26
|
Casadei R, De Paolis M, Drago G, Romagnoli C, Donati D. Total elbow arthroplasty for primary and metastatic tumor. Orthop Traumatol Surg Res 2016; 102:459-65. [PMID: 27084091 DOI: 10.1016/j.otsr.2015.12.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/05/2015] [Accepted: 12/23/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Prostheses can be used in elbow reconstruction in both primary and metastatic lesions. Several authors have reported their experience with different types of implant, but not with modular prostheses. HYPOTHESIS Limb salvage using an elbow prosthesis is effective in obtaining good functional results and reliable local tumor control. MATERIAL AND METHODS Forty-seven patients treated at the Rizzoli Institute for elbow neoplasm from 1990 to 2012 were evaluated. There were 30 primary tumors (64%), 24 bone tumors and 6 soft tissue sarcomas, and 17 bone metastases. Elbow reconstruction used a modular prosthesis in 25 patients and a standard prosthesis in 22. Reconstruction was primary in 30 patients and secondary in 17. RESULTS At last control, 15 (32%) were dead of disease (DOD) at a mean follow-up of 35 months, 12 (25%) were alive with disease (AWD) at a mean follow-up of 29 months, 19 (40%) showed no evidence of disease (NED) at a mean follow-up of 80 months. Early complications were related to unexpected neurological damage, observed in 12 patients (25%): in 5 cases the deficit resolved in a mean 6 months; in the others, no or only partial recovery was observed. Two implants (4%) developed infection: 1 was treated with antibiotic therapy, and the other required implant revision. One implant showing cement extrusion was revised. In 3 patients (6%) radiography showed a radiolucent halo around the stem (2 humeral, 1 ulnar); no measures were taken, as the patients were completely asymptomatic at every follow-up. In 3 patients (6%) partial resorption of the allograft was observed on X-ray, but remained unchanged at last follow-up, without pain or functional impairment. Seven local recurrences (15%) were observed, at a mean of 16 months after surgery; 5 were treated by resection and/or radiotherapy, and 2 by amputation. Mean functional scores on MEPS and MSTS were respectively 84% and 22/30 (73%). CONCLUSIONS Elbow prostheses provided better function in primary than in metastatic tumor. Elbow prosthesis reconstruction after tumor resection is a viable option both for primary and secondary bone neoplasms. TYPE OF STUDY Therapeutic. LEVEL OF EVIDENCE IV, retrospective study.
Collapse
|
27
|
Picciotti PM, Battista M, Pandolfini M, Paludetti G, Ausili E, Romagnoli C, Rendeli C. Audiological evaluation in children affected by myelomeningocele. Childs Nerv Syst 2015; 31:2321-4. [PMID: 26351072 DOI: 10.1007/s00381-015-2898-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 09/01/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of the present study is to evaluate the auditory system in children affected by myelomeningocele and comparing the results with clinical neurological conditions. MATERIALS AND METHODS Forty-three children, aged between 7 and 26 years, affected by myelomeningocele were investigated by means of subjective tonal audiometry and objective impedance audiometry (tympanometry and acoustic stapedial reflex). RESULTS Audiological evaluation showed an alteration in 32 patients (74%%). Nine patients presented a mild hearing loss: bilateral in six cases (three sensorineural, one mixed, and two conductive) and unilateral in three cases (two mixed and one conductive). One patient had moderate unilateral conductive deafness and, finally another one severe unilateral sensorineural. Almost all patients with deafness were affected by myelomeningocele and Chiari II. Stapedial-cochlear reflex investigation showed an alteration in 30 patients (70%): 9 of these also showed deafness while the remaining 21 was normal hearing. In these 30 patients, we demonstrated the presence of myelomeningocele, hydrocephalus, and Chiari II malformation in 21 subjects (70%). CONCLUSION Otoneurological evaluation is important in myelomeningocele not only at the birth but also in the follow-up. It could have an important prognostic role for neurological impairment.
