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Cicinelli E, Matteo M, Tinelli R, Lepera A, Alfonso R, Indraccolo U, Marrocchella S, Greco P, Resta L. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Hum Reprod 2014; 30:323-30. [DOI: 10.1093/humrep/deu292] [Citation(s) in RCA: 242] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Chironna M, Neve A, Sallustio A, De Robertis A, Quarto M, Germinario C, Lepera A, Cicinelli E, Carriero C, Pinto V, Miniello G, Borraccino V, Blasi N, Romano F, Noya E. Frequency of human papillomavirus infection and genotype distribution among women with known cytological diagnosis in a Southern Italian region. J Prev Med Hyg 2010; 51:139-145. [PMID: 21553558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION In the Puglia region (South Italy) about 200 new hospitalizations for cervical cancer are registered every year. The study investigated the frequency of Human Papillomavirus (HPV) infection and the genotype distribution of HPV in a sample of women with known cytology attending the outpatient clinics of four Gynecological Departments of the University of Bari over a four-year period (2005-2008). METHODS Cervical samples from 1,168 women were analyzed for the presence of HPV-DNA through Polymerase Chain Reaction (PCR) in L1 region and reverse hybridization. The cytological results were associated with HPV positivity and type-specific prevalence. RESULTS Overall, HPV infection was found in 355 (30.4%) women. HPV-DNA was found in 34.4% of women with a cytological diagnosis of ASCUS, in 46.8% of women with Low-grade Squamous Intraepithelial Lesion (LSIL) and in 87.0% of women with High-grade Squamous Intraepithelial Lesion (HSIL)/carcinoma. Also 16.0% of women with normal Pap smear were found to be HPV-DNA positive. The most common HPVgenotype was type 16 found in 27.3% of positives, followed by type 53 (11.5%), type 66 (9.2%) and type 31 (9.0%). HPV genotype 18 was found in 6.4% of positives. Types 16 or 18 were detected in about 34% (120/355) of all infected women, in about 33% of LSIL and in 60% of HSIL/ carcinoma HPV-positive women. Among low risk (LR) genotypes, type 61 was found in 10.7% of HPV positive women, type 62 in 8.4%, type 42 in 8.1% and type CP6108 in 7.8%. DISCUSSION AND CONCLUSIONS The findings of the study give evidence that HPV infection is frequent in the studied cohort of women. The most widespread genotypes found were 16 and 53. These data may represent a benchmark for future evaluation after the recent introduction of vaccination against HPV in 12-year-old girls.
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Affiliation(s)
- M Chironna
- Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, Italy.
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Basso A, Lovreglio P, D'Errico MN, Panuzzo L, Ferrara F, Lepera A, Serra R, Milano V, Nesta D, Soleo L. [The role of the occupational physician in the assessment of accident risk]. G Ital Med Lav Ergon 2010; 32:374-378. [PMID: 21438303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The prevention of accidents at work in Italy is a target still to be reached for the safety of workers in workplaces, despite the innovative provisions introduced by the Legislative Decree 81/08 and the decrease of the number of total and fatal accidents occurred in the period 2001-2008, as reported in the statistics of the Italian Workers' Compensation Authority (INAIL). The occupational physician performs a very important role in the accident risk assessment, based on his biomedical and ergonomic knowledge. His role is carried out during the phase of safety risk assessment, contributing to assess plants, machines, tools, personal protective equipments, to be used by the workers. His knowledge of the health status of workers, acquired by medical surveillance and aimed to prevent accidents by providing the fitness for work evaluation in relation to the presence of diabetes mellitus, musculoskeletal diseases, sleep disorders, or to the assumption of hypnotic drugs, when the employee works at height or as driver such as in the transport or construction industry, is not less important. Unfortunately, this latter role of the occupational physician is limited because the Italian Safety Legislation does not provide for the sanitary surveillance of all the workers employed in factories.
