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Torre RL, Bevilacqua E, D’Ambrosio V, Pasquali G, Aliberti C, Ventriglia F, Giancotti A. Matrix array transducer for the examination of fetal heart. CLIN EXP OBSTET GYN 2014. [DOI: 10.12891/ceog17142014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Imperiale L, Marchetti C, Salerno L, Iadarola R, Bracchi C, Vertechy L, di Francesco L, Musella A, Bevilacqua E, Pennesi P, Palaia I, Panici PB. Nonabsorbable suture granuloma mimicking ovarian cancer recurrence at combined positron emission tomography/computed tomography evaluation: a case report. J Med Case Rep 2014; 8:202. [PMID: 24942653 PMCID: PMC4082177 DOI: 10.1186/1752-1947-8-202] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/22/2014] [Indexed: 11/30/2022] Open
Abstract
Introduction This is the first case of suture granuloma mimicking isolated ovarian cancer relapse. Only six analogous cases have been previously reported in other malignancies. Case presentation We report the case of a 44-year-old Caucasian woman with partially platinum-sensitive ovarian cancer in which radiological features, including computed tomography and combined 18F-fluorodeoxyglucose-positron emission tomography/computed tomography, were strongly suggestive of isolated cancer relapse in her right subdiaphragmatic region. Laparoscopic examination resulted negative, but was not completely suitable due to widespread adhesive syndrome. The laparotomy for secondary cytoreductive surgery and biopsy of the suspected area showed inflammatory granuloma caused by nonabsorbable propylene suture, without evidence of neoplastic cells. Moreover, unexpected peritoneal carcinosis was found. Conclusions This evidence suggests that clinical details about previous surgical procedures are necessary for adequate interpretation. Although much progress has been made in imaging techniques, especially in the promising field of combined 18F-fluorodeoxyglucose positron emission tomography/computed tomography, these procedures should be still thoroughly investigated in order to promptly rule out tumor recurrence and avoid unnecessary surgery.
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Bevilacqua E, Aliberti C, D’Ambrosio V, Giancotti A, Perrone G, La Torre R. Spontaneous septostomy in monochorionic diamniotic twins: Difficult diagnosis, difficult management. J OBSTET GYNAECOL 2014; 34:359. [DOI: 10.3109/01443615.2013.874408] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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La Torre R, Bevilacqua E, D'Ambrosio V, Pasquali G, Aliberti C, Perrone G, Giancotti A. A case of uterine rupture in mid-trimester spontaneous abortion: a complication of gemeprost vaginal administration. CLIN EXP OBSTET GYN 2014; 41:599-600. [PMID: 25864271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The only prostaglandin analogue licensed in Italy for induction of labour in spontaneous and therapeutic abortion is gemeprost. The authors report a case of spontaneous uterine rupture of a scarred uterus, for previous caesarean sections, in a woman at 20 weeks of gestation with a diagnosis of spontaneous abortion. She received a pessary of gemeprost every three hours. After the fifth pessary, she complained of severe pain. At the ultrasound examination, uterine cavity appeared empty and the dead fetus was dislocated in the abdomen. Emergency laparotomy was performed and uterine tear was repaired. To induce labour for fetal demise or therapeutic abortion in second trimester in women with scarred uterus, the authors decided to lengthen the time between administrations of pessary from four to five hours depending on patient's symptoms. However the appropriate drug regimen has still to be found and more data are necessary.
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La Torre R, Bevilacqua E, D'Ambrosio V, Pasquali G, Aliberti C, Ventriglia F, Giancotti A. Matrix array transducer for the examination of fetal heart. CLIN EXP OBSTET GYN 2014; 41:581-582. [PMID: 25864265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The X6-1 xmatrix array transducer allows a completely new approach to the diagnostic ultrasound: it permits visualization of fetal heart in real time, without the need for gating, and it is unaffected by motion artefacts. It is obtained in real time, without any spatial reconstruction. The authors compared this technology with the traditional one in two case reports: a diagnostic doubt of small muscular ventricular septal defect was solved using this new technique; a diagnosis of complete atrioventricular septal defect was confirmed. Three-dimensional real-time imaging would seem very precise in the study of fetal heart: the defects were fully visualized from any angulations. This new technology is promising but from the authors' limited experience, there is no evidence to use it in routine practice. It should be very useful to commence a prospective study on fetuses at risk while testing the superiority of this technique.
