 28 types were performed. In case of positivity to the DNA of the 5 genotypes 16, 18, 31, 33 and/or 45, we proceeded to detect HPV E6/E7 mRNA. Preliminary results. The 95.8% of 168 selected patients were HPV DNA positive at T0. In 60.9% of cases the infections were single (mostly HPV 16 and 31), in 39.1% were multiple. HPV 16 was the most frequent genotype detected (57%). The 94.3% (117/124) of patients positive for 5 genotypes of HPV DNA were mRNA positive. Of the 168 patients 38 dropped out. At 18 months (95% of patients), the persistence of HPV DNA of any genotype was 46%, of HPV DNA of 5 genotypes was 39%, with mRNA expression in 21%. We found recurrent disease (CIN2 +) in 10.8% (14/130) at 18 months. Citology was negative in 4/14 cases, HPV DNA test was positive in all cases, mRNA testing in 11/12 cases. Conclusions: HR-HPV DNA test is more sensitive than cytology, mRNA testing is more specific in identifying a recurrence. Final data will be available after the follow-up planned.
Carletti, Angela <1976>. "Diagnosi prenatale delle malformazioni fetali: ecografia e risonanza magnetica a confronto in 11 anni di esperienza." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5682/1/carletti_angela_tesi.pdf.
Повний текст джерелаObjective: To evaluate the accuracy of fetal magnetic resonance (MRI) compared to 2D-3D ultrasound in the prenatal diagnosis of congenital anomalies. Materials and methods: We retrospectively evaluated all cases of fetal malformations underwent "expert" ultrasound and MRI in our Hospital from October 2001 to October 2012. The gestational age at ultrasound and magnetic resonance were respectively 28 and 30 weeks. The ultrasound diagnosis was compared with the MRI and then with the postnatal diagnosis. Results: 383 cases were selected, with a sonographic diagnosis or suspected fetal "complex" malformation or obstetric history of positive prenatal infections, evaluated with 2D-3D ultrasound, MRI and complete of follow-up. The study population included: 196 anomalies of the central nervous system (CNS) (51.2%), 73 thoracic defects (19.1%), 20 abnormalities of the face and the neck (5.2%), 29 malformations of the gastrointestinal tract (7.6%), 37 genitourinary defects (9.7%) and 28 cases with other indications (7.3%). An agreement between ultrasound, MRI and postnatal diagnosis was observed in 289 cases (75.5%) and was greater for the CNS anomalies, 156/196 cases (79.6%), compared with the others congenital defects, 133/187 cases (71.1%). The MRI has added important diagnostic information in 42 cases (11%): 21 CNS abnormalities, 2 facial and neck defects, 7 thoracic malformations, 6 gastrointestinal anomalies, 5 genitourinary defects and 1 case of suspected lumbar emivertebra. The ultrasound was more accurate than MRI in 15 cases (3.9%). In 37 cases (9.7%) both techniques were not correlated with postnatal findings. Conclusions: Prenatal ultrasound is still the primary fetal imaging modality. In some complex CNS and extra-CNS anomalies, particularly in late pregnancy, MRI can add relevant information.
Carletti, Angela <1976>. "Diagnosi prenatale delle malformazioni fetali: ecografia e risonanza magnetica a confronto in 11 anni di esperienza." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5682/.
Повний текст джерелаObjective: To evaluate the accuracy of fetal magnetic resonance (MRI) compared to 2D-3D ultrasound in the prenatal diagnosis of congenital anomalies. Materials and methods: We retrospectively evaluated all cases of fetal malformations underwent "expert" ultrasound and MRI in our Hospital from October 2001 to October 2012. The gestational age at ultrasound and magnetic resonance were respectively 28 and 30 weeks. The ultrasound diagnosis was compared with the MRI and then with the postnatal diagnosis. Results: 383 cases were selected, with a sonographic diagnosis or suspected fetal "complex" malformation or obstetric history of positive prenatal infections, evaluated with 2D-3D ultrasound, MRI and complete of follow-up. The study population included: 196 anomalies of the central nervous system (CNS) (51.2%), 73 thoracic defects (19.1%), 20 abnormalities of the face and the neck (5.2%), 29 malformations of the gastrointestinal tract (7.6%), 37 genitourinary defects (9.7%) and 28 cases with other indications (7.3%). An agreement between ultrasound, MRI and postnatal diagnosis was observed in 289 cases (75.5%) and was greater for the CNS anomalies, 156/196 cases (79.6%), compared with the others congenital defects, 133/187 cases (71.1%). The MRI has added important diagnostic information in 42 cases (11%): 21 CNS abnormalities, 2 facial and neck defects, 7 thoracic malformations, 6 gastrointestinal anomalies, 5 genitourinary defects and 1 case of suspected lumbar emivertebra. The ultrasound was more accurate than MRI in 15 cases (3.9%). In 37 cases (9.7%) both techniques were not correlated with postnatal findings. Conclusions: Prenatal ultrasound is still the primary fetal imaging modality. In some complex CNS and extra-CNS anomalies, particularly in late pregnancy, MRI can add relevant information.
Costantino, Antonietta <1968>. "Combinazioni androgeno-progestiniche per la contraccezione maschile." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5727/1/Costantino_Antonietta_Tesi.pdf.
Повний текст джерелаContraception is a basic human right for its role on health, quality of life and weelbeing. Since the introduction of female hormonal contraception the responsibility of family planning has fallen mostly on women. Family planning is one of the most important tools because it gives the possibility to man and women to share the responsibility on the contraceptive choice and to participate in the same way to the reproductive life. Actually, only few contraceptive methods are available for men but there is a new interest in men to support their partners more actively. In the last decades different trials have been performed, with important advances in the development of safer and more effective contraceptive for men. Currently, several methods of contraception for men are under development. This work summaries the most recent trials performed over the past decades to develop a safe, effective, reversible and acceptable male contraceptive.
Costantino, Antonietta <1968>. "Combinazioni androgeno-progestiniche per la contraccezione maschile." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5727/.
Повний текст джерелаContraception is a basic human right for its role on health, quality of life and weelbeing. Since the introduction of female hormonal contraception the responsibility of family planning has fallen mostly on women. Family planning is one of the most important tools because it gives the possibility to man and women to share the responsibility on the contraceptive choice and to participate in the same way to the reproductive life. Actually, only few contraceptive methods are available for men but there is a new interest in men to support their partners more actively. In the last decades different trials have been performed, with important advances in the development of safer and more effective contraceptive for men. Currently, several methods of contraception for men are under development. This work summaries the most recent trials performed over the past decades to develop a safe, effective, reversible and acceptable male contraceptive.
Contro, Elena <1979>. "Il ruolo dell’ecografia prenatale nella diagnosi precoce delle anomalie fetali della fossa cranica posteriore." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5905/1/contro_elena_tesi.pdf.
