Roberta Santorsola

Bio: Roberta Santorsola is an academic researcher from University of Milan. The author has contributed to research in topics: Levobupivacaine & Nerve block. The author has an hindex of 7, co-authored 7 publications receiving 267 citations. Previous affiliations of Roberta Santorsola include University of Parma.

Sciatic nerve block with 0.5% levobupivacaine, 0.75% levobupivacaine or 0.75% ropivacaine: a double-blind, randomized comparison

Abstract: Background and objective: This prospective, randomized, double-blind study was conducted to evaluate the onset time and duration of sciatic nerve block produced with 0.5% levobupivacaine, 0.75% levobupivacaine and 0.75% ropivacaine. Methods: Forty-five healthy patients undergoing hallux valgus repair were randomly allocated to receive sciatic nerve block with levobupivacaine 0.5% (n = 15), levobupivacaine 0.75% (n = 15) or ropivacaine 0.75% 20 mL (n = 15). A femoral nerve block was also performed with mepivacaine 2% 15 mL to cover pain related to the thigh tourniquet. A blinded observer recorded the onset time and duration of sciatic nerve block. Results: The median (range) onset time was 5 (5-40) min with 0.75% levobupivacaine, 30 (5-60) min with 0.5% levobupivacaine and 20 (5-50) min with 0.75% ropivacaine (P = 0.02 and P = 0.12, respectively). Mean (25-75 percentiles) first request for pain medication occurred after 13 (11-14) h with 0.75% ropivacaine, 18 (15-19) h with 0.75% levobupivacaine and 16 (13-20) h with 0.5% levobupivacaine (P = 0.002 and P = 0.002, respectively). Rescue tramadol after surgery was required by three patients in the 0.75% levobupivacaine group, eight patients in the 0.5% levobupivacaine group and nine patients in the 0.75% ropivacaine group (P = 0.05). Conclusions: We conclude that 0.75% levobupivacaine provides a shorter onset time than 0.5% levobupivacaine and a longer duration of postoperative analgesia than both 0.5% levobupivacaine and 0.75% ropivacaine with reduced need for rescue analgesia after surgery.

Endometrial receptivity markers, the journey to successful embryo implantation.

Abstract: Human embryo implantation is a three-stage process (apposition, adhesion and invasion) involving synchronized crosstalk between a receptive endometrium and a functional blastocyst. This ovarian steroid-dependent phenomenon can only take place during the window of implantation, a self-limited period of endometrial receptivity spanning between days 20 and 24 of the menstrual cycle. Implantation involves a complex sequence of signalling events, consisting in the acquisition of adhesion ligands together with the loss of inhibitory components, which are crucial to the establishment of pregnancy. Histological evaluation, now considered to add little clinically significant information, should be replaced by functional assessment of endometrial receptivity. A large number of molecular mediators have been identified to date, including adhesion molecules, cytokines, growth factors, lipids and others. Thus, endometrial biopsy samples can be used to identify molecules associated with uterine receptivity to obtain a better insight into human implantation. In addition, development of functional in vitro systems to study embryo-uterine interactions will lead to better definition of the interactions existing between the molecules involved in this process. The purpose of this review was not only to describe the different players of the implantation process but also to try to portray the relationship between these factors and their timing in the process of uterine receptivity.

The Role of Cytokines in Endometriosis

Abstract: PROBLEM: To review the literature on the role of peritoneal cytokines in the pathogenesis and endometriosis-related infertility. METHODS OF STUDY: A MEDLINE search was conducted by the key words of cytokine and endometriosis in the English publications, and references identified within the identified papers were also reviewed. RESULTS: Several cytokines including interleukin (IL)-1, 6, 8, 10, tumor necrosis factor (TNF)-α, and vascular endothelial growth factor (VEGF) were reported to be increased in the peritoneal fluid (PF) of women with endometriosis. Those cytokines may be involved in macrophage activation, inflammatory change and enhanced angiogenesis. However, some cytokines were less expressed such as IL-2, and interferon (IFN)-γ. They reflect the impaired T- and natural killer (NK)-cell function. Endometriotic implants produce some factors, e.g. matrix metalloproteinases (MMPs), Bcl-2, and affect their capacity to implant into the peritoneum. CONCLUSION: Peritoneal cytokines, which are produced by mesothelial cells, leukocytes and ectopic endometrial cells, interwork locally and systemically in women with endometriosis. More studies about the specific role and interactions of these cytokines are needed to improve the understanding of endometriosis and to develop novel therapies.

Priorities for Endometriosis Research: Recommendations From an International Consensus Workshop

Abstract: Endometriosis is an estrogen-dependent disorder where endometrial tissue forms lesions outside the uterus. Endometriosis affects an estimated 10% of women in the reproductive-age group, rising to 30% to 50% in patients with infertility and/or pain, with significant impact on their physical, mental, and social well-being. There is no known cure, and most current medical treatments are not suitable long term due to their side-effect profiles. Endometriosis has an estimated annual cost in the United States of $18.8 to $22 billion (2002 figures). Although endometriosis was first described more than 100 years ago, current knowledge of its pathogenesis, spontaneous evolution, and the pathophysiology of the related infertility and pelvic pain, remain unclear. A consensus workshop was convened following the 10th World Congress on Endometriosis to establish recommendations for priorities in endometriosis research. One major issue identified as impacting on the capacity to undertake endometriosis research is the need for multidisciplinary expertise. A total of 25 recommendations for research have been developed, grouped under 5 subheadings: (1) diagnosis, (2) classification and prognosis, (3) treatment and outcome, (4) epidemiology, and (5) pathophysiology. Endometriosis research is underfunded relative to other diseases with high health care burdens. This may be due to the practical difficulties of developing competitive research proposals on a complex and poorly understood disease, which affects only women. By producing this consensus international research priorities statement it is the hope of the workshop participants that researchers will be encouraged to develop new interdisciplinary research proposals that will attract increased funding support for work on endometriosis.

Molecular Biology of Gonadotropin-Releasing Hormone (GnRH)-I, GnRH-II, and Their Receptors in Humans

Abstract: In human beings, two forms of GnRH, termed GnRH-I and GnRH-II, encoded by separate genes have been identified. Although these hormones share comparable cDNA and genomic structures, their tissue distribution and regulation of gene expression are significantly dissimilar. The actions of GnRH are mediated by the GnRH receptor, which belongs to a member of the rhodopsin-like G protein-coupled receptor superfamily. However, to date, only one conventional GnRH receptor subtype (type I GnRH receptor) uniquely lacking a carboxyl-terminal tail has been found in the human body. Studies on the transcriptional regulation of the human GnRH receptor gene have indicated that tissue-specific gene expression is mediated by differential promoter usage in various cell types. Functionally, there is growing evidence showing that both GnRH-I and GnRH-II are potentially important autocrine and/or paracrine regulators in some extrapituitary compartments. Recent cloning of a second GnRH receptor subtype (type II GnRH receptor) in...