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Colnaghi M, Matassa PG, Fumagalli M, Messina D, Mosca F. Pharyngeal pressure value using two continuous positive airway pressure devices. Arch Dis Child Fetal Neonatal Ed 2008; 93:F302-4. [PMID: 18334615 DOI: 10.1136/adc.2007.120428] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The aim of the study was to measure the difference between the set continuous positive airway pressure (CPAP) value and the pharyngeal pressure reading during CPAP in premature infants with mild respiratory distress syndrome, using two different devices: hood CPAP and the conventional nasal system. The preliminary results suggest that hood CPAP may produce more stable pharyngeal pressure than the conventional nasal device.
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Colnaghi M, Condo V, Gagliardi L, Mirabile L, Fumagalli M, Mosca F. Prenatal diagnosis and postnatal management of congenital laryngeal atresia in a preterm infant. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2007; 29:583-5. [PMID: 17405111 DOI: 10.1002/uog.3978] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Laryngeal atresia is a rare congenital cause of high airway obstruction that can lead to death if not correctly recognized and treated at birth. Postnatal management is difficult and the prognosis is often poor. We report a case of prenatal diagnosis of laryngeal atresia in a fetus that was delivered preterm at 29 weeks of gestation. Tracheotomy was performed as an ex utero intrapartum treatment (EXIT) to guarantee patent airway, and laryngotracheoplasty was performed at 22 months of corrected age. A favorable ventilatory and neurodevelopmental outcome was observed at 33 months of age.
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Gianní ML, Picciolini O, Ravasi M, Gardon L, Vegni C, Fumagalli M, Mosca F. The effects of an early developmental mother-child intervention program on neurodevelopment outcome in very low birth weight infants: a pilot study. Early Hum Dev 2006; 82:691-5. [PMID: 16530990 DOI: 10.1016/j.earlhumdev.2006.01.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2005] [Revised: 01/11/2006] [Accepted: 01/19/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several studies report increased minor neurodevelopment dysfunctions in children born very low birth weight (VLBW). Usefulness of preventive early intervention programs to improve neurodevelopment outcome of VLBW infants is still under investigation. AIMS To evaluate the effects of an early post-discharge developmental mother-child intervention program on neurodevelopment outcome at 36 months in VLBW infants. STUDY DESIGN Prospective study. SUBJECTS 36 VLBW infants ([mean (S.D.)] birthweight=864 g (204 g); gestational age=27.9 weeks (2.4 weeks)), consecutively born January-August 2001, randomized in intervention and control groups. OUTCOME MEASURES Neurodevelopment assessment at 36 months of chronological age with use of the Griffiths Mental Development Scale and related subscales. RESULTS At 36 months of chronological age, as compared to controls, children in intervention group exhibited higher scores in personal-social subscales ([mean (S.D.)]=101.4 (9.3) vs. 92.9 (12.1), P=0.02), eye-hand coordination (92.7 (4.5) vs. 87.1 (9.9), P=0.041), practical reasoning (98.6 (8.2) vs. 89.4 (10.1), P=0.01). Development Scale were 97.6 (5.5) and 92.4 (9.9), respectively, in intervention and control groups (P=0.074). CONCLUSIONS Early post-discharge developmental mother-child intervention program may have a positive effect on later neurodevelopment outcome of VLBW children.
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Berardi R, Braconi C, Mantello G, Scartozzi M, Del Prete S, Luppi G, Martinelli R, Fumagalli M, Valeri G, Bearzi I, Marmovale C, Grillö-Ruggieri F, Cascinu S. Anemia may influence the outcome of patients undergoing neo-adjuvant treatment of rectal cancer. Ann Oncol 2006; 17:1661-4. [PMID: 16968873 DOI: 10.1093/annonc/mdl285] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND We hypothesized that anemia could represent one of the major factors influencing the outcome of patients undergoing neo-adjuvant treatment of rectal cancer. PATIENTS AND METHODS This analysis included all the consecutive patients who underwent neo-adjuvant treatment (chemotherapy and/or radiotherapy) before surgery for rectal cancer in three oncology/radiotherapy departments from June 1996 to December 2003. RESULTS Three hundred and seventeen patients were eligible for our analysis. Median age at diagnosis was 64 years (range 26-88 years); male/female ratio was 184/133. Two hundred and eighty-five patients (89.9%) were diagnosed with adenocarcinoma, while 32/317 (10.1%) with mucinous adenocarcinoma. Neo-adjuvant treatments carried out were as follows: radiotherapy alone in 75/317 patients (23.7%), radiotherapy plus chemotherapy in 242/317 patients (76.3%). At univariate and multivariate analysis, only the hemoglobin (Hb) level (group 1: < or=12 g/dl versus group 2: >12 g/dl) resulted in a significant factor for disease-free survival. The role of the Hb level seemed to be confirmed further by the clinical downstaging obtained in approximately 55% of patients in group 2, in comparison with 35% of the patients achieving a significant downstaging in group 1. CONCLUSION Our results indicated that anemia could represent an important parameter able to influence the outcome in patients receiving neo-adjuvant treatment of rectal cancer.
