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Marinoni E, Frigiola A, Gazzolo D, Greco P, Vimercati A, Moscarini M, Abella R, Di Iorio R. S100 beta protein is increased in fetuses with neural tube defect. Front Biosci (Elite Ed) 2010; 2:47-51. [PMID: 20036852 DOI: 10.2741/e64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We investigated the levels of S100 beta protein (S100B) in the serum of fetuses with neural tube defects (NTD), and their mother. Samples from 20 fetuses with NTD and 30 controls at the same gestational age, and their mothers, were studied. S100B protein levels were determined using Lia-mat Sangtec. kit. S100B concentrations were significantly higher in NTD fetuses (median 2.71 microg/L) than in control subjects (median 0.98 microg/L). Increased S100B levels were also found in mothers carrying fetuses with NTD compared to control and uncomplicated pregnancies. This study indicates that NTD is associated with increased serum concentration of S100B in fetuses and mothers. Moreover, it gives information on S100B levels in the fetal circulation in early-mid gestation.
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Ceci O, Scioscia M, Pinto L, Laera A, Achilarre M, Camporeale A, Vimercati A, Bettocchi S. Hysteroscopic Evaluation of Different Types of Healing of the Uterine Incision for Caesarean Section. J Minim Invasive Gynecol 2009. [DOI: 10.1016/j.jmig.2009.08.427] [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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78
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Achilarre M, Bettocchi S, Pinto L, Nardelli C, Camporeale A, Ceci O, Vimercati A. Ectopic Pregnancy within the Caesarean Scar: Extremely Rare Case Complicated by Incomplete Curettage Following Voluntary Interruption of Pregnancy. J Minim Invasive Gynecol 2009. [DOI: 10.1016/j.jmig.2009.08.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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79
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Vimercati A, Scioscia M, Nardelli C, Panella E, Laforgia N, Decosmo L, Selvaggi LE. Are active labour and mode of delivery still a challenge for extremely low birth weight infants? Experience at a tertiary care hospital. Eur J Obstet Gynecol Reprod Biol 2009; 145:154-7. [DOI: 10.1016/j.ejogrb.2009.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 03/12/2009] [Accepted: 04/21/2009] [Indexed: 11/17/2022]
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80
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Scioscia M, Vimercati A, Selvaggi LE, Rodeck CH, Rademacher TW. Inositol phosphoglycan putative insulin mediator in human amniotic fluid. J Matern Fetal Neonatal Med 2009; 19:9-12. [PMID: 16492584 DOI: 10.1080/14767050500362321] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Many hormones such as insulin, insulin-like growth factors, and the glucocorticoids are involved in regulating fetal growth. Inositol phosphoglycans (IPGs), a family of putative second messengers of insulin, are reported to exert several of insulin's metabolic effects. METHODS A prospective cross-sectional study was carried out to investigate IPG P-type (P-IPG) in human amniotic fluid and in adult urine under physiological conditions. An amniotic fluid sample was taken from 78 women undergoing early amniocentesis and a mid-stream urine specimen was collected from 109 healthy pregnant and 66 non-pregnant women. All samples were assessed using a polyclonal antibody-based ELISA. RESULTS The P-IPG content was a thousand times higher in the amniotic fluid than in the urine (p < 0.0001). Urinary specimens showed a four-fold higher P-IPG content during pregnancy than in healthy non-pregnant women (p < 0.001). CONCLUSIONS Under physiological conditions, human amniotic fluid was found to be enriched in P-IPG compared with maternal urine, suggesting a possible fetal origin. Therefore, IPGs may play a role in insulin sensitivity and fetal growth and, perhaps, be involved in some of its abnormalities such as macrosomia and intrauterine growth restriction.
