1
|
Strozzi C, Di Battista C, Graziosi A, D'Adamo E, Librandi M, Patacchiola R, Maconi A, Ghiglione V, Pelazzo C, Pasino M, Paterlini G, Bozzetti V, Salvo V, Gazzolo F, Concolino D, Abella L, Spinelli M, Betti M, Bertolotti M, Gazzolo D. Cerebral and systemic near infrared spectroscopy patterns in preterm infants treated by caffeine. Acta Paediatr 2024; 113:700-708. [PMID: 38156367 DOI: 10.1111/apa.17077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/22/2023] [Accepted: 12/14/2023] [Indexed: 12/30/2023]
Abstract
AIM To investigate the effects of caffeine loading/maintenance administration on near-infrared spectroscopy cerebral, kidney and splanchnic patterns in preterm infants. METHODS We conducted a multicentre case-control prospective study in 40 preterm infants (gestational age 29 ± 2 weeks) where each case acted as its own control. A caffeine loading dose of 20 mg/kg and a maintenance dose of 5 mg/kg after 24 h were administered intravenously. Near infrared spectroscopy monitoring parameters were monitored 30 min before, 30 min during and 180 min after caffeine therapy administration. RESULTS A significant increase (p < 0.05) in splanchnic regional oxygenation and tissue function and a decrease (p < 0.05) in cerebral tissue function after loading dose was shown. A preferential hemodynamic redistribution from cerebral to splanchnic bloodstream was also observed. After caffeine maintenance dose regional oxygenation did not change in the monitored districts, while tissue function increased in kidney and splanchnic bloodstream. CONCLUSION Different caffeine administration modalities affect cerebral/systemic oxygenation status, tissue function and hemodynamic pattern in preterm infants. Future studies correlating near infrared spectroscopy parameters and caffeine therapy are needed to determine the short/long-term effect of caffeine in preterm infants.
Collapse
Affiliation(s)
- Chiara Strozzi
- Neonatal Intensive Care Unit, ASO SS Antonio, Biagio, C. Arrigo, Alessandria, Italy
| | | | | | - Ebe D'Adamo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Michela Librandi
- Department of Pediatrics, G. d'Annunzio University, Chieti, Italy
| | | | - Antonio Maconi
- Neonatal Intensive Care Unit, ASO SS Antonio, Biagio, C. Arrigo, Alessandria, Italy
| | - Valeria Ghiglione
- Neonatal Intensive Care Unit, ASO SS Antonio, Biagio, C. Arrigo, Alessandria, Italy
| | - Claudia Pelazzo
- Neonatal Intensive Care Unit, ASO SS Antonio, Biagio, C. Arrigo, Alessandria, Italy
| | - Marta Pasino
- Neonatal Intensive Care Unit, ASO SS Antonio, Biagio, C. Arrigo, Alessandria, Italy
| | - Giuseppe Paterlini
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Monza-Brianza, Italy
| | - Valentina Bozzetti
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Monza-Brianza, Italy
| | - Vincenzo Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Francesca Gazzolo
- Pediatric Unit, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Daniela Concolino
- Pediatric Unit, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | | | - Martina Spinelli
- Department of Science and Technological Innovation, Piemonte Orientale University, Alessandria, Italy
| | - Marta Betti
- Integrated Activities Research Innovation Department, ASO SS Antonio, Biagio, C. Arrigo, Alessandria, Italy
| | - Marinella Bertolotti
- Integrated Activities Research Innovation Department, ASO SS Antonio, Biagio, C. Arrigo, Alessandria, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| |
Collapse
|
2
|
Salvo V, Gazzolo D, Zimmermann LJ. The Complex Interrelationship Between Mechanical Ventilation and Therapeutic Hypothermia in Asphyxiated Newborns. A Review. Ther Hypothermia Temp Manag 2023. [PMID: 37625025 DOI: 10.1089/ther.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