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Picciolini O, Giannì ML, Vegni C, Fumagalli M, Mosca F. Usefulness of an early neurofunctional assessment in predicting neurodevelopmental outcome in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 2006; 91:F111-7. [PMID: 16492947 PMCID: PMC2672665 DOI: 10.1136/adc.2005.073262] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate whether early neurofunctional assessment may be useful in predicting neurodevelopmental outcome in children of very low birth weight (VLBW). DESIGN Observational longitudinal study. SETTINGS Northern Italy. PATIENTS A total of 250 VLBW children (129 boys, 121 girls) born consecutively 1996-1999. MAIN OUTCOME MEASURES Neurodevelopment at 36 months of chronological age, classified in accordance with the classification of Tardieu and the International classification of functioning. RESULTS Of the infants exhibiting normal neurodevelopment (n = 183) or major dysfunction (n = 17) at 3 months of corrected age, 72% and 94% respectively did not change their score during the study. Minor dysfunctions at 3 months of corrected age were transient in 17 (34%) children. After adjustment for neonatal variables, neurodevelopment at 3 months of corrected age remained predictive of dysfunction at 36 months (odds ratio = 4.33, 95% confidence interval 2.05 to 9.12). If the results for the normal and minor dysfunction groups were pooled, the predictive qualities of the 3 month neurofunctional assessment were: sensitivity 0.5, specificity 0.99, positive predictive value 0.94, negative predictive value 0.93. CONCLUSION Early neurofunctional evaluation may be useful in predicting later neurodevelopmental outcome in VLBW children.
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Rossini F, Terruzzi E, Cammarota S, Morini F, Fumagalli M, Verga L, Elli E, Verga M, Miccolis I, Parma M, Pogliani EM. Cytomegalovirus infection after autologous stem cell transplantation: incidence and outcome in a group of patients undergoing a surveillance program. Transpl Infect Dis 2006; 7:122-5. [PMID: 16390400 DOI: 10.1111/j.1399-3062.2005.000111.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study was performed to evaluate the incidence, risk factors, and outcome of cytomegalovirus (CMV) infection in autologous stem cell transplantation (ASCT), with the aim of performing preemptive therapy in patients with antigenemia. Starting from 2001, 171 consecutive ASCTs were performed in 136 patients; 102 of these patients were seropositive for CMV at the onset of hematological disease. In all these patients, a CMV pp65 antigenemia assay was determined weekly, starting from the day when the absolute neutrophil count went above 500/microL, and until day 60 after ASCT; subsequently, antigenemia was determined only when a CMV infection was suspected. Among the 136 transplanted patients, 40 (29.4%) presented a positive antigenemia; all of them were seropositive for CMV before ASCT; and no cases of primary infection were seen. The incidence of CMV infection in the seropositive population was 40/102 (39.3%); 6 patients (5 with multiple myeloma and 1 with non-Hodgkin's lymphoma) who received 2 ASCTs developed CMV infections after both transplantations, so that positive antigenemia developed after 46/171 (26.9%) transplantations. First positive antigenemia presented a median of 32 days (range 7-57) after stem cell reinfusion. The median antigenemia level at the first appearance was 2/200,000 (range 1-1000). No significant prognostic factors could be shown. Enteritis was present in 5 patients; 2 of them also had fever, and 1 of them also had thrombocytopenia. In 5 patients fever without any other clinical signs or symptoms was present; 30 patients were asymptomatic. Fourteen patients were treated with anti-CMV drugs. CMV reactivation was successfully treated in all patients, and no patient died from CMV disease.