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81
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Floridia M, Tamburrini E, Anzidei G, Tibaldi C, Guaraldi G, Guerra B, Meloni A, Vimercati A, Molinari A, Pinnetti C, Dalzero S, Ravizza M. Plasma lipid profile in pregnant women with HIV receiving nevirapine. AIDS Patient Care STDS 2009; 23:147-52. [PMID: 19866532 DOI: 10.1089/apc.2008.0148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Limited information is currently available on the metabolic profile of nevirapine in pregnancy. We used data from a national observational study to evaluate plasma lipid profile in pregnant women receiving nevirapine. Lipid values were collected during routine clinical visits. Midpregnancy (second trimester) lipid values were analyzed according to use of nevirapine, calculating differences and 95% confidence intervals (CI) between women taking and not taking this drug. In order to adjust for possible confounders, multivariable models were constructed using as dependent variables levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG) levels and TC/HDL-C ratio, and as independent variables age, body weight, previous treatment history, CD4 count, and presence of any antiretroviral therapy, use or nonuse of protease inhibitors, stavudine, and nevirapine at the time of blood sampling. Overall, 375 women had available data for analysis. Pregnant women on nevirapine, compared to women not taking this drug, had in univariate analyses higher levels of HDL-C (difference: +13.0mg/dL [95%CI 7.4-18.6], p < 0.001), lower values of TC/HDL-C ratio (difference: -0.51 [0.23-0.80], p < 0.001) and a trend for lower levels of triglycerides (difference: -17.6mg/dL [0.7-35.9], p = 0.06). Higher HDL-C levels were also associated with use of protease inhibitors and with no previous antiretroviral experience before pregnancy. The associations with higher HDL-C levels were confirmed in multivariable analyses. Our study indicates in pregnant women an association between nevirapine use and higher HDL-C levels. Further studies should assess whether this effect is due to an intrinsic activity of nevirapine and define the potential mechanisms involved.
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Scioscia M, Vimercati A, Cito L, Chironna E, Scattarella D, Selvaggi LE. Social determinants of the increasing caesarean section rate in Italy. MINERVA GINECOLOGICA 2008; 60:115-120. [PMID: 18487961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM Consistent modifications of socio-economic factors may represent crucial non-clinical determinants for the rising rate of caesarean section among primiparae. This increasing trend has been reported in many countries and its relationship with social modifications is widely accepted, though poorly supported by published data. METHODS Population-based social and economic data were analyzed between two study periods 30 years apart (1971 vs 2001). RESULTS The number of births dropped dramatically within the study period (about -40%). Italian women tend to delay childbearing (25.1 vs 28.8 years of age at first delivery) to pursue a career and a later marriage and motherhood lead to a contraction of the number of members of the family. Older mothers are at higher risk of caesarean (treble over 40 years of age), especially those with high career position. Health expenditures increased significantly between 1971 and 2001. A progressive contraction of the number of women in reproductive age is expected in the next 50 years in Italy. CONCLUSION Many determinants are involved in the choice of a caesarean section and most of these are not strictly medical. The rapidly mounting number of legal claims may indeed lead to defensive practices. Given these data, a reduction of caesarean section rate seems unlikely to be achieved at present.
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Scioscia M, Scioscia F, Vimercati A, Caradonna F, Nardelli C, Pinto LR, Selvaggi LE. Estimation of fetal weight by measurement of fetal thigh soft-tissue thickness in the late third trimester. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 31:314-320. [PMID: 18307214 DOI: 10.1002/uog.5253] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The accuracy of current formulae for the sonographic estimation of fetal weight (EFW) is compromised by significant intra- and interobserver variability of biometrical measurements, particularly circumferences. The aim of this study was to assess the reliability of the linear measurement of mid-thigh soft-tissue thickness (STT) and to derive a novel formula for EFW. METHODS This was a prospective study involving 388 singleton uncomplicated pregnancies. There were three consecutive phases: (1) to verify the relationship between STT and birth weight, (2) to derive a novel formula for EFW using femur length and STT only, and (3) to test the accuracy of the new equation. Only the 290 patients who delivered within 48 h of measurement were considered for the analysis. A comparison with other formulae was performed. RESULTS STT was significantly correlated with both abdominal circumference and birth weight (r(2) = 0.36 and 0.46, respectively; P < 0.001). Both intra- and interobserver variability were satisfactory (0.44 +/- 0.27 and 0.57 +/- 0.35 mm, respectively). The equation for EFW was developed using multiple stepwise regression analysis (EFW = - 1687.47 + (54.1 x femur length) + (76.68 x STT)) and tested prospectively on 69 patients. The new formula yielded results (r = 0.79) that were slightly better in accuracy than two other published equations, and had an absolute mean error of < 15% in 97% of cases. CONCLUSIONS Our findings confirm the potential of the linear measurement of mid-thigh STT as a valuable parameter for the sonographic assessment of fetal growth and EFW. Our new equation is apparently at least as reliable as the most widely used formulae for EFW.