Повний текст джерелаObjective: To evaluate the role of the brainstem-vermis angle (BV angle) at 16-18 weeks in the early diagnosis of fetal posterior fossa abnormalities. Methods: A prospective multicenter observational study. Three-dimensional ultrasound volumes of the head were acquired in fetuses at 16-18 weeks. Three experienced operators measured the BV angle in the sagittal plane as previously described1,2 and noted whether the 4th ventricle was open in the axial view. A detailed follow-up was provided in each case. Results: Between November 2009 and March 2011, 150 volumes were acquired at 16 wks mean gestational age. Due to low-quality images, 49 cases were excluded, leading to a study population of 101 cases. Of these, 6 were diagnosed with Dandy-Walker malformation (DWM) and 2 with Blake’s pouch cyst (BPC) in later gestation, the remaining were normal. Postnatal follow-up confirmed the diagnosis in all cases. In all fetuses with posterior fossa anomalies, the BV angle was significantly increased compared to controls (57.3+23.0° vs 9.4+7.7°, U-Mann Whitney test p<0.000005). In 90.3% of normal fetuses the BV angle was <20° and the 4th ventricle was closed in axial planes. In 9 normal fetuses and in all cases with BPC the angle was >20° but <45° (25.8+5.6°), and a posterior opening of the 4th ventricle could not be demonstrated in the standard transcerebellar view, but only using a steeper angulation of the transducer. In all fetuses with DWM the BV angle was >45° (67.9+13.9°) and the 4th ventricle appeared widely open even in the standard transcerebellar view (figure 2). Conclusion: Thus far, the diagnosis of cystic posterior fossa anomalies has been considered difficult or impossible prior to 20 wks, owing to the late development of the cerebellar vermis. Our experience suggest that measurement of the BV angle allows precise identification of this conditions at 16 wks.
Contro, Elena <1979>. "Il ruolo dell’ecografia prenatale nella diagnosi precoce delle anomalie fetali della fossa cranica posteriore." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5905/.
Повний текст джерелаObjective: To evaluate the role of the brainstem-vermis angle (BV angle) at 16-18 weeks in the early diagnosis of fetal posterior fossa abnormalities. Methods: A prospective multicenter observational study. Three-dimensional ultrasound volumes of the head were acquired in fetuses at 16-18 weeks. Three experienced operators measured the BV angle in the sagittal plane as previously described1,2 and noted whether the 4th ventricle was open in the axial view. A detailed follow-up was provided in each case. Results: Between November 2009 and March 2011, 150 volumes were acquired at 16 wks mean gestational age. Due to low-quality images, 49 cases were excluded, leading to a study population of 101 cases. Of these, 6 were diagnosed with Dandy-Walker malformation (DWM) and 2 with Blake’s pouch cyst (BPC) in later gestation, the remaining were normal. Postnatal follow-up confirmed the diagnosis in all cases. In all fetuses with posterior fossa anomalies, the BV angle was significantly increased compared to controls (57.3+23.0° vs 9.4+7.7°, U-Mann Whitney test p<0.000005). In 90.3% of normal fetuses the BV angle was <20° and the 4th ventricle was closed in axial planes. In 9 normal fetuses and in all cases with BPC the angle was >20° but <45° (25.8+5.6°), and a posterior opening of the 4th ventricle could not be demonstrated in the standard transcerebellar view, but only using a steeper angulation of the transducer. In all fetuses with DWM the BV angle was >45° (67.9+13.9°) and the 4th ventricle appeared widely open even in the standard transcerebellar view (figure 2). Conclusion: Thus far, the diagnosis of cystic posterior fossa anomalies has been considered difficult or impossible prior to 20 wks, owing to the late development of the cerebellar vermis. Our experience suggest that measurement of the BV angle allows precise identification of this conditions at 16 wks.
Arcangeli, Tiziana <1980>. "Effetto dell'analgesia epidurale sulla progressione della testa fetale valutata mediante ecografia 3D." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2014. http://amsdottorato.unibo.it/6286/1/Arcangeli_Tiziana_tesi.pdf.
Повний текст джерелаObjectives: To assess the effect of epidural analgesia on sonographic progression of fetal head in second stage of labor. Methods: Nulliparous low-risk women at term (37+0-42+0) attending the labor ward of our University Hospital were recruited for the purpose of this study. A volume dataset was acquired by translabial ultrasound every 20 minutes from the beginning of the active second stage until delivery. A series of sonographic parameters were derived from offline analysis of each volume (angle of progression, progression distance, head symphysis distance and midline angle). All parameters were compared at each time interval between patients with or without elective epidural at the onset of labor. Results: 71 patients were recruited in the study; 41 (57.7%) of them in the epidural group. Spontaneous vaginal delivery was achieved in 58 (81.7%) cases. Vacuum delivery and Cesarean section were performed in 8 (11.3%) and 5 (7.0%) cases, respectively. All ultrasound parameters values were comparable at each time interval in the epidural and non-epidural group. Conclusions: Fetal head progression, longitudinally assessed by three-dimensional ultrasound, seems to be comparable in patients submitted or not to epidural administration.
Arcangeli, Tiziana <1980>. "Effetto dell'analgesia epidurale sulla progressione della testa fetale valutata mediante ecografia 3D." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2014. http://amsdottorato.unibo.it/6286/.
Повний текст джерелаObjectives: To assess the effect of epidural analgesia on sonographic progression of fetal head in second stage of labor. Methods: Nulliparous low-risk women at term (37+0-42+0) attending the labor ward of our University Hospital were recruited for the purpose of this study. A volume dataset was acquired by translabial ultrasound every 20 minutes from the beginning of the active second stage until delivery. A series of sonographic parameters were derived from offline analysis of each volume (angle of progression, progression distance, head symphysis distance and midline angle). All parameters were compared at each time interval between patients with or without elective epidural at the onset of labor. Results: 71 patients were recruited in the study; 41 (57.7%) of them in the epidural group. Spontaneous vaginal delivery was achieved in 58 (81.7%) cases. Vacuum delivery and Cesarean section were performed in 8 (11.3%) and 5 (7.0%) cases, respectively. All ultrasound parameters values were comparable at each time interval in the epidural and non-epidural group. Conclusions: Fetal head progression, longitudinally assessed by three-dimensional ultrasound, seems to be comparable in patients submitted or not to epidural administration.
Bisulli, Maria <1979>. "Confronto fra cerchiaggio cervicale elettivo, eco-indicato e d’emergenza dal 2001 al 2013." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2014. http://amsdottorato.unibo.it/6295/1/tesi_bisulli.pdf.
Повний текст джерелаObject: The porpoise of our study is to evaluate the utility of cervical cerclage in prevention of preterm birth in relation to different indications it is placed for, at the University Hospital Sant’Orsola-Malpighi of Bologna in a 13 years period (since January 2001 to December 2013). The second Outcome is to compare our results with recent scientific evidence to evaluate how they modified our practice. Methods: it was a retrospective evaluation of all women underwent cervical cerclage in our center. The population was divided in 5 groups: I group had History indicated cerclage, II group had ultrasound indicated cerclage, III group had physical exam indicated cerclage, IV and V were twin and triplet pregnancy. For each pregnancy we record in an ad Hoc data base: pregnancy outcome (delivery gestational age, birth weight, Apgar score, PH and Base Excess) and the Appropriateness of the indications. Resultes: 191 cerclages were performed in these 13 years: 109 group I, 24 Group II, 39 group III, and 13 and 6 group IV and V respectively. There was one transabdominal laparoscopic cerclage performed before pregnancy. Distribution of different cerclage indication is change during years: since 2007 no cerclages were used in multiple pregnancy; we placed less history indicated cerclage than we did in the past instead physical exam indicated cerclages were more frequent even if they had higher morbility rate. We had one septic abortion with maternal septic shock and subsequent hysterectomy in group III. Conclusion: restricted indications for cervical cerclage caused a reduction in number of cerclage placement. Physical exam indicated cerclage appere to be the last chance to convert an anavoidable abortion in a birth of a new born baby.