Asphyxiated newborns often require both therapeutic hypothermia (TH) and mechanical ventilation (MV) and the complex interrelationship between these two therapeutic interventions is very interesting, which could not only have several synergistic positive effects but also some risks. Perinatal asphyxia is the leading cause of neonatal hypoxic-ischemic encephalopathy (HIE) and TH is the only approved neuroprotective treatment to limit brain injury, improving the mortality rate and long-term neurological outcomes. HIE is often associated with severe respiratory failure, requiring MV, due to different lung diseases or an impairment of the respiratory drive. The respiratory support management of asphyxiated newborns is very difficult, considering (a) various pathophysiological contexts, (b) the strong impact of TH on gas metabolism and (c) on lung mechanics, and (d) complex TH-MV interactions. Therefore, it is necessary to evaluate the real indications of MV for cooled newborns, considering the risks of respiratory overassistance (hypocapnia/hyperoxia), as well as the adequate monitoring systems. To date, specific randomized studies about the optimal respiratory approach for cooled newborns are lacking, and strategies for MV support vary from center to center. Moreover, there are many open questions about the real effects of cooling on lung mechanics and on surfactant, most appropriate method of blood gas analysis, and clear indications for pharmacological sedation. The aim of this review is to propose a reasoned approach for respiratory management of cooled newborns, considering the pathophysiological context, multiple actions of TH, and consequences of TH-MV matched action and its related risks.
Collapse
Affiliation(s)
- Vincenzo Salvo
- Mother and Child Health Department, Neonatal Intensive Care Unit, "Giovanni Paolo II" Hospital of Ragusa, ASP Ragusa, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit, "G. D'Annunzio" University, Chieti, Italy
| | - Luc J Zimmermann
- Department of Pediatrics and Neonatology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
- European Foundation for the Care of Newborn Infants (EFCNI), München
| |
Collapse
|
3
|
Pecoraro M, Del Giudice F, Campa R, Cipollari S, Salvo V, Bicchetti M, Sciarra A, Simone G, Gallucci M, Leonardo C, De Berardinis E, Catalano C, Panebianco V. Prospective validation of vesical imaging-reporting and data system (VI-RADS) for non-muscle invasive (NMI) vs. muscle invasive bladder cancer (MIBC) discrimination in patients candidate for primary transurethral resection of bladder tumors (TURBT)κκκ. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33134-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
4
|
Del Giudice F, Barchetti G, De Berardinis E, Pecoraro M, Salvo V, Simone G, Sciarra A, Leonardo C, Gallucci M, Catalano C, Catto JW, Panebianco V. Prospective Assessment of Vesical Imaging Reporting and Data System (VI-RADS) and Its Clinical Impact on the Management of High-risk Non–muscle-invasive Bladder Cancer Patients Candidate for Repeated Transurethral Resection. Eur Urol 2020; 77:101-109. [DOI: 10.1016/j.eururo.2019.09.029] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
|
5
|
Chimenz R, Fede C, Di Benedetto V, Concolino D, Scuderi MG, Salvo V, Gitto E, Cucinotta U, Viola V, Betta P, Cannavò L, Cuppari C. Hemodialysis in children: how, when and why. J BIOL REG HOMEOS AG 2019; 33:87-89. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
End-stage renal diseases requiring chronic dialysis are rare in childhood and adolescence, but they are associated with high mortality and impaired quality of life (1, 2). The most common disease that causes chronic kidney disease (CKD) is primary glomerular disease (GD), followed by congenital abnormalities of the kidney and urinary tract, cystic, hereditary or congenital disorders and, more rarely, secondary GD. However, patients with secondary GD, urologic disorders, and metabolic diseases have greater mortality risk than patients with primary GD (3). Here, we focused on the different options of treatment available, and specifically we compared peritoneal dialysis and hemodialysis, showing pros and cons between them.