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Bevilacqua E, Paulesu L, Ferro EAV, Ietta F, Faria MR, Lorenzon AR, Costa AF, Martucci M. Review: putative roles for the macrophage migratory inhibitory factor at the maternal fetal interface. Placenta 2013; 35 Suppl:S51-6. [PMID: 24215782 DOI: 10.1016/j.placenta.2013.10.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 12/22/2022]
Abstract
Complex and dynamic networks of molecules participate in the essential interactions between maternal organism, placenta and fetus in a healthy and successful pregnancy. Macrophage migratory inhibitory factor (MIF) is one of several molecules produced at implantation sites; MIF is mostly expressed by trophoblast cells. This has led to expectations of MIF's relevance as a partner in the maternal/fetal dialog. MIF is known by its biological interactions and functional roles as an activator of innate immunity, regulating subsequent adaptive responses, which include inhibition of migration of mononuclear cells in vitro, antagonism of glucocorticoids, and regulation of expression of Toll-like receptor 4. Beyond roles in the inflammatory response, MIF can interfere with proliferative activities in different cell types, as well as with cell death pathways. This intriguing factor found at the human, porcine, ovine, bovine and rodent maternal-fetal interfaces is present in a time- and spatially-dependent manner, indicating regulatory roles in the process of embryo implantation, placental development, maintenance of pregnancy and birth. Here, we will review MIF participation in placental physiology, including new evidence for a dialog with uterine cells, and a potential role in protection of uterine decidual cells.
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Giancotti A, Muto B, Diambrosio V, Bevilacqua E, Pasquali G, Squarcella A, La Torre R. Ultrasound management and clinical outcome of twin pregnancies. J OBSTET GYNAECOL 2013; 33:675-7. [DOI: 10.3109/01443615.2013.813915] [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]
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Corrêa-Silva S, Moreli J, De Rosa L, Damasceno D, Rudge M, Bevilacqua E, Calderon I. Influence of hyperglicemia in pro-inflamatory cytokine levels in serum and placenta. Placenta 2013. [DOI: 10.1016/j.placenta.2013.06.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Patacchioli FR, Perrone G, Merlino L, Simeoni S, Bevilacqua E, Capri O, Galoppi P, Brunelli R. Dysregulation of Diurnal Salivary Cortisol Production Is Associated with Spontaneous Preterm Delivery: A Pilot Study. Gynecol Obstet Invest 2013; 76:69-73. [DOI: 10.1159/000351873] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 05/08/2013] [Indexed: 11/19/2022]
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Perrone G, Capri O, Galoppi P, Patacchioli FR, Bevilacqua E, de Stefano MG, Brunelli R. Menopausal Symptoms after the Discontinuation of Long-Term Hormone Replacement Therapy in Women under 60: A 3-Year Follow-Up. Gynecol Obstet Invest 2013; 76:38-43. [DOI: 10.1159/000351104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 04/03/2013] [Indexed: 11/19/2022]
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De Rosa L, Ruocco A, Moreli J, Corrêa-Silva S, Bevilacqua E, Rudge M, Calderon I. W189 PLACENTAL VASCULARIZATION IN DIABETIC AND MILD HYPERGLYCEMIC PREGNANCIES. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61914-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Calderon I, Moreli J, Damasceno D, Morceli G, Corrêa-Silva S, De Rosa L, Bevilacqua E, Rudge M. W260 IL-1β AND IL-6 PLASMA LEVELS IN PREGNANCIES COMPLICATED BY DIABETES OR MILD GESTATIONAL HYPERGLYCEMIA. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61984-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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63
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Corrêa-Silva S, Paixão-Alencar A, Moreli J, Damasceno D, De Rosa L, Rudge M, Bevilacqua E, Calderon I. O150 DETECTION OF PLACENTAL INDUCIBLE NITRIC OXIDE SYNTHASE (iNOS) IN DIABETIC AND MILD GESTATIONAL HYPERGLYCEMIC PREGNANCIES. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60580-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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64