Bisulli, Maria <1979>. "Confronto fra cerchiaggio cervicale elettivo, eco-indicato e d’emergenza dal 2001 al 2013." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2014. http://amsdottorato.unibo.it/6295/.
Повний текст джерелаObject: The porpoise of our study is to evaluate the utility of cervical cerclage in prevention of preterm birth in relation to different indications it is placed for, at the University Hospital Sant’Orsola-Malpighi of Bologna in a 13 years period (since January 2001 to December 2013). The second Outcome is to compare our results with recent scientific evidence to evaluate how they modified our practice. Methods: it was a retrospective evaluation of all women underwent cervical cerclage in our center. The population was divided in 5 groups: I group had History indicated cerclage, II group had ultrasound indicated cerclage, III group had physical exam indicated cerclage, IV and V were twin and triplet pregnancy. For each pregnancy we record in an ad Hoc data base: pregnancy outcome (delivery gestational age, birth weight, Apgar score, PH and Base Excess) and the Appropriateness of the indications. Resultes: 191 cerclages were performed in these 13 years: 109 group I, 24 Group II, 39 group III, and 13 and 6 group IV and V respectively. There was one transabdominal laparoscopic cerclage performed before pregnancy. Distribution of different cerclage indication is change during years: since 2007 no cerclages were used in multiple pregnancy; we placed less history indicated cerclage than we did in the past instead physical exam indicated cerclages were more frequent even if they had higher morbility rate. We had one septic abortion with maternal septic shock and subsequent hysterectomy in group III. Conclusion: restricted indications for cervical cerclage caused a reduction in number of cerclage placement. Physical exam indicated cerclage appere to be the last chance to convert an anavoidable abortion in a birth of a new born baby.
Berra, Marta <1979>. "Sindrome da insensitività completa agli androgeni e massa ossea. Valutazione basale e longitudinale dopo oltre 12 mesi di terapia estrogenica." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2015. http://amsdottorato.unibo.it/6783/1/tesi_dottorato_Berra_finale.pdf.
Повний текст джерелаBone is a target tissue for both estrogens and androgens. Women with Complete Androgen Insensitivity Syndrome (CAIS)present with a 46XY cariotype but absence of receptorial androgen action. In our study we evaluated bone mineral density (BMD)among adult CAIS women who previously underwent bilateral gonadectomy at recruitment and after at least 12 month estrogen treatment. The main goal was to evaluate if full dosage estrogen only therapy was enough to preserve/improve BMD. 24 CAIS women underwent lumbar spine and hip DXA scan at recruitment (t1), after estrogen treatment of 12 months (t1) and more (t>2). BMD(g/cm2),lumbar spine (L2-L4) and hip Zscore at t1,t2 e t>2 were evaluated. It was considered wether (group1) or not (group2) women were on hormonal treatment at recruitment and age at gonadectomy. Results:at t1 BMD and Z score at spine and hip were significantly reduced when compared to control population in all groups: all population (spine 0,900+0,12; -1,976+0,07, hip 0,831 + 0,14; -1,385+0,98) , group 1 (spine 0,918+0,116;-1,924+0,79, hip 0,824+0,13;-1,40+1,00) and group 2 (spine 0.845+0,11-2,13+1,15, hip 0,857+0,17;-1,348+1,05).At t2 and t>2 spine BMD and Zscore were significantly increased (p=0,05 e p=0,02). Spine Zscore, hip BMD and Zscore did not show significant changes. Postpubertal age at gonadectomy was related to higher lumbar spine and hip Zscore at t1 In CAIS women estrogen therapy is essential to prevent further bone loss but it doesn't seem to restore normal BMD values. Our study support the hypothesis that androgen, thorough receptorial action, have a direct role in reaching and preserving BMD.
Berra, Marta <1979>. "Sindrome da insensitività completa agli androgeni e massa ossea. Valutazione basale e longitudinale dopo oltre 12 mesi di terapia estrogenica." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2015. http://amsdottorato.unibo.it/6783/.
Повний текст джерелаBone is a target tissue for both estrogens and androgens. Women with Complete Androgen Insensitivity Syndrome (CAIS)present with a 46XY cariotype but absence of receptorial androgen action. In our study we evaluated bone mineral density (BMD)among adult CAIS women who previously underwent bilateral gonadectomy at recruitment and after at least 12 month estrogen treatment. The main goal was to evaluate if full dosage estrogen only therapy was enough to preserve/improve BMD. 24 CAIS women underwent lumbar spine and hip DXA scan at recruitment (t1), after estrogen treatment of 12 months (t1) and more (t>2). BMD(g/cm2),lumbar spine (L2-L4) and hip Zscore at t1,t2 e t>2 were evaluated. It was considered wether (group1) or not (group2) women were on hormonal treatment at recruitment and age at gonadectomy. Results:at t1 BMD and Z score at spine and hip were significantly reduced when compared to control population in all groups: all population (spine 0,900+0,12; -1,976+0,07, hip 0,831 + 0,14; -1,385+0,98) , group 1 (spine 0,918+0,116;-1,924+0,79, hip 0,824+0,13;-1,40+1,00) and group 2 (spine 0.845+0,11-2,13+1,15, hip 0,857+0,17;-1,348+1,05).At t2 and t>2 spine BMD and Zscore were significantly increased (p=0,05 e p=0,02). Spine Zscore, hip BMD and Zscore did not show significant changes. Postpubertal age at gonadectomy was related to higher lumbar spine and hip Zscore at t1 In CAIS women estrogen therapy is essential to prevent further bone loss but it doesn't seem to restore normal BMD values. Our study support the hypothesis that androgen, thorough receptorial action, have a direct role in reaching and preserving BMD.
Puccetti, Chiara <1980>. "Outcomes feto-neonatali dell'infezione non primaria da Cytomegalovirus." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2015. http://amsdottorato.unibo.it/7049/1/TESI__dottorato_Puccetti.pdf.
Повний текст джерелаOBJECTIVE: To evaluate fetal and neonatal outcomes in case of non-primary cytomegalovirus (CMV) infection. STUDY DESIGN: Retrospective cohort study, including pregnant women with active CMV infection, referred to our units in a 13-year period (2000-2013). Patients were divided into two groups according to the results of confirmatory serologic testing (avidity test, immunoblotting): serologic profile consistent with non-primary infection and serologic profile suggestive of primary infection. The vertical transmission rate and the percentage of symptomatic congenital infection were compared into the two groups. RESULTS: Follow-up was available in 1122 cases, including 182 non-primary infections and 940 primary maternal infections. Congenital infection was diagnosed in 7 (3.86%) fetuses/neonates of non-primary infection group and in 217 (23%) fetuses/neonates of primary infection group (p<0.001). Symptomatic infected fetuses/neonates rate was similar into the two groups: 3 (42,8%) in non-primary infections versus 43 (19,8%) in primary infections (p = 0,13). CONCLUSION: Previous maternal immunity offers substantial protection against intrauterine transmission of CMV infection, but not against disease once the fetus is infected.
Puccetti, Chiara <1980>. "Outcomes feto-neonatali dell'infezione non primaria da Cytomegalovirus." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2015. http://amsdottorato.unibo.it/7049/.