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Affiliation(s)
- A Basso
- Università di Bari Aldo Moro, Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Medicina del Lavoro E.C. Vigliani, Bari, Italy
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Cicinelli E, Tinelli R, Colafiglio G, Mastrolia SA, Lepera A, Pinto V. [Reliability of the diagnostic fluid mini-hysteroscopy in the diagnosis of intrauterine pathologies]. Minerva Ginecol 2009; 61:431-437. [PMID: 19749674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM The aim of this study was to determine the diagnostic accuracy of minihysteroscopy with fluid distention and vaginoscopic approach for the diagnosis of endometrial pathologies. METHODS This controlled clinical study was conducted on 930 women with endometrial abnormalities who referred to our Department of Obstetrics and Gynecology, University Medical School of Bari, to perform hysterectomy. One week before hysterectomy all the patients underwent minihysteroscopy with fluid distention. Histological diagnoses were compared with the hysteroscopic findings, and the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined. RESULTS Hysteroscopy was technically successful in all women and revealed sensitivity of 98%, specificity of 99%, a positive predictive value of 92%, a negative predictive value of 99%, and diagnostic accuracy of 99% for the diagnosis of endometrial carcinoma. CONCLUSIONS Size reduction of the hysteroscope is of greatest importance for reducing pain and risk of vasovagal reaction. In conclusion, the best approach in terms of ease, reliability, acceptability, and safety to patients in whom intrauterine exploration is indicated should be simple diagnostic mini-hysteroscopy using a small-diameter, rod lens hysteroscope with a single-flow diagnostic sheath, vaginoscopic approach, and fluid distention. In this way in about 90% of patients, a correct diagnosis and proper choice for eventual subsequent operative strategy can be obtained, without discomfort and risk.
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Affiliation(s)
- E Cicinelli
- Dipartimento di Ostetricia e Ginecologia, Università di Bari, Policlinico, Bari, Italia.
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Marinaccio M, Mele E, Lepera A, De Marino E, Cicinelli E, Catacchio R, Schonauer S. Phase II study of weekly topotecan in recurrent ovarian cancer: duration of response based on a prolonged follow-up. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cicinelli E, De Vito D, Zappimbulso V, Nicoletti R, Lepera A, Marinaccio M. Uterine Cavity Findings at Fluid Mini-Hysteroscopy in Patients With no Evidence of Uterine Cavity Abnormality at TVE Who Repeatedly Failed to Conceive at IVF. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fiore J, Suligoi B, Di Stefano M, Lepera A, Favia A, Tateo M, Lisco A, Altini A, Laddago V, Angarano G, Pastore G. SHEDDING CERVICOVAGINALE DI HIV-1: CORRELATI CLINICI, IMMUNOLOGICI E TERAPEUTICI. Microbiol Med 2003. [DOI: 10.4081/mm.2003.4365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Carlucci M, Cimmino A, Fiore MG, Lepera A, Tantimonaco L, Ricco R. [The Pap test in HIV-positive women]. Pathologica 2001; 93:651-3. [PMID: 11785116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
The aim of this work was to estimate the frequency of abnormal Papanicolau (Pap) smears in a group of HIV-infected women undergoing cervical screening. We re-examined 162 Pap smears from 118 patients infected with HIV. The patients were aged 23-55 years. A total of 108 smears (66.6%) from 80 patients were negative; 14 smears (8.6%) from 14 patients showed inflammation; 3 smears (1.8%) from 3 patients had atypical squamous cells of undetermined significance (ASCUS); 20 smears (13.5%) from 16 patients were abnormal for human papillomavirus (HPV); 13 smears (8.0%) from 9 patients revealed low-grade, squamous intraepithelial lesions; 10 smears (6.2%) from 7 patients were SIL-HG; the diagnosis of carcinoma was made in 3 cases (1.8%) and 2 smears from 2 patients were unsatisfactory. HIV-infected women have an increased rate of abnormal Pap smears for both HPV infections and cervical dysplasia. These results confirm the validity of cervical screening by Pap test.
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Affiliation(s)
- M Carlucci
- Dipartimento di Anatomia Patologica e Genetica, Università di Bari, Piazza G. Cesare 11, I-70124 Bari, Italia.
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Favia A, Di Stefano M, Lepera A, Mangiacotti L, Saracino A, Fiore JR, Angarano G, Pastore G. "In vitro" spontaneous production of B-chemokines by endocervical and endometrial short-term bioptic cultures. New Microbiol 2001; 24:95-8. [PMID: 11209849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Several studies indicate that HIV-1 is present in the cervico-vaginal tissues and secretions of infected women representing an important determinant of both sexual and mother-to-child transmission. HIV-1 genital shedding is influenced by various factors; among these, proinflammatory cytokines, in particular the beta/C-C chemokine group (RANTES, MIP-1alpha and MIP-1beta), are known to suppress HIV-1 replication and thus might affect both sexual and vertical transmission. This study aimed to standardize a procedure to measure "in vitro" uterine spontaneous chemokine production by means of short-term cultures of endocervical and endometrial bioptic fragments. In most cases, "in vitro" chemokine production was observed in both fragment cultures. These results further confirm that beta/C-C chemokines exist in the female genital tract and that uterine mucosa actively produces basal levels of these immuno-active substances. This method constitutes a useful approach to evaluate cytokine production and expression in the female genital tract, their influence on HIV-1 expression and infectivity in this site, and their possible role in viral transmission.