Collapse
|
28
|
Luciano R, Fracchiolla A, Ricci D, Cota F, D'Andrea V, Gallini F, Papacci P, Mercuri E, Romagnoli C. Are high cumulative doses of erythropoietin neuroprotective in preterm infants? A two year follow-up report. Ital J Pediatr 2015; 41:64. [PMID: 26376632 PMCID: PMC4574078 DOI: 10.1186/s13052-015-0171-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/01/2015] [Indexed: 01/24/2023] Open
Abstract
Background Preterm infants are at risk for neurodevelopmental sequelae even in absence of major cerebral lesions. The hypothesis that Human Recombinant Erythropoietin (rEpo) could improve the neurodevelopmental outcome in risk neonates has raised the highest interest in recent years. Methods A group of preterm neonates born at a gestational age ≤ 30 weeks and free from major cerebral lesions or major visual impairment, were included in the study if they had a complete neurologic evaluation for at least 24 months of postmenstrual age. They were assigned to group I in the case they had been treated with rEpo or group II if untreated. The aim was to evaluate whether rEpo, given at the high cumulative doses utilized for hematologic purposes, is able to improve the neurodevelopmental outcome in preterm infants born at a gestational age ≤ 30 weeks. A group of 104 preterm neonates were studied: 59 neonates who received rEpo for 6.9 ± 2.4 weeks at a median cumulative dose of 6300 UI/Kg (6337 ± 2434 UI/Kg), starting at a median age of 4 days and 45 neonates who were born in the period preceding the routine use of rEpo. The neurodevelopmental quotient at 24 month postmenstrual age was assessed utilizing the Griffiths’ Mental Developmental Scales. Results Our results failed to show any difference in the Developmental Quotient at 24 month. Bronchopulmonary dysplasia, minor intraventricular hemorrhages and blood transfusions were the clinical features significantly related to the Developmental Quotient. Conclusions Our results do not support the hypothesis that rEpo, administered with the schedule utilized for hematologic purposes, improve the neurodevelopmental outcome of preterm neonates, at least those preterm infants free from major impairments.
Collapse
|
29
|
Costa S, Giannantonio C, Romagnoli C, Barone G, Gervasoni J, Perri A, Zecca E. Lutein and zeaxanthin concentrations in formula and human milk samples from Italian mothers. Eur J Clin Nutr 2015; 69:531-2. [PMID: 25626411 DOI: 10.1038/ejcn.2014.282] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
30
|
Gibson E, Gaed M, Gómez J, Moussa M, Romagnoli C, Kassam Z, Bastian-Jordan M, Cool D, Pautler S, Chin J, Crukley C, Bauman G, Fenster A, Ward A. Toward Prostate Cancer Contouring Guidelines on MRI: Dominant Lesion Gross and Clinical Target Volume Coverage via Accurate Histology Fusion. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
31
|
Vento G, Tana M, Tirone C, Aurilia C, Lio A, Ricci C, Gambacorta A, Romagnoli C. Lung recruitment strategies and surfactant in neonatal intensive care unit. ACTA BIO-MEDICA : ATENEI PARMENSIS 2014; 85:11-14. [PMID: 24957340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 06/20/2014] [Indexed: 06/03/2023]
Abstract
Several studies in the lamb model have shown that hyperinflation of the lungs early in life may cause a blunted response to surfactant with signs of lung injury and any attempt to recruit lung volume in the surfactant deficient preterm infant by large lung inflations at birth should be potentially dangerous. As regards the situation when surfactant is given later, as rescue treatment for established RDS, the evidence for a clinically beneficial effect of a recruitment maneuver is yet insufficient and, hopefully, future studies will gather more data on this aspect.
Collapse
|
32
|
Zuppa AA, Alighieri G, Fracchiolla A, Galluccio C, Riccardi R, Cavani M, Romagnoli C. Effectiveness of a prematurity-based protocol for management of infants born to mothers with Group B Streptococcus colonisation. J OBSTET GYNAECOL 2014; 34:673-8. [PMID: 24921191 DOI: 10.3109/01443615.2014.920796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to validate the efficacy of a protocol for the management of infants born to colonised mothers with Group B Streptococcus (GBS). We studied a cohort of newborns admitted at the A. Gemelli University Hospital between May 2006 and December 2009. A total of 1,108 were newborns of mothers with GBS; 178 were children of mothers with unknown GBS status. Newborns were managed according to the care protocol in use at our division. Infected infants were born to mothers who underwent inadequate intrapartum antibiotic prophylaxis (IAP). No mother with complete IAP had an infected newborn. The incidence of invasive GBS infection in newborns of mothers with GBS was 0.4% and in newborns of mothers with unknown GBS status was 2.2%. Only 17.4% of newborns of mothers with GBS had risk factors. The complete IAP should always be performed regardless of the presence or the absence of risk factors. The care protocol applied offers successful management of the newborns of mothers with GBS, based on the correct execution of IAP, considering as a primary risk factor, the gestational age of < 35 weeks.
