1,721,116 research outputs found
Metformina. impieghi clinici e sperimentali
No full textQuesto volume racchiude le conoscenze più aggiornate sulla metformina, farmaco insulino-sensibilizzante ampiamente diffuso in campo diabetologico che, negli ultimi tempi, è stato sperimentato per indicazioni cliniche nel campo della terapia della sindrome dell’ovaio policistico (PCOS).
Da qui l’esigenza di diffondere e stilare un testo completo e aggiornato, che potesse essere consultato non solo da ultra-specialisti in materia, ma anche da diabetologi, endocrinologi, ginecologi, medici internisti, medici di medicina generale e specializzandi che abbiano la voglia e l’esigenza di aggiornarsi sulle conoscenze ormai consolidate e su quelle di recente acquisizione circa l’impiego diffuso della metformina nella pratica clinica.
L’approccio all’argomento e il taglio dato al testo seguono una metodologia rigorosamente scientifica, senza tralasciare di illustrare l’applicazione nella pratica clinica quotidiana dei risultati delle ricerche.
Nella prima parte gli autori hanno illustrato le caratteristiche generali del farmaco con la descrizione del meccanismo d’azione e del razionale del suo impiego nella terapia del diabete e della PCOS.
Segue l’illustrazione di farmacocinetica, effetti collaterali farmaco-correlati, regimi terapeutici nei diversi impieghi clinici e potenziali fattori predittivi di risposta.
Nella seconda parte sono stati analizzati i risultati dell’impiego per la sua indicazione classica, quale consolidata terapia per pazienti affetti da diabete mellito di tipo 2.
In secondo luogo, sono stati descritti i risultati degli studi clinici e sperimentali che hanno analizzato l’impiego innovativo della metformina in pazienti affette o ad alto rischio per PCOS
Presurgical assessment of intra abdominal visceral fat in obese patients
No full textTo date, obesity is simply defined as body mass index (BMI) higher or equal to 30 kg/m2 (National Heart, Lung, and Blood Institute/National Institutes of Diabetes and Digestive and Kidney diseases 1998). Although BMI is widely accepted as a marker of adiposity in population-based studies, and is recognized as an instrument to diagnose obesity for all age groups, it should be more properly seen as an index of weight excess, rather than body fatness
Safety of laparoscopy vs laparotomy in the surgical staging of endometrial cancer. a systematic review and metaanalysis of randomized controlled trials
No full textThe aim of the current study was to compare the safety of the laparoscopic vs abdominal approach to staging endometrial cancer. A search was conducted for randomized controlled trials that reported data from women with histologically confirmed endometrial cancer who underwent laparoscopic or abdominal surgery. An additional metaanalysis was performed. The primary endpoints were the rates of intraoperative and postoperative complications. A total of 8 original randomized controlled trials were included in the final analysis. No significant difference was observed in the relative risk (RR) for intraoperative complications between laparoscopy and laparotomy (RR, 1.25; 95% confidence interval, 0.99-1.56; P = .062). In contrast, a significant advantage of laparoscopy over laparotomy was obtained in terms of postoperative complications (RR, 0.71; 95% confidence interval, 0.63-0.79; P = .016). In comparison with abdominal surgery, the safety of the laparoscopic approach for surgical staging of endometrial cancer is similar in terms of intraoperative complications but results in fewer postoperative complications
Effects of metformin in women with polycystic ovary syndrome treated with gonadotrophins for in vitro fertilisation and intracytoplasmic sperm injection cycles: A systematic review and meta-analysis of randomised controlled trials
No full textBackground
Metformin is widely used for treating women with polycystic ovary syndrome (PCOS), and many patients with PCOS who are infertile receive gonadotrophins while being treated with metformin.
Objectives
To assess the effects of metformin administration in infertile patients with PCOS who receive gonadotrophins for in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
Search strategy
We searched international scientific databases, websites for the registration of trials, and bibliographies of retrieved articles, books, and review articles up to August 2012.
Selection criteria
Randomised controlled trials (RCTs).
Data collection and analysis
Authors independently reviewed and extracted the data.
Main results
Ten RCTs (with a total of 845 women with PCOS) were included in the final analysis. Metformin administration in IVF/ICSI cycles had no effect on the rates of pregnancy (OR 1.20, 95% CI 0.90–1.61) and live birth (OR 1.69, 95% CI 0.85–3.34). No effect of metformin dose, metformin pretreatment duration, and stopping time of metformin administration was observed on these reproductive end points. Metformin administration reduced the risk of ovarian hyperstimulation syndrome (OHSS; OR 0.27, 95% CI 0.16–0.46) and of miscarriage (OR 0.50, 95% CI 0.30–0.83), while increased that of implantation (OR 1.42, 95% CI 1.24–2.75).
Author's conclusions
In infertile patients with PCOS treated with gonadotrophins for IVF/ICSI cycles, metformin exerts no clinical effect on rates of pregnancy or live birth, but it reduces the risk of OHSS, and improves the rates of miscarriage and implantation. Further RCTs are needed to assess the reproductive effect of metformin in young well-selected patients with PCOS and specific phenotypes and features
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Insulin-sensitizing agents and reproductive function in polycystic ovary syndrome patients.
No full textIsolated port-site metastasis after laparoscopic surgery for endometrial cancer. a case report
No full textIsolated port-site metastasis is a rare event after laparoscopy in the surgical staging of endometrial cancer. ► More aggressive strategies in case of potentially increased risk for port-site metastasis are needed
Midazolam versus propofol for conscious sedation in ambulatory oral surgery [Midazolam vs. propofol per la sedazione cosciente in chirurgia orale ambulatoriale.]
No full text- …