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Affiliation(s)
- A Favia
- Clinic of Infectious Diseases, University of Bari, Italy
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Marinaccio M, Geusa C, Larocca A, Lepera A, Schonauer L, Latiano T, Cantinieri C. Serum half-life of CA72.4 during adjuvant chemotherapy for ovarian cancer. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)82398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Saracino A, Di Stefano M, Fiore JR, Lepera A, Raimondi D, Angarano G, Pastore G. Frequent detection of HIV-1 RNA but low rates of HIV-1 isolation in cervicovaginal secretions from infected women. New Microbiol 2000; 23:79-83. [PMID: 10946409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Information regarding the presence of HIV-1 in the female genital tract is necessary to gain insight into the mechanism of HIV-1 heterosexual transmission. Herein, we present the results of a study on virus isolation and HIV-1 RNA detection from cervicovaginal lavage (CVL) samples from 25 HIV-1 seropositive women. Despite detectable levels of HIV-1 RNA in 88% of CVL samples, HIV-1 was isolated in only four (19%) samples. Although HIV-1 shedding in cervicovaginal secretions is a common event at all disease stages, the recovery of infectious virus in cell cultures appears to be rare; this renders viral isolation in studies aimed to evaluate the infectivity of cervicovaginal secretions relatively useless.
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Affiliation(s)
- A Saracino
- Clinic of Infectious Diseases, University of Bari, Italy
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Fiore JR, Laddago V, Lepera A, La Grasta L, Di Stefano M, Saracino A, Lopalco P, Pastore G, Angarano G. Limited secretory-IgA response in cervicovaginal secretions from HIV-1 infected, but not high risk seronegative women: lack of correlation to genital viral shedding. New Microbiol 2000; 23:85-92. [PMID: 10946410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The presence and antigen specificity of IgG and secretory-IgA (s-IgA) to HIV-1 were evaluated in cervicovaginal lavages (CVL) from 26 infected and 10 high-risk seronegative women. All the seropositive women had detectable IgG recognizing several viral antigens, while a smaller percentage of women demonstrated s-IgA to the virus. In addition, s-IgA were of limited specificity and provided weak reactivities on Immunoblot bands; an almost constant absence of s-IgA to gp120 was also observed. Neither the presence nor the specificity of either IgG or s-IgA to the virus in CVL prevented the shedding of HIV-1 in this body fluid; in fact, viral RNA was detected in all the women studied and the amounts of viral shedding was unrelated to the genital antibody response. On the other hand, none of the high-risk seronegative women had detectable antibodies to HIV-1 in CVL of either the IgG or s-IgA isotype. Our results a) confirm an impairment of mucosal antibody response during HIV-1 infection and suggest that mucosal immunity is not able to prevent viral shedding in the female genital tract and thus cannot modulate the infectivity of genital secretions; aa) do not provide evidence for a mucosal "memory/protective" antibody response in the genital tract of high-risk seronegative women.
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Affiliation(s)
- J R Fiore
- Clinic of Infectious Diseases, University of Bari, Italy
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Fiore JR, Di Stefano M, Lepera A, Saracino A, Monno L, Angarano G, Pastore G. Evidence for a local synthesis of beta-chemokines within the genital tract of both HIV-1-infected and uninfected women. J Acquir Immune Defic Syndr 1999; 21:255-7. [PMID: 10421252 DOI: 10.1097/00126334-199907010-00013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Calabrò ML, Fiore JR, Favero A, Lepera A, Saracino A, Angarano G, Schulz TF, Chieco-Bianchi L. Detection of human herpesvirus 8 in cervicovaginal secretions and seroprevalence in human immunodeficiency virus type 1-seropositive and -seronegative women. J Infect Dis 1999; 179:1534-7. [PMID: 10228077 DOI: 10.1086/314765] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Epidemiologic studies suggest that human herpesvirus 8 (HHV-8) may be sexually transmitted. To study the potential for HHV-8 transmission through cervicovaginal (CV) secretions, the presence of HHV-8 DNA was investigated by nested polymerase chain reaction in the cellular fraction of CV secretions from 36 human immunodeficiency virus type 1 (HIV-1)-seropositive and 29 HIV-1-seronegative women. The same patients were tested for antibodies to two defined HHV-8 antigens (latency-associated nuclear antigen and open-reading frame 65-encoded structural protein) and for HHV-8 DNA in their peripheral blood mononuclear cells (PBMC). The findings were compared with the rate of HHV-8 detection in semen samples of 20 HIV-1-infected men. HHV-8 DNA was detected in the CV samples from only 1 HHV-8-seropositive AIDS patient, in 3 PBMC samples (1/29 HIV-1-seronegative patients, 1/3 AIDS patients with Kaposi's sarcoma, and 1/19 AIDS patients), and in 1 of 20 semen samples. HHV-8 infection was more common in HIV-1-infected than uninfected women. Thus HHV-8 DNA is only rarely detectable in CV secretions and semen of HHV-8-infected individuals.