Collapse
Affiliation(s)
- R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - V Di Benedetto
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - M G Scuderi
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - V Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - E Gitto
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - V Viola
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - P Betta
- Neonatal Intensive Care Unit, Policlinico-Vittorio Emanuele" of Catania, Italy
| | - L Cannavò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| |
Collapse
|
6
|
D'Angelo G, Marseglia L, Salvo V, Calabrò MP, Fede C, Chimenz R, Cuppari C, Salpietro C, Gitto E. Renal oxidative injury in newborns. J BIOL REG HOMEOS AG 2019; 33:75-78. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- G D'Angelo
- Department of Clinical and Experimental Medicine, University of Messina, Italy
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - L Marseglia
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - V Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino"Messina, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino"Messina, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Salpietro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - E Gitto
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| |
Collapse
|
7
|
Arrigo T, Stroscio G, Impollonia D, Salvo V, Scuderi MG, Di Benedetto V, Betta P, Fusco M, Sallemi A, Fede C, Calabrò MP, Salpietro C, Chimenz R. Cardiac dysfunction in children with essential obesity: preliminary data. J BIOL REG HOMEOS AG 2019; 33:79-85. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Obesity in children has been recognized as a major underlying factor of the pathogenesis of several diseases and a reduced life expectancy. This study aims to verify if clinical parameters, such as waist circumference and/or body mass index and biohumoral and inflammatory parameters can help predict cardiac structural and functional alterations, through an echocardiogram test in obese children and adolescents. Children were prospectively enrolled at the AUOC outpatients' department of Emergency Paediatrics, University Hospital, Messina, from June to December 2017. Clinical, metabolic parameters and an inflammation marker (HMGB1) were evaluated and a transthoracic echocardiogram was carried out. Twenty-two obese subjects were prospectively enrolled.HMGB1 values were 12.6 ± 2ng/ml, significantly higher compared to a previously studied healthy control group. A significant positive correlation was found both between total cholesterol levels and HMGB1 values (r=0.846, p=0.000) and between LDL cholesterol and HMBG1 values (r=0.663, p=0.001). No correlation was found between clinical, biohumoral and echocardiograph parameters. In obese children cardiac parameters obtained from echocardiogram tests may be in the normal range. However, other parameters may be altered in the early phase, showing that infantile obesity can compromise myocardial functions, even in the absence of comorbidities. Furthermore, the evaluation of concentrations of HMBG1 could explain how an initial inflammation can trigger the condition of meta-inflammation.
Collapse
Affiliation(s)
- T Arrigo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - G Stroscio
- Radiodiagnostic Unit C.O.T., Messina, Italy
| | | | - V Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - M G Scuderi
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - V Di Benedetto
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - P Betta
- Neonatal Intensive Care Unit, Policlinico-Vittorio Emanuele" of Catania, Italy
| | - M Fusco
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - A Sallemi
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, Policlinico "G.Martino"Messina, Italy
| | - C Salpietro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| |
Collapse
|
8
|
Chimenz R, Sallemi A, Fusco M, Cannavò L, Salvo V, Marseglia L, Cucinotta U, Gitto E, Concolino D, Arrigo T, Salpietro C. Local therapy with ozone in the management of the exit site in a patient undergoing peritoneal dialysis. J BIOL REG HOMEOS AG 2019; 33:91-94. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The natural history of children with end stage renal disease is dialysis until a transplant can be done. There are two types of dialysis: hemodialysis and peritoneal dialysis (1). Peritoneal dialysis is preferred in young children because getting the vascular access for hemodialysis is challenging (2). Catheters should be surgically placed in a paramedian or lateral abdominal region with an extremity located in Douglas' pouch.
