Papers by Giampiero Capobianco
Acta haematologica, Jan 10, 2017
ular menses. Among those who became pregnant, conception was spontaneous in 7, all of whom had re... more ular menses. Among those who became pregnant, conception was spontaneous in 7, all of whom had regular menses. Nine pregnancies were achieved following gonadotrophin-induced ovulation, while intrauterine insemination was performed in 3 cases. Two patients developed gestational The life expectancy and quality of life of patients with thalassemia has significantly increased over the last few years due to an improvement in the management of a transfusional approach and iron chelation therapy. Despite these advances, hypogonadotropic hypogonadism is still a common problem [1] that has been associated with increased fetal and maternal complications during pregnancy [2] . As only a few studies have described the evolution of pregnancy in subjects with beta-thalassemia major when managed according to the most recent recommendations [3–5] , the present study investigated the methods of conception and the mode of delivery as well as the course and outcome of pregnancy in a cohort of 46 patients in North Sardinia during the period between 2001 and 2017. All patients provided informed consent and the study was approved by the local ethics committee. As shown in Figure 1 , 19 pregnancies occurred in 15 women with thalassemia major. The mean age at the time of the first pregnancy was 33 years (range 28–38). Of these, 4 were being treated with deferasirox, 6 with deferoxamine, 2 with deferiprone, and 3 with deferoxamine plus deferiprone. Chelation therapy was discontinued in all pregnancies. Three patients had primary amenorrhea, 1 had secondary amenorrhea, and 1 had oligomenorrhea, while 10 patients had basically regReceived: August 17, 2017 Accepted after revision: August 20, 2017 Published online: October 10, 2017
European journal of gynaecological oncology, 2015
The aim of this study was to analyze and describe the incidence and mortality trends of ovarian c... more The aim of this study was to analyze and describe the incidence and mortality trends of ovarian cancer in North Sardinia, Italy, in the period 1992-2010. Data were obtained from the tumor registry of Sassari province which makes part of a wider registry web, coordinated today by the Italian Association for Tumor Registries. The overall number of ovarian cancer cases registered in the period under investigation was 600. The mean age of the patients was 62 years. The standardized incidence and mortality rates were 11.2/100,000 and 5.1/100,000 respectively. A substantially stable trend in incidence and mortality of ovarian cancer was evidenced. Relative survival at five years from diagnosis was 44.2%. The incidence and mortality trends of ovarian cancer in North Sardinia remained relatively stable in the last decades, while prognosis remains relatively poor.
Clinical and experimental obstetrics & gynecology, 2012
The aim of this study was to measure plasmatic concentrations of vascular endothelial growth fact... more The aim of this study was to measure plasmatic concentrations of vascular endothelial growth factor-A (VEGF-A) and placental growth factor (PIGF) in pregnant women, and to evaluate their relationship with age, hormonal status, gestational age, and different diseases of pregnancy. We selected a control group of 163 patients (96 fertile and 67 in menopause) and a group of 214 pregnant patients during the whole gestational period. VEGF-A and PlGF were assayed by ELISA and EIA methods, respectively. Statistical analysis was performed using the Mann-Whitney test. The control group showed mean VEGF-A and PlGF values of 89.87 pg/ml and 10.22 pg/ml, respectively; PlGF showed the highest values in menopausal patients. The group of pregnant patients showed VEGF-A values of 27.05 pg/ml and PlGF values of 231.36 pg/ml respectively, with lower (for the VEGF-A) and higher (for the PlGF) statistical significance. These values were not influenced by biological age, but were related to gestational a...
European journal of gynaecological oncology, 2009
Lymph node involvement is the single most important factor in the prognosis of endometrial cancer... more Lymph node involvement is the single most important factor in the prognosis of endometrial cancer, because it is predictive of locoregional and distant metastases. The purpose of our study was to determine whether lymphadenectomy is useful in the surgical staging of endometrial cancer and if it may help establish a more accurate prognosis and reduce the need for postoperative therapy in patients without surgical complications. We conducted a retrospective study on 55 patients with diagnosis of endometrial cancer. Surgical staging of patients undergoing pelvic lymphadenectomy (47/55) showed that 59.6% of cases (n = 28) had Stage I cancer (IA in 4, IB in 16, IC in 8), 17.02% (n = 8) Stage II (IIA in 3, IIB in 5), 21.2% (n = 10) Stage III (IIIB in 5, IIIC in 5), and 2.1% (n = 1) Stage IVA. In the remaining eight patients with a very high anesthesiologic risk (ASA 4), surgical staging was incomplete because they underwent only node palpation. In conclusion, as we wait for the sentinel l...