Collapse
|
33
|
Costa S, Barone G, Vento G, Tirone C, Perelli S, Romagnoli C. Adrenocortical insufficiency is not a problem in preterm infants treated with antifungal prophylaxis with fluconazole. Acta Paediatr 2014; 103:e234-7. [PMID: 24575768 DOI: 10.1111/apa.12613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 02/24/2014] [Indexed: 11/30/2022]
Abstract
AIM Fluconazole prophylaxis of invasive fungal infections is a cornerstone of neonatal care, but in vitro studies have shown that it inhibits corticosteroid production. This study assessed whether preterm infants demonstrated an association between fluconazole administration, and its duration, and symptoms of adrenocortical insufficiency. METHODS We compared two groups who were treated before and after we introduced the use of fluconazole to our neonatal intensive care unit. Infants with a gestational age of ≤27 weeks or with a birth weight of ≤750 g were considered for the retrospective analysis. In order to assess whether the duration of prophylaxis was related to adrenocortical insufficiency, regression models were performed in all preterm infants in the fluconazole group. RESULTS The fluconazole group (n = 37) and nonfluconazole group (n = 41) were compared. No differences were found in the percentage of infants with symptoms of adrenocortical insufficiency, such as hypotension or need of vasopressor therapy. The incidence of hypotension and the use of vasopressor therapy were not related to duration of fluconazole prophylaxis. CONCLUSION Fluconazole and it duration were not associated with the incidence of symptoms related to adrenocortical insufficiency. Further prospective trials are needed to better define the relationship between fluconazole and adrenocortical insufficiency.
Collapse
|
34
|
Billia M, Burtnyk M, Kuru T, Pahernik S, Roethke M, Schlemmer H, Romagnoli C, Chin J. 1133 MRI-guided transurethral ultrasound ablation of prostate cancer: Preliminary outcomes of a phase I clinical trial. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/s1569-9056(14)61113-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
35
|
Gibson E, Gaed M, Gómez JA, Moussa M, Romagnoli C, Pautler S, Chin JL, Crukley C, Bauman GS, Fenster A, Ward AD. 3D prostate histology reconstruction: an evaluation of image-based and fiducial-based algorithms. Med Phys 2014; 40:093501. [PMID: 24007184 DOI: 10.1118/1.4816946] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Evaluation of in vivo prostate imaging modalities for determining the spatial distribution and aggressiveness of prostate cancer ideally requires accurate registration of images to an accepted reference standard, such as histopathological examination of radical prostatectomy specimens. Three-dimensional (3D) reconstruction of prostate histology facilitates these registration-based evaluations by reintroducing 3D spatial information lost during histology processing. Because the reconstruction accuracy may constrain the clinical questions that can be answered with these data, it is important to assess the tradeoffs between minimally disruptive methods based on intrinsic image information and potentially more robust methods based on extrinsic fiducial markers. METHODS Ex vivo magnetic resonance (MR) images and digitized whole-mount histology images from 12 radical prostatectomy specimens were used to evaluate four 3D histology reconstruction algorithms. 3D reconstructions were computed by registering each histology image to the corresponding ex vivo MR image using one of two similarity metrics (mutual information or fiducial registration error) and one of two search domains (affine transformations or a constrained subset thereof). The algorithms were evaluated for accuracy using the mean target registration error (TRE) computed from homologous intrinsic point landmarks (3-16 per histology section; 232 total) identified on histology and MR images, and for the sensitivity of TRE to rotational, translational, and scaling initialization errors. RESULTS The algorithms using fiducial registration error and mutual information had mean ± standard deviation TREs of 0.7 ± 0.4 and 1.2 ± 0.7 mm, respectively, and one algorithm using fiducial registration error and affine transforms had negligible sensitivities to initialization errors. The postoptimization values of the mutual information-based metric showed evidence of errors due to both the optimizer and the similarity metric, and variation of parameters of the mutual information-based metric did not improve its performance. CONCLUSIONS The extrinsic fiducial-based algorithm had lower mean TRE and lower sensitivity to initialization than the intrinsic intensity-based algorithm using mutual information. A model relating statistical power to registration error for certain imaging validation study designs estimated that a reconstruction algorithm with a mean TRE of 0.7 mm would require 27% fewer subjects than the method used to initialize the algorithms (mean TRE 1.3 ± 0.7 mm), suggesting the choice of reconstruction technique can have a substantial impact on the design of imaging validation studies, and on their overall cost.