Collapse
Affiliation(s)
- R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - A Sallemi
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - M Fusco
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - L Cannavò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - V Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - L Marseglia
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - E Gitto
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - T Arrigo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Salpietro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| |
Collapse
|
9
|
Chimenz R, Cannavò L, Viola V, Di Benedetto V, Scuderi MG, Pensabene L, Salvo V, D'Angelo G, Stroscio G, Impollonia D, Concolino D, Fede C, Alibrandi A, Cuppari C. Pediatric urolithiasis. J BIOL REG HOMEOS AG 2019; 33:39-44. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Urolithiasis is a well-known condition that can affect any part of the urinary tract. With a rate of 3-5% the incidence of upper urinary tract for long has been higher in adults (1-3), but recently it has increased among children reaching 3,3% . Indeed, more than 1% of all urinary stones are seen in patients aged less than 18 years (4). Pediatric urolithiasis is endemic in Turkey and Far East and it is probably due to malnutrition and racial factors (5). The spontaneous stone passage is more likely in children than in adults, indeed ureteral calculi spontaneously pass into 41-63% of children (1). Rate of stone passage depends on size and stone location in the urinary system. Stones sized less than 5 mm have a passage rate ranging from 40% to 98%, whilst stones > 5 mm have between 55% and 50% (6). In the last decade, the use of alpha blockers has proven well efficacious in helping spontaneous passage of distal ureteric stones in adults (7-9). The latest EAU guidelines support their use in adults while remain vague about their use in children because of unclear safety and efficacy (4). In search of evidence supporting or not the use of medical expulsive therapy in children we reviewed the literature dealing with the management of urolithiasis in pediatric patients. The primary aim of the present study was to evaluate the efficacy of medical expulsive therapy (MET), defined as stone expulsion rate, with a-blockers compared to a control group. The secondary aim was to assess the safety, defined as side effects rate, of MET compared to a control group.
Collapse
Affiliation(s)
- R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - L Cannavò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics.University of Messina, Policlinico "G.Martino" Messina, Italy
| | - V Viola
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics.University of Messina, Policlinico "G.Martino" Messina, Italy
| | - V Di Benedetto
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - M G Scuderi
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - L Pensabene
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - V Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - G D'Angelo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - G Stroscio
- Radiodiagnostic Unit C.O.T. Messina, Italy
| | | | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G.Martino" Messina, Italy
| | - A Alibrandi
- Department of Economics Unit of Statistical and Mathematical Sciences University of Messina, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics.University of Messina, Policlinico "G.Martino" Messina, Italy
| |
Collapse
|
10
|
Sallemi A, Stroscio G, Impollonia D, Arrigo T, Di Benedetto V, Salvo V, Marseglia L, Scuderi MG, Calabrò MP, Fede C, Cuppari C, Salpietro C, Chimenz R. Failure to thrive: the importance of measuring the electrolytes. J BIOL REG HOMEOS AG 2019; 33:3-5. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Diabetes insipidus (DI) is characterized by hypoosmotic polyuria related to deficiency of arginine-vasopressin (AVP) secretion (centraldiabetesinsipidus, CDI) or renalinsensitivity to AVP (nephrogenicdiabetesinsipidus, NDI). We report a case of a child with congenital NDI.
Collapse
Affiliation(s)
- A Sallemi
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - G Stroscio
- Radiodiagnostic Unit C.O.T. Messina, Italy
| | | | - T Arrigo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - V Di Benedetto
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - V Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - L Marseglia
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - M G Scuderi
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Salpietro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| |
Collapse
|
11
|