Повний текст джерелаOBJECTIVE: To evaluate fetal and neonatal outcomes in case of non-primary cytomegalovirus (CMV) infection. STUDY DESIGN: Retrospective cohort study, including pregnant women with active CMV infection, referred to our units in a 13-year period (2000-2013). Patients were divided into two groups according to the results of confirmatory serologic testing (avidity test, immunoblotting): serologic profile consistent with non-primary infection and serologic profile suggestive of primary infection. The vertical transmission rate and the percentage of symptomatic congenital infection were compared into the two groups. RESULTS: Follow-up was available in 1122 cases, including 182 non-primary infections and 940 primary maternal infections. Congenital infection was diagnosed in 7 (3.86%) fetuses/neonates of non-primary infection group and in 217 (23%) fetuses/neonates of primary infection group (p<0.001). Symptomatic infected fetuses/neonates rate was similar into the two groups: 3 (42,8%) in non-primary infections versus 43 (19,8%) in primary infections (p = 0,13). CONCLUSION: Previous maternal immunity offers substantial protection against intrauterine transmission of CMV infection, but not against disease once the fetus is infected.
Nanni, Michela <1976>. "Variabilita delle strutture commessurali nell'agenesia isolata del corpo calloso in un'ampia casistica di risonanza magnetica fetale." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7626/2/tesi_08-04-2016.pdf.
Повний текст джерелаBackground and Purpose Agenesis of corpus callosum (ACC), even when isolated, may be characterized by anatomical variability. The aim of this study was to describe the types of other forebrain commissures, in a large cohort of randomly enrolled fetuses with apparently isolated ACC at prenatal magnetic resonance (MR) imaging. Materials and Methods From 2004 to 2014 in all fetuses with apparently isolated ACC submitted to prenatal MR imaging, the presence of the anterior (AC) or a vestigial hippocampal commissure (HC) was assessed "in consensus" by two pediatric neuroradiologists. Results Overall 62 cases of ACC were retrieved from our database. In 3/62 fetuses (4,8%) no forebrain commissure was visible at prenatal MR imaging, 23/62 cases (37,1%) presented only the AC, 20/62 cases (32,3%) showed both the AC and a residual vestigial HC, whereas in the remaining 16/62 cases (25,8%) a hybrid structure (HS) merging a residual vestigial HC and a rudiment of CC body was detectable. Postnatal MR imaging, when available, confirmed prenatal forebrain commissure findings. Conclusions The vast majority of fetuses with apparently isolated ACC showed at least one forebrain commissure at prenatal MR imaging, and about half of cases also a second commissure: a vestigial HC or a hybrid made of HC and rudiment CC body. It remains to be assessed if such variability is the result of different genotype and if it may have any impact on the long term neurodevelopmental outcome
Nanni, Michela <1976>. "Variabilita delle strutture commessurali nell'agenesia isolata del corpo calloso in un'ampia casistica di risonanza magnetica fetale." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7626/.
Повний текст джерелаBackground and Purpose Agenesis of corpus callosum (ACC), even when isolated, may be characterized by anatomical variability. The aim of this study was to describe the types of other forebrain commissures, in a large cohort of randomly enrolled fetuses with apparently isolated ACC at prenatal magnetic resonance (MR) imaging. Materials and Methods From 2004 to 2014 in all fetuses with apparently isolated ACC submitted to prenatal MR imaging, the presence of the anterior (AC) or a vestigial hippocampal commissure (HC) was assessed "in consensus" by two pediatric neuroradiologists. Results Overall 62 cases of ACC were retrieved from our database. In 3/62 fetuses (4,8%) no forebrain commissure was visible at prenatal MR imaging, 23/62 cases (37,1%) presented only the AC, 20/62 cases (32,3%) showed both the AC and a residual vestigial HC, whereas in the remaining 16/62 cases (25,8%) a hybrid structure (HS) merging a residual vestigial HC and a rudiment of CC body was detectable. Postnatal MR imaging, when available, confirmed prenatal forebrain commissure findings. Conclusions The vast majority of fetuses with apparently isolated ACC showed at least one forebrain commissure at prenatal MR imaging, and about half of cases also a second commissure: a vestigial HC or a hybrid made of HC and rudiment CC body. It remains to be assessed if such variability is the result of different genotype and if it may have any impact on the long term neurodevelopmental outcome
Maroni, Elisa <1979>. "Randomised Italian Sonography Position of Occiput Trial Antevacum. Predizione dell'outome nel parto operativo mediante ecografia in travaglio di parto. Valutazione in itinere." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7671/1/tesi_dottorato.pdf.
Повний текст джерелаObjective: To evaluate if ultrasound evaluation of fetal occiput position before vacuum extraction improves the delivery outcome. Material and methods: Multi-centre randomised trial. Nulliparous women, at term, with single cephalic fetus undergoing vaginal instrumental delivery have been randomized, after written consent, to receive clinical assessment (standard care) or ultrasound evaluation and clinical assessment. The delivery outcome, fetal and maternal complications have been compared between the two groups. Results: From May 2014 to December 2015 91 patients have been recruited: 40 (45%) in the ultrasound group and 51 (55%) in the clinical evaluation group. Gestational age at birth was 39,5 ± 1,2 week. 57 patients (64,8%) have been submitted to epidural analgesia. Mean birth and demographic features were comparable between the two groups. Conclusions: Preliminary data show no statistically significant differences between the two groups. Although number are too small to drawn any conclusion.
Maroni, Elisa <1979>. "Randomised Italian Sonography Position of Occiput Trial Antevacum. Predizione dell'outome nel parto operativo mediante ecografia in travaglio di parto. Valutazione in itinere." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7671/.
Повний текст джерелаObjective: To evaluate if ultrasound evaluation of fetal occiput position before vacuum extraction improves the delivery outcome. Material and methods: Multi-centre randomised trial. Nulliparous women, at term, with single cephalic fetus undergoing vaginal instrumental delivery have been randomized, after written consent, to receive clinical assessment (standard care) or ultrasound evaluation and clinical assessment. The delivery outcome, fetal and maternal complications have been compared between the two groups. Results: From May 2014 to December 2015 91 patients have been recruited: 40 (45%) in the ultrasound group and 51 (55%) in the clinical evaluation group. Gestational age at birth was 39,5 ± 1,2 week. 57 patients (64,8%) have been submitted to epidural analgesia. Mean birth and demographic features were comparable between the two groups. Conclusions: Preliminary data show no statistically significant differences between the two groups. Although number are too small to drawn any conclusion.
Zannoni, Letizia <1982>. "Accuracy of new sonographic markers in the diagnosis of adenomyosis." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2017. http://amsdottorato.unibo.it/7818/3/ZANNONI%20LETIZIA_TESI%20DOTTORATO.pdf.