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Riario-Sforza GG, Incorvaia C, Paterniti F, Dugnani N, Fumagalli M. Different outcomes of pulmonary rehabilitation in patients with COPD with or without exacerbations. Monaldi Arch Chest Dis 2005; 63:129-32. [PMID: 16312202 DOI: 10.4081/monaldi.2005.629] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Pulmonary rehabilitation is recognised as an effective treatment in reducing disability and improving the quality of life in patients with COPD. We evaluated the effects of a course of pulmonary rehabilitation in improving the physical performance and lung function in patients with or without COPD exacerbations. METHODS 74 patients with COPD were enrolled, 37 (24 males and 13 females, mean age 74.6 years) without exacerbations (group A), and 37 (23 males, 14 females, mean age 73.9 years) with exacerbations (group B). The latter must have had the latest exacerbation at least one month before the inclusion. All patients underwent to a rehabilitation programme of 8 visits in 4 weeks in a day-hospital setting, with exercise training, respiratory muscle training and education on COPD. The changes in physical performance and lung function in respect to baseline were measured by a 6-minute walking test, using phethysmography, and by an analogic manometer measuring maximal inspiratory and expiratory pressures (MIP, MEP). RESULTS Patients of group A showed a mean increase in timed walk distance of 58.38 +/- 57.46 m, compared to a mean increase of 31.38 +/- 44.78 m in group B patients (p = 0.028). As to lung function, a mean increase of 178.92 +/- 132.28 ml in FEV1 in group A versus 67.84 +/- 102.04 ml in group B (p < 0.0001) and a mean increase of 22.36 +/- 25.06 cm H2O in MEP in group A versus 7.70 +/- 12.28 cm H2O in group B (p = 0.002) was found. CONCLUSIONS These findings indicate that patients with COPD with exacerbations achieve a less favourable outcome of pulmonary rehabilitation, with a significantly lower improvement of physical performance, respiratory muscle strength and lung function in respect to subjects without exacerbations.
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Ramenghi LA, Fumagalli M, Righini A, Triulzi F, Kustermann A, Mosca F. Thrombophilia and fetal germinal matrix-intraventricular hemorrhage: does it matter? ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2005; 26:574-6. [PMID: 16184507 DOI: 10.1002/uog.2586] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Germinal matrix-intraventricular hemorrhage (GMH-IVH) in the fetus is very rare and the role of thrombophilia in its pathogenesis is unclear. We report on the prenatal diagnosis by magnetic resonance imaging of GMH-IVH in a 24-week fetus. The newborn presented posthemorrhagic ventriculomegaly and was found to be heterozygous for two thrombophilic patterns, factor V Leiden and methylenetetrahydrofolate reductase mutation. The combination of this hypercoagulable state and prenatal GMH-IVH is discussed together with the opportunity of testing these infants for thrombophilia.
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Berardi R, Mantello G, Scartozzi M, Del Prete S, Luppi G, Martinelli R, Fumagalli M, Tummarello D, Grillo-Ruggieri F, Cascinu S. A novel clinical-pathological score correlates with global outcome of locally advanced rectal cancer patients receiving neoadjuvant chemo-radiotherapy. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Fumagalli M, Ramenghi LA, Mosca F. Palpebral ecchymosis and cerebral venous thrombosis in a near term infant. Arch Dis Child Fetal Neonatal Ed 2004; 89:F530. [PMID: 15499148 PMCID: PMC1721776 DOI: 10.1136/adc.2004.049775] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bergallo M, Merlino C, Fumagalli M, Tarallo S, Scutera S, Giacchino F, Negro Ponzi A, Cavallo R. FOLLOW UP DELLA CARICA VIRALE DELL’EBV NEI LINFOMONOCITI DI TRAPIANTATI RENALI MEDIANTE UN PROTOCOLLO DI PCR QUANTITATIVA. MICROBIOLOGIA MEDICA 2003. [DOI: 10.4081/mm.2003.4353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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63
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Mosca F, Fumagalli M. [Near infrared spectroscopy: what applications?]. LA PEDIATRIA MEDICA E CHIRURGICA 2002; 24:419-21. [PMID: 12610912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
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Ciompi ML, Amoresano C, Balzarini P, Bazzichi LM, Broggini M, Buratti L, Calcagnile F, Ciocci A, Ferri S, Fichera C, Fumagalli M, Muratore M, Nitti F, Peruz G, Romagnoni G. [Sodium gold thiosulfate therapy: an open, viewed, multicenter trial in rheumatoid arthritis patients followed for two years]. Reumatismo 2002; 54:251-6. [PMID: 12404034 DOI: 10.4081/reumatismo.2002.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate if parenteral gold-therapy with Sodium gold thiosulfate is effective and safe for the treatment of rheumatoid arthritis we began an open, multicenter trial. METHODS 126 rheumatoid arthritis patients were treated with Sodium gold thiosulfate for two years. Efficacy, quality of life, progression of joint damage, inflammatory parameters and side effects were evaluated. RESULTS Gold salts reduced joint inflammation and improved subjective and objective symptoms, quality of life and activity of illness within 6 months. Side effects appeared in 13,8% of all cases and regressed, promptly, when gold therapy stopped. The poor efficacy caused the interruption and the change from the gold therapy to others disease-modifying anti-rheumatic drugs (DMRDs) in 17,8 % of the patients. CONCLUSIONS The follow-up showed Sodium gold thiosulfate was effective in Rheumatoid Arthritis and the survival in therapy was of 77,8% to one year and of 68,4% to two years.
