{"paper_id":"ded53a3d-13d8-44e9-a815-37df66f30a06","body_text":"Abstract\nThe research activity of the Obstetrics and Gynecology Section of our Department (Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche—Università Politecnica delle Marche) was characterized from strong interest to clinical application of our findings, with the aim of improving prevention, diagnosis and therapy both in Obstetrics and in Gynecology. Here we present the history and the current developments of our main research areas: benign and preneoplastic diseases of the female reproductive system (uterine fibroids, cervical intraepithelial neoplasia, endometriosis), gynecological oncology, pre-eclampsia, and obstetric complications.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nCiavattini A, Tsiroglou D, Litta P, Frizzo H, Tranquilli AL (2009) Ultra-minilaparotomy myomectomy: a minimally invasive surgical approach for the treatment of large uterine myomas. Gynecol Obstet Invest 68(2):127–133\nCiavattini A, Tsiroglou D, Tranquilli AL, Litta P (2010) Laparoscopic versus ultraminilaparotomic myomectomy for the treatment of large uterine myomas. Acta Obstet Gynecol Scand 89(1):151–155\nCiavattini A, Tsiroglou D, Piccioni M, Lugnani F, Litta P, Feliciotti F, Tranquilli AL (2004) Laparoscopic cryomyolysis: an alternative to myomectomy in women with symptomatic fibroids. Surg Endosc 18(12):1785–1788 Epub 2004 Oct 26\nCiavattini A, Tsiroglou D, Litta P, Vichi M, Tranquilli AL (2006) Pregnancy outcome after laparoscopic cryomyolysis of uterine myomas: report of nine cases. J Minim Invasive Gynecol 13(2):141–144\nCiavattini A, Clemente N, Delli Carpini G, Saccardi C, Borgato S, Litta P (2017) Laparoscopic uterine artery bipolar coagulation plus myomectomy vs traditional laparoscopic myomectomy for “large” uterine fibroids: comparison of clinical efficacy. Arch Gynecol Obstet 296(6):1167–1173\nCiavattini A, Delli Carpini G, Serri M, Vignini A, Sabbatinelli J, Tozzi A, Aggiusti A, Clemente N (2016) Hypovitaminosis D and “small burden” uterine fibroids: Opportunity for a vitamin D supplementation. Medicine (Baltimore) 95(52):e5698\nCiavattini A, Clemente N, Delli Carpini G, Di Giuseppe J, Giannubilo SR, Tranquilli AL (2015) Number and size of uterine fibroids and obstetric outcomes. J Matern Fetal Neonatal Med 28(4):484–488\nCiavattini A, Delli Carpini G, Clemente N, Moriconi L, Gentili C, Di Giuseppe J (2016) Growth trend of small uterine fibroids and human chorionic gonadotropin serum levels in early pregnancy: an observational study. Fertil Steril 105(5):1255–1260\nMenzo S, Ciavattini A, Bagnarelli P, Marinelli K, Sisti S, Clementi M (2008) Molecular epidemiology and pathogenic potential of underdiagnosed human papillomavirus types. BMC Microbiol 4(8):112\nMenzo S, Monachetti A, Trozzi C, Ciavattini A, Carloni G, Varaldo PE, Clementi M (2001) Identification of six putative novel human papillomaviruses (HPV) and characterization of candidate HPV type 87. J Virol 75(23):11913–11919\nCiavattini A, Clemente N, Tsiroglou D, Sopracordevole F, Serri M, Delli Carpini G, Papiccio M, Cattani P (2017) Follow up in women with biopsy diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL): how long should it be? Arch Gynecol Obstet 295(4):997–1003\nCiavattini A, Clemente N, Delli Carpini G, Gentili C, Di Giuseppe J, Barbadoro P, Prospero E, Liverani CA (2015) Loop electrosurgical excision procedure and risk of miscarriage. Fertil Steril 103(4):1043–1048\nLiverani CA, Di Giuseppe J, Clemente N, Delli Carpini G, Monti E, Fanetti F, Bolis G, Ciavattini A (2016) Length but not transverse diameter of the excision specimen for high-grade cervical intraepithelial neoplasia (CIN 2-3) is a predictor of pregnancy outcome. Eur J Cancer Prev 25(5):416–422\nCiavattini A, Delli