Повний текст джерелаObiettivo: valutare le capacità diagnostiche dei marker ecografici già noti di adenomiosi e di due innovativi, ovvero il question mark sign e la transvaginal ultrasound uterine tenderness. Metodi: 78 pazienti candidate ad isterectomia per patologia uterina benigna sono state sottoposte ad ecografia transvaginale preoperatoria per la valutazione dei criteri di diagnosi ecografica di adenomiosi riportati dal consensus statement MUSA. L’adenomiosi è stata diagnosticata in presenza di due o più fra i seguenti parametri: asimmetria delle pareti uterine, strie iperecogene, lacune anecogene, isole iperecogene, irregolarità sub-endometriali, interruzione o irregolarità della zona giunzionale, vascolarizzazione trans-lesionale. In aggiunta, sono stati valutati due marker ecografici innovativi: il question mark sign e la transvaginal ultrasound uterine tenderness, ovvero la sezione longitudinale dell’utero con morfologia a punto interrogativo e la valutazione ecografica dinamica della dolorabilità dell’utero alla pressione mirata della sonda vaginale. Le caratteristiche ecografiche sono state confrontate con l’esame istologico. Risultati: La prevalenza di adenomiosi nel campione è risultata pari a 33.3%. Sensibilità, specificità, valore predittivo positivo e negativo e accuratezza dell’ecografia transvaginale nella diagnosi di adenomiosi sono risultate rispettivamente 83%, 96%, 91%, 89% e 92%. Asimmetria, strie iperecogene ed interruzione della zona giunzionale sono risultati i marker più accurati per la diagnosi di adenomiosi. La caratteristica più frequentemente riscontrata (100%) è stata l’eterogeneità miometriale, ma ha mostrato scarsa specificità (7%). Il question mark sign e la transvaginal ultrasound uterine tenderness hanno presentato sensibilità, specificità, valore predittivo positivo e negativo e accuratezza pari rispettivamente a 41%, 96%, 83%, 77%, e 69% e 69%, 65%, 66%, 81%, e 67%. Conclusioni: I marker ecografici proposti dal consensus statement MUSA si confermano accurati nella diagnosi di adenomiosi. Il question mark sign e e la transvaginal ultrasound uterine tenderness hanno dimostrato buone capacità diagnostiche e potrebbero rivelarsi un utile complemento nella diagnosi ecografica di adenomiosi.
Curti, Alessandra <1982>. "Basi molecolari per uno screening non invasivo delle malformazioni cardiache congenite al secondo trimestre di gravidanza." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2017. http://amsdottorato.unibo.it/7926/1/Tesi%20CURTI.pdf.
Повний текст джерелаObjective: To verify the hypothesis that aberrant placental mRNA genes related to cardiogenesis can be detected in maternal plasma at the second trimester of pregnancy. Methods: NanoString technology was used to identify aberrant genes, comparing 79 women carrying a fetus with a congenital heart defect (CHD) to 44 controls at 19–24 weeks of gestation. The genes with differential expression were subsequently tested using real time polymerase chain reaction. Linear discriminant analysis (LDA) was used to combine all the mRNA species with discriminant ability for CHD. A multivariable receiver operating characteristic (ROC) curve having the estimated discriminant score as an explanatory variable was generated. A subsequent analysis was performed to detect an aberrant mRNA expression according to categories of CHD, namely obstruction of the left ventricular outflow tract (LVOT). Results: Six genes with differential expression, namely FALZ, PAPP-A, PRKACB, SAV1, STK4 and TNXB2, were found. The ROC curve yielded a detection rate of 66.7% at a false positive rate of 10%. A higher discriminant score (>75th centile) was reached for 14 CHD cases (82.4%) and only 1 control (5.8%). Two cases (11.8%) of heart rhythm disorders also yielded a discriminant score value >75th centile. According to secondary analysis, 8 genes were found with aberrant expression in case of LVOT, namely ARF1, DPP8, PRKCD, PSMF1, SAP30, SH3GLB1, SND1 e STK4. Conclusions: These data represent a step forward in the screening of CHDs. Additional studies are needed to detect more mRNAs with discriminant ability and to move the first trimester screening.
Youssef, Aly Mohamed Alaaeldin Kamaleldin Aly <1978>. "Ultrasound Prediction of the Mode of Delivery in the Second Stage of Labor Using the Fetal Head-Symphysis Distance." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2017. http://amsdottorato.unibo.it/7977/1/2017.03.24%20TESI%20PHD%20%2B%20Aly%20%2B%20Frontespizio.pdf.
Повний текст джерелаVicenti, Rossella <1986>. "Effetto dei chemioterapici e degli antiossidanti sulla preservazione del tessuto ovarico crioconservato prelevato da pazienti oncologiche." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2017. http://amsdottorato.unibo.it/8150/1/Vicenti%20R.pdf.
Повний текст джерелаIntroduction The cryopreservation of ovarian tissue is a viable strategy for preserving ovarian function of cancer patients at risk of ovarian failure due to chemotherapy treatments. Aims 1.To evaluate the effect of antioxidant N-acetylcysteine (NAC) on the morpho-functional characteristics of the ovarian tissue undergoing cryopreservation. 2.To evaluate the protective in-vitro effect of NAC and luteinizing hormone (LH) on the ovarian tissue treated with doxorubicin and cisplatin. Materials and methods 1.The ovarian tissue of 10 patients was cryopreserved in presence/absence of NAC to assess: a)the levels of reactive radical species (SRR) produced during the cryopreservation procedure; b)the morphological preservation of cryopreserved ovarian tissue. 2.The stromal cells, isolated from cryopreserved ovarian tissue of 5 patients, were treated with doxorubicin and cisplatin to assess: a)cell viability; b)activation of the apoptotic processes; c)inhibition of cell proliferation and differentiation. Subsequently, the stromal cells were treated with doxorubicin and cisplatin in combination with NAC to evaluate the cellular integrity and the expression of inflammatory markers, or in combination with LH to assess cell viability. Results and Conclusions 1.The NAC determines a good preservation of cryopreserved ovarian tissue and a reduction of oxidative stress, although not at baseline levels. Further studies are needed to test the most effective concentrations of NAC or to identify other antioxidants to reduce the levels of SRR. 2.Doxorubicin and cisplatin reduce cell growth, activate apoptosis and inhibit cell proliferation and differentiation. The cotreatment of stromal cells with chemotherapeutic agents and NAC or LH reduces the cytotoxic effect of drugs by improving the cellular preservation. Further studies are needed to place these substances in the category of "fertisave agents" and to be able to prescribe them to patients in combination with chemotherapy. Research in this field should continue in order to identify other substances which are effective in the ovarian protection.
Montanari, Giulia <1982>. "Le alterazioni della zona giunzionale endometrio-miometrio nelle pazienti con adenomiosi ed endometriosi pelvica sono correlate ad outcomes ostetrici sfavorevoli?" Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2017. http://amsdottorato.unibo.it/8163/9/frontespizio%20e%20tesi.pdf.
Повний текст джерелаRecent studies showed that there is an association between endometriosis and obstetric risks. In particular it seems that some of these risks are related to the alteration of the junctional zone (JZ) representing the uterine endometrium-myometrium interface. The goal of our study 'was to highlight whether the presence of a pre-conception alterations of the junctional zone correlates with the occurrence of specific risks obstetricians during pregnancy. Patients with adenomyosis and / or severe pelvic endometriosis were enrolled and underwent transvaginal ultrasound 2D, 3D and power Doppler. Of the 88 patients studied, 20 patients achieved a spontaneous pregnancy . Three patients presented bleeding in the first trimester. Thirteen patients completed pregnancy, 2 had a preterm birth for complications of pregnancy (preeclampsia and DIPNI). Of the 13 patients who completed the pregnancy, 10 had spontaneous parts and 3 were subjected to cesarean section. During pregnancy a patient had pre-eclampsia from 30 weeks of gestation.
Martelli, Valentina <1984>. "Transperineal ultrasound in women with rectal endometriosis: could sonographic parameters be correlated with bowel symptoms?" Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amsdottorato.unibo.it/8390/1/tesi%20martelli%2B%20frontespizio.pdf.
