Emilio Giugliano - Academia.edu (original) (raw)

Papers by Emilio Giugliano

PubMed, Aug 1, 2014

Aim: To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth r... more Aim: To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth restriction. Patients and methods: Thirty consecutive pregnant women with an ultrasound diagnosis of foetal growth restriction were included in this study (group A) while 30 women with a physiologic pregnancy were recruited as control group (group B). The diagnosis was performed during the ultrasound of the third trimester and confirmed at birth. Blood samples were drawn after the ultrasound of the third trimester for all patients. The analyzed populations were: WBC, total lymphocytes, CD2+, CD3+, CD4+, CD5+, CD8+, CD19+, CD56+, HLA-DR+, CD45+, CD3+HLA-DR+, CD4+CD3+, CD3+CD8+, CD2+CD56+, CD19+CD5+, ratio (CD4+CD3+)/(CD3+CD8+). Results: The percentage and absolute value of the NK cells was higher in the group A [(20.90 vs. 15.09)%, p = 0.0005; (419.55 vs. 341.40) UI/μl, p = 0.0005]. This trend was confirmed by the CD2+CD56+ natural killer (NK) subset [(18.84 vs. 13.42) UI/μl, p = 0.0005]. Instead, the CD4+ percentage value was lower in the group A [(41.15 vs. 44.84)%, p = 0.03] through the CD4+CD3+/CD3+CD8+ ratio was not significantly different. Conclusions: Our findings reinforce the concept of pregnancy as a controlled systemic inflammatory state that if altered can have adverse consequences for the mother and the foetus.

PubMed, 2014

Aim: To assess the eventual influence of low dose betamethasone throughout pregnancy on fetal gro... more Aim: To assess the eventual influence of low dose betamethasone throughout pregnancy on fetal growth. Patients and methods: 320 patients - admitted to the Section of Obstetrics and Gynecology of Ferrara University from January 2005 to December 2010 - were subdivided in two groups: 160 patients affected by recurrent spontaneous abortion (Group A), treated by low dose of betamethasone (0.5 mg/daily) throughout pregnancy for preventive purposes, 160 patients with physiological pregnancy as control group (Group B). Primary measured outcomes were neonatal biometric parameters such as birth weight, head circumference and neonatal length. Unpaired t-test was used to compare the neonatal biometric parameters. Results: Birth weight, length and circumference head resulted significantly lower in groups treated by GCs. However, excluding bias as pregnancy complicated by diseases, which could affect fetal growth, biometric neonatal parameters were not different between two groups. Furthermore, analyzing the distribution of the value of birth weight we observed that in the group A there were 44 newborns with a weight even higher than fiftieth percentile. Conclusions: Betamethasone seems not to influence fetal growth. Our analysis demonstrates that fetal growth is influenced by several factors, therefore, homogeneous study population is essential to have convincing results.

Gynecologic and Obstetric Investigation, 2014

therefore suggest that the glycoprotein may exert a protective role against ominous pregnancy com... more therefore suggest that the glycoprotein may exert a protective role against ominous pregnancy complications linked to an increased level of the cytokine, such as abortion secondary to amniocentesis.

European Journal of Obstetrics & Gynecology and Reproductive Biology, Jun 1, 2013

To test the adjuvant use of the combination of N-palmitoylethanolamine and transpolydatin in the ... more To test the adjuvant use of the combination of N-palmitoylethanolamine and transpolydatin in the medical treatment of endometriotic pain. Study design: We enrolled 47 patients admitted to the Outpatient Endometriosis Care Unit of Ferrara University from January 2011 to December 2011. They were divided into two groups according to the endometriosis site (group A: recto-vaginal septum; group B: ovary). One tablet, containing 400 mg of micronized N-palmitoylethanolamine plus 40 mg transpolydatin, was administered twice daily on a full stomach for 90 days. Each patient was requested to grade the severity of dysmenorrhea, chronic pelvic pain, dyspareunia and dyschezia using a 0-10 cm visual analogic scale prior to beginning treatment (T0), after 30 days (T1), 60 days (T2) and 90 days (T3). The continuous and categorical variables were compared, respectively, using Student's t-test and the chi-square test. Analysis of variance for repeated measures was used to verify the reduction of endometriotic pain. Results: The intensity of endometriotic pain decreased significantly for both groups (p < 0.0001). The efficacy of drug treatment was significant after 30 days. Pain intensity decreased equally in the two groups except for dysmenorrhea, which was reduced more rapidly in group B. Conclusions: The combination of N-palmitoylethanolamine and transpolydatin reduced pain related to endometriosis irrespective of lesion site. It had a marked effect on chronic pelvic pain determined by deep endometriosis and on dysmenorrhea correlated to ovarian endometriosis.