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Vimercati A, Scioscia M, Lorusso F, Laera AF, Lamanna G, Coluccia A, Bettocchi S, Selvaggi L, Depalo R. Do uterine fibroids affect IVF outcomes? Reprod Biomed Online 2008; 15:686-91. [PMID: 18062866 DOI: 10.1016/s1472-6483(10)60536-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The effect of myomectomy on implantation and pregnancy rates prior to assisted reproduction treatments is controversial. This study was designed to assess clinical outcomes of IVF cycles in women with uterine fibroids. A retrospective single-centre assessment of clinical outcomes of IVF/intracytoplasmic sperm injection (ICSI) treatments in infertile women in a 4-year span was carried out. All patients underwent detailed transvaginal ultrasound and hysteroscopy to precisely identify presence, location and intracavitary growth of uterine fibroids. Cumulative pregnancy, ongoing pregnancy and live birth rates were considered primary outcome measurements. Fifty-one women with fibroids (97 treatment cycles), 63 patients with previous myomectomy (127 cycles), and 106 infertile women who did not demonstrate fibroids anywhere in the uterus (215 cycles) were considered for the analysis. No significant difference was found for pregnancy and live birth rates between groups. Women with fibroids>4 cm required an increased number of cycles to obtain an ongoing pregnancy, compared with the other groups. The data do not support pre-IVF myomectomy in women with small-to-moderate uterine fibroids, regardless of their location. This represents valuable information in the counselling of women with fibroids before reproductive assisted cycles.
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Vimercati A, Scioscia M, Panella E, Nardelli C, Coluccia A, Camporeale C, DeCosmo L, Laforgia N, Selvaggi L. Perinatal Risk Factors and Mode of Delivery Correlated to Survival and Psychomotor Disability in Extremely Low Birth Weight Infants. Gynecol Obstet Invest 2008; 66:91-7. [DOI: 10.1159/000127983] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Accepted: 11/06/2007] [Indexed: 11/19/2022]
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86
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Caccavo D, Pellegrino NM, Lorusso F, Capotorto M, Vacca M, Vimercati A, Depalo R. Anticardiolipin antibody levels in women undergoing first in vitro fertilization/embryo transfer. Hum Reprod 2007; 22:2494-500. [PMID: 17609246 DOI: 10.1093/humrep/dem179] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The clinical relevance of antiphospholipid antibodies (aPL) in women undergoing in vitro fertilization/embryo transfer (IVF/ET) and the role of IVF treatment in affecting antiphospholipid levels are controversial. The aim of this study was to evaluate anticardiolipin antibody (aCL) levels and the effect of IVF treatment on aCL in women undergoing their first IVF/ET cycle. METHODS Immunoglobulin G (IgG)- and IgM-aCL were determined by enzyme-linked immunosorbent assay in 50 women undergoing IVF/ET, 18 due to endometriosis, 16 to tubal factor (TF) and 16 to male factor, before starting treatment (T0), on the day of oocyte retrieval (T1) and 14 days after ET (T2). A group of 31 age-matched fertile women served as controls. RESULTS aCL levels detected at T0 in patients were not significantly different compared with the control group. IgG- but not IgM-aCL significantly increased at T2 in comparison with T0 (P < 0.001) and T1 (P < 0.05). The difference between T2 and T0 reached statistical significance in patients with endometriosis (P = 0.003) or TF (P = 0.018). No relationship was found between aCL and pregnancy. CONCLUSIONS Our results indicate that IVF treatment increases IgG-aCL levels in patients with endometriosis and TF, but their presence seems to have no clinical relevance.
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Di Giacomo MC, Susca FC, Resta N, Bukvic N, Vimercati A, Guanti G. Trisomy 13 mosaicism in a phenotypically normal child: Description of cytogenetic and clinical findings from early pregnancy beyond 2 years of age. Am J Med Genet A 2007; 143A:518-20. [PMID: 17163529 DOI: 10.1002/ajmg.a.31515] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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88
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Scioscia M, Vimercati A, Pontrelli G, Nappi L, Selvaggi L. Patients’ obstetric history in mid-trimester termination of pregnancy with gemeprost: Does it really matter? Eur J Obstet Gynecol Reprod Biol 2007; 130:42-5. [PMID: 16309822 DOI: 10.1016/j.ejogrb.2005.08.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Revised: 05/17/2005] [Accepted: 08/08/2005] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The objective was to investigate the importance of previous obstetric history for termination of pregnancy in the second-trimester with gemeprost alone. STUDY DESIGN A consecutive series of 423 mid-trimester inductions of abortion at our teaching hospital was reviewed. Termination of pregnancy was carried out with 1mg of vaginal gemeprost every 3h up to three doses over a 24-h period, repeated the following day if necessary. Failed induction was defined as women undelivered by 96 h. The study population was then stratified by gestational age, parity, gravidity and previous uterine scars. Main outcome parameters were failed induction and complication rates. Statistical analysis was performed using the chi(2) test or Fisher's exact test for categorical data, and the t-test and linear regression for continuous variables. RESULTS No significant differences were found in the primary outcome parameters with regard to the obstetric parameters considered. The failed induction rate was 1.2% with an overall incidence of complications of 7.4%. Parity was the main factor that affected clinical response (time to abortion interval and number of pessaries). CONCLUSION Patients' obstetric history does affect the clinical response to gemeprost, but its safety and effectiveness are preserved. These data provide clinicians with important information for correct counselling.
