645 research outputs found
Photorefractive Solitons and Their Underlying Nonlocal Physics
No full textOur aim is to provide an account of the recent progress in the physical understanding of the phenomenon, including the origin of quasi-steady-state solitons and round two-dimensional (2D) solitons, which is something beyond to providing an extensive review of photorefractive soliton phenomenology, as can be found in a number of review articles (Crosignani et al., 1998;DelRe, Crosignani, and Di Porto, 2001; DelRe et al., 2006; Krolikowski, Luther-Davies, and Denz, 2003)
Minimal and mild endometriosis. Is there anything new under the sun?
No full textResearch on endometriosis in patients with minimal or mild lesions is marred by our ignorance of the prevalence of limited stages in the asymptomatic female population of reproductive age. Laparoscopic studies performed on women undergoing tubal sterilization suggest that 2-8% are affected. However, the estimates may be unreliable because the studies were retrospective and misdiagnosis of subtle endometriosis cannot be excluded. In a recent prospective study of 86 asymptomatic women, more than 40% had minimal or mild lesions at laparoscopy. The data available do not support the suggestion that limited forms must always be treated to prevent disease progression, nor do they demonstrate worsening in all cases of minimal and mild endometriosis. Furthermore, there is no definitive evidence that the medical and surgical cytoreductive treatments available are effective in preventing eventual progression of the disease in some of the patients. We still do not know the prevalence of minimal and mild endometriosis in the healthy population, the percentage of progression towards severe stages or the risk factors of evolution of the disease. The hypothesis to test is that minimal endometriosis is partly a paraphysiologic condition that is frequently self-limited or resolves spontaneously
Current treatment issues in female hyperprolactinaemia
No full textHigh prolactin levels can occur as a physiological condition in females who are pregnant or lactating. As a pathological condition, hyperprolactinaemia is associated with gonadal dysfunction, infertility and an increased risk of long-term complications including osteoporosis. The most frequent cause of persistent hyperprolactinaemia is the presence of a micro- (<10 mm diameter) or macroprolactinoma (≥10 mm). These pituitary tumours may produce an excessive amount of prolactin or disrupt the normal delivery of dopamine from the hypothalamus to the pituitary; prolactin secretion from the pituitary is inhibited by dopamine released from neurones in the hypothalamus. Medications including anti-psychotics can induce hyperprolactinaemia, while idiopathic hyperprolactinaemia accounts for 30–40% of cases. The prevalence of hyperprolactinaemia is difficult to establish as not all sufferers are symptomatic or concerned by their symptoms and may remain undiagnosed. Symptoms of hyperprolactinaemia include signs of hypogonadism, with oligomenorrhoea, amenorrhoea and galactorrhoea frequently observed. Pharmacological intervention should be considered the first line therapy and involves the use of dopamine agonists to reduce tumour size and prolactin levels. Bromocriptine has the longest history of use and is a well-established, inexpensive, safe and effective therapy option. However, bromocriptine requires multiple daily dosing and some patients are resistant or intolerant to this therapy. The two newer dopamine agonists, quinagolide and cabergoline, provide more effective and better tolerated treatments compared with bromocriptine and may offer effective therapies for bromocriptine-resistant or intolerant patients. Quinagolide can be used until pregnancy is confirmed and may result in improved compliance in females wishing to become pregnant. For patients with hyperprolactinaemia, pregnancy is safe and can frequently be beneficial, inducing a decrease in prolactin levels. There does not appear to be any increased risk of abortion, malformations or multiple births in pregnancies achieved with bromocriptine and this dopamine agonist can be used safely during pregnancy. Surgery should be considered only in certain circumstances, and for the majority of patients, dopamine agonists will be sufficient to alleviate symptoms and restore normal prolactin levels
Conservative surgery for severe endometriosis: should laparotomy be abandoned definitively?
No full textAccording to current opinion, surgery at laparotomy for conservative treatment of endometriosis is obsolete. The debate on the indications, modalities and results of surgical treatment for the most severe forms has recently been rekindled. Although some expert endoscopists propose advanced techniques to deal with the most problematic pelvic lesions, various authors wonder if such interventions have been demonstrated as efficacious and safe enough to justify abandoning the standard reference treatment. We have reviewed the data, comments and proposals recently published on the topic. The available scientific evidence appears insufficient to recommend laparoscopy instead of surgery at laparotomy, even for the most severe forms of endometriosis. Intestinal, vesical, periureteral, retroperitoneal, and vaginal lesions and large endometriomas associated with extensive dense adhesions may still benefit from classical surgery at laparotomy. However, the lack of comparative studies prevents a correct comparison of the methods in terms of pregnancy rate, resolution of pain and incidence of recurrences
Progetto OCCAM: sistema informativo per la rivelazione dei tumori di sospetta origine professionale basato sui Registri tumori Italiani.
No full textsistema informativo - tumori di sospetta origine professionale - Registri tumor
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