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The protective effect of pregnancy on endometriosis is well known, but complications related to the pregnant state, such as hemoperitoneum, uroperitoneum and bowel perforation may occur.

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The authors report the results of a study conducted on 136 patients affected by breast cancer under treatment with tamoxifen at a daily dose of 20 mg who underwent a strict follow-up including endometrial surveillance. The cytologic evaluation of the endometrium was performed on smears obtained by the endocyte sampling. The results were in accordance with what is reported in the literature. Forty cases presented with hyperplasia which was atypical in two cases. Only in one case did histology show a well differentiated adenocarcinoma. In 25 cases the endometrium resulted to be proliferative in accordance with the effect of tamoxifen, while the remaining 67 cases were atrophic. The investigation was not possible in four cases due to stenosis. In our study the endocyte sampler resulted to be an economic, simple and painless cytologic device, suitable for clinical use because of its low incidence of false positives.

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Breast pathology, during adolescence, shows a typology like that in adults but with a completely different incidence. We observed 472 patients aged between 12 and 19 years in Senology Center of II Clinic of Obstetrics and Gynecology from 1984 to 1992. The most frequent pathologies diagnosed were: fibroadenomas (in the variety simple, phylloides, giant), cysts (simple and apocrine cysts); lower incidence for congenital anomalies, mastitis, mammary secretion caused by ductal hyperplasia or intraductal papilloma, lipoma. No incidence of cancer was detected. Echography was the principal diagnostic method for those patients who showed, at the clinical examination, a lump or palpable abnormalities. Mammography in this period does not affect the diagnoses and can be potentially harmful due to the exposure at X rays on such a sensible tissue.

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In Italy breast cancer mortality is constantly increasing in women over 70 years of age. The retrospective analysis of the cases observed at the "Senology Center" of the II Institute of Obstetrics and Gynecology (University "La Sapienza" of Rome) shows when compared to the group of women under age of 40 a higher number of advanced cases. This delayed diagnosis needs a most radical treatment and adjuvant therapies (i.e. chemotherapy) that cannot often be carried out because of general problems. Therefore, elderly women should be sensibilized to undergo periodical and regular sanitary inspection.

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Mammary pathology, during adolescence, is an uncommon event and generally not very serious. During this growth period the different tissue mammary components are influenced by metabolic and hormonal stimulus in a proliferative and differentiative sense. In this growth period an efficient clinical approach is really necessary and it must not be only confined to senologic control, but inserted in the traditional semeiotics of a teenage patient, associated with a practice of self-palpation from the conclusive phases of the mammary development.

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Our investigation has confirmed the low incidence of mammarian pathology in adolescents and the near absence of malignant neoplastic pathology. Programs of breast control in this age can be valid only by aiming at health education prevention and correction of eventual risk factors. The group of adolescents studied by us has allowed us to define the most frequent pathology as the functional one, that is, mastodinia, and among the organic cases single or multiple fibroadenomas are the most frequent lesions. An exact diagnostic profile is necessary in order to reassure the patient in cases of absence of pathology, or to schedule a follow-up or to program an eventual surgical and/or medical treatment.

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The antalgic effect of synthetic diosmin in 120 patients suffering from vascular and premenstrual mastodynia is studied compared to the same number of non-treated cases. The therapy has been carried out for one consecutive year. For the same period the course of the painful symptomatology, both in the cases treated and in the controls, has been checked. For the treated cases a significant decrease of the painful symptomatology has been obtained and this decrease was maintained.

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The Authors have investigated preneoplastic lesions and the problem of the identification of benign lesions considered with or without preneoplastic potential, comparing for the occasion the presence of transformation markers in these lesions with the positivity of tumor markers in neoplastic tissue. The dosages have been valued on neoplastic tissue (180 cases), dysplastic tissue (50 cases), on cystic fluid (70 cases), and on nipple discharge (80 cases). The data obtained show a marked positivity to the tumor markers and the ionic and hormonal content (K+, Na+ DHEAS, PRL evaluation). The positivity of some lesions, not properly preneoplastic (or atypical) towards some markers of neoplasia could show some differences of great interest between benignity and malignity.

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Dysplasia is an alteration of organ and tissues cellular composition. It means quantitative and qualitative variations (differentiation) of the cells. More recently many Authors have investigated about epithelial neoplasia (breast, cervix, lung, respiratory tract, bladder, colon) and dysplastic epithelial processes and about their medical treatment and prevention of potentially transformative lesions. The view that certain vitamins such as vitamin A (in the form of retinol or its precursor beta-carotene) and vitamin E may protect against the risk of cancer has recently attracted much scientific attention. The potential use of retinoids (and alpha tocopherol) for chemoprevention has been demonstrated by numerous recent experiences. In gynaecology there are no evidence of therapeutical investigations about endometrial and ovarian dysplastic lesions, and then about protective role for consequent neoplasia development. Regarding cervical cancer there are only epidemiological retrospective data about dietary intake of vitamin A. The clinical trial is insufficient, perhaps for technical difficulties of administration, but we hope to obtain satisfactory results in the future. Benign breast disease, instead, so present in woman's life (in particular in fertile phase) is the most common clinical syndrome encompassing several distinct histopathological varieties. BBD is associated with an increase in breast cancer risk, particularly related to the presence of epithelial hyperplasia. In our study (collaborative study; University of L'Aquila--University of Rome) we have treated a group of women (double-blind trial) affected by breast dysplasia, with vitamin A and E association to evaluate the effectiveness of retinoids and alpha-tocopherol in reducing or resolving clinical palpable breast findings (with pain, tension, nodularity and instrumental patterns).(ABSTRACT TRUNCATED AT 250 WORDS)

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