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Floridia M, Ravizza M, Tamburrini E, Anzidei G, Tibaldi C, Maccabruni A, Guaraldi G, Alberico S, Vimercati A, Degli Antoni A, Ferrazzi E. Diagnosis of HIV infection in pregnancy: data from a national cohort of pregnant women with HIV in Italy. Epidemiol Infect 2006; 134:1120-7. [PMID: 16512968 PMCID: PMC2870491 DOI: 10.1017/s0950268806006066] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2006] [Indexed: 11/06/2022] Open
Abstract
We analysed the characteristics of the pregnancies with a previously undetected HIV infection in a national observational study of pregnant women with HIV in Italy. In a total of 443 pregnancies with available date of HIV diagnosis, 118 were characterized by a previously undetected HIV infection (26.6%, 95% CI 22.5-30.8). The following factors were independently associated with this occurrence in a multivariate analysis (adjusted odds ratios; 95% CIs): foreign nationality (5.1, 2.8-9.3); no pre-conception counselling (35.9, 4.8-266.1); first pregnancy (2.1, 1.2-4.0); asymptomatic status (6.8, 1.5-30.6). Women with previously undetected infection started antiretroviral treatment significantly later during pregnancy (P < 0.001). Missed diagnosis was responsible for one case of transmission. A high rate of previously undetected HIV infection was observed. This suggests a good HIV detection during pregnancy, but also the need to reinforce HIV testing strategies among women of childbearing age. We identified some determinants which may be considered for intervention measures.
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Ingrassia F, Fiore JR, Vimercati A, Tateo MG, Campanale F, Volpe A, Di Stefano MA, Greco P, Pastore G. Isolated antibodies against the core antigen of hepatitis B virus in HIV-infected pregnant women. MINERVA GINECOLOGICA 2006; 58:255-6. [PMID: 16783299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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91
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Floridia M, Guaraldi G, Tamburrini E, Tibaldi C, Bucceri A, Anzidei G, Meloni A, Vimercati A, Polizzi C, Dalle Nogare ER, Alberico S, Ravizza M. Lipodystrophy is an independent predictor of hypertriglyceridemia during pregnancy in HIV-infected women. AIDS 2006; 20:944-7. [PMID: 16549985 DOI: 10.1097/01.aids.0000218565.97649.6e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Lipid values were measured during pregnancy in HIV-infected, treatment-experienced women. A previous history of lipodystrophy was associated with significantly higher triglyceride values at all pregnancy trimesters. In multivariate analyses lipodystrophy independently increased the risk of hypertriglyceridemia by threefold at the first trimester, and by eightfold at the second and third trimesters. Protease inhibitor treatment was also independently associated with hypertriglyceridemia.
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Vimercati A, Scioscia M, Angelici M, Nappi L, Depalo R, Greco P, Selvaggi L. Proposal of a Model for Prevention and Treatment of Congenital Toxoplasmosis. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-923763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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93
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Scioscia M, Vimercati A, Maiorano A, Depalo R, Selvaggi L. A critical analysis on Italian perinatal mortality in a 50-year span. Eur J Obstet Gynecol Reprod Biol 2006; 130:60-5. [PMID: 16460869 DOI: 10.1016/j.ejogrb.2005.12.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2005] [Revised: 10/15/2005] [Accepted: 12/12/2005] [Indexed: 11/21/2022]
Abstract
BACKGROUND Perinatal mortality rate is used as an indicator of reproductive health worldwide. In western countries, national mortality registers are usually accurate and reliable. METHODS AND AIMS We reviewed the data recorded in the past 50 years in Italy on perinatal and infant mortality. Each single class of mortality rate (according to WHO definitions) was assessed on temporal trends allowing a critical speculative analysis, mainly focusing on the last 20 years, in an attempt to evaluate the impact of prenatal diagnosis. RESULTS Infant mortality rate (IMR) constantly decreased in the study period whereas early neonatal mortality rate progressively diminished in a 5-year comparison till the early 1990s. Perinatal mortality showed a linear negative trend until the 1980s, after which the decrease steadied at about 23% in the following 5-year period. Infant mortality attributable to congenital anomalies throughout a 20-year span (1980-2000) was steady at about 23% although a progressive reduction in general infant mortality was reported. CONCLUSIONS A higher reduction in neonatal and perinatal mortality rate was found before the wide availability of the ultrasonographic prenatal diagnosis and the introduction of the law on voluntary abortion in Italy. Given these data, it seems that advances in neonatal care have improved the infant survival rates more than prenatal diagnosis, whereas obstetric care is linked to a reduction of the early perinatal mortality rate.