Повний текст джерелаGiorgetta, Francesca <1983>. "Ruolo diagnostico della crescita della misura della circonferenza addominale fetale nell'identificazione dei feti piccoli per l'epoca gestazionale nelle gravidanze ad alto rischio utilizzando le curve “INTERGROWTH-21st”." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amsdottorato.unibo.it/8396/1/Giorgetta_Francesca_Tesi.pdf.
Повний текст джерелаThe aim of the work was to evaluate if the SGA fetuses presented a reduced increase in the abdominal circumference compared to the AGA fetuses and to understand if this could have a diagnostic role in identifying fetuses at risk of developing growth delay on the basis of an increase reduced CA; calculate the diagnostic accuracy in the different periods of pregnancy and evaluate the diagnostic contribution of longitudinal ultrasound examinations in the third trimester of pregnancy. Patients viewed consecutively at the ultrasound clinics were selected for the presence of risk factors for fetal growth restriction and fetal CA measurements were recorded at each examination performed in III trimester. Of a total of 420 women, with 1240 ultrasound scans,151 fetuses were SGA. In the high risk population, the SGA and AGA fetuses have a similar and not statistically different growth rate. The growth rate correlates with the LBW, but weakly, so adding the given growth rate in two independent examinations at 2-4 weeks to the simple CA z-score in the first exam does not improve the diagnostic accuracy. A small proportion of fetuses has a growth arrest, which occurs at 35 weeks; fetuses with growth arrest are born before and are on average smaller, both in absolute and in relation to gestational age and have a greater rate of neonatal complications. The SGA and AGA fetuses have a similar and statistically not different growth rate and the longitudinal controls of fetal growth are not very influential for the diagnosis and management of fetuses at risk of being SGA, except for that modest portion of fetuses that in the last part of pregnancy show a stop of growth. These fetuses are slightly smaller and have a slightly increased risk of complications, that may be secondary to the increased iatrogenic prematurity.
Frasca', Clarissa <1983>. "Confronto tra morcellazione elettromeccanica classica e morcellazione manuale nel sacchetto endoscopico in corso di miomectomia laparoscopica: studio randomizzato controllato." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amsdottorato.unibo.it/8415/1/Tesi%20dottorato%20Frasca%CC%80.pdf.
Повний текст джерелаBackground: Laparoscopic myomectomy represents the gold standard in the treatment of symptomatic premenopausal women affected by myomas. Morcellation is an important part of the laparoscopic procedure, allowing the removal of a large specimen through a small incision. In April 2014, the FDA discouraged the use of power morcellators, because of the risk of inadvertent dissemination of small tissue pieces through the abdominal cavity. In-bag manual morcellation could reduce this risk, preventing surgeons from abandoning a laparoscopic approach. Objective: To compare in-bag manual morcellation and classic power morcellation during laparoscopic myomectomy in terms of feasibility and safety. Matherials and Methods: Patients submitted to laparoscopic myomectomy at our Centre from November 2015 and October 2016 were considered for the study. Seventy-two patients were therefore included and randomly divided into two groups: 38 underwent classic power morcellation (control group) while 34 patients were submitted to in-bag manual morcellation (experimental group). The comparison of morcellation operative time (MOT) between the two groups represented the primary objective. Secondary objectives were: total operative time (TOT), rate of intraoperative complications and postoperative outcomes. Results: in the experimental group, longer MOT (9.47 ± 5.05 vs 6.16 ± 7.73 minutes; p = .01) and TOT (113.24 ± 28.12 vs 96.74 ± 33.51 minutes; p = .01) were required compared to the control group. No intraoperative complications, bag tear or conversion to laparotomy were reported. The two study groups presented similar hemoglobin drop, hospitalization and postoperative outcomes. Conclusion: In-bag manual morcellation could represent a safe and feasible alternative to classic power morcellation, despite slightly longer operative time required.
Cervi, Francesca <1983>. "Infezione primaria da Citomegalovirus in gravidanza: fattori prognostici di malattia sintomatica determinabili entro la ventiduesima settimana di gestazione." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amsdottorato.unibo.it/8506/1/CERVI_FRANCESCA_TESI.pdf.
Повний текст джерелаBackground. Primary maternal Cytomegalovirus (CMV) infection during pregnancy can lead to congenital infection in around 30% of newborns, with 15-20% of infected children developing long-term symptoms including hearing loss and neurological sequelae. Severe brain ultrasound anomalies are associated with poor prognosis, but post-natal outcomes of fetuses with mild ultrasound anomalies are difficult to establish. Objective. The aim of the study was to evaluate the predictive value of mild ultrasound anomalies and viral load in amniotic fluid, performed before twenty-second week of gestation, in relation to the presence of symptomatic congenital disease. Methods. This is a prospective observational study of pregnant women with primary CMV infection enrolled between 2007 and 2015: fetal ultrasound scan with detailed neurosonogram and viral isolation in amniotic fluid were performed in all pregnancies between 20 and 21 weeks of gestation, at least 6 weeks after maternal infection. Sign and symptoms of congenital infection were evaluated at birth and at neonatal follow up in live-borns, post-mortem examinations were carried out in second trimester aborted fetuses. Results. Ultrasound fetal scan of 306 pregnant women with primary CMV infection detected the presence of mild cerebral and extracerebral anomalies in 15 cases (4.9%). These features was significantly associated with symptomatic congenital disease (OR= 18.5; 95%CI: 5.43-62.8, P<0.001) with high specificity (97.6%) and high negative predictive value (95.6%). The combined specificity and negative predictive value of ultrasound and viral isolation in amniotic fluid were 99.7% and 95.7%, respectively. The presence of one of this features alone reached sensibility of 94.7% and negative predictive value of 99.6%. Conclusion. The evaluation of neonatal risk of symptomatic CMV congenital disease can be realized with a good sensibility and specificity through the combination of detailed ultrasound fetal scan and viral isolation within the twenty-second week of gestation.
Del, Forno Simona <1984>. "Terapia riabilitativa del pavimento pelvico in donne con endometriosi profonda infiltrante e dispareunia: studio prospettico randomizzato controllato." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2020. http://amsdottorato.unibo.it/9159/1/del%20forno_tesi%20dottorato.pdf.
Повний текст джерелаThe primary aim of this randomized controlled trial was to evaluate the effects of PFM physiotherapy in women with deep infiltrating endometriosis (DIE) and superficial dyspareunia in terms of pelvic floor morphometry (PFM) modifications at transperineal ultrasound during Valsalva maneuver. Modifications of PFM at rest and during pelvic floor contraction and variations of superficial dyspareunia were also analyzed as secondary outcomes. We recruited a series of nulliparous women, with clinical or sonographic diagnosis of DIE and associated superficial dyspareunia. All women underwent a first examination to assess the Levator Hiatus Area (LHA) with a 3-D/4-D transperineal ultrasound at rest, at maximum pelvic floor muscle (PFM) contraction and during maximum Valsalva maneuver; moreover pain symptoms were evaluated using a Numerical Rating Scale (NRS). Subsequently, women were randomized into 2 groups: women submitted to five individual sessions of pelvic floor physiotherapy at weeks 1, 3, 5, 8, 11 from the first examination (study group) and women submitted to normal care (control group). After 4 months from the first examination (second examination), pain symptoms and LHA were reassessed in all women. Twenty-seven women completed the study, 17 in the study group and 10 in the control group. After physiotherapy, in the study group the enlargement of LHA was significantly greater at maximum Valsalva maneuver in comparison with the control group, with a difference between the 2 groups of 20.7%. Moreover, in the study group we detected a significant reduction of superficial dyspareunia (mean Δ = –3.1 ± 2.7, P < 0.001) and chronic pelvic pain (mean Δ = –1.1 ± 1.9, P = 0.021) at second examination. In women with DIE pelvic floor physiotherapy seems to be effective in improving pelvic floor muscle relaxation, evaluated with transperineal ultrasound, superficial dyspareunia and chronic pelvic pain.
