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39. Could harmonic scalpel (Ultracision®) be considered the best device in surgical treatment of vulvar cancer of patients with implanted pace-maker? Proposal and rationale

Author

Gizzo, Salvatore, Andrisani, Alessandra, Ancona, Emanuele, Quaranta, Michela, Vitagliano, Amerigo, Noventa, Marco, Nardelli, Giovanni Battista, and Ambrosini, Guido

Subjects
Pacemaker, Genetics and Molecular Biology (all), Surgical safety, Surgical, Medicine (all), Gold standard, Surgical device, Harmonic scalpel, Ultracision®, Original Article, Biochemistry, Biochemistry, Genetics and Molecular Biology (all)
Abstract

Vulvar cancer (VC) represents about 4% of gynecologic malignancies, its incidence increases with age and peak incidence is found between 70-79 years. In cases of locally advanced disease surgery is often required and radical vulvectomy, with or without mono-bilateral inguino-femoral lymphadenectomy, is standard management. Various devices have been implemented in gynecological surgery in an attempt to minimize or avoid frequent intra/postoperative complications linked to energy use, unfortunately the majority of these devices require monopolar or bipolar energy. Ultracision® represents a unique surgical device capable of performing both cutting and coagulation at different intensities without use of electric energy. The use of Ultracision® in the radical treatment of VC has advantages both in terms of intraoperative and postoperative complications responsible for the reduction of surgical time and blood loss, complete tissue removal according to oncological criteria, diminished desensitization of peripheral areas and reduction of wound complications. These advantages have been widely demonstrated and contribute to making Ultracision® a cost-effective option in the routine treatment of patients affected by vulvar cancer especially when considering its safety in cardiopathic patients with implanted pacemaker. If the impressive results achieved in radical vulvar surgery will be confirmed, scalpel use could be proposed as routine for surgery of the routinely in surgical approach of vulvar and perineal area, in both benign and malignant disease.

Published
2015

40. Male and Couple Fertility Impairment due to HPV-DNA Sperm Infection: Update on Molecular Mechanism and Clinical Impact—Systematic Review

Author

Gizzo, Salvatore, Ferrari, Bruno, Noventa, Marco, Ferrari, Emanuele, Patrelli, Tito Silvio, Gangemi, Michele, and Nardelli, Giovanni Battista

Subjects
Article Subject
Abstract

Recent evidences identify Human Papillomavirus (HPV) sperm infection as a possible cause of male and couple infertility. It acts through different mechanisms at various steps of human conception and early gestational development. We performed a systematic review to assess the role of HPV semen infection on male and couple infertility. Analysis of available and eligible data does not permit us to fund clear evidences about clinical impact of HPV infection on fertility, although sperm parameters impairment is the most widely recognized effect. Regarding biomolecular implications, the available data are often conflicting. More studies are required to define the role of HPV sperm infection in clinical practice. The great majority of evidences are obtained by in vitro studies and this fact represents a limitation for the clinical management of HPVDNA sperm infection. Understanding the biological significance of HPV-DNA semen infection could permit us to explain most of the idiopathic male and couple infertility, leading to a better management of infertile men and a better timing for sperm banking storage before ART cycles.

Published
2014
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42. An Update on Diabetic Women Obstetrical Outcomes Linked to Preconception and Pregnancy Glycemic Profile: A Systematic Literature Review

Author

Gizzo, Salvatore, Patrelli, Tito Silvio, Rossanese, Marta, Noventa, Marco, Berretta, Roberto, Di Gangi, Stefania, Bertin, Martina, Gangemi, Michele, and Nardelli, Giovanni Battista

Subjects
Article Subject
Abstract

Women with type 2 diabetes were less likely to have diabetes related complications than women with type 1. Women with type 1 diabetes had a high prepregnancy care and showed a worse glycemic control than women with type 2 both in the preconception period and during pregnancy. Obstetrical outcomes showed that preeclampsia and stillbirth rate is almost doubled in type 1 patients while perinatal deaths and SGA importantly increased in type 2 diabetes. In modern obstetrical care it is mandatory to maintain glucose levels as close to normal as possible particularly in diabetic population. HbA1C no higher than 6% before pregnancy and during the first trimester seems to decrease the risk of adverse obstetrical outcomes. Both the preconceptional counseling and glycemic profile optimization represent a fundamental step to improve pregnancy outcomes in women with preexisting diabetes. A systematic approach to family planning and the availability of preconception care for all diabetic women who desire pregnancy could be an essential step for diabetic management program.

Published
2013
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43. Uterine fibroid size modifications during pregnancy and puerperium: evidence from the first systematic review of literature.

Author

Vitagliano, Amerigo, Noventa, Marco, Di Spiezio Sardo, Attilio, Saccone, Gabriele, Gizzo, Salvatore, Borgato, Shara, Vitale, Salvatore Giovannni, Laganà, Antonio Simone, Nardelli, Giovanni Battista, Litta, Pietro Salvatore, and Saccardi, Carlo

Subjects
LITERATURE reviews, UTERINE fibroids, PUERPERIUM, PREGNANCY complications, TUMOR growth
Abstract

Purpose: The influence of pregnancy on uterine fibroid size still remains an unsolved dilemma. Basing on current knowledge, physicians are not able to inform patients about the likelihood of uterine fibroids to modify their size during pregnancy. Study aim was to summarize available evidence concerning the size modifications of uterine fibroids during each trimester of pregnancy and during puerperium.Methods: The review was reported following the PRISMA guidelines and registered in PROSPERO (registration number: CRD42017071117). A literature search was conducted in electronic database (PubMed, Embase, Sciencedirect, the Cochrane library and Clinicaltrials.gov) until July 2017. All studies evaluating fibroids' changes during pregnancy and puerperium by ultrasound or magnetic-resonance-imaging were included. Descriptive characteristics of studies and patients were collected. The modifications of uterine fibroid diameter and volume were the outcome measures.Results: Concerning the first trimester of pregnancy, all authors reported a significant growth of uterine fibroids. Contradictory evidence was found about uterine fibroid modifications during the second and third trimesters, mainly supporting a slowdown during mid pregnancy and a subsequent size reduction during late pregnancy. Concerning the overall modifications during pregnancy and puerperium, poor evidence quality suggests that uterine fibroids do not modify their volume/slightly enlarge during pregnancy and subsequently reduce in size during puerperium.Conclusions: Uterine fibroids seem to be subject to a non-linear trend of modifications during pregnancy and puerperium, which may vary from myoma to myoma. Adequate evidence supports uterine fibroid systematic enlargement during the first trimester of pregnancy, while inconsistent evidence is available about the changes of uterine fibroids during second and third trimesters. In addition, the overall modifications of myomas during pregnancy and puerperium remain unclear. [ABSTRACT FROM AUTHOR]

Published
2018
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44. Rhabdomyoma of the vagina

Author

Patrelli, Ts, Franchi, L, Gizzo, Salvatore, Kiener, A, Berretta, R, Piantelli, G, Caruana, P, Nardelli, GIOVANNI BATTISTA, and Bacchi Modena, A.

Published
2012

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