European journal of gynaecological oncology, 2002
To evaluate, in patients with benign and malignant ovarian cysts, serum samples and ovarian intra... more To evaluate, in patients with benign and malignant ovarian cysts, serum samples and ovarian intracystic fluids for the presence of tumor markers such as CA 125, CA 15.3, tissue polypeptide antigen (TPA), CA 19.9 and the carcinoembryonic antigen (CEA). We studied overall 64 patients with ovarian pathology. Sixteen patients were affected by functional cysts, 28 women by benign cystic tumors and 20 by cystoadenocarcinomas. Average serum levels of all but CA 15.3, TPA and CEA tumor markers of benign cystic ovarian tumors were higher than those of functional cysts. All but CA 19.9 mean intracystic fluid markers levels were more elevated in benign tumors than in functional cysts. In patients with malignant cystic tumors, all but CEA mean serum marker levels were higher than those of benign tumors; furthermore even all mean intracystic levels of markers were more elevated than those of benign tumors. This study confirmed the high positivity of tumor markers such as CA 125, CA 15.3, TPA, CA...
European journal of gynaecological oncology, 2002
To evaluate the usefulness of bipolar electrocautery scissors for cervical conization. Forty pati... more To evaluate the usefulness of bipolar electrocautery scissors for cervical conization. Forty patients with severe dysplasia/in situ carcinoma of the uterine cervix underwent cervical conization: 20 randomly selected patients were operated on with the unipolar energy scalpel and the other 20 were operated on with bipolar electrocautery scissors. In both groups operating time, number of ligations, blood loss, duration of recovery, perioperative complications and adequacy of the margins of the lesion were assessed. Data were compared by analysis of variance. In the bipolar group the average operating time and duration of recovery were significantly reduced (halved), no ligations were needed and the amount of blood loss was significantly reduced. Regarding perioperative complications, in the bipolar group there were no hemorrhages nor need of a second operation or transfusion. Infections did not occur in either group. We found no difference between the two groups regarding adequacy of t...
European journal of gynaecological oncology, 2014
To show management of patients with breast lobular carcinoma in situ (LCIS). This study is the re... more To show management of patients with breast lobular carcinoma in situ (LCIS). This study is the retrospective review of 65 patients, between 1996 and 2012, with isolated LCIS of the breast, evaluated through clinical examination, ultrasound, and mammography at the first examination and follow-up. In 53 patients (81.54%), clinical examination was negative. In 14/65 (21.54%) cases, ultrasound was positive and led to biopsy. The clusters of tiny calcifications were the predominant mammographic pattern (45 cases, 69.23%). Forty-six patients (70.77%) underwent surgical biopsy after guided stereotactic placement of metallic marker (hook-wire), 12 (18.46%) by stereotactic vacuum biopsy (SVB), 5 (7.69%) by core needle biopsy (CNB) under ultrasound guidance, two (3.08%) patients CNB with clinically palpable nodules. Fourteen (21.54%) women underwent a quadrantectomy or total mastectomy after the first diagnosis; in this latter group follow-up was negative. Among the 51 patients (78.46%) who d...
