Minerva ginecologica (Minerva Ginecol )


A Journal on Obstetrical and Gynecological Pathophysiology, Clinical Medicine and Therapy. Frequency: Bi-Monthly.

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Publications in this journal

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    ABSTRACT: Mammalian fertilization is a highly programmed process by which sperm and egg unite to form a zygote, a cell with somatic chromosome numbers. To fertilize an egg, the capacitated (acrosome-intact) spermatozoa recognize and bind to the egg's extracellular glycocalyx coat, the zona pellucida (ZP). The tight and irreversible binding of the opposite gametes in the mouse and many other species studied, including man, results in the opening of Ca2+ channels on sperm plasma membrane (PM) and influx of Ca2+. The transient rise in Ca2+ and other second messengers, such as cAMP and IP3, initiates a cascade of signaling events that elevate sperm pH and triggers the fusion of the sperm PM and underlying outer acrosomal membrane at multiple sites (induction of the acrosomal reaction). The fusion of the two membranes results in the exocytosis of acrosomal contents at the site of sperm-egg adhesion. The hydrolytic action of the acrosomal enzymes (glycohydrolases, proteinases, esterases, sulfatases etc), released at the site of sperm-egg adhesion, along with the enhanced thrust generated by the hyperactivated spermatozoon, are important factors that regulate the penetration of the ZP and the fusion of the acrosome-reacted spermatozoon with the egg. Evidence accumulated over the past two decades strongly suggests that glycan units of the ZP have a significant role in the recognition and adhesion of the opposite gametes and induction of the AR. In this review article, we intend to highlight well programmed molecular events that results in the sperm-egg adhesion and fertilization. Our intention is also to discuss the increasing controversy on the role of ZP glycan chains in sperm-egg interactions.
    Minerva ginecologica 08/2014; 66(4):409-419.
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    ABSTRACT: Aim of the study was to compare the effects of outpatient clinic-based versus home-based intravaginal electrical stimulation (ES) for the treatment of urinary incontinence.
    Minerva ginecologica 08/2014; 66(4):347-353.
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    ABSTRACT: The aim of this study was to estimate the incidence of endometrial pathologies and compare the findings in postmenopausal women with or without bleeding who had endometrial thickness ≥5 mm.
    Minerva ginecologica 08/2014; 66(4):335-340.
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    ABSTRACT: The aim of this study was to determine the efficacy of a new topic non-hormonal treatment for postmenopausal women complaining of symptoms of vaginal atrophy.
    Minerva ginecologica 08/2014; 66(4):377-381.
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    ABSTRACT: Postmenopausal osteoporosis is a silent systemic progressive disease characterised by a decrease in bone mass per unit volume. This condition compromises the physical strength of the skeleton and increases the susceptibility to fractures on minor trauma. The imbalance between bone formation and bone resorption is known to be responsible for postmenopausal bone loss. Estrogen deficiency contributes to bone loss by increasing the production of pro-inflammatory cytokines by bone marrow and bone cells. Clinical and molecular evidence indicates that estrogen-regulated cytokines exert regulatory effects on bone turnover implicating their role as being the primary mediators of the accelerated bone loss at menopause. The current perspective on the role and interaction of cytokines such as IL-1, IL-4, IL-6, IL-17, TNF, IFN-γ and TGF-β in bone loss linked with estrogen deficiency is reviewed. Current treatment options and emerging drug therapies in the management of postmenopausal osteoporosis are also evaluated.
    Minerva ginecologica 08/2014; 66(4):391-407.
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    ABSTRACT: The aim of this study was to compare human menopausal gonadotropins with recombinant follicle stimulating hormone-follitropin alpha following a long down-regulation protocol in intra cytoplasmic sperm injection cycles in our clinic, and to review the outcomes in the light of preceding studies.
    Minerva ginecologica 08/2014; 66(4):341-346.