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Fumagalli M, Incorvaia C, Nitti F, Broggini M, Baratelli E, Balzarini P, Galvani L, Romagnoni GG. The assessment of quality of life as a measure of gold salts treatment efficacy in rheumatoid arthritis. Minerva Med 2002; 93:199-202. [PMID: 12094150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND In the evaluation of functional status of patients with rheumatoid arthritis (RA) the health related quality of life is currently considered important because of its approach to various components of life, such as social, psychological, and physical aspects. We used the Stanford Health Assessment Questionnaire (HAQ) to assess the improvement of functional status in patients with RA treated with gold salts. METHODS In a prospective investigation 91 patients with RA in anatomical stage I, II, or III, 66 females and 25 males, with a mean age of 53.17 years, were evaluated during medical treatment in a 1-year follow-up. The treatment consisted in sodium aureothiosulphate, plus corticosteroids and NSAID. The assessments were done during ambulatory visits, at baseline and after 6 and 12 months of treatment, by HAQ as well as by other parameters such as Ritchie Index, visual analog scale (VAS), and morning stiffness. A group of 19 RA patients included by the same criteria and treated only by corticosteroids and NSAID was used as control for the first 6 months of the study. RESULTS HAQ scores and other parameters were significantly lower (p=0.0001) at the 6th and 12th month measurements when compared with baseline. In the control group only a significant difference in the VAS score was detected. CONCLUSIONS All the parameters measured in our study were useful in detecting clinical improvement in RA patients treated with sodium aureothiosulphate plus corticosteroids and NSAIDs, but the HAQ provides a more global assessment of the patient's status.
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Mosca F, Fumagalli M, Bray M, Barbarini M, Gagliardi L, Colnaghi M, Pugni L. [Cerebral oxygenation and near-infrared rays spectrophotometry]. ACTA BIO-MEDICA DE L'ATENEO PARMENSE : ORGANO DELLA SOCIETA DI MEDICINA E SCIENZE NATURALI DI PARMA 2001; 71 Suppl 1:599-607. [PMID: 11424814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Near infrared spectroscopy (NIRS) is a new technique which allows non invasive bedside monitoring of cerebral oxygenation and hemodynamics by measuring relative changes in cerebral oxy- and deoxyhaemoglobin and cytochrome aa3. We have applied this technique to evaluate the possible effects on cerebral oxygenation and hemodynamics of clinical procedures usually performed on preterm infants:--endotracheal suctioning, and we have demonstrated that the magnitude and the duration of the negative effects of open system are significantly reduced using closed endotracheal suctioning system;--withdrawal and infusion through umbilical vein and artery cause significant changes in cerebral hemodynamics: these effects are significantly reduced after administration of ibuprofen;--treatment of patent ductus arteriosus with ibuprofen does not significantly reduce cerebral perfusion and oxygen availability compared to indomethacin and ibuprofen administration also does not affect cerebral vasoreactivity to arterial carbon dioxide tension;--administration of different types and doses of natural surfactant causes different changes in cerebral hemodynamics and these effects seem to be dose-related. Therefore NIRS is an useful device to investigate cerebral oxygenation state of preterm infants and new possibilities could derive from the introduction of a new NIRS method which allows to measure the tissue oxygenation index.