Barchetti G, Simone G, Ceravolo I, Salvo V, Campa R, Del Giudice F, De Berardinis E, Buccilli D, Catalano C, Gallucci M, Catto JWF, Panebianco V. Multiparametric MRI of the bladder: inter-observer agreement and accuracy with the Vesical Imaging-Reporting and Data System (VI-RADS) at a single reference center. Eur Radiol 2019; 29:5498-5506. [PMID: 30887202 DOI: 10.1007/s00330-019-06117-8] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/09/2019] [Accepted: 02/15/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To evaluate accuracy and inter-observer variability using Vesical Imaging-Reporting and Data System (VI-RADS) for discrimination between non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). METHODS Between September 2017 and July 2018, 78 patients referred for suspected bladder cancer underwent multiparametric MRI of the bladder (mpMRI) prior to transurethral resection of bladder tumor (TURBT). All mpMRI were reviewed by two radiologists, who scored each lesion according to VI-RADS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each VI-RADS cutoff. Receiver operating characteristics curves were used to evaluate the performance of mpMRI. The Ƙ statistics was used to estimate inter-reader agreement. RESULTS Seventy-five patients were included in the final analysis, 53 with NMIBC and 22 with MIBC. Sensitivity and specificity were 91% and 89% for reader 1 and 82% and 85% for reader 2 respectively when the cutoff VI-RADS > 2 was used to define MIBC. At the same cutoff, PPV and NPV were 77% and 96% for reader 1 and 69% and 92% for reader 2. When the cutoff VI-RADS > 3 was used, sensitivity and specificity were 82% and 94% for reader 1 and 77% and 89% for reader 2. Corresponding PPV and NPV were 86% and 93% for reader 1 and 74% and 91% for reader 2. Area under curve was 0.926 and 0.873 for reader 1 and 2 respectively. Inter-reader agreement was good for the overall score (Ƙ = 0.731). CONCLUSIONS VI-RADS is accurate in differentiating MIBC from NMIBC. Inter-reader agreement is overall good. KEY POINTS • Traditionally, the local staging of bladder cancer relies on transurethral resection of bladder tumor. • However, transurethral resection of bladder tumor carries a significant risk of understaging a cancer; therefore, more accurate, faster, and non-invasive staging techniques are needed to improve outcomes. • Multiparametric MRI has proved to be the best imaging modality for local staging; therefore, its use in suitable patients has the potential to expedite radical treatment when necessary and non-invasive diagnosis in patients with poor fitness.
Collapse
Affiliation(s)
- Giovanni Barchetti
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Simone
- Department of Urology, Regina Elena National Cancer Insitute, Rome, Italy
| | - Isabella Ceravolo
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Salvo
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Riccardo Campa
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Francesco Del Giudice
- Department of Gynecological-Obstetric and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Ettore De Berardinis
- Department of Gynecological-Obstetric and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Dorelsa Buccilli
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Michele Gallucci
- Department of Urology, Regina Elena National Cancer Insitute, Rome, Italy
| | - James W F Catto
- Academic Urology Unit, University of Sheffield, Sheffield, UK
| | - Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
| |
Collapse
|
12
|
Campa R, Del Monte M, Barchetti G, Pecoraro M, Salvo V, Ceravolo I, Indino EL, Ciardi A, Catalano C, Panebianco V. Improvement of prostate cancer detection combining a computer-aided diagnostic system with TRUS-MRI targeted biopsy. Abdom Radiol (NY) 2019; 44:264-271. [PMID: 30054684 DOI: 10.1007/s00261-018-1712-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To validate a novel consensus method, called target-in-target, combining human analysis of mpMRI with automated CAD system analysis, with the aim to increasing the prostate cancer detection rate of targeted biopsies. METHODS A cohort of 420 patients was enrolled and 253 patients were rolled out, due to exclusion criteria. 167 patients, underwent diagnostic 3T MpMRI. Two expert radiologists evaluated the exams adopting PI-RADSv2 and CAD system. When a CAD target overlapped with a radiologic one, we performed the biopsy in the overlapping area which we defined as target-in-target. Targeted TRUS-MRI fusion biopsy was performed in 63 patients with a total of 212 targets. The MRI data of all targets were quantitatively analyzed, and diagnostic findings were compared to pathologist's biopsy reports. RESULTS CAD system diagnostic performance exhibited sensitivity and specificity scores of 55.2% and 74.1% [AUC = 0.63 (0.54 ÷ 0.71)] , respectively. Human readers achieved an AUC value, in ROC analysis, of 0.71 (0.63 ÷ 0.79). The target-in-target method provided a detection rate per targeted biopsy core of 81.8 % vs. a detection rate per targeted biopsy core of 68.6 % for pure PI-RADS based on target definitions. The higher per-core detection rate of the target-in-target approach was achieved irrespective of the presence of technical flaws and artifacts. CONCLUSIONS A novel consensus method combining human reader evaluation with automated CAD system analysis of mpMRI to define prostate biopsy targets was shown to improve the detection rate per biopsy core of TRUS-MRI fusion biopsies. Results suggest that the combination of CAD system analysis and human reader evaluation is a winning strategy to improve targeted biopsy efficiency.