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    ABSTRACT: Today, 88% of pregnancies has a physiological course during which just basic care, while in 12% of cases there is a high-risk pregnancy that requires additional assistance and specific. The approach that should be used is that of supervision in all pregnant women considering their potential to have a normal pregnancy until there is no clear evidence to the contrary. Pregnancy is considered at risk if there are medical conditions that may affect maternal or fetal health or life of the mother, fetus or both. Among the risk factors for pregnancy there is first the woman's age, in fact the increase in high-risk pregnancies in the last 20 years is attributable to the increase in the average age of women who face pregnancy. In addition, the diet is very important during pregnancy and diabetes or autoimmune diseases often lead to the failure of a pregnancy. Risk factors for pregnancy, also, are the complications that occur during its course as hypertension during pregnancy, and infectious diseases. Fears and anxieties typical of a high-risk pregnancy prevent the couple to live happily in the months of gestation. Effective communication, control and early detection are important tools that doctors must be able to ensure that women in order to plan the best treatment strategies and to minimize the risks of maternal and / or fetal.
    Minerva ginecologica 08/2014; 66(4):383-389.
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    ABSTRACT: Urinary incontinence (UI) or involuntary leakage of urine is a distressing and serious health problem. It has a significant psychosocial and economic burden leading to significant quality of life issues. UI is more prevalent than most chronic diseases yet largely underreported. Aging and age--related changes in the bladder play a significant role in the development of UI. This in combination with cognitive dysfunction, functional impairment, pharmacotherapy, smoking, childbearing, obesity and coexisiting comorbidities worsen the condition. Due to the burden UI places on the individual, their family and society, it is important for providers to diagnose and have ready treatment options available. The three most common types of UI are stress urinary incontinence (SUI), urge urinary incontinence (UUI), or a combination of both, mixed urinary incontinence (MUI). This review describes the pathophysiology of incontinence; and diagnosis and treatment (conservative, pharmacological, and surgical therapies) of incontinence in women.
    Minerva ginecologica 07/2014;
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    ABSTRACT: AIM:To assess the recovery and quality of sexual activity of women during post--partum, in relation to delivery.
    Minerva ginecologica 06/2014;
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    ABSTRACT: Oxytocin (OT) signalling plays a fundamental role in the mechanisms of parturition. OT is one of the most frequently used drugs in obstetrics, promoting uterine contractions for labor induction and augmentation and to prevent postpartum hemorrhage (PPH). Expression of the oxytocin receptor (OTR) in the human myometrium is tightly regulated during pregnancy and its levels have been shown to peak upon labour onset and to fall sharply in advanced labour and the postpartum period, when the uterus become refractive to OT. However, uterine sensitivity to OT varies between pregnant women, probably reflecting differences in their myometrial OTR expression. Control of OTR expression is mediated by a combination of steroid hormone stimulation, stretch, and inflammation. This review summarises current knowledge regarding the complex regulation of myometrial OTR expression and its associated intracellular signaling pathways.
    Minerva ginecologica 06/2014; 66(3):267-80.
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    ABSTRACT: The recent epidemiological explosion of diabetes amplified the problems regarding the various complications related to the disease and its complex healthcare management. Among these, those relating to the pregnancy of women with diabetes are highly significant from the point of view of social health, for the consequences of the disease on the unborn child, but also in the mother. It is possible that diabetes exists before pregnancy (pregestational diabetes), but much more often it can appear during pregnancy in women unaware of the disease (gestational diabetes). The mainstay of therapy for diabetes and gestational diabetes resides in diet, therapy with oral hypoglycemic agents or insulin, but the appearance on the market of supplements consisting of substances such as D-chiro-Inositol (DCI) arousing considerable interest, as it seems to be able to help in the glycemic control in this type of disease but, of course, its effectiveness must be proved. The data of our study seem to show that the DCI supplement has a role in the regulation of glucose metabolism and insulin sensitivity, and is able to act on the metabolism of pregnant women at risk of developing gestational diabetes, who probably have a basic alteration of insulin and glucose metabolism. It acts improving insulin sensitivity and reducing the onset of gestational diabetes in pregnant women at risk, decreasing the weight gain and nocturnal hypoglycemia responsible for the attacks of hunger at night. Further studies would be desirable to clarify the mechanism of action of DCI at the cellular level in glucose metabolism during pregnancy, and clinical data must be confirmed with wider studies.
