European review for medical and pharmacological sciences, 2018
OBJECTIVE Endometrial cancer (EC) is a complex gynecological neoplasm with several clinical, hist... more OBJECTIVE Endometrial cancer (EC) is a complex gynecological neoplasm with several clinical, histopathological and genetic features. Different hormonal, metabolic and biochemical axes are involved in pathogenesis. Obesity is a well-known risk factor for this disease and the role of local and systemic effects of adipose tissue, especially in the promotion of subclinical chronic inflammation, is an important issue. Indeed, inflammation is related to the pathogenesis of different tumors, including EC. This review aims to remark the role of obesity and inflammation in the pathogenesis of EC cancer through an exploration of the current literature. MATERIALS AND METHODS We performed a comprehensive review of the literature through a PubMed search using key words and including English language papers looking at this topic. RESULTS Only few authors analyzed the role of inflammatory cytokines released by adipose tissue in visceral abdominal fat depots. Tumor Necrosis Factor-α, Interleukin-6,...
Introduction:Aim of this study is to evaluate the prevalence and intensity of postoperative pain ... more Introduction:Aim of this study is to evaluate the prevalence and intensity of postoperative pain and to find pain-related factors in women undergoing gynecologic surgery, using a dedicated form. Methods: The sample is divided into three groups, according to the type of surgical access (transversal laparotomy TL, longitudinal laparotomy LL, vaginal VAG). Each patient received postoperative painkillers according to hospital therapy protocols. Postoperative pain episodes that have been recorded during the first three days after surgery (days 0,1,2)) were studied. Pain intensity was measured using Numerical Rating Scale (NRS). Results:The 64% of operated women complained at least one episode of pain during the three days after surgery. Among women complaining pain, its intensity was moderate for the 89% (NRS 4-7) and it was severe only in few cases (11%), mainly in the VAG group. The due-hour painkillers administration was associated to a lower percentage of pain episodes if compared to the "rescue doses". Conclusions: Pain control is important to promote safe surgery. A dedicated form is useful to assess this vital sign. The results present a detailed pictureof this extremely subjective symptom and they suggest how to improve the analgesic therapies when necessary
BACKGROUND Covid-19 pandemic has impacted professional, economic and social activities. In the su... more BACKGROUND Covid-19 pandemic has impacted professional, economic and social activities. In the surgical field, it has brought changes to operating activities, the organization of workforces, the protection measures for patients and personnel against possible intraoperative transmissions as well as training young surgeons. This study intends to assess the extent of this impact in our institution. METHODS The patients operated on in nine Operating Units(OUs) in the period February 1 - March 31 2020 with follow-ups on April 30 2020 were evaluated both retrospectively and prospectively. Organizational, clinical and impact parameters on staff were evaluated. RESULTS Of the 833 consecutive admitted patients, 742 were operated on ,705 of whom were recruited for the study. Compared to the same period in 2019 there was a decrease in the number of operations (742 compared to 1187), similar use of intensive care unit (ICU), a diagnostic activity only for symptomatic patients, heterogeneity in organizational behaviors, an impact on staff who highlighted concerns about getting sick or passing the infection on to others (87.64%) or their family members (75.14%). CONCLUSIONS The study made it possible to detect the need to make significant changes in the clinical, organizational and teaching fields, for which some operational proposals are suggested.
BACKGROUND Role of lymphadenectomy in endometrial cancer is unclear. Our objective is to assess t... more BACKGROUND Role of lymphadenectomy in endometrial cancer is unclear. Our objective is to assess the role of lymphadenectomy in endometrial cancer. METHODS The study reviewed retrospectively 829 cases of endometrial cancer from a single non-oncological center from 1981 to 2014. Multivariable Cox regression analyses were performed. Independent variables were: 2009 FIGO stage, histological type of endometrial cancer (non-endometrioid, endometrioid, grading 1, 2 and 3), radicality on parametria, lymphatic dissection (any kind) (yes/no), any kind of chemotherapy, any kind of radiotherapy, brachytherapy, patients' age. Dependent variable was death for endometrial cancer and first relapse. Time variable was the semester of follow-up. P value for significance was set <0.05. RESULTS Many data about the extension of node dissection were missing. Pelvic node dissection or sampling seem the more common procedure performed. At the 10-semester of follow-up, at the 20-semester of follow-up ...
Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 2019
Objective The aim of the present study was to perform a comprehensive review of the literature to... more Objective The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele—a hypoechoic area within the myometrium at the site of the uterine scar of a previous cesarean section—by exploring in depth every aspect of this condition. Methods A comprehensive review of the literature was performed to identify the most relevant studies about this topic. Results Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data. Conclusion Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.
Benign multicystic peritoneal mesothelioma is a very rare benign cystic tumor; at present approxi... more Benign multicystic peritoneal mesothelioma is a very rare benign cystic tumor; at present approximately 130 cases have been reported. It more frequently occurs in females (87%), expecially in the pelvic area of the cul-de-sac, uterus and rectum; the pathogenesis has remained controversial. Abdominal pain is the most common symptom (75%). Ultrasound, Computerized Tomography (CT) and magnetic resonance imaging are helpful, but the diagnosis is confirmed by histopathological and immunohistochemical examination. Benign multicystic peritoneal mesothelioma shows high recurrence after surgical resection, but it does not present a tendency to transform into malignancy. Surgery is the only effective treatment, and peritonectomy is recommended. A prolonged systematic followup of these patients, perhaps for all life, is required. Here we report two cases that underwent surgery for benign multicystic peritoneal mesothelioma. In the first case the lesion was a multicystic fluid mass of the large...
1Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicin... more 1Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, Azienda OspedalieroUniversitaria S. Anna, Università di Ferrara, Cona, Ferrara, Italy 2Section of Obstetrics and Gynaecology, Policlinico di Abano Terme, Abano Terme, Padova, Italy 3Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
European review for medical and pharmacological sciences, 2018
OBJECTIVE Endometrial cancer (EC) is a complex gynecological neoplasm with several clinical, hist... more OBJECTIVE Endometrial cancer (EC) is a complex gynecological neoplasm with several clinical, histopathological and genetic features. Different hormonal, metabolic and biochemical axes are involved in pathogenesis. Obesity is a well-known risk factor for this disease and the role of local and systemic effects of adipose tissue, especially in the promotion of subclinical chronic inflammation, is an important issue. Indeed, inflammation is related to the pathogenesis of different tumors, including EC. This review aims to remark the role of obesity and inflammation in the pathogenesis of EC cancer through an exploration of the current literature. MATERIALS AND METHODS We performed a comprehensive review of the literature through a PubMed search using key words and including English language papers looking at this topic. RESULTS Only few authors analyzed the role of inflammatory cytokines released by adipose tissue in visceral abdominal fat depots. Tumor Necrosis Factor-α, Interleukin-6,...