Collapse
|
36
|
Zuppa AA, D’Andrea V, Verrillo G, Riccardi R, Savarese I, Cavani M, Romagnoli C. Spontaneous neonatal pneumomediastinum: Radiological or clinical diagnosis? J OBSTET GYNAECOL 2014; 34:138-40. [DOI: 10.3109/01443615.2013.830597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
37
|
Girtler MT, Krasinski A, Dejaco C, Kitzler HH, Cui LG, Sherebrin S, Gardi L, Chhem RK, Fenster A, Romagnoli C, De Zordo T. Feasibility of 3D ultrasound to evaluate upper extremity nerves. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2013; 34:382-387. [PMID: 23023451 DOI: 10.1055/s-0032-1325397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE This study investigates the performance of a 3 D Ultrasound (US) system in imaging elbow and wrist nerves. MATERIALS AND METHODS Twenty healthy volunteers with asymptomatic median, ulnar and radial nerves were prospectively investigated. Bilateral 3DUS scans of the elbows and wrists were acquired by using a commercially available US scanner (18 MHz, AplioXG, Toshiba) and stored as a 3 D volume by a dedicated software (CURE, Robarts Research Institute). Retrospectively, qualitative (image quality, atypical nerve location, findings potentially associated with compression neuropathy) and quantitative (cross-sectional area measurements) evaluations were performed. RESULTS In all 200 nerves 3DUS was feasible (100%). Image quality was insufficient in 13.5% (25 ulnar nerve elbow, 2 radial nerve) and sonomorphology was not assessable in those nerves. Measurement of cross sectional areas was feasible in all nerves (100%). Median cross-sectional area (range) were: median nerve elbow 7 mm2 (6-9), radial nerve 3 mm2 (1-4), ulnar nerve elbow 8 mm2 (5-11), median nerve wrist 8 mm2 (5-10), and ulnar nerve wrist 4 mm2 (2-6). No significant changes in nerve cross-sectional area along each nerve was found. Ulnar nerve subluxation was found in 2 nerves (6.7%). No anconeus epitrochlearis muscle or osteophytes were found. CONCLUSION 3DUS is a feasible method for assessing nerves of the upper extremity and has been shown to provide a good overview of the median, ulnar and radial nerve at the elbow and wrist, but is limited for evaluation of the ulnar nerve in the cubital tunnel. This technique enables reliable measurements at different locations along the nerve.