    Minerva ginecologica 06/2014; 66(3):281-291.
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    ABSTRACT: Among couples unable to conceive without any identifiable cause, 30% are defined as having unexplained infertility. Management depends on duration of infertility and age of female partner. In order to increase pregnancy rate, couples with infertility of unknown origin can undergo ovulation induction and intrauterine insemination. These techniques are able to increase pregnancy rate in case of unexplained infertility. Clomiphene citrate and menopausal or recombinant gonodotropins are the most used drugs to induce ovulation. Aim of the present study was to evaluate the success rate after homologous intrauterine insemination (IUI) combined with clomiphene citrate (CC) stimulation.
    Minerva ginecologica 06/2014; 66(3):309-12.
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    ABSTRACT: Unexplained infertility affects 30% of infertile couples. Management depends on duration of infertility and age of female partner. Ovulation induction, together with intrauterine insemination, is commonly offered to couples with infertility of unknown origin. Intrauterine insemination gained its popularity because it is simple, non-invasive and cost-effective technique. The association with pharmacological stimulation is suitable to induce follicular maturation. The most used drugs to induce ovulation are clomiphene citrate and menopausal or recombinant gonodotropins. The aim of this paper was to evaluate the success rate after homologous intrauterine insemination (IUI) combined with menopausal gonadotropins stimulation.
    Minerva ginecologica 06/2014; 66(3):303-7.
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    ABSTRACT: The putative role and use of dehydroepiandrosterone (DHEA) as replacement therapy for menopausal women has been under consideration during the latest years. DHEA is one of the main adrenal hormones that progressively reduces its plasmatic levels from the beginning of ageing. This phenomenon implies not only the reduction of the plasmatic androgens but also the decrease of a peculiar category of hormones, named neurosteroids, in particular one: allopregnanolone. This review aims to elucidate the peculiar aspects of DHEA administration and its putative use as substitutive/integrative hormonal treatment alone or in combination with the traditional hormone replacement therapy.
    Minerva ginecologica 06/2014; 66(3):313-324.
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    ABSTRACT: Stress urinary incontinence is the most common form of urinary incontinence, occurring in pure or mixed forms in nearly 80% of women with incontinence. Hypoestrogenism may cause female incontinence and low bone mineral density, together. So, we investigated the relationship between stress urinary incontinence, serum E2 levels and osteoporosis in premenopausal and postmenopausal women.
    Minerva ginecologica 06/2014; 66(3):293-8.
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    ABSTRACT: Pre-eclampsia is a multisystem disorder of pregnancy that affects 5-8% of pregnancies. The pathophysiologic mechanisms that lead to the development of pre-eclampsia are poorly understood. Higher than normal levels of circulating TH17 is observed in preeclamptic women compared to women with normal pregnancy. TH17 cells are a subset of CD4+ T helper cells that are characterized by their secretion of IL-17. Recent studies suggest a role for TH17 cells and IL-17 in the pathophysiology of pre-eclampsia. In this review, we will discuss the known function of TH17 cells and IL-17 in immunity and vascular function. We will then review the role of IL-17 and TH17 cells in normal pregnancy and their association with pre-eclampsia, followed by a discussion of the literature to examine a potential role for IL-17 and TH17 cells in mediating pathophysiology in pre-eclampsia.
    Minerva ginecologica 06/2014; 66(3):243-9.
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    ABSTRACT: Polycystic ovary syndrome (PCOS) is one of the most common causes of ovulatory infertility. It is an endocrine disorders characterized by a high level of male hormones (androgens) and frequent anovulatory cycles associated with multiple ovarian microcysts. The aim of this paper was to evaluate effects of a Clomiphene citrate alone versus a combined treatment (Metformin and Clomiphene citrate).
    Minerva ginecologica 06/2014; 66(3):299-301.

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