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Bagna R, Bertino E, Colnaghi MR, Fumagalli M, Fabris C, Marini A. Spontaneous rupture and successful removal of Silastic catheters in two low birth weight infants. Eur J Pediatr 2001; 160:525. [PMID: 11548198 DOI: 10.1007/pl00008457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fariselli L, Mapelli M, Fumagalli M, Milanesi I. Comparison of dynamic conformal radiotherapy with micro-multileaf collimator vs arc non conformal radiotherapy vs static conformal radiotherapy. Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)81263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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69
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Fariselli L, Fumagalli M, Mapelli M, Sagaria N, Gimosti L, Corradino G, Milanesi I, Pelligrini R. The virtual simulation process. Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)81281-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Uderzo C, Fumagalli M, De Lorenzo P, Busca A, Vassallo E, Bonanomi S, Lanino E, Dini G, Varotto S, Messina C, Miniero R, Valsecchi MG, Balduzzi A. Impact of thrombotic thrombocytopenic purpura on leukemic children undergoing bone marrow transplantation. Bone Marrow Transplant 2000; 26:1005-9. [PMID: 11100281 DOI: 10.1038/sj.bmt.1702648] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Thrombotic thrombocytopenic purpura (TTP) has emerged as one of the main transplant-related complications over the last 15 years. The current study defines the incidence and the risk factors for the occurrence of TTP in 131 consecutive leukemic children who were transplanted between January 1994 and December 1997 at four Italian pediatric centers. Patients with ALL (101), AML (21), MDS (9), underwent an HLA-identical sibling BMT (82) or an HLA-identical unrelated BMT (49), receiving a conditioning regimen consisting of high-dose chemotherapy in 24 patients and of F-TBI combined with high-dose chemotherapy in 107 patients. The diagnosis of TTP was retrospectively evaluated on the basis of parallel criteria. TTP treatment varied according to the protocol of each treatment center. Twenty-eight of 131 patients (21.4%) developed TTP at a median of 46 days (range 21-80) after BMT. Multivariate analysis demonstrated that the risk of TTP was higher in patients who underwent unrelated BMT (P value = 0.02). Acute GVHD, stage of disease at BMT, conditioning with TBI, gender, age, did not appear to be associated with the occurrence of TTP. As to the outcome, TTP resolved in 19 patients while in nine it was the principal cause of death (32.1%). In patients with TTP, LDH peak value was the only statistically significant factor (P = 0.001) related to severe TTP. In conclusion, our experience demonstrates that leukemic children undergoing BMT, especially from an unrelated donor, should be carefully assessed for TTP which appears to be a severe and relatively common transplant-related complication when strict diagnostic criteria are applied.
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Longoni DV, Fumagalli R, Fumagalli M, Cappellini A, Uderzo C. Severe disseminated toxoplasmosis after unrelated bone marrow transplantation: a case report. Haematologica 2000; 85:781-2. [PMID: 10897145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Mosca F, Bray M, Colnaghi MR, Fumagalli M, Compagnoni G. Cerebral vasoreactivity to arterial carbon dioxide tension in preterm infants: the effect of ibuprofen. J Pediatr 1999; 135:644-6. [PMID: 10547255 DOI: 10.1016/s0022-3476(99)70065-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cerebral vasoreactivity to CO(2), calculated by linear regression of total cerebral hemoglobin, measured by near infrared spectroscopy, and corresponding PaCO(2), in infants <32 weeks' gestation, was found to be unaffected by the administration of ibuprofen, which was given on the first postnatal day as prophylaxis against patent ductus arteriosus.
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Riario-Sforza GG, Incorvaia C, Bellotto R, Salimbeni R, Fumagalli M. Determination of cut-off positivity values in nasal challenge testing of patients with allergic rhinitis. Allergy Asthma Proc 1999; 20:109-14. [PMID: 10209688 DOI: 10.2500/108854199778612563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nasal challenge testing with allergen extracts is currently used to diagnose nasal allergy and, to a greater extent, in studies of pathophysiology of allergic rhinitis. The resulting nasal obstruction, measured as nasal airway resistance (NAR), is determined by rhinomanometry (RMM). The aim of this study was to define a cut-off NAR value for a positive response in a nasal allergen challenge test. Forty-two, grass-allergic adult patients and 40 nonallergic adults were challenged out of the grass pollen season under standard conditions with timothy grass extract administered intranasally in doses increasing from 10 to 1500 IU/mL. Inspiratory NAR was determined by computerized anterior active RMM. The cut-off value for a positive test was determined from receiver operating characteristic curves plotted from these data with the LABROC1 computer program. In addition, the subjects' nasal cycle was recorded during the four hours preceding the allergen challenge. The patients' mean NAR value at baseline (0.33 Pa/cc/sec) and when challenged with normal saline solution did not differ from those of the control subjects. The patients, but not the control subjects, experienced typical nasal allergic symptoms when challenged with the grass extract. The control subjects had no symptoms and their NAR did not change significantly when they were challenged with the same extract. All 42 allergic patients had measurable increases in NAR at the 800 IU/mL allergen dose; 19/42 patients had complete obstruction (i.e., NAR unmeasurable) when challenged with the 1500 IU/mL dose. The maximum diagnostic value (= sensitivity + specificity at the discriminator position on the receiver operating characteristic curves) was 1.96 with the 800 IU/mL dose. At that dose, the NAR cut-off value was 0.91 Pa/cc/sec, which was 2.7 times greater than their mean value at baseline. NAR varied less than 1-fold between the maximum and minimum points of the normal nasal cycle in both groups of subjects. An increase of NAR of nearly three-fold during nasal allergen challenge compared to the baseline value determined by computerized anterior active RMM discriminates best patients with allergic rhinitis from nonallergic adults.