Journal of Emergencies, Trauma, and Shock, 2013

InTech eBooks, Nov 28, 2012

Clinical and Experimental Reproductive Medicine, 2013

Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the l... more Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, Jan 19, 2015

Our aim is to assess the impact of the ultrasonographic detection of follicular rupture on the in... more Our aim is to assess the impact of the ultrasonographic detection of follicular rupture on the intrauterine insemination success. A total of 313 women undergoing ovarian stimulation for intrauterine insemination were enrolled. Transvaginal ultrasonography was performed to check whether the dominant follicle had ruptured and according to that the patients were divided into two groups. The ultrasound detection of follicular rupture was observed in 156 patients (54%). The independent variables favoring follicular rupture were: Age (t: 7.646, p < 0.0005), FSH value (t: -5.637, p < 0.0005), duration of infertility (t: -4.265, p < 0.0005), menstrual cycle length (t: -4.927, p < 0.0005). Moreover, the logistic regression analysis demonstrated that the predictive variables for follicular rupture were: FSH value (OR 1.7, CI 95% 1.3-2.3, p < 0.0005), duration of infertility (OR 2.6, CI 95% 1.6-4.2, p < 0.0005) and menstrual cycle length (OR 2.4, CI 95% 1.7-3.4, p < 0.0005...

To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth restri... more To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth restriction.

Cleveland Clinic journal of medicine, 2013

With the odds of surviving cancer improving, many young women facing chemotherapy or radiotherapy... more With the odds of surviving cancer improving, many young women facing chemotherapy or radiotherapy may first wish to take steps to ensure that they will still be able to bear children afterward. The options depend on the type of disease, the treatment required, the age of the patient, whether she has a long-term partner, and whether cancer treatment can be delayed. This paper is an overview of current and experimental strategies for preserving fertility in female cancer patients.

Clinical and experimental obstetrics & gynecology, 2012

In this case report, the authors discuss clinical presentation, surgical procedure and early resu... more In this case report, the authors discuss clinical presentation, surgical procedure and early results of chemotherapy of pancreatic carcinoma with liver metastases diagnosed a few days after delivery. Pancreatic adenocarcinoma occurs infrequently in pregnant and childbearing women: only ten cases have been reported in the literature. The early diagnosis of pancreatic cancer is difficult because symptoms appear when cancer is about to reach an advanced stage. In pregnancy, it is even more difficult because symptoms like dyspepsia, vomiting and epigastric pain may result confusing. The authors outline the difficulties in diagnosis and treatment of this kind of disease during pregnancy.

The Journal of Obstetrics and Gynecology of India, 2013

Glucocorticoids - New Recognition of Our Familiar Friend, 2012

Clinical and Experimental Reproductive Medicine, 2013

Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the l... more Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.

Gynecological Endocrinology, 2014

Clinical and Experimental Reproductive Medicine, 2012

To evaluate the effect of hysterosalpingo-contrast sonography (HyCoSy) on natural conception in t... more To evaluate the effect of hysterosalpingo-contrast sonography (HyCoSy) on natural conception in the infertile patient. Methods: We conducted a prospective observational study recruiting 180 patients admitted to Infertility Center of Ferrara University from January 2010 to February 2012. The essential inclusion criteria was the couple's desire to perform only diagnostic evaluation on infertility causes and to wait for natural conception before proceeding with further management. Couples were investigated with hormonal profile, semen analysis and HyCoSy. Expected time for spontaneous pregnancy was 180 days from HyCoSy. First datation sonography of pregnancy was used calculating time elapsed from HyCoSy at conception. Results: Forty patients (22.2%) obtained spontaneous pregnancy within 6 months after HyCoSy. The mean of "conception time" was 75 days. The pregnancy rate was significantly higher in the first 30 days (45%) compared to other the months of observation (p<0.0005). Multiple linear regression analysis showed that maternal age and sterility duration proved independent variables in detecting the "conception time" after HyCoSy (t=3.742, p=0.001, t=2.371, p=0.02, respectively). Conclusion: A possible beneficial effect of HyCoSy is feasible especially in the days following its execution. This temporal correlation supports its therapeutic use.