Carpini G, Moriconi L, Clemente N, Montik N, De Vincenzo R, Del Fabro A, Buttignol M, Ricci C, Moro F, Sopracordevole F (2018) Effect of age and cone dimensions on cervical regeneration: an Italian multicentric prospective observational study. BMJ Open 8(3):e020675\nCiavattini A, Clemente N, Liverani CA, Cattani P, Giannella L, Delli Carpini G, Morini S, Buttignol M, Sopracordevole F (2017) Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV). Cervical excision procedure: a trend of decreasing length of excision observed in a multicenter survey. J Low Genit Tract Dis 21(4):279–283\nCiavattini A, Sopracordevole F, Di Giuseppe J, Moriconi L, Lucarini G, Mancioli F, Zizzi A, Goteri G (2017) Cervical intraepithelial neoplasia in pregnancy: interference of pregnancy status with p16 and Ki-67 protein expression. 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J Endocrinol Invest 18(8):645–652\nGarzetti GG, Ciavattini A, Provinciali M, Amati M, Muzzioli M, Governa M (1998) Decrease in peripheral blood polymorphonuclear leukocyte chemotactic index in endometriosis: role of prostaglandin E2 release. Obstet Gynecol 91(1):25–29\nGarzetti GG, Ciavattini A, Provinciali M, Muzzioli M, Di Stefano G, Fabris N (1996) Natural cytotoxicity and GnRH agonist administration in advanced endometriosis: positive modulation on natural killer activity. Obstet Gynecol 88(2):234–240\nGoteri G, Lucarini G, Filosa A, Pierantoni A, Montik N, Biagini G, Fabris G, Ciavattini A (2004) Immunohistochemical analysis of vascular endothelial growth factor cellular expression in ovarian endometriomata. Fertil Steril 81(6):1528–1533\nGoteri G, Lucarini G, Pieramici T, Filosa A, Pugnaloni A, Montik N, Biagini G, Tranquilli AL, Fabris G, Ciavattini A, Lo Muzio L (2005) Endothelial cell survivin is involved in the growth of ovarian endometriotic cysts. Anticancer Res 25(6B):4313–4318\nCiavattini A, Serri M, Delli Carpini G, Morini S, Clemente N (2017) Ovarian endometriosis and vitamin D serum levels. Gynecol Endocrinol 33(2):164–167\nCiavattini A, Delli Carpini G, Serri M, Tozzi A, Leoni F, Di Loreto E, Saccucci F (2018) Unfolded protein response, a link between endometrioid ovarian carcinoma and endometriosis: a pilot study. Oncol Lett 16(4):5449–5454\nGarzetti GG, Ciavattini A, Goteri G, De Nictolis M, Stramazzotti D, Lucarini G, Biagini G (1995) Ki67 antigen immunostaining (MIB 1 monoclonal antibody) in serous ovarian tumors: index of proliferative activity with prognostic significance. Gynecol Oncol 56(2):169–174\nGarzetti GG, Ciavattini A, Lucarini G, Goteri G, De Nictolis M, Biagini G (1997) MIB 1 immunostaining in cervical carcinoma of young patients. Gynecol Oncol 67(2):184–187\nGarzetti GG, Ciavattini A, Lucarini G, Goteri G, de Nictolis M, Muzzioli M, Fabris N, Romanini C, Biagini G (1995) MIB 1 immunostaining in stage I squamous cervical carcinoma: relationship with natural killer cell activity. Gynecol Oncol 58(1):28–33\nGarzetti GG, Cignitti M, Ciavattini A, Fabris N, Romanini C (1993) Natural killer cell activity and progression-free survival in ovarian cancer. Gynecol Obstet Invest 35(2):118–120\nGarzetti GG, Ciavattini A, Muzzioli M, Goteri G, Mannello B, Romanini C, Fabris N (1995) Natural killer cell activity in patients with invasive cervical carcinoma: importance of a longitudinal evaluation in follow-up. Gynecol Obstet Invest 40(2):133–138\nGarzetti GG, Ciavattini A, Provinciali M, Valensise H, Romanini C, Fabris N (1994) Influence of neoadjuvant polychemotherapy on natural killer cell activity in patients with locally advanced cervical squamous carcinoma. Gynecol Oncol 52(1):39–43\nGarzetti GG, Ciavattini A, Goteri G, Tranquilli AL, Muzzioli M, Fabris N, De Nictolis M, Romanini C (1994) Natural killer cell activity in stage I endometrial