Bellussi, Federica <1983>. "Validazione delle curve Intergrowth-21 per la diagnosi di restrizione di crescita fetale in una popolazione a rischio." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2020. http://amsdottorato.unibo.it/9320/1/TESI%2025%20feb%202020%20pdf.pdf.
Повний текст джерелаObjectives: to compare the accuracy of various parameters in the prediction of small for gestational age (SGA) newborns. Material and Methods: We included all patients with a singleton pregnancy who were seen in the University Hospital of Bologna and Padua from 2013 to 2015. In the first study we compared the curves of the fetal abdominal circumference (AC) according to Intergrowth-21 (IG-21) and according to SIEOG. The accuracy of IG-21 and SIEOG AC standards in the detection of SGA neonates was analyzed by ROC-AUC. In the second study we compared the IG-21 AC curves, estimated fetal weight (EFW) according to IG-21 neonatal standards, EFW according to Hadlock and IG-21 prenatal standard. We retrieved EFW according to neonatal IG-21 standards EFW according to prenatal Hadlock and IG-21 standards. The accuracy of these parameters was assessed by the comparison of their ROC-AUC. Results: I study: 428 patients. 19%, 9.3% and 6.2% of neonates were <10’, 5’ and 3’ percentile for GA. AC z-scores ROC curves according to IG-21 and SIEOG performed similarly. II study: 406 patients. 22.9% and 8.9% of neonates were <10’ and 3’ percentile for GA. Prenatal IG-21 and Hadlock standard of AC and EFW performed similarly and significantly better than post-natal standards. Prenatal EFW IG-21 curves were more accurate than postnatal curves and AC. Conclusions: SIEOG and IG-21 AC curves are both accurate in the prediction of SGA neonates. EFW performed better then AC measurement and prenatal standards performed better then IG-21 postnatal standard in the identification of SGA neonates.
Gava, Giulia <1987>. "Fattori di rischio metabolico e recidiva di prolasso degli organi pelvici dopo trattamento chirurgico fasciale per via vaginale in donne in post-menopausa." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2021. http://amsdottorato.unibo.it/9532/1/Gava_Giulia_tesi_dottorato.pdf.
Повний текст джерелаIntroduction. Despite technical improvements, pelvic reconstructive surgery still represents a challenge with anatomic recurrence rates ranging between 9 and 40%. Recent data suggest that metabolic syndrome (MS) and its components may be associated with the diagnosis and severity of pelvic organ prolapse (POP). To date, there are no data regarding metabolic risk factors and the recurrence of POP after surgery. Methods. The presence of MS and its components [elevated triglycerides (TG), waist circumference, blood pressure, and fasting glucose (FG) and decreased high-density lipoprotein cholesterol (HDL-C)] were evaluated in postmenopausal women undergoing vaginal surgery for POP (including hysterectomy and suspension of the vagina to the uterosacral or sacrospinous ligaments). During the postoperative follow-up visits, the presence of anatomic recurrences defined as POP-Q stage ≥II was assessed. Results. One hundred and forty-one patients were included in the analysis. The mean age at the time of surgery was 63.1 ± 9.6 years and the mean follow-up time was 21.1 ± 9.3 months (range: 12-36 months). During the follow-up period, 4 women reported genital bulging (2.8%), and 31 women presented with anatomic recurrence (21.9%). No patient required another surgical treatment. Fasting glycemia was higher in the group of women with POP recurrence (p = 0.002) while HDL-C was lower (even if remaining in the range of normality). In women with POP recurrence the prevalence of hypertriglyceridemia or hyperglycemia was higher (p = 0.035 and p = 0.030, respectively). The presence of waist circumference ≥88 cm and altered glycemic values were significant risk factors for POP recurrence (p=0.031, OR 3.2, 1.3-14.1 95% CI and p = 0.028, OR 2.9, 1.5-14.3 95% CI, respectively). Conclusions. In our cohort, some metabolic aspects such as increased waist circumference and elevated triglycerides and fasting glucose were associated with an increased risk of POP recurrence after corrective surgery.
Raimondo, Diego <1987>. "Angiografia a fluorescenza con verde di indocianina durante chirurgia radicale e conservativa per endometriosi retto-sigmoidea: studio prospettico di fattibilità." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2021. http://amsdottorato.unibo.it/9585/1/TESI%20RAIMONDO.pdf.
Повний текст джерелаObjective: To evaluate feasibility and safety of near-infrared indocyanine green (NIR-ICG) imaging for bowel vascularization assessment after minimally invasive conservative and radical excision of recto-sigmoid endometriosis (RSE). Materials and methods: Prospective, monocentric, preliminary study on consecutive symptomatic patients scheduled for minimally invasive surgical excision of RSE from May 2018 to January 2020 at the Sant’Orsola University Hospital in Bologna. Fluorescence degree of the bowel resected area was evaluated through NIR-ICG evaluation using a three-point Likert scale, as follows: 0 or "absent" (no fluorescence observed), 1 or "irregular" (non-uniform or weak fluorescence) and 2 or "regular" (uniform distribution of fluorescence and similar to the proximal colon). The primary outcome of this study was the protocol completion rate. Secondary outcomes included protocol time, inter-operator agreement, peri-operative complications and any changes in the surgical strategy adopted. Results: During the study period, 46 patients who met the eligibility criteria were enrolled in the study. In all cases NIR-ICG protocol was successfully performed. Forty-five (97.8%) cases showed regular fluorescence (Likert 2 scale); in one patient (2.2%) with irregular fluorescence after discoid excision, we changed the surgical strategy reinforcing anastomotic suture. No complications related to the use of ICG were recorded. Median protocol time was 4 (range, 3-5) minutes. Excellent inter-operator agreement was observed. Conclusion: NIR-ICG imaging for bowel perfusion evaluation after RSE surgery appears to be a feasible, safe and reproducible method. Further prospective studies are needed to evaluate its efficacy in reducing morbidity associated with colorectal surgery for RSE.
Salsi, Ginevra <1986>. "Ruolo della risonanza magnetica prenatale in feti con ventricolomegalia isolata nell'era della neurosonografia: uno studio multicentrico." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2021. http://amsdottorato.unibo.it/9618/1/Tesi%20dottorato%20Ginevra%2020_10%20con%20abstract%20e%20frontespizio%20giusto.pdf.