Journal of Emergencies, Trauma, and Shock, 2013

Journal of Clinical Ultrasound, 2014

Background. To test the velocimetric pattern of the ovarian artery as a routine ovarian reserve t... more Background. To test the velocimetric pattern of the ovarian artery as a routine ovarian reserve test. Methods. We enrolled 317 consecutive patients from January 2011 to June 2012. At the second day of the menstrual cycle, a transvaginal ultrasound was performed to evaluate the antral follicle count and ovarian volume, and Doppler of both ovarian arteries was also performed. Controlled ovarian stimulation was performed and the patients were divided in two groups according to the result of the intrauterine insemination: group A (nonpregnant women) and group B (pregnant women). Results. Ovarian velocimetric pattern was similar between the two groups. Follicle stimulating hormone value had a significant correlation with the ultrasound markers; however, the multiple regression linear analysis showed that the only independent variables were the antral follicle count (t 5 22.74, p 5 0.008) and the systolic/diastolic ratio (t 5 3.95, p 5 0.0005). The best parameters in predicting the pregnancy were the mean ovarian volume, total and partial antral follicle count between 7 and 10 mm, and the mean resistance index (area under the curve: 0.744, 0.671, 0.667, 0.573, respectively). Conclusions. The Doppler study of the ovarian arteries did not add significant information about the ovarian reserve status. Only the mean resistance index had a significant diagnostic accuracy, but its specificity (53%) is too low to consider it a screening test. V

Health and Quality of Life Outcomes, 2012

PubMed, Aug 1, 2014

Aim: To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth r... more Aim: To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth restriction. Patients and methods: Thirty consecutive pregnant women with an ultrasound diagnosis of foetal growth restriction were included in this study (group A) while 30 women with a physiologic pregnancy were recruited as control group (group B). The diagnosis was performed during the ultrasound of the third trimester and confirmed at birth. Blood samples were drawn after the ultrasound of the third trimester for all patients. The analyzed populations were: WBC, total lymphocytes, CD2+, CD3+, CD4+, CD5+, CD8+, CD19+, CD56+, HLA-DR+, CD45+, CD3+HLA-DR+, CD4+CD3+, CD3+CD8+, CD2+CD56+, CD19+CD5+, ratio (CD4+CD3+)/(CD3+CD8+). Results: The percentage and absolute value of the NK cells was higher in the group A [(20.90 vs. 15.09)%, p = 0.0005; (419.55 vs. 341.40) UI/μl, p = 0.0005]. This trend was confirmed by the CD2+CD56+ natural killer (NK) subset [(18.84 vs. 13.42) UI/μl, p = 0.0005]. Instead, the CD4+ percentage value was lower in the group A [(41.15 vs. 44.84)%, p = 0.03] through the CD4+CD3+/CD3+CD8+ ratio was not significantly different. Conclusions: Our findings reinforce the concept of pregnancy as a controlled systemic inflammatory state that if altered can have adverse consequences for the mother and the foetus.