carcinoma: correlation with nuclear grading, myometrial invasion, and immunoreactivity of proliferating cell nuclear antigen. Gynecol Oncol 55(1):111–114\nGarzetti GG, Ciavattini A, Muzzioli M, Goteri G, Fabris N, Valensise H, Romanini C (1994) The relationship of clinical-pathologic status and adjuvant treatment with natural killer cell activity in stage I and II endometrial carcinoma. Acta Obstet Gynecol Scand 73(8):652–657\nGarzetti GG, Ciavattini A, Lucarini G, Goteri G, de e Nictolis M, Garbisa S, Masiero L, Romanini C, Graziella B (1995) Tissue and serum metalloproteinase (MMP-2) expression in advanced ovarian serous cystoadenocarcinomas: clinical and prognostic implications. Anticancer Res 15(6B):2799–2804\nDe Nictolis M, Garbisa S, Lucarini G, Goteri G, Masiero L, Ciavattini A, Garzetti GG, Stetler-Stevenson WG, Fabris G, Biagini G, Prat J (1996) 72-kilodalton type IV collagenase, type IV collagen, and Ki 67 antigen in serous tumors or the ovary: a clinicopathologic, immunohistochemical, and Serological study. Int J Gynecol Pathol 15(2):102–109\nGarzetti GG, Ciavattini A, Lucarini G, Pugnaloni A, De Nictolis M, Amati S, Romanini C, Biagini G (1999) Expression of vascular endothelial growth factor related to 72-kilodalton metalloproteinase immunostaining in patients with serous ovarian tumors. Cancer 85(10):2219–2225\nGarzetti GG, Ciavattini A, Lucarini G, Goteri G, Romanini C, Biagini G (1996) The 72-kDa metalloproteinase immunostaining in cervical carcinoma: relationship with lymph nodal involvement. Gynecol Oncol 60(2):271–276\nGarzetti GG, Ciavattini A, Lucarini G, Goteri G, De Nictolis M, Romanini C, Biagini G (1996) Recurrence patterns in locally advanced cervical carcinoma: role of nodal status and 72-kDa metalloproteinase index. Gynecol Oncol 61(1):83–89\nGarzetti GG, Ciavattini A, Lucarini G, Goteri G, Menso S, De Nictolis M, Romanini C, Biagini G (1998) The role of human papillomavirus DNAs in cervical carcinoma and risk of lymph node metastasis: association with 72-kilodalton metalloproteinase immunostaining. Cancer 82(5):886–892\nGarzetti GG, Ciavattini A, Lucarini G, Goteri G, Nictolis MD, Romanini C, Biagini G (1998) Ras p 21 immunostaining in early stage squamous cervical carcinoma: relationship with lymph nodal involvement and 72 kDa-metalloproteinase index. Anticancer Res 18(1B):609–613\nCiavattini A, DI Giuseppe J, Clemente N, Moriconi L, Carpini GD, Montik N, Mazzanti L (2016) Thickness of preperitoneal fat as a predictor of malignancy in overweight and obese women with endometrial polyps. Oncol Lett 11(3):2278–2282\nLitta P, Di Giuseppe J, Moriconi L, Delli Carpini G, Piermartiri MG, Ciavattini A (2014) Predictors of malignancy in endometrial polyps: a multi-institutional cohort study. Eur J Gynaecol Oncol 35(4):382–386\nAmerican College of Obstetricians and Gynecologists [ACOG] (2002) National Heart, Lung, and Blood Institute [NHLBI] National High Blood Pressure Education Program\nACOG; NHLBI National High Blood Pressure Education Program; Norwitz and Repke, 2009\nTranquilli AL, Mazzanti L, Bertoli E, Romanini C (1988) Sodium/potassium-adenosine triphosphatase on erythrocyte ghosts from pregnant women and its relationship to pregnancy-induced hypertension. Obstet Gynecol 71(4):627–630\nTranquilli AL, Rabini RA, Cugini AM, Cester N, Valensise H, Romanini C, Bertoli E, Mazzanti L (1989) Calcium and sodium transport in gestational hypertension. Int J Cardiol 25 Suppl 1:S53–55\nTranquilli AL, Garzetti GG, De Tommaso G, Boemi M, Lucino E, Fumelli P, Romanini C (1992) Nifedipine treatment in preeclampsia reverts the increased erythrocyte aggregation to normal. Am J Obstet Gynecol 167(4 Pt 1):942–945\nGiannubilo SR, Bezzeccheri V, Cecchi S, Landi B, Battistoni GI, Vitali P, Cecchi L, Tranquilli AL (2012) Nifedipine versus labetalol in the treatment of hypertensive disorders of pregnancy. Arch Gynecol Obstet 286(3):637–642\nGarzetti GG, Tranquilli AL, Cugini AM, Mazzanti L, Cester N, Romanini C (1993) Altered lipid composition, increased lipid peroxidation, and altered fluidity of the membrane as evidence of platelet damage in preeclampsia. Obstet Gynecol 81(3):337–340\nMazzanti L, Nanetti L, Vignini A, Rabini RA, Grechi G, Cester N, Curzi CM, Tranquilli AL (2004) Gestational diabetes affects platelet behaviour through modified oxidative radical metabolism. Diabet Med 21(1):68–72\nKoshland DE Jr (1992) The molecule of the year. Science 258(5090):1861\nTranquilli AL, Bezzeccheri V, Giannubilo SR, Scagnoli C, Mazzanti L, Garzetti GG (2004) Amniotic vascular endothelial growth factor (VEGF) and nitric oxide (NO) in women with subsequent preeclampsia. Eur J Obstet Gynecol Reprod Biol 113(1):17–20\nNanetti L, Giannubilo SR, Raffaelli F, Curzi CM, Vignini A, Moroni C, Tanase L, Carboni E, Turi A, Mazzanti L, Tranquilli AL (2008) Nitric oxide and peroxynitrite platelet levels in women with small-for-gestational-age fetuses. BJOG 115(1):14–21\nGiannubilo SR, Tranquilli AL, Santolini C, Prinicipi F, Mancinelli R, Littarru GP (2005) Placental CoQ10 levels in HELLP syndrome. BioFactors 25(1–4):159–163\nGiannubilo SR, Tiano L, Cecchi S, Principi F, Tranquilli AL, Littarru GP (2011) Plasma coenzyme Q10 is increased during gestational diabetes. Diabetes Res Clin Pract 94(2):230–235\nGiannubilo SR, Tiano L, Ciavattini A, Landi B, Carnevali P, Principi F, Littarru GP, Mazzanti L (2014) Amniotic coenzyme Q10: is it related to pregnancy outcomes? Antioxid Redox Signal 21(11):1582–1586\nTuri A, Giannubilo SR, Brugè F, Principi F, Battistoni S, Santoni F, Tranquilli AL, Littarru G, Tiano L (2012) Coenzyme Q10 content in follicular fluid and its relationship with oocyte fertilization and embryo grading. Arch Gynecol Obstet 285(4):1173–1176\nGiannubilo SR, Orlando P, Silvestri S, Cirilli I, Marcheggiani F, Ciavattini A, Tiano L (2018) CoQ10 Supplementation in patients undergoing IVF-ET: the relationship with follicular fluid content and oocyte maturity. Antioxidants (Basel) 7(10)\nGiannubilo SR, Landi B, Pozzi V, Sartini D, Cecati M, Stortoni P, Corradetti A, Saccucci F, Tranquilli AL, Emanuelli M (2012) The involvement of inflammatory cytokines in the pathogenesis of recurrent miscarriage. Cytokine 58(1):50–56\nMonari F, Alberico S, Avagliano L, Cetin I, Cozzolino S, Gargano G, Marozio L, Mecacci F, Neri I, Tranquilli AL, Venturini P, Facchinetti F (2012) Relation between maternal thrombophilia and stillbirth according to causes/associated conditions of death. Early Hum Dev 88(4):251–254\nGiannubilo SR, Tranquilli AL (2012) Anticoagulant therapy during pregnancy for maternal and fetal acquired and inherited thrombophilia. Curr Med Chem 19(27):4562–4571\nTranquilli AL, Saccucci F, Giannubilo SR, Cecati M, Nocchi L, Lorenzi S, Emanuelli M (2010) Unexplained fetal loss: the fetal side of thrombophilia. Fertil Steril 94(1):378–380\nCecati M, Giannubilo SR, Saccucci F, Sartini D, Ciavattini A, Emanuelli M, Tranquilli AL (2016) Potential role of placental klotho in the pathogenesis of preeclampsia. Cell Biochem Biophys 74(1):49–57\nGiannubilo SR, Cecchi S, Tidu E, Ciavattini A (2014) Maternal NT-proBNP in chronic hypertensive pregnancies and superimposed preeclampsia. Int J Cardiol 176(3):1227–1229\nGiannubilo SR, Pasculli A, Tidu E, Biagini A, Boscarato V, Ciavattini A (2017) Relationship between maternal hemodynamics and plasma natriuretic peptide concentrations during pregnancy complicated by preeclampsia and fetal growth restriction. Perinatol 37(5):484–487\nValensise H, Bezzeccheri V, Rizzo G, Tranquilli AL, Garzetti GG, Romanini C (1993) Doppler