Collapse
|
38
|
Inchingolo R, Maresca G, Cacaci S, Ausili E, Paolucci V, Bonomo L, Romagnoli C, Rendeli C. Post-natal ultrasound morpho-dynamic evaluation of mild fetal hydronephrosis: a new management. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2013; 17:2232-9. [PMID: 23893191 DOI: pmid/23893191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Fetal hydronephrosis is the most common anomaly detected on antenatal ultrasound examination, affecting 1-5% pregnancies. AIM A new management in mild antenatal renal pelvis dilatation (ARPD), using a technique based on both morphological and dynamical evaluation. MATERIALS AND METHODS Prospective study conducted during a 36-months period in 180 consecutive newborns referred as having mild ARPD. Examinations consisted in a morphological ultra-sound (US) scan evaluating antero-posterior diameter, renal parenchyma, ureteral evidence and pelvis morphology and, subsequently, a dynamic evaluation to analyze any change of the urinary tract during bladder voiding. All children were evaluated both at 3rd day and 1 month after birth. They were divided among those with negative examinations and those with at least one positive scan, trying to discriminate within the latter, children suspected for transient pyelectasis from those suspected for organic pathology. RESULTS 108 patients had normal US findings both at birth and at 1 month. The remaining 72 babies had at least one abnormal US examination: 54 were suspected for transient pyelectasis, while 18 suspected for organic pathology. At the end of the study, 61 babies (33.9%) had final diagnosis of transient pyelectasis and 11 cases (6.1%) of organic pathology. At one month the dynamic pattern of US findings had the highest negative predictive value, while renal parenchyma evaluation has the highest accuracy. CONCLUSIONS a dynamic US approach allowed to better select among infants suspected for transient pyelectasis from those suspected for organic pathology, avoiding unnecessary and invasive examinations in healthy babies.
Collapse
|
39
|
Zuppa AA, Alighieri G, Fracchiolla A, Catenazzi P, D'Antuono A, Riccardi R, Cavani M, Romagnoli C. Comparison between two treatment protocols with recombinant human erythropoietin (rHuEpo) in the treatment of late anemia in neonates with Rh-isoimmunization. LA PEDIATRIA MEDICA E CHIRURGICA 2012; 34:186-91. [PMID: 23173411 DOI: 10.4081/pmc.2012.72] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE [corrected] The Rh-hemolytic disease can lead to a late anemia by hemolytic and hyporigenerative mechanism. We compared the effectiveness of rHuEPO in two care protocols that differ for doses of rHuEPO administrated and for timing of administration. METHODS A cohort of 14 neonates was investigated. The neonates were treated with two different protocols. Protocol A: a dose of 200 U/kg/day of rHuEpo administered subcutaneously starting from the end of the second week of life; Protocol B: a dose of 400 U/kg/day of rHuEpo administered subcutaneously starting from the end of the first week of life. RESULTS The hematocrit values in the protocol A group decreased during treatment (32,5% vs 25,2%), whereas the hematocrit value in protocol B group remained almost stable (38,7% vs 42,8%). The mean numbers of platelets remained stable in both groups while neutrophils increased in protocol A group and decreased in protocol B (p<0,05). Reticulocyte count increased during treatment in both groups, although only in protocol B group it was statistically significative (p<0,05). CONCLUSIONS Our results suggest a similar efficacy between the two treatment protocols. Increasing doses of rHuEPO do not seem enhancing their effectiveness and the incidence of side effects.
Collapse
|
40
|
|
41
|
Shahedi M, Fenster A, Romagnoli C, Ward AD. MO-G-BRA-03: Semi-Automatic Segmentation of the Prostate Midgland in Magnetic Resonance Images Using Shape and Local Appearance Similarity Analysis. Med Phys 2012. [DOI: 10.1118/1.4735848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
42
|
Tana M, Zecca E, Tirone C, Aurilia C, Cota F, Lio A, Tesfagabir MG, Romagnoli C, Vento G. Target fraction of inspired oxygen during open lung strategy in neonatal high frequency oscillatory ventilation: a retrospective study. Minerva Anestesiol 2012; 78:151-159. [PMID: 21712769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is no agreement to define the target FiO2 to adopt in the lung recruitment phase during HFOV in preterm infants. We report our experience of an optimal lung volume strategy (OLVS), defined as FiO2≤0.25 during the recruitment phase, in a cohort of neonates with gestational age (GA) ≤27 weeks treated with elective HFOV for respiratory distress syndrome (RDS) between July 2006 and September 2008. METHODS FiO2 used during the recruitment phase was different according to physician' evaluation. 51 newborns were then divided into two groups: patients reaching FiO2≤0.25 (OLVS Group, N.=28), and patients reaching FiO2>0.25 (No-OLVS Group, N.=23). RESULTS Prior to surfactant administration OLVS Group, respect to No-OLVS Group, received a significantly higher continuous distending pressure (CDP): 12.8±1.1 cmH2O vs 11.2±1.3 cmH2O (P<0.0001) and a significantly lower FiO2: 0.25±0.01 vs 0.35±0.06 (P<0.0001). A multivariate modeling approach confirmed that OLVS was significantly associated to the need for less surfactant doses (OR 0.19[95% CI 0.05-0.84]), a decreased risk of ductus arteriosus surgically ligated (OR 0.13[95% CI 0.02-0.86]) and to a lower number of ventilation hours before extubation: -152 (95% CI -284- -20). CONCLUSION OLVS to fully recruit the lungs achieving FiO2≤0.25 during elective HFOV is associated with better short-term pulmonary outcomes respect to a strategy where the patients received a FiO2>0.25 during the recruitment phase. Utilizing HFOV in this way provides a more effective means to recruit and protect acutely injured lungs.