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Lorenzon A, Farah S, Fisher S, Bevilacqua E. Expression of the presumptive chemokine Stromal Cell Derived Factor-2 (SDF-2) by different cell types in human placenta: function insights. J Reprod Immunol 2012. [DOI: 10.1016/j.jri.2012.03.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Correa-Silva S, Prado K, Oliveira L, Ono E, Camara N, Bevilacqua E. Comparison between cytokines in peripheral and placental compartment in renal-transplanted pregnant women. J Reprod Immunol 2012. [DOI: 10.1016/j.jri.2012.03.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Giancotti A, Bevilacqua E, D'Ambrosio V, Pasquali G, Gasbarri A. A new technology in the diagnosis of small ventricular septal defects. J OBSTET GYNAECOL 2012; 32:394-5. [PMID: 22519490 DOI: 10.3109/01443615.2012.664585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Giancotti A, La Torre R, Bevilacqua E, D'Ambrosio V, Pasquali G, Panici PB. Mediastinal masses: a case of fetal teratoma and literature review. CLIN EXP OBSTET GYN 2012; 39:384-387. [PMID: 23157052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Fetal mediastinal masses are rare congenital formations that could complicate pregnancy. They are usually discovered as space occupying lesions in the fetal chest during routine ultrasound scan. The most important prognostic factors of mediastinal masses are mass location, compressing effect causing pulmonary hypoplasia and/or heart failure, and the presence or absence of hydrops. We report a case of fetal mediastinal teratoma and a review of the literature. A 32-year-old woman carrying a fetus with hydrops due to a mediastinal mass underwent cesarean section at 32 1/7 weeks' gestation. A well encapsulated tumor was excised by surgery at one day of life. The baby is now eight months old without respiratory difficulty. To our knowledge, this is the fourth case report of a mediastinal teratoma associated with nonimmune hydrops in a fetus that survived the neonatal period. Fetal mediastinal teratoma requires close surveillance and multidisciplinary management by obstetricians, neonatologists, and pediatric surgeons.
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Amarante-Paffaro A, Hoshida M, Yokota S, Gonçalves C, Joazeiro P, Bevilacqua E, Yamada A. Localization of Cathepsins D and B at the Maternal-Fetal Interface and the Invasiveness of the Trophoblast during the Postimplantation Period in the Mouse. Cells Tissues Organs 2011; 193:417-25. [DOI: 10.1159/000320546] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2010] [Indexed: 01/22/2023] Open
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Fernández C, Bevilacqua E, Fernández N, Gajate P, de la Cámara AG, Garcimartín M, Vives R, Rodríguez J. Asthma related to Alternaria sensitization: an analysis of skin-test and serum-specific IgE efficiency based on the bronchial provocation test. Clin Exp Allergy 2010; 41:649-56. [PMID: 21105919 DOI: 10.1111/j.1365-2222.2010.03645.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND It is difficult to find a causal relationship between exposure to Alternaria spores and the development of asthma symptoms in sensitized individuals due to the complexity of clinical situations in which positive diagnostic tests are often found. OBJECTIVE To analyse the diagnostic efficiency of skin testing (ST) and serum-specific IgE to Alternaria, based on the results of a bronchial specific challenge with Alternaria extracts. METHODS Seventy-four asthmatic patients sensitized to Alternaria underwent a specific bronchial challenge with this mould. Skin-testing weal sizes, serum-specific IgE values (CAP-system) and bronchial challenge results were analysed by receiver operating characteristics curves (ROC curves) and logistic regression. The sensitivity, specificity, positive and negative predictive values were calculated for different cut-off points. RESULTS Bronchial challenges to Alternaria elicited a positive result in 45 patients (61%). Skin prick testing almost perfectly predicted the outcome of bronchoprovocation tests (area under the ROC curve of 0.957), whereas intradermal skin testing had moderate efficacy. A negative result for skin prick test (SPT) showed a 4% probability of a positive bronchial challenge in the logistic regression analysis. However, weals around 5.5 mm in diameter had 90% probability of a positive challenge. Quantification of serum-specific IgE correctly classified 86% of the cases. In the logistic regression analysis, a CAP value 16 kU(A)/L predicted a positive bronchial challenge result with 99% accuracy, whereas for a CAP value <0.35 kU(A)/L, this probability was 33%. CONCLUSIONS AND CLINICAL RELEVANCE Most asthmatic patients with positive SPT results to Alternaria would have a positive bronchial challenge. As atmospheric mould levels may vary significantly with the weather conditions, sensitized patients should be instructed on the risk situations, environmental control measures and the importance of correct medication compliance. Immunotherapy with Alternaria could also be taken into account as a valid therapeutic option.