velocimetry of the uterine artery as a screening test for gestational hypertension. Ultrasound Obstet Gynecol 3(1):18–22\nValensise H1, Bezzeccheri V, Tranquilli AL, Garzetti GG, Romanini C (1991) Computerized cardiotocographic assessment with the “8000 System”. I. Construction of normal curves. Ann Ostet Ginecol Med Perinat 112(5):281–285\nValensise H, Pizzichini L, Cingolani F, Bezzeccheri V, De Santis C, Tranquilli AL, Garzetti GG, Romanini C (1991) Telephone transmission of the cardiotocographic recording from the office to the obstetrical clinic. Ann Ostet Ginecol Med Perinat 112(5):275–280\nTranquilli AL, Giannubilo SR, Dell’Uomo B, Corradetti A (2004) Prediction of gestational hypertension or intrauterine fetal growth restriction by mid-trimester 24-h ambulatory blood pressure monitoring. Int J Gynaecol Obstet 85(2):126–131\nTranquilli AL, Turi A, Giannubilo SR, Garbati E (2004) Circadian melatonin concentration rhythm is lost in pregnant women with altered blood pressure rhythm. Gynecol Endocrinol 18(3):124–129\nTranquilli AL, Garzetti GG (1997) A new ethical and clinical dilemma in obstetric practice: cesarean section “on maternal request”. Am J Obstet Gynecol 177(1):245–246\nTranquilli AL, Giannubilo SR (2004) Cesarean delivery on maternal request in Italy. Int J Gynaecol Obstet 84(2):169–170\nTranquilli AL, Giannubilo SR, Bezzeccheri V, Scagnoli C (2005) Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial. BJOG 112(6):759–763\nBuscicchio G, Giannubilo SR, Bezzeccheri V, Scagnoli C, Rinci A, Tranquilli AL (2006) Computerized analysis of the fetal heart rate in pregnancies complicated by preterm premature rupture of membranes (pPROM). J Matern Fetal Neonatal Med 19(1):39–42\nCecati M, Sartini D, Campagna R, Biagini A, Ciavattini A, Emanuelli M, Giannubilo SR (2017) Molecular analysis of endometrial inflammation in preterm birth. Cell Mol Biol (Noisy-le-grand) 63(3):51–57\nAgostinelli A, Grillo M, Biagini A, Giuliani C, Burattini L, Fioretti S, Di Nardo F, Giannubilo SR, Ciavattini A, Burattini L (2015) Noninvasive fetal electrocardiography: an overview of the signal electrophysiological meaning, recording procedures, and processing techniques. Ann Noninvasive Electrocardiol 20(4):303–313\nCecati M, Emanuelli M, Giannubilo SR, Quarona V, Senetta R, Malavasi F, Tranquilli AL, Saccucci F (2013) Contribution of adenosine-producing ectoenzymes to the mechanisms underlying the mitigation of maternal-fetal conflicts. J Biol Regul Homeost Agents 27(2):519–529\nRaffaelli F, Nanetti L, Vignini A, Mazzanti L, Giannubilo SR, Curzi CM, Turi A, Vitali P, Tranquilli AL (2010) Nitric oxide platelet production in spontaneous miscarriage in the first trimester. Fertil Steril 93(6):1976–1982\nTranquilli AL, Lorenzi S, Buscicchio G, Di Tommaso M, Mazzanti L, Emanuelli M (2014) Female fetuses are more reactive when mother eats chocolate. J Matern Fetal Neonatal Med 27(1):72–74\nGiannubilo SR, Pasculli A, Ballatori C, Biagini A, Ciavattini A (2018) Fetal sex, need for insulin, and perinatal outcomes in gestational diabetes mellitus: an observational cohort study. Clin Ther 40(4):587–592\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2020 Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nGiannubilo, S.R., Delli Carpini, G., Ciavattini, A. (2020). From Clinical Research to Clinical Practice in Obstetrics and Gynecology. In: Longhi, S., et al. The First Outstanding 50 Years of “Università Politecnica delle Marche”. Springer, Cham. https://doi.org/10.1007/978-3-030-33832-9_8\nDownload citation\nDOI: https://doi.org/10.1007/978-3-030-33832-9_8\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-030-33831-2\nOnline ISBN: 978-3-030-33832-9\neBook Packages: EducationEducation (R0)","source_license":"CC0","license_restricted":false}