Collapse
Affiliation(s)
- Riccardo Campa
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Maurizio Del Monte
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Giovanni Barchetti
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Martina Pecoraro
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Vincenzo Salvo
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Isabella Ceravolo
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Elena Lucia Indino
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Antonio Ciardi
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy
| | - Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy.
| |
Collapse
|
13
|
Pratico AD, Longo L, Mansueto S, Gozzo L, Barberi I, Tiralongo V, Salvo V, Falsaperla R, Vitaliti G, La Rosa M, Leonardi S, Rotondo A, Avola N, Sgarlata D, Damiano A, Tirantello M, Anzelmo G, Cipolla D, Rizzo A, Russo A, Ruggieri M, Salomone S, Drago F. Off-Label Use of Drugs and Adverse Drug Reactions in Pediatric Units: A Prospective, Multicenter Study. Curr Drug Saf 2018; 13:200-207. [DOI: 10.2174/1574886313666180619120406] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 11/22/2022]
Affiliation(s)
- Andrea D. Pratico
- Clinical Neuroscience Institute, Kings College London, London, United Kingdom
| | - Laura Longo
- Regional Pharmacovigilance Centre of Catania, Unit of Pharmacology – A.O.U. Policlinico – Vittorio Emanuele, Catania, Italy
| | - Silvana Mansueto
- Regional Pharmacovigilance Centre of Catania, Unit of Pharmacology – A.O.U. Policlinico – Vittorio Emanuele, Catania, Italy
| | - Lucia Gozzo
- Regional Pharmacovigilance Centre of Catania, Unit of Pharmacology – A.O.U. Policlinico – Vittorio Emanuele, Catania, Italy
| | - Ignazio Barberi
- Neonatal Intensive Care Unit, Hospital "G. Martino", University of Messina, Messina, Italy
| | - Venera Tiralongo
- Neonatal Intensive Care Unit, Hospital "G. Martino", University of Messina, Messina, Italy
| | - Vincenzo Salvo
- Neonatal Intensive Care Unit, Hospital "G. Martino", University of Messina, Messina, Italy
| | - Raffaele Falsaperla
- Unit of Pediatrics and Pediatrics Emergency, Hospital "Policlinico-Vittorio Emanuele", Catania, Italy
| | - Giovanna Vitaliti
- Unit of Pediatrics and Pediatrics Emergency, Hospital "Policlinico-Vittorio Emanuele", Catania, Italy
| | - Mario La Rosa
- Unit of Bronchopneumology and Cystic Fibrosis, Hospital "Policlinico-Vittorio Emanuele", Catania, Italy
| | - Salvatore Leonardi
- Unit of Bronchopneumology and Cystic Fibrosis, Hospital "Policlinico-Vittorio Emanuele", Catania, Italy
| | - Antonio Rotondo
- Unit of Pediatrics and Neonatology - Hospital Umberto I, Siracusa, Italy
| | - Nicoletta Avola
- Unit of Pediatrics and Neonatology - Hospital Umberto I, Siracusa, Italy
| | - Debora Sgarlata
- Unit of Pediatrics and Neonatology - Hospital Umberto I, Siracusa, Italy
| | - Annalisa Damiano
- Unit of Pediatrics and Neonatology - Hospital Umberto I, Siracusa, Italy
| | - Massimo Tirantello
- Unit of Pediatrics and Neonatology - Hospital Umberto I, Siracusa, Italy
| | - Gaspare Anzelmo
- Units of Pediatrics and Neonatology, ASP of Palermo, Palermo, Italy
| | - Domenico Cipolla
- Units of Pediatrics and Neonatology, ASP of Palermo, Palermo, Italy
| | - Angelo Rizzo
- Units of Pediatrics and Neonatology, ASP of Palermo, Palermo, Italy
| | - Antonio Russo
- Units of Pediatrics and Neonatology, ASP of Palermo, Palermo, Italy
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Sciences, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy
| | - Salvatore Salomone
- Section of Pharmacology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Filippo Drago
- Section of Pharmacology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| |
Collapse
|
14
|
Salvo V, Brogna B, Sampirisi L, Casinelli A, Emanuela R. Diffuse-primary-B-cell lymphoma of the cranial vault presenting as stroke. Radiol Case Rep 2018; 13:658-662. [PMID: 30046364 PMCID: PMC6056756 DOI: 10.1016/j.radcr.2018.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 03/12/2018] [Indexed: 11/29/2022] Open
Abstract
A rare case of diffuse-primary-B-cell lymphoma was misdiagnosed on emergency computed tomography because of blurred findings and a sclerotic appearance of the right parietal bone. In spite of computed tomography, magnetic resonance imaging provided a higher diagnostic yield, revealing more extensive diploic alterations and indicating the involvement of all of the cranial vault compartments. Therefore, a histologic examination of the surgical specimen was conducted to reach a conclusive diagnosis.