Collapse
|
43
|
Vento G, Tana M, Tirone C, Aurilia C, Lio A, Perelli S, Ricci C, Romagnoli C. Effectiveness of treatment with surfactant in premature infants with respiratory failure and pulmonary infection. ACTA BIO-MEDICA : ATENEI PARMENSIS 2012; 83 Suppl 1:33-36. [PMID: 23029875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Surfactant inactivation is present in neonatal pneumonia. MATERIALS AND METHODS One hundred thirty-nine preterm babies with Birth Weight (BW) < or = 1250 grams were studied and subdivided in two groups: RDS Group, with a diagnosis of "simple" RDS (N 80) and RDS with Pneumonia Group, consisting of babies with a diagnosis of RDS and a positive BALF culture in the first 24-48 h of life (N 59). OUTCOMES Surfactant administration seems less effective in the latter group, because a significantly higher number of infants needed a second dose of surfactant, compared to the patients suffering from RDS alone. (www.actabiomedica.it).
Collapse
|
44
|
Borgia P, Cambieri A, Chini F, Coltella L, Delogu G, Di Rosa E, Fadda G, Giorgi Rossi P, Girardi E, Goletti D, Guasticchi G, Morrone A, Pezzotti P, Romagnoli C, Sacerdote M, Russo C, Villani A, Zarelli L. Suspected transmission of tuberculosis in a maternity ward from a smear-positive nurse: preliminary results of clinical evaluations and testing of neonates potentially exposed, Rome, Italy, 1 January to 28 July 2011. ACTA ACUST UNITED AC 2011; 16. [PMID: 21996378 DOI: 10.2807/ese.16.40.19984-en] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report preventive measures adopted after tuberculosis(TB) transmission from a nurse to a newborn assessed in late July 2011. All exposed neonates born between January and July 2011 were clinically evaluated and tested by QuantiFERON TB gold in-tube; newborns testing positive were referred for prophylaxis.Of 1,340 newborns, 118 (9%) tested positive and no other active cases of TB were found. Active surveillance for TB will be continued over the next three years for all those exposed.
Collapse
|
45
|
Costa S, Cota F, Romagnoli C, Latella C, Maggio L, Gallini F. Urinary aldosterone excretion and electrolytic balance in response to chronic diuretic therapy in very low-birth weight infants. J Endocrinol Invest 2011; 34:604-8. [PMID: 21060248 DOI: 10.3275/7330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
BACKGROUND It has been reported that the reninangiotensin- aldosterone system of healthy newborn infants and pre-term infants responds to acute furosemide challenge. OBJECTIVE To assess urinary aldosterone excretion (UAE) and electrolytic balance in very low-birth weight (VLBW) infants who received chronic therapy with furosemide and to compare them with those of infants who did not receive diuretic therapy. METHODS Infants with birth weight <1500 g were considered eligible for this prospective observational study. On the 10th day of life, infants enrolled were divided in 2 groups on the basis of our predictive score for chronic lung disease (CLD): group 1, with positive score, received furosemide and group 2, with negative score, did not receive diuretic therapy. Urinary aldosterone and electrolytes excretion, electrolytes intakes and clearance of creatinine were investigated before the beginning of the treatment and then weekly until discharge in both groups, and results were compared. RESULTS Thirty infants were studied: 15 received long-term furosemide and 15 did not. UAE progressively increased in infants who received furosemide whereas remained unchanged in infants who did not receive treatment. UAE was greater in group 1 than in group 2 after 3 weeks of diuretic treatment, reaching statistical significance after 4 weeks of treatment. CONCLUSIONS In VLBW infants, chronic therapy with furosemide leads to a progressive increase in UAE that may potentially limit the diuretic effect of long-term use of furosemide in the management of CLD.