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Fiore J, Volpe A, Di Stefano M, Vimercati A, Tateo M, Cantatore S, Ingrassia F, Greco P, Pastore G, Dentico P. Detection of Antibodies to Human Herpesvirus 8 (HHV-8) among Women of Child-Bearing Age in the Apulia Region (South-Eastern Italy). EUR J INFLAMM 2006. [DOI: 10.1177/1721727x0600400106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In this study the authors investigated the presence of serum antibodies to Human Herpesvirus 8 (HHV-8) in a group of women of child-bearing age in the Apulia region (South Eastern Italy). A seroprevalence of 16.8% was observed, increasing, although non significantly, with the age of the women (10.6% in women between 19 and 25 years, 25.3% in women aging more than 35 years). The presence of antibodies to Hepatitis C Virus (HCV) was significantly associated to the detection of antibodies to HHV-8. Possible mother-to-child transmission of HHV-8 as well as the outcome of fetuses or children born to HHV-8 positive mothers are still a matter of debate. This study, showing the wide diffusion of HHV-8 infection in healthy women of child-bearing age in our geographical area, highlights the urgency of studies aimed to better clarify these relevant topics.
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Vimercati A, Scioscia M, Burattini MG, Pontrelli G, Selvaggi LE. Prenatal diagnosis of Freeman–Sheldon syndrome and usefulness of an ultrasound fetal lip width normogram. Prenat Diagn 2006; 26:679-83. [PMID: 16715537 DOI: 10.1002/pd.1470] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Freeman-Sheldon syndrome (FSS) is a rare genetic condition with facial and joint abnormalities. Here we report the first case of prenatal diagnosis in a fetus with negative familial history for this syndrome. A chart of the fetal mouth length was generated and its usefulness verified. METHODS A cross-sectional study was carried out to derive standard charts for fetal lip lengths. The study population was made up of 371 fetuses between 15 and 38 weeks of gestation examined only once for this purpose. A statistical analysis previously recommended to derive normal ranges in fetal growth charts was employed. RESULTS A 34-year-old woman was referred at 28 weeks of gestation for polyhydramnios and clubfeet. A detailed scan confirmed those findings and showed joint contractures of hands, a severe microstomia with a 'whistling' mouth, and an H-shaped mark over the chin. FSS was suspected, though there was no family history for this genetic syndrome. After emergency delivery at 32 weeks, the syndrome was confirmed. The infant died two months later from pneumonia. Upon construction of a standard mouth length chart, it was found that the fetal lip width in this case of FSS was well below the 5th centile. CONCLUSION Here we present a standard chart for fetal lip width. We demonstrated its usefulness in cases with fetal face anomalies. Specific charts are fundamental for an objective assessment of the fetal parameters.
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Scioscia M, Vimercati A, Selvaggi L. Nuchal cords in term and postterm deliveries--do we need to know? Obstet Gynecol 2005; 106:1417; Author reply 1417-8. [PMID: 16319275 DOI: 10.1097/01.aog.0000190478.63532.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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97
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Lorusso F, Depalo R, Bettocchi S, Vacca M, Vimercati A, Selvaggi L. Outcome of in vitro fertilization after transabdominal ultrasound–assisted embryo transfer with a full or empty bladder. Fertil Steril 2005; 84:1046-8. [PMID: 16213872 DOI: 10.1016/j.fertnstert.2005.04.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2004] [Revised: 04/25/2005] [Accepted: 04/25/2005] [Indexed: 11/29/2022]
Abstract
The use of ultrasound guidance has proven to be a key factor in performing embryo transfer in a gentle and atraumatic manner. However, despite the lower incidence of brusque maneuvers, bladder distension has not shown any positive impact on the IVF success rate.