Introduction:Aim of this study is to evaluate the prevalence and intensity of postoperative pain ... more Introduction:Aim of this study is to evaluate the prevalence and intensity of postoperative pain and to find pain-related factors in women undergoing gynecologic surgery, using a dedicated form. Methods: The sample is divided into three groups, according to the type of surgical access (transversal laparotomy TL, longitudinal laparotomy LL, vaginal VAG). Each patient received postoperative painkillers according to hospital therapy protocols. Postoperative pain episodes that have been recorded during the first three days after surgery (days 0,1,2)) were studied. Pain intensity was measured using Numerical Rating Scale (NRS). Results:The 64% of operated women complained at least one episode of pain during the three days after surgery. Among women complaining pain, its intensity was moderate for the 89% (NRS 4-7) and it was severe only in few cases (11%), mainly in the VAG group. The due-hour painkillers administration was associated to a lower percentage of pain episodes if compared to the "rescue doses". Conclusions: Pain control is important to promote safe surgery. A dedicated form is useful to assess this vital sign. The results present a detailed pictureof this extremely subjective symptom and they suggest how to improve the analgesic therapies when necessary
BACKGROUND Covid-19 pandemic has impacted professional, economic and social activities. In the su... more BACKGROUND Covid-19 pandemic has impacted professional, economic and social activities. In the surgical field, it has brought changes to operating activities, the organization of workforces, the protection measures for patients and personnel against possible intraoperative transmissions as well as training young surgeons. This study intends to assess the extent of this impact in our institution. METHODS The patients operated on in nine Operating Units(OUs) in the period February 1 - March 31 2020 with follow-ups on April 30 2020 were evaluated both retrospectively and prospectively. Organizational, clinical and impact parameters on staff were evaluated. RESULTS Of the 833 consecutive admitted patients, 742 were operated on ,705 of whom were recruited for the study. Compared to the same period in 2019 there was a decrease in the number of operations (742 compared to 1187), similar use of intensive care unit (ICU), a diagnostic activity only for symptomatic patients, heterogeneity in organizational behaviors, an impact on staff who highlighted concerns about getting sick or passing the infection on to others (87.64%) or their family members (75.14%). CONCLUSIONS The study made it possible to detect the need to make significant changes in the clinical, organizational and teaching fields, for which some operational proposals are suggested.
BACKGROUND Role of lymphadenectomy in endometrial cancer is unclear. Our objective is to assess t... more BACKGROUND Role of lymphadenectomy in endometrial cancer is unclear. Our objective is to assess the role of lymphadenectomy in endometrial cancer. METHODS The study reviewed retrospectively 829 cases of endometrial cancer from a single non-oncological center from 1981 to 2014. Multivariable Cox regression analyses were performed. Independent variables were: 2009 FIGO stage, histological type of endometrial cancer (non-endometrioid, endometrioid, grading 1, 2 and 3), radicality on parametria, lymphatic dissection (any kind) (yes/no), any kind of chemotherapy, any kind of radiotherapy, brachytherapy, patients' age. Dependent variable was death for endometrial cancer and first relapse. Time variable was the semester of follow-up. P value for significance was set <0.05. RESULTS Many data about the extension of node dissection were missing. Pelvic node dissection or sampling seem the more common procedure performed. At the 10-semester of follow-up, at the 20-semester of follow-up ...
Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 2019
Objective The aim of the present study was to perform a comprehensive review of the literature to... more Objective The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele—a hypoechoic area within the myometrium at the site of the uterine scar of a previous cesarean section—by exploring in depth every aspect of this condition. Methods A comprehensive review of the literature was performed to identify the most relevant studies about this topic. Results Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data. Conclusion Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.
Benign multicystic peritoneal mesothelioma is a very rare benign cystic tumor; at present approxi... more Benign multicystic peritoneal mesothelioma is a very rare benign cystic tumor; at present approximately 130 cases have been reported. It more frequently occurs in females (87%), expecially in the pelvic area of the cul-de-sac, uterus and rectum; the pathogenesis has remained controversial. Abdominal pain is the most common symptom (75%). Ultrasound, Computerized Tomography (CT) and magnetic resonance imaging are helpful, but the diagnosis is confirmed by histopathological and immunohistochemical examination. Benign multicystic peritoneal mesothelioma shows high recurrence after surgical resection, but it does not present a tendency to transform into malignancy. Surgery is the only effective treatment, and peritonectomy is recommended. A prolonged systematic followup of these patients, perhaps for all life, is required. Here we report two cases that underwent surgery for benign multicystic peritoneal mesothelioma. In the first case the lesion was a multicystic fluid mass of the large...
1Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicin... more 1Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, Azienda OspedalieroUniversitaria S. Anna, Università di Ferrara, Cona, Ferrara, Italy 2Section of Obstetrics and Gynaecology, Policlinico di Abano Terme, Abano Terme, Padova, Italy 3Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
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Papers by Ruby Martinello