Collapse
|
46
|
De Carolis MP, Bersani I, De Rosa G, Cota F, Romagnoli C. Ibuprofen Lysinate and sodium ibuprofen for prophylaxis of patent ductus arteriosus in preterm neonates. Indian Pediatr 2011; 49:47-9. [DOI: 10.1007/s13312-012-0006-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 03/28/2011] [Indexed: 11/29/2022]
|
47
|
Karnik V, Fenster A, Bax J, Romagnoli C, Ward A. SU-E-U-04: MRI-Targeted, 3D TRUS-Guided Prostate Biopsy: Measurement of Inter-Modality Prostate Deformation and Rigid Registration Algorithm Performance. Med Phys 2011. [DOI: 10.1118/1.3612864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
48
|
Karnik VV, Fenster A, Bax J, Romagnoli C, Ward AD. Evaluation of intersession 3D-TRUS to 3D-TRUS image registration for repeat prostate biopsies. Med Phys 2011; 38:1832-43. [DOI: 10.1118/1.3560883] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
49
|
Abstract
Erythropoietin (EPO) is a glycoprotein that regulates many functions of an organism: It stimulates the production of red blood cells and it has angiogenic and neuroprotective properties in newborn infants. Retinopathy of prematurity (ROP) is a frequent cause of visual impairment in preterm newborn infants and it has two distinct phases in which hypoxia-induced angiogenic factors are involved. The relationship between EPO and ROP is derived from the observation of studies done on the haematopoietic effect of EPO. The first observations suggested that a precocious treatment with EPO increases the risk of ROP, while the most recent reports suggested that the late treatment with high doses of rhEPO can increase the risk of ROP. All these studies were not designed to demonstrate the relationship between EPO and ROP. Further studies specifically designed should be performed. New ongoing studies on the neuroprotective role of EPO should consider this objective. In the mean time the use of EPO in the neonatal period should be cautious, mainly in very low birth weight infants.
Collapse
|
50
|
De Zordo T, Ahmad N, Ødegaard F, Girtler MT, Jaschke W, Klauser AS, Chhem RK, Romagnoli C. US-guided therapy of calcific tendinopathy: clinical and radiological outcome assessment in shoulder and non-shoulder tendons. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2011; 32 Suppl 1:S117-S123. [PMID: 20414859 DOI: 10.1055/s-0029-1245333] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE To analyze the effectiveness and complication rate of ultrasound (US)-guided perforation and lavage using a two-needle technique with 16 - 18 G needles in the treatment of patients with calcific tendinopathy in the shoulder, elbow, hip, and knee by radiological and clinical follow-up. MATERIALS AND METHODS A retrospective chart review was performed and 40 patients (13 male, 27 female; mean age, 53.5 years; range 24 -74 years) were identified as having received US-guided perforation and lavage due to symptomatic calcific tendinopathy of the rotator cuff tendons, triceps, extensor and flexor tendons at the elbow, rectus femoris tendon and patellar tendons. The radiographic outcome was assessed by comparison of the size and quality of the calcification before and 6 weeks after the procedure. On US images, the quality of the acoustic shadow was assessed, together with other alterations of the tendon and surrounding tissue. Patients were interviewed by telephone to assess the clinical outcome regarding pre-treatment and post-treatment pain and tendon function. RESULTS 34 shoulder tendons and 6 non-shoulder tendons were identified. The mean calcium reduction was 39.9 mm(2) (range, 0 - 215; p < 0.001), while 80 % of patient showed a resolution of more than 60 % resulting in good clinical improvement. A very low complication rate was found (1 partial tear). CONCLUSION The US-guided perforation and lavage technique is an effective and safe treatment for rotator cuff calcifications as well as for other body tendons. Although the two-needle technique and large needles were used in this study, a very low complication rate was detected.
Collapse
|