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Mosca FA, Colnaghi M, Lattanzio M, Bray M, Pugliese S, Fumagalli M. Closed versus open endotracheal suctioning in preterm infants: effects on cerebral oxygenation and blood volume. BIOLOGY OF THE NEONATE 1997; 72:9-14. [PMID: 9313829 DOI: 10.1159/000244460] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The aim of our study was to compare, using near-infrared spectroscopy (NIRS), the effects on cerebral intracellular oxygenation and cerebral blood volume (CBV) of closed endotracheal suctioning (CS), which permits continuous ventilation of the patient, with open endotracheal suctioning (OS), which requires disconnection from the ventilator. Eleven preterm infants were studied. Each patient underwent one CS, followed, after 60 min, by one OS, or vice versa, three times during the same day. Modifications in CBV and oxidized cytochrome oxidase (CytO2) were continuously detected by NIRS; arterial oxygen saturation (SaO2) heart rate (HR), transcutaneous carbon dioxide tension and mean arterial blood pressure were simultaneously recorded. Significant reductions in HR and SaO2 were observed following OS; the magnitude and duration of these negative effects of suctioning were significantly reduced with CS. In addition, the decrease in CBV was more pronounced than following CS. No changes in CytO2 concentration were seen.
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Mosca F, Bray M, Lattanzio M, Fumagalli M, Tosetto C. Comparative evaluation of the effects of indomethacin and ibuprofen on cerebral perfusion and oxygenation in preterm infants with patent ductus arteriosus. J Pediatr 1997; 131:549-54. [PMID: 9386657 DOI: 10.1016/s0022-3476(97)70060-x] [Citation(s) in RCA: 160] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To compare the effects on cerebral perfusion and oxygenation of intravenous ibuprofen and indomethacin as treatment for patent ductus arteriosus in preterm infants. STUDY DESIGN Sixteen infants receiving mechanical ventilation (< 31 weeks gestation) with patent ductus arteriosus received either 0.2 mg/kg indomethacin (n = 8) or 10 mg/kg ibuprofen (n = 8) infused over 1 minute. Near-infrared spectroscopy was used to measure changes in cerebral blood volume and in oxidized cytochrome oxidase concentration. Cerebral blood flow velocity in the pericallosal artery was measured using Doppler ultrasonography. RESULTS Indomethacin caused a significant reduction of CBV (maximal changes in cerebral blood volume: -320 +/- 171 microL/100 gm) and, in four of eight patients, a fall in oxidized cytochrome oxidase concentration (maximal change in oxidized cytochrome oxidase concentration in the eight patients: -0.68 +/- 0.98 mumol/L, NS). Cerebral blood flow velocity fell significantly. Ibuprofen caused no significant reduction of cerebral blood volume, oxidized cytochrome oxidase concentration, or cerebral blood flow velocity, whereas a significant increase of cerebral blood volume (+207 +/- 200 microL/100 gm) was observed after 60 minutes. Ductus closure was seen in six of eight infants after the first dose of indomethacin and in five of eight infants after the first dose of ibuprofen. The therapeutic cycle involved administration of a second and third dose, provided no side effects occurred. Treatment was effective in all infants. CONCLUSION Compared with indomethacin, treatment with ibuprofen does not significantly reduce cerebral perfusion and oxygen availability; the observed increase in cerebral blood volume requires further investigation.
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