Collapse
Affiliation(s)
- Vincenzo Salvo
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, "Sapienza" University of Rome, Piazzale Aldo Moro n 5, 00185 Rome, Italy
| | - Barbara Brogna
- Department of Internal and Experimental Medicine "Magrassi-Lanzara", Institute of Radiology, Second University of Naples, Naples, Italy
| | - Luigi Sampirisi
- Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy
| | - Alice Casinelli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, "Sapienza" University of Rome, Piazzale Aldo Moro n 5, 00185 Rome, Italy
| | - Rastelli Emanuela
- Department of Neurology and Psychiatry, Neuroradiology, "Sapienza" University of Rome, Rome, Italy
| |
Collapse
|
15
|
Del Monte M, Leonardo C, Salvo V, Grompone MD, Pecoraro M, Stanzione A, Campa R, Vullo F, Sciarra A, Catalano C, Panebianco V. MRI/US fusion-guided biopsy: performing exclusively targeted biopsies for the early detection of prostate cancer. Radiol Med 2017; 123:227-234. [PMID: 29075977 DOI: 10.1007/s11547-017-0825-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/09/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of this study was to validate the role of MR/Ultrasound Fusion-Guided Targeted Biopsy as a first diagnostic modality in subjects with clinical suspicion of prostate cancer (PCa). MATERIALS AND METHODS 108 men (age range 46-78 years) with clinical suspicion for PCa (PSA > 4 ng/mL) underwent multiparametric MRI of the prostate (mpMRI) and, when suspicious lesion were found (according to the PIRADSv2 scoring system), targeted biopsy was performed. All patients without significant alteration patterns at mpMRI have been referred for follow-up at 1 year. RESULTS 91/108 patients showed on the mpMRI highly suspicious lesions (PIRADS 4 and 5); the remaining 17/108 patients revealed no significant alteration consistent with PCa (PIRADS 3). Among the first group of patients, 58/91 proved to be positive for PCa on the pathology report: 24 patients had a Gleason Score (GS) 6 (3 + 3); 18 patients GS 7 of which 7 (3 + 4) and 11 (4 + 3); 14 patients GS 8 (4 + 4); two patients GS 9 (5 + 4); 33 proved to be negative. Overall cancer detection rate (CDR) was 63%. However, the CDR rises significantly, up to 77%, after the 53 initial consecutive biopsies that were performed (p < 0,05) and thus identified as part of the learning curve. Patients of the second group (17/108) have been followed with serial PSA assessments, clinical reevaluation, and follow-up mpMRI. CONCLUSION Performing exclusively targeted MR/Ultrasound Fusion-Guided biopsies for the diagnosis of PCa in patients with suspicious PSA levels (> 4 ng/mL) increases the detection rate of clinically significant cancer, changing both the therapeutic options and the prognosis.