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Affiliation(s)
- M L Calabrò
- Department of Oncology and Surgical Sciences, Oncology Section, University of Padova, I-35128 Padova, Italy.
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Di Stefano M, Fiore JR, Monno L, Lepera A, Pastore G, Angarano G. Detection of multiple drug-resistance-associated pol mutations in cervicovaginal secretions from women largely treated with antiretroviral agents. AIDS 1999; 13:992-4. [PMID: 10371183 DOI: 10.1097/00002030-199905280-00018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fiore JR, Lepera A, Di Stefano M, Saracino A, Favia A, Pastore G, Angarano G. Frequent cervicovaginal shedding of HIV-1 in asymptomatic, non-severely immunodeficient women. AIDS 1999; 13:626-7. [PMID: 10203392 DOI: 10.1097/00002030-199904010-00016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Loverro G, Cormio G, Renzulli G, Lepera A, Ricco R, Selvaggi L. Serous papillary cystadenoma of borderline malignancy of the broad ligament. Eur J Obstet Gynecol Reprod Biol 1997; 74:211-3. [PMID: 9306121 DOI: 10.1016/s0301-2115(97)00108-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Serous papillary cystadenoma of borderline malignancy arising in the broad ligament is extremely rare. We report the case of a 28-year-old female with a cystic mass in the broad ligament, who underwent complete excision of the mass, right salpingo-oophorectomy, omentectomy and multiple peritoneal biopsies. Pathology showed a serous papillary cystadenoma of borderline malignancy of the broad ligament, without peritoneal and omental involvement. A review of the literature about this rare pathologic condition is reported.
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Affiliation(s)
- G Loverro
- Department of Obstetrics and Gynecology, University of Bari, Italy
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Di Vagno G, Cormio G, Vimercati A, Nacci G, Greco P, Lepera A, Loverro G, Selvaggi L. [Transvaginal color-Doppler sonography for monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer]. Minerva Ginecol 1996; 48:463-7. [PMID: 9005372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Changes in blood flow characteristics, observed with transvaginal color-Doppler ultrasonography have recently been reported in patients with advanced cervical cancer. In order to evaluate the reliability of TVCDUS in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer, a prospective study was undertaken on the blood flow characteristics of the cervical vessels. Pulsatility Index (PI) and Resistance Index (RI) of the uterine and cervical arteries of 12 patients with histologically proven advanced cervical cancer, scheduled for neoadjuvant chemotherapy were evaluated at diagnosis, during every cycle of chemotherapy and before surgery. A significantly lower value of mean PI and RI between cervical and uterine arteries was observed in patients with cervical cancer (PI = 1.671 +/- 0.18 vs 2.159 +/- 0.24)-(RI = 0.43 +/- 0.17 vs 0.72 +/- 0.22). Mean RI and mean PI of the descending branches of the uterine arteries were significantly lower in patients with cervical cancer, compared to healthy control women. No difference in blood flow parameters could be detected between stage I vs stage II-III, and between left and right cervical artery in patients with cervical cancer. Both RI and PI values appeared strictly related to the tumor response to chemotherapy. In fact in 8 patients in which treatment resulted in tumor regression, evaluated by pelvic examination and MR imaging, a significant (p < 0.01) increase of resistance indices was observed (PI = 1.671 +/- 0.18 vs 2.158 +/- 0.22)-(RI = 0.43 +/- 0.17 vs 0.79 +/- 0.16). On the other side 4 patients not responding to chemotherapy, had stable values of both PI and RI. Transvaginal color-Doppler ultrasonography might be useful in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical carcinoma.
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Affiliation(s)
- G Di Vagno
- Istituto di Patologia Ostetrica e Ginecologica R, Università degli Studi,Bari
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