The bacterium group B Streptococcus (GBS) is the leading cause of neonatal bacterial infection in... more The bacterium group B Streptococcus (GBS) is the leading cause of neonatal bacterial infection in developed countries. GBS is a Gram positive bacterium located primarly in the gastrointestinal tract and genitourinary system. The presentation of GBS neonatal disease includes pneumonia, respiratory distress and meningitis. The newborn is colonized during passage through the birth canal. The mother, when colonized, is usually asymptomatic. GBS is present in the vagina of about 10-15% of women towards the end of pregnancy. During the first 7 days of life (early onset infection) about 3% of the colonized children develop the infection, especially meningitis, that may be fatal or leave sequelae; this infection predominantly results from vertical transmission of GBS from colonized mothers during the intrapartum period. Infection of GBS from one week to 90 days of age (late onset infection) results from transmission after birth. In Italy, according to national guidelines of pregnancy 2011, a culture-based screening approach is performed: all patients are screened for vaginal and rectal GBS between 36 and 37 weeks of gestation and if found positive are then treated with prophylactic antibiotics during labor. Intravenous intrapartum antibiotic prophylaxis (IAP) in women who carry GBS, from the onset of labour until delivery (given ≥ 4 hours before delivery), reduces the risk of early onset neonatal GBS infection from 4.7% to 0.4%. P enicillin G is the antibiotic of choice. In case of penicillin allergy, erythromicin or clindamycin are generally active against GBS and carry no particular risks for the infant. Articoli Selezionati del “3° Convegno Pediatrico del Medio Campidano” · Guspini · 25 Maggio 2013 Guest Editor: Roberto Antonucci
Blood, 2005
Background: The prognosis of patients with aggressive non-Hodgkin's lymphoma (NHL) relapsing or p... more Background: The prognosis of patients with aggressive non-Hodgkin's lymphoma (NHL) relapsing or progressing after front-line therapy remains poor. Since high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) can cure a proportion of such patients, provided that a substantial tumor shrinkage is achieved, the development of more effective and less toxic salvage regimens remains a major challenge. We evaluated the clinical activity, toxicity and mobilizing capacity of a new salvage regimen, which combines gemcitabine and oxaliplatin with ifosfamide and rituximab (R-GIFOX) in patients with relapsed and refractory CD20 + NHL. Patients and methods: Patients were scheduled to receive three courses of therapy followed by mobilization and ASCT or three more courses if ineligible for ASCT. R-GIFOX consisted of rituximab (375 mg/m 2 on day 1), gemcitabine (1000 mg/m 2 on day 2), oxaliplatin (130 mg/m 2 on day 3) and ifosfamide (5 g/m 2 on day 3) as a 24-h single infusion in patients aged £65 years, or fractionated over 3 days (days 3-5) in patients aged >65 years. Treatment was given every 2 weeks with G-CSF support (5 lg/kg/day or 10 lg/kg/day at the end of the third course for stem cell mobilization). Responses were evaluated by the integrated FDG-PET/IWC criteria after the third course and at the end of the entire program. Results: Fourteen patients (median age 63 years, range 37-78 years) with relapsed (n = 9) or primary progressive (n = 5) aggressive (diffuse large cell, mantle cell, follicular G3), advanced (stage IV 71%), poor risk (IPI 3-5 50%) NHL were accrued in this pilot study. Patients had received a median of two previous treatment lines (range 1-4). The median number of R-GIFOX courses delivered was 4 (range 1-6). Thirteen patients completed at least three courses of therapy and were evaluable for response. The overall response rate assessed after three courses of R-GIFOX was 77%, with seven complete responses and three partial responses. Effective CD34 + cell mobilization was obtained in four of six eligible patients and two had ASCT. Hematologic and extra-hematologic toxicity was tolerable. Failure-free survival was 79.6% at median follow-up of 6 months (range 2-12). Molecular remissions were documented in two patients with mantle cell NHL. Conclusions: Based on the results of this pilot study, we conclude that the R-GIFOX regimen is feasible, tolerable, effective and able to mobilize peripheral stem cells in patients with relapsed and refractory aggressive NHL.
Seminars in Cancer Biology
In the last decade, a growing attention has been focused on identifying effective therapeutic str... more In the last decade, a growing attention has been focused on identifying effective therapeutic strategies also in the orphan clinical setting of women with platinum-resistant disease. In this context, secondary cytoreductive surgery (SCS) remains a potential approach only in women with platinum sensitive relapse, but experimental data have been published supporting the role of SCS also in patients with platinum-resistant recurrence. In particular, surgery is emerging as a potential option in specific subgroups of women, such as those patients with low-grade serous histology, or low-volume relapse with disease located in the so-called pharmacological sanctuaries. Furthermore, contrasting evidences have suggested a potential role in this clinical setting of SCS combined with intraperitoneal hyperthermic chemotherapy. In this complex scenario we review here the available evidences regarding the role surgery in ovarian cancer patients with platinum resistant disease, trying also to understand which patients may benefit from this challenging, experimental approach.
Archives of gynecology and obstetrics, 2001
Primary malignant tumors of the breast are the most frequently occurring neoplasms in women where... more Primary malignant tumors of the breast are the most frequently occurring neoplasms in women whereas breast metastases are rare. We report the first case, in literature, of metastasis within the breast resulting from a previous cecum carcinoma. We discuss the case and review the literature.