PubMed, 2014

Aim: To assess the eventual influence of low dose betamethasone throughout pregnancy on fetal gro... more Aim: To assess the eventual influence of low dose betamethasone throughout pregnancy on fetal growth. Patients and methods: 320 patients - admitted to the Section of Obstetrics and Gynecology of Ferrara University from January 2005 to December 2010 - were subdivided in two groups: 160 patients affected by recurrent spontaneous abortion (Group A), treated by low dose of betamethasone (0.5 mg/daily) throughout pregnancy for preventive purposes, 160 patients with physiological pregnancy as control group (Group B). Primary measured outcomes were neonatal biometric parameters such as birth weight, head circumference and neonatal length. Unpaired t-test was used to compare the neonatal biometric parameters. Results: Birth weight, length and circumference head resulted significantly lower in groups treated by GCs. However, excluding bias as pregnancy complicated by diseases, which could affect fetal growth, biometric neonatal parameters were not different between two groups. Furthermore, analyzing the distribution of the value of birth weight we observed that in the group A there were 44 newborns with a weight even higher than fiftieth percentile. Conclusions: Betamethasone seems not to influence fetal growth. Our analysis demonstrates that fetal growth is influenced by several factors, therefore, homogeneous study population is essential to have convincing results.

Gynecologic and Obstetric Investigation, 2014

therefore suggest that the glycoprotein may exert a protective role against ominous pregnancy com... more therefore suggest that the glycoprotein may exert a protective role against ominous pregnancy complications linked to an increased level of the cytokine, such as abortion secondary to amniocentesis.

European Journal of Obstetrics & Gynecology and Reproductive Biology, Jun 1, 2013

To test the adjuvant use of the combination of N-palmitoylethanolamine and transpolydatin in the ... more To test the adjuvant use of the combination of N-palmitoylethanolamine and transpolydatin in the medical treatment of endometriotic pain. Study design: We enrolled 47 patients admitted to the Outpatient Endometriosis Care Unit of Ferrara University from January 2011 to December 2011. They were divided into two groups according to the endometriosis site (group A: recto-vaginal septum; group B: ovary). One tablet, containing 400 mg of micronized N-palmitoylethanolamine plus 40 mg transpolydatin, was administered twice daily on a full stomach for 90 days. Each patient was requested to grade the severity of dysmenorrhea, chronic pelvic pain, dyspareunia and dyschezia using a 0-10 cm visual analogic scale prior to beginning treatment (T0), after 30 days (T1), 60 days (T2) and 90 days (T3). The continuous and categorical variables were compared, respectively, using Student's t-test and the chi-square test. Analysis of variance for repeated measures was used to verify the reduction of endometriotic pain. Results: The intensity of endometriotic pain decreased significantly for both groups (p < 0.0001). The efficacy of drug treatment was significant after 30 days. Pain intensity decreased equally in the two groups except for dysmenorrhea, which was reduced more rapidly in group B. Conclusions: The combination of N-palmitoylethanolamine and transpolydatin reduced pain related to endometriosis irrespective of lesion site. It had a marked effect on chronic pelvic pain determined by deep endometriosis and on dysmenorrhea correlated to ovarian endometriosis.

Journal of Emergencies, Trauma, and Shock, 2013

InTech eBooks, Nov 28, 2012

Clinical and Experimental Reproductive Medicine, 2013

Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the l... more Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, Jan 19, 2015

Our aim is to assess the impact of the ultrasonographic detection of follicular rupture on the in... more Our aim is to assess the impact of the ultrasonographic detection of follicular rupture on the intrauterine insemination success. A total of 313 women undergoing ovarian stimulation for intrauterine insemination were enrolled. Transvaginal ultrasonography was performed to check whether the dominant follicle had ruptured and according to that the patients were divided into two groups. The ultrasound detection of follicular rupture was observed in 156 patients (54%). The independent variables favoring follicular rupture were: Age (t: 7.646, p < 0.0005), FSH value (t: -5.637, p < 0.0005), duration of infertility (t: -4.265, p < 0.0005), menstrual cycle length (t: -4.927, p < 0.0005). Moreover, the logistic regression analysis demonstrated that the predictive variables for follicular rupture were: FSH value (OR 1.7, CI 95% 1.3-2.3, p < 0.0005), duration of infertility (OR 2.6, CI 95% 1.6-4.2, p < 0.0005) and menstrual cycle length (OR 2.4, CI 95% 1.7-3.4, p < 0.0005...

To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth restri... more To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth restriction.