Collapse
Affiliation(s)
- Maurizio Del Monte
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161, Rome, Italy
| | | | - Vincenzo Salvo
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161, Rome, Italy
| | - Marcello Domenico Grompone
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161, Rome, Italy
| | - Martina Pecoraro
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161, Rome, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Riccardo Campa
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161, Rome, Italy
| | - Francesco Vullo
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161, Rome, Italy
| | | | - Carlo Catalano
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161, Rome, Italy
| | - Valeria Panebianco
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161, Rome, Italy.
| |
Collapse
|
16
|
Salvo V, Lista G, Lupo E, Ricotti A, Zimmermann LJI, Gavilanes AWD, Gitto E, Colivicchi M, Ferraù V, Gazzolo D. Comparison of three non-invasive ventilation strategies (NSIPPV/BiPAP/NCPAP) for RDS in VLBW infants. J Matern Fetal Neonatal Med 2017; 31:2832-2838. [PMID: 28718356 DOI: 10.1080/14767058.2017.1357693] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Vincenzo Salvo
- Neonatal Intensive Care Unit, “G. Martino” University Hospital of Messina, Messina, Italy
| | - Gianluca Lista
- Neonatal Intensive Care Unit, V. Buzzi Children’s Hospital, ASST-FBF-Sacco, Milan, Italy
| | - Enrica Lupo
- Neonatal Intensive Care Unit, V. Buzzi Children’s Hospital, ASST-FBF-Sacco, Milan, Italy
| | - Alberto Ricotti
- Neonatal Intensive Care Unit, C. Arrigo Children’s Hospital, Alessandria, Italy
| | - Luc J. I. Zimmermann
- Department of Pediatrics and Neonatology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Antonio W. D. Gavilanes
- Department of Pediatrics and Neonatology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Eloisa Gitto
- Neonatal Intensive Care Unit, “G. Martino” University Hospital of Messina, Messina, Italy
| | - Micaela Colivicchi
- Neonatal Intensive Care Unit, C. Arrigo Children’s Hospital, Alessandria, Italy
| | - Valeria Ferraù
- Neonatal Intensive Care Unit, “G. Martino” University Hospital of Messina, Messina, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit, C. Arrigo Children’s Hospital, Alessandria, Italy
| |
Collapse
|
17
|
D'Epiro S, Macaluso L, Salvi M, Luci C, Mattozzi C, Marzocca F, Salvo V, Scarnò M, Calvieri S, Richetta AG. Safety and prolonged efficacy of Botulin Toxin A in primary hyperhidrosis. Clin Ter 2017; 165:e395-400. [PMID: 25524193 DOI: 10.7417/ct.2014.1780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hyperhidrosis is a condition characterized by generalized or localized hyperfunction of the eccrine sweat glands with a deep negative impact on patient's quality of life. OBJECTIVES To evaluate the efficacy and the safety of Botulin Toxin A (BTX-A) intradermal injection in the treatment of primary axillary and palmar hyperhidrosis, investigating symptoms-free period, and the subjective improving of quality life. MATERIALS AND METHODS 50 consecutive patients with primary hyperhidrosis were evaluated detecting age, gender, hyperhidrosis onset period, disease duration and years of treatment with BTX-A, Minor's iodine test, Hyperhidrosis Disease Severity Scale (HDSS), Dermatology Life Quality Index (DLQI). RESULTS The treatment is significantly effective both for axillae and palms: the majority of the patients improved their HDSS and Minor's scores from a value of 4 in the two tests, to values of 1 (HDSS) and 0 (Minor test). Patients reported a duration of symptoms relief from 4 to 12 months, with a mean of 5.68 months; specifically, we have observed that the axillary group experienced a longer symptoms-free period (mean RFS 7.2 months) than the palmar group (mean: RFS 4.27 months). CONCLUSIONS Authors suggest that BTX-A is a safe, easy, and fast procedure for the treatment of primary axillary and palmar hyperhidrosis.
Collapse
Affiliation(s)
- S D'Epiro
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - L Macaluso
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - M Salvi
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - C Luci
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - C Mattozzi
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - F Marzocca
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - V Salvo
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - M Scarnò
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - S Calvieri
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - A G Richetta
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| |
Collapse
|
18
|
Arena S, Iacona R, Antonuccio P, Russo T, Salvo V, Gitto E, Impellizzeri P, Romeo C. Medical perspective in testicular ischemia-reperfusion injury. Exp