Journal of Clinical Medicine
The aim of this systematic review and meta-analysis is to summarize data on the effectiveness of ... more The aim of this systematic review and meta-analysis is to summarize data on the effectiveness of Sildenafil supplementation for women undergoing assisted reproduction techniques. This meta-analysis of randomized controlled trials (RCTs) evaluates the effects of Sildenafil administration during infertility treatments compared with a control group in infertile women. Outcomes evaluated were endometrial thickness (ETh) and the clinical pregnancy rate (CPR). The chemical pregnancy rate (ChPR) was also evaluated. Pooled results were expressed as the risk ratio (RR) or mean differences (MD) with a 95% confidence interval (95% CI). Women undergoing ovulation induction who received Sildenafil showed higher ETh and a higher CPR in comparison to controls. In this group, both the ETh and ChPR resulted in significantly higher values only with delayed start administration. Women undergoing fresh or frozen embryo transfer who received Sildenafil showed no significant advantages regarding ETh and ...
Gynecologic and Obstetric Investigation
Abnormally invasive placenta (AIP) includes placenta accreta, increta, and percreta and represent... more Abnormally invasive placenta (AIP) includes placenta accreta, increta, and percreta and represents major complications of pregnancy. This study was designed to assess the role of ultrasonography in the identification of AIP among pregnant women with antepartum diagnosis of placenta previa. A cross-sectional study was performed between May 2015 and April 2016 in 11 centers, including 242 women with antepartum diagnosis of placenta previa. Ninety-eight out of 242 (40.49%) women had a histological diagnosis of placenta accreta. A higher number of caesarean deliveries (p = 0.001) and curettages (p = 0.027) and older age of the woman at the delivery (p = 0.031) were identified as risk factors for placenta accreta. The presence of irregularly shaped placental lacunae (vascular spaces) within the placenta (p = 0.008), protrusion of the placenta into the bladder (p < 0.0001), and turbulent blood flow through the lacunae on Doppler ultrasonography (p = 0.008) were predictors of placenta accreta. Women with a prior delivery by caesarean section have a high incidence of placenta accreta among women with antepartum diagnosis of placenta previa.
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 2018
This observational study was conducted in healthy premenopausal women, who presented themselves f... more This observational study was conducted in healthy premenopausal women, who presented themselves for contraception with an intrauterine system (IUS) releasing LNG (6 mcg/d) (Jaydess®, Bayer, Germany) at the outpatient Family Planning Clinics of the Departments of Obstetrics and Gynaecology of the Universities of Cagliari and Sassari (CA/SS), University-Hospitals of CA/SS (Italy). After a screening visit, 31 women without contraindications to Jaydess® were included in the study. No difficulty in Jaydess® insertion (Ji) was found in 87% of subjects, with pelvic pain (PP) (visual analogic scale, VAS:5.33 ± 2.54) reported by 27/31 subjects at the Ji. Pelvic pain was reported by 17/31 subjects on the first day (VAS: 3.07 ± 3.1), 16/31 subjects on the second day (VAS:2.37 ± 2.71), and 11/31 subjects on the third day (VAS:1.18 ± 2.02) from Ji, with a significant (p < .001) decrease in the intensity. The primary purposes of the study were to evaluate whether a 12-month-treatment (12-M-T) ...
Biochemia Medica, 2018
Anisocytosis has been associated with the severity and prognosis of several acute and chronic dis... more Anisocytosis has been associated with the severity and prognosis of several acute and chronic diseases, as well as physiological conditions such as pregnancy. Anisocytosis is quantified by the red blood cell distribution width (RDW), expressed as the ratio, multiplied by 100, between the standard deviation of red blood cell volumes and the mean corpuscular volume), or as the SD of erythrocyte volumes (RDW-SD). The aim of the present review was to report the state of the art on the physiological values and the putative diagnostic and prognostic roles of RDW in complicated pregnancy. Literature research for articles published in the last ten years was conducted in Pubmed, Web of Science, and Scopus databases. Abstracts were independently screened by two investigators. If relevant, full articles were retrieved. References, in these articles, citing relevant reviews or original studies were also accessed to identify additional eligible studies. Any disagreement between the reviewers was...