Повний текст джерелаObjectives: To assess the role of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses presenting with mild and moderate isolated ventriculomegaly (VM) undergoing multiplanar ultrasound (US) evaluation of fetal brain. Methods: Multicenter, retrospective, cohort study involving 15 referral fetal medicine centers in Italy, United Kingdom, and Spain. Inclusion criteria: fetuses affected by isolated VM on US, undergoing detailed assessment of fetal brain via a multiplanar approach. Primary outcome: to report the rate of additional CNS anomalies detected exclusively at prenatal MRI and missed at US; secondary aim: to estimate the incidence of additional anomalies detected exclusively after birth and missed at prenatal imaging. Results: 556 fetuses with a prenatal diagnosis of isolated fetal VM on US were included. Additional structural anomalies were detected at prenatal MRI and missed at US in 5.4% (95% CI 3.8-7.6) of cases. Fetuses with an associated anomaly detected only at MRI were more likely to have moderate compared to mild VM (60.0% vs 17.7%, p<0.001), while there was no significant difference between the proportion of cases with bilateral VM between the two groups (p=0.2). The results of the logistic regression analysis showed that maternal body mass index (OR: 0.85, 95% CI 0.7-0.99, p= 0.030), presence of moderate VM (OR: 5.8, 95% CI 2.6-13.4, p<0.001) and gestational age at MRI ≥24 weeks of gestation (OR: 4.1, 95% CI 1.1-15.3, p= 0.038) were independently associated with the probability of detecting associated anomalies at MRI. Associated anomalies were detected exclusively at birth and missed at prenatal imaging in 3.8% of cases. Conclusions: The rate of associated fetal anomalies missed at US and detected only at fetal MRI in fetuses with isolated mild and moderate VM undergoing neurosonography is lower than that previously reported. The large majority of these anomalies are difficult to detect on ultrasound
Cariello, Luisa <1986>. "L'ecografia transperineale tridimensionale nella diagnosi di avulsione del muscolo elevatore dell'ano dopo parto vaginale." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2022. http://amsdottorato.unibo.it/10114/1/Tesi%20Dott.ssa%20Cariello%20PDF.pdf.
Повний текст джерелаAims: To evaluate the intermethod agreement between the tomographic ultrasound imaging (TUI), considered as the gold standard, and the OmniView-VCI in the diagnosis of levator ani muscle (LAM) avulsion and in the measurement of levator-urethral gap (LUG). Methods: We acquired dynamic 4D transperineal ultrasound volumes from 114 women. Each data set was analyzed on maximal pelvic floor contraction by TUI and OmniView-VCI techniques to check for LAM avulsion. Moreover, we measured LUG using both TUI and OmniView-VCI, twice by an operator and once by another to assess intraobserver and interobserver reproducibility. Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficient (ICC) and Cohen's kappa coefficient. Results: In the diagnosis of ani levator avulsion, the two techniques showed a good agreement (Cohen's κ = 0.691, 95% confidence interval [CI], 0.522-0.860; P < .001); we also reported a good intraobserver and interobserver agreement (Cohen's κ = 0.738, 95% CI, 0.597-0.879; P < .001, and Cohen's κ = 0.864, 95% CI, 0.750-0.978; P < .001, respectively). LUG measurements by OmniView-VCI technique showed high intraobserver (ICC 0.895; 95% CI, 0.866-0.918) and interobserver (ICC 0.821; 95% CI, 0.774-0.858) reproducibility. High intermethod agreement was demonstrated between the two methods (ICC 0.813; 95% CI, 0.764-0.853). The area under the receiver-operating characteristic curve of LUG in predicting avulsion was 0.931 (0.868-0.994, 95% CI; P < .001) with 24 mm showing the best sensitivity (82%) and specificity (97%). Conclusions: OmniView-VCI is a reliable method for LUG measurement and for levator avulsion diagnosis.
Moro, Elisa <1987>. "Studio prospettico osservazionale sull'interruzione volontaria farmacologica di gravidanza: fattori predittivi di dolore pelvico durante il trattamento." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2022. http://amsdottorato.unibo.it/10290/1/TESI%20DOTTORATO%20DI%20RICERCA%20MORO%20ELISA.pdf.
Повний текст джерелаINTRODUCTION Few studies in Literature have investigated the anamnestic and medical features that might be associated with increased pain levels during medical abortion. The primary aim of our study is to identify the anamnestic and clinical characteristics that may represent risk factors for intense pain levels, with particular focus on women’s pre-treatment psychological distress and anxiety levels. Moreover, we evaluate the correlation between pain and gestational age. MATERIALS AND METHODS This prospective, observational, non-pharmacological, multicentric study was conducted at the Department of Obstetrics and Gynecology of Azienda USL of Bologna, and at the Department of Gynecology and Human Reproduction Physiopathology of IRCCS S. Orsola – Malpighi Hospital. We included all women who opted for medical treatment for abortion, between June 1st, 2021 and November 30th, 2021. In addition to anamnestic records and ultrasound data, women were asked to fill in the following questionnaires: GHQ-12, GAD-7, STAI-6, VAS. The potential risk factors were, therefore, selected for inclusion in the multivariate regression analysis. RESULTS On 242 women enrolled, 38.0% experienced severe pain during medical abortion. A previous history of intense dysmenorrhea appeared the strongest risk factor for pain, when evaluating the size effect of each significant predictor (OR = 6.30, 95% CI 2.66 – 14.91), followed by a GHQ-12 score > 9 (OR = 3.33, 95% CI 1.43 – 7.76). On the contrary, our analysis confirmed that a previous vaginal delivery represented a protective feature against intense pain (OR 0.26, 95% CI 0.14 – 0.50). CONCLUSIONS Our data clearly show that nulliparity, dysmenorrhea, and increased baseline anxiety levels significantly increase the likelihood of severe pain in women undergoing medical abortion. Medical abortion is a safe and effective procedure, but it is often associated with pain symptoms. The identification of women at risk for experiencing severe pain is crucial to improve women’s care.
Zanello, Margherita <1987>. "Pattern peristaltico uterino nell'adenomiosi isolata: studio prospettico." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2022. http://amsdottorato.unibo.it/10294/1/TESI%20DOTTORATO%20Margherita%20Zanello.pdf.
Повний текст джерелаObjectives: To evaluate uterine peristalsis assessed by transvaginal ultrasound in periovulatory phase in women with adenomyosis compared with a control group and to assess the inter-observer agreement of transvaginal ultrasound in the evaluation of endometrial waves (EW) pattern. Study design: Observational prospective study conducted in S. Orsola- Malpighi University Hospital, Bologna, Italy. Materials and Methods: Patients referred to the Centre for an outpatient evaluation were enrolled and subsequently divided in 2 groups according to inclusion and exclusion criteria: patients in group A had a clinical and ultrasonographic diagnosis of adenomyosis, patients in group B had no pathological findings. Three-minute recording of transvaginal ultrasound scanning on sagittal uterine plane at periovulatory phase was performed by a single experienced sonographer gynecologist. Analysis of the EW patterns was performed offline by two different experienced sonographer gynecologists not aware of patients’ clinical history and blinded each other. A sample size of 18 patients per group was calculated to obtain a difference of 20% in the primary objective with a significance of 5% (power 80%). Results: 51 women were enrolled into this study and 36 patients met the inclusion criteria, 18 per group. The EW pattern was significantly altered when comparing the women with adenomyosis and control (p value= 0,02). Retrograde contractions were observed in 27,8% vs 72,2%, anterograde contractions in 11,1% vs 16,7%, opposing in 38,9% vs 5,6%, random in 22,2% vs 5,6%, respectively, in adenomyosis group versus the control group. EW evaluation showed a perfect inter-observer agreement (κ value= 0,92). Conclusions: Adenomyosis is associated with altered uterine contractility, which may aid in explaining the symptoms related with. Ultrasound imaging is an easy to access and useful method to evaluate uterine peristalsis, with a perfect inter-observer agreement.