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Pietro L, Daher S, Rudge MVC, Calderon IMP, Damasceno DC, Sinzato YK, Bandeira C, Bevilacqua E. Vascular endothelial growth factor (VEGF) and VEGF-receptor expression in placenta of hyperglycemic pregnant women. Placenta 2010; 31:770-80. [PMID: 20674013 DOI: 10.1016/j.placenta.2010.07.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 07/07/2010] [Accepted: 07/10/2010] [Indexed: 12/13/2022]
Abstract
Hyperglycemia occurs in a variety of conditions such as overt diabetes, gestational diabetes and mild hyperglycemia, all of which are generally defined based on the oral glucose tolerance test and glucose profiles. Whereas diabetes has received considerable attention in recent decades, few studies have examined the mechanisms of mild hyperglycemia and its associated disturbances. Mild gestational hyperglycemia is associated with macrosomia and a high risk of perinatal mortality. Morphologically, the placenta of these women is characterized by an increase in the number of terminal villi and capillaries, presumably as part of a compensatory mechanism to maintain homeostasis at the maternal-fetal interface. In this study, we analised the expression of VEGF and its receptors VEGFR-1 (Flt-1) and VEGFR-2 (KDR) in placentas from mildly hyperglycemic women. This expression was compared with that of normoglycemic women and women with gestational and overt diabetes. Immunohistochemistry revealed strong staining for VEGF and VEGFR-2 in vascular and trophoblastic cells of mildly hyperglycemic women, whereas the staining for VEGFR-1 was discrete and limited to the trophoblast. The pattern of VEGF and VEGF-receptor reactivity in placentas from women with overt diabetes was similar to that of normoglycemic women. In women with gestational diabetes, strong staining for VEGFR-1 was observed in vascular and trophoblastic cells whereas VEGF and VEGFR-2 were detected only in the trophoblast. The expression of these proteins was confirmed by western blotting, which revealed the presence of an additional band of 75 kDa. In the decidual compartment, only extravillous trophoblast reacted with all antibodies. Morphological analysis revealed collagen deposition around large arteries in all groups with altered glycemia. These findings indicate a placental response to altered glycemia that could have important consequences for the fetus. The change in the placental VEGF/VEGFR expression ratio in mild hyperglycemia may favor angiogenesis in placental tissue and could explain the hypercapillarization of villi seen in this gestational disturbance.
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Bevilacqua E, Brunelli R, Anceschi MM. Review and meta-analysis: Benefits and risks of multiple courses of antenatal corticosteroids. J Matern Fetal Neonatal Med 2010; 23:244-60. [PMID: 19670040 DOI: 10.1080/14767050903165222] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Preterm birth causes infant morbidity and mortality. A single course of antenatal corticosteroids (ACS) should be considered routine for preterm delivery. Benefits of therapy before 34 weeks' gestation have been established for infants born between 24 h and 7 days after treatment. It is still unclear whether multiple courses (MC) of ACS should be performed in women at risk of preterm delivery 7 days or more after initial treatment. OBJECTIVES To determine the risks and benefits of MC of ACS. METHODS Search and selection for human randomized controlled trials were conducted in PubMed and The Cochrane Central Register of Controlled Trials. Statistical analysis was performed using the Review Manager 4.3 software. MAIN RESULTS MC of ACS were associated with a statistically decrease in the occurrence of respiratory distress syndrome, patent ductus arteriosus, use of surfactant, ventilation support, and any maternal side effects. This treatment was also associated with a significant reduction in birth weight and head circumference. CONCLUSIONS MC of ACS in women at risk of preterm birth do not offer significant benefits concerning the composite neonatal morbidity. Data on long-term safety are still insufficient. Further evaluations, most by follow-up studies, are required to study the long-term effects.
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Bevilacqua E, Brunelli R, Anceschi MM. Review and meta-analysis: Benefits and risks of multiple courses of antenatal corticosteroids. J Matern Fetal Neonatal Med 2010. [DOI: 10.3109/14767050903165222] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Correa-Silva S, Oliveira L, Sass N, Camara N, Bevilacqua E. Immunophenotype of dendritic cells in renal transplanted pregnant women at first, second and third trimester. J Reprod Immunol 2009. [DOI: 10.1016/j.jri.2009.06.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Daher S, Guimarães A, Mattar R, Zenclussen A, Paulesu L, Bevilacqua E. Immunolocalization of pro- and anti-apoptotic molecules in early human placentas in abortion and healthy pregnancies. J Reprod Immunol 2009. [DOI: 10.1016/j.jri.2009.06.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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75
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Perrone G, Capri O, Galoppi P, Brunelli R, Bevilacqua E, Ceci F, Ciarla M, Strom R. Effects of either Tibolone or Continuous Combined Transdermal Estradiol with Medroxyprogesterone Acetate on Coagulatory Factors and Lipoprotein(a) in Menopause. Gynecol Obstet Invest 2009; 68:33-9. [DOI: 10.1159/000211676] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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