Archives of Gynecology and Obstetrics
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder that affects women of repr... more Polycystic ovary syndrome (PCOS) is the most common endocrine disorder that affects women of reproductive age and is characterized by ovulatory dysfunction and/or androgen excess or polycystic ovaries. Women with PCOS present a number of systemic symptoms in addition to those related to the reproductive system. It has been associated with functional derangements in adipose tissue, metabolic syndrome, type 2 diabetes, and an increased risk of cardiovascular disease (CVD). A detailed literature search on Pubmed was done for articles about PCOS, adipokines, insulin resistance, and metabolic syndrome. Original articles, reviews, and meta-analysis were included. PCOS women are prone to visceral fat hypertrophy in the presence of androgen excess and the presence of these conditions is related to insulin resistance and worsens the PCO phenotype. Disturbed secretion of many adipocyte-derived substances (adipokines) is associated with chronic low-grade inflammation and contributes to insulin resistance. Abdominal obesity and insulin resistance stimulate ovarian and adrenal androgen production, and may further increase abdominal obesity and inflammation, thus creating a vicious cycle. The high prevalence of metabolic disorders mainly related to insulin resistance and CVD risk factors in women with PCOS highlight the need for early lifestyle changes for reducing metabolic risks in these patients.
BioMed research international, 2017
Recent studies have shown that infants with intrauterine growth restriction (IUGR) undergo catch-... more Recent studies have shown that infants with intrauterine growth restriction (IUGR) undergo catch-up growth during infancy. The aim of our study was to evaluate the postnatal growth in a cohort of IUGR infants born in a tertiary-level Obstetric University Hospital of Northern Sardinia. An observational retrospective study was conducted on 12 IUGR (group A) and 12 control infants (group B) by measuring the anthropometric parameters of weight (W), length (L) and head circumference (HC) from birth to the 3rd postnatal year. At birth, significant differences were found between group A and group B with regard to all the auxological parameters (W, mean 1846.6 versus 3170.8 g, p < 0.0001; HC, 30.1 versus 34.4 cm, p < 0.0001; L, mean 43.4 versus 49.4 cm, p < 0.0001). During the 1st year, 8 of 12 (70%) IUGR infants exhibited a significant catch-up growth in the 3 anthropometric parameters and a regular growth until the 3rd year of follow-up. The majority but not all infants born with...
Italian Journal of Anatomy and Embryology, 2014
HUVECs are worldwide used to study the endothelial physiology and pathology that might be involve... more HUVECs are worldwide used to study the endothelial physiology and pathology that might be involved in sex and gender differences detected at the cardiovascular level. The present work characterised the phenotype of HUVECs in terms of morphology, proliferative and migratory capacity and in the gene expression of oestrogen and androgen receptors and nitric oxide synthase 3 (NOS3) to evaluated if they are sexually dimorphic. Moreover, autophagic process was analysed in male and female HUVECs (MHUVECs and FHUVECs), as autophagy is influenced by sex. Umbilical cords were obtained from healthy, normal weight, male and female neonates born to healthy non-obese and non-smoking women. HUVECs morphology was analysed by electron microscopy, and their function was investigated by proliferation, viability, wound healing and chemotaxis assays. Real-time PCR was used to evaluate gene expression for oestrogen and androgen receptors and for NOS3, while the expression of the primary molecules involved in autophagic process [(Akt, the mammalian target of rapamycin (mTOR), beclin-1 and microtubule-associated protein 1 light chain 3 (LC3)] and NOS3 were analysed by western blotting. FHUVECs showed significantly higher proliferation and migration rate, and NOS3 mRNA and protein expression than MHUVECs. Conversely, beclin-1 and the LC3-II/LC3-I ratio were higher in MHUVECs than in FHUVECs, indicating a higher autophagy in male cells as also indicated by ultrastructural analysis showing a buildup of autophagic vacuoles at different stages in MHUVECs. The expression of oestrogen and androgen receptor genes, the protein expression of Akt, mTOR, and cellular size and shape were not influenced by sex. Male and female neonates did not differ in body weight, but the weight of male babies was positively associated with the weight of the mother, suggesting that the weight of the mother may exert a different influence on male and female babies. Our findings indicate that sex differences exist from prenatal life and are parameter- specific, suggesting that a better quality of the research on the endothelium in vitro can be obtained by analyzing HUVECs of both sexes as well as its translational value. Moreover, the sex differences observed in HUVECs could help the diseases of adulthood because endothelial dysfunction has a key role in cardiovascular diseases, diabetes mellitus, neurodegeneration and immune diseases.
Journal of Obstetrics & Gynaecology, 2014
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Papers by Giampiero Capobianco