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Vimercati A, Scioscia M, Vicino M, Selvaggi L. Prenatal Evaluation of an Extremely Rare and Bizarre Case of Cephalothoracopagus Monosymmetros Janiceps Twins. Geburtshilfe Frauenheilkd 2005. [DOI: 10.1055/s-2005-872869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Patano N, Marinaccio M, Vimercati A, Camerino C, Mancini L, Selvaggi L, Zallone A. Enhanced osteoclastogenesis in women after natural delivery. Biochem Biophys Res Commun 2005; 334:487-90. [PMID: 16005853 DOI: 10.1016/j.bbrc.2005.06.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Accepted: 06/20/2005] [Indexed: 11/15/2022]
Abstract
In the pre-expulsive and expulsive phases of labor, oxytocin and several other osteoclastogenic mediators, such as prostaglandins and IL-6, are secreted in high concentrations. This study was undertaken to assess whether the peripheral blood obtained from healthy women after vaginal delivery contains a larger pool of osteoclast precursors compared with age- and gender-matched controls. Our results clearly show that the number and size of osteoclasts generated in vitro from osteoclast precursors isolated from women after delivery are significantly larger than those from controls. This finding can account for the decrease in bone mass that is often observed during the breastfeeding period and the concomitant release of high quantities of calcium in the milk. Further investigations are required to establish whether analysis of blood osteoclast precursors can be predictive of changes in bone remodeling in this setting.
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Nappi L, Carriero C, Bettocchi S, Herrero J, Vimercati A, Putignano G. Cervical squamous intraepithelial lesions of low-grade in HIV-infected women: recurrence, persistence, and progression, in treated and untreated women. Eur J Obstet Gynecol Reprod Biol 2005; 121:226-32. [PMID: 16054967 DOI: 10.1016/j.ejogrb.2004.12.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2003] [Revised: 09/12/2004] [Accepted: 12/06/2004] [Indexed: 11/24/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV)-infected patients are more predisposed than HIV-negative women to develop squamous intraepithelial lesions (SIL) of the uterine cervix, and cervical dysplasia may be of higher grade in HIV-positive women than in HIV-negative subjects, with more extensive and multi-centric involvement of the lower genital tract by human papillomavirus (HPV)-associated lesions. Moreover, recurrence and progression rate of cervical intraepithelial neoplasia (CIN) is particularly higher in immunocompromised women. DESIGN Retrospective case-control study of HIV-positive women and HIV-negative controls, all affected by low-grade SIL of the uterine cervix, treated by loop excision or followed-up without treatment. Correlation of progression and recurrence of SIL with HIV status and CD4+ count. PATIENTS From September 1990 to October 1997, 75 HIV-positive low-grade-SIL patients, 47 treated and 28 followed-up without treatment, and 75 HIV-negative low-grade-SIL controls, 45 treated and 30 followed-up. RESULTS Among treated patients, 17/47 (36.2%) HIV-positive and 5/45 (11.1%) controls had recurrence (P < 0.0101, O.R. = 4.53, 95% CI = 1.5-13.7), progression of untreated lesion was seen in 15/28 (53.6%) HIV-positive and 7/30 (23%) controls (P < 0.05, O.R. = 3.79, 95% CI = 1.23-11.69). The risk of recurrence or progression of low-grade SIL linked to HIV seropositivity is about 4-5 times higher in comparison with seronegative counterpart, matched for age, risk factors and lesion size. More significantly, considering the cut-off of 200 CD4+/mm(3) in HIV-positive women, 13/17 cases of recurrence (P < 0.05, O.R. = 4.88, 95% CI = 1.28-18.58) and 10/15 cases with progression (P < 0.05, O.R. = 6.67, 95% CI = 1.24-35.73) were immunocompromised (<200 CD4+/mm3), with a significant higher risk of recurrence or progression linked to immunodeficiency status. Considering time of progression or recurrence, during follow-up, Kaplan-Meier curves shows that HIV-positive status and immunodeficiency are correlated with more rapid evolution of cervical dysplasia and HPV-related lesions: comparison of recurrence in treated patients report P < 0.005 and progression in untreated P<0.05 (Mantel-Haenszel log-rank test). CONCLUSIONS Immunological status seems to be a determinant factor in prognosis of cervical SIL, HIV-positive women affected by this lesion, even if low-grade, need more aggressive management than the immunocompetent counterpart. Strict cytologic and colposcopic screening is recommended and CD4+ count and HPV-DNA testing may be useful risk indicators. Excisional procedures are preferred, while ablative treatments or wait and see policy may expose to some risk this type of population with poor compliance to follow-up.
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