Cleveland Clinic journal of medicine, 2013

With the odds of surviving cancer improving, many young women facing chemotherapy or radiotherapy... more With the odds of surviving cancer improving, many young women facing chemotherapy or radiotherapy may first wish to take steps to ensure that they will still be able to bear children afterward. The options depend on the type of disease, the treatment required, the age of the patient, whether she has a long-term partner, and whether cancer treatment can be delayed. This paper is an overview of current and experimental strategies for preserving fertility in female cancer patients.

Clinical and experimental obstetrics & gynecology, 2012

In this case report, the authors discuss clinical presentation, surgical procedure and early resu... more In this case report, the authors discuss clinical presentation, surgical procedure and early results of chemotherapy of pancreatic carcinoma with liver metastases diagnosed a few days after delivery. Pancreatic adenocarcinoma occurs infrequently in pregnant and childbearing women: only ten cases have been reported in the literature. The early diagnosis of pancreatic cancer is difficult because symptoms appear when cancer is about to reach an advanced stage. In pregnancy, it is even more difficult because symptoms like dyspepsia, vomiting and epigastric pain may result confusing. The authors outline the difficulties in diagnosis and treatment of this kind of disease during pregnancy.

The Journal of Obstetrics and Gynecology of India, 2013

Glucocorticoids - New Recognition of Our Familiar Friend, 2012

Clinical and Experimental Reproductive Medicine, 2013

Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the l... more Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.

Gynecological Endocrinology, 2014

Clinical and Experimental Reproductive Medicine, 2012

To evaluate the effect of hysterosalpingo-contrast sonography (HyCoSy) on natural conception in t... more To evaluate the effect of hysterosalpingo-contrast sonography (HyCoSy) on natural conception in the infertile patient. Methods: We conducted a prospective observational study recruiting 180 patients admitted to Infertility Center of Ferrara University from January 2010 to February 2012. The essential inclusion criteria was the couple's desire to perform only diagnostic evaluation on infertility causes and to wait for natural conception before proceeding with further management. Couples were investigated with hormonal profile, semen analysis and HyCoSy. Expected time for spontaneous pregnancy was 180 days from HyCoSy. First datation sonography of pregnancy was used calculating time elapsed from HyCoSy at conception. Results: Forty patients (22.2%) obtained spontaneous pregnancy within 6 months after HyCoSy. The mean of "conception time" was 75 days. The pregnancy rate was significantly higher in the first 30 days (45%) compared to other the months of observation (p<0.0005). Multiple linear regression analysis showed that maternal age and sterility duration proved independent variables in detecting the "conception time" after HyCoSy (t=3.742, p=0.001, t=2.371, p=0.02, respectively). Conclusion: A possible beneficial effect of HyCoSy is feasible especially in the days following its execution. This temporal correlation supports its therapeutic use.

Journal of Emergencies, Trauma, and Shock, 2013

Journal of Clinical Ultrasound, 2014

Background. To test the velocimetric pattern of the ovarian artery as a routine ovarian reserve t... more Background. To test the velocimetric pattern of the ovarian artery as a routine ovarian reserve test. Methods. We enrolled 317 consecutive patients from January 2011 to June 2012. At the second day of the menstrual cycle, a transvaginal ultrasound was performed to evaluate the antral follicle count and ovarian volume, and Doppler of both ovarian arteries was also performed. Controlled ovarian stimulation was performed and the patients were divided in two groups according to the result of the intrauterine insemination: group A (nonpregnant women) and group B (pregnant women). Results. Ovarian velocimetric pattern was similar between the two groups. Follicle stimulating hormone value had a significant correlation with the ultrasound markers; however, the multiple regression linear analysis showed that the only independent variables were the antral follicle count (t 5 22.74, p 5 0.008) and the systolic/diastolic ratio (t 5 3.95, p 5 0.0005). The best parameters in predicting the pregnancy were the mean ovarian volume, total and partial antral follicle count between 7 and 10 mm, and the mean resistance index (area under the curve: 0.744, 0.671, 0.667, 0.573, respectively). Conclusions. The Doppler study of the ovarian arteries did not add significant information about the ovarian reserve status. Only the mean resistance index had a significant diagnostic accuracy, but its specificity (53%) is too low to consider it a screening test. V

Health and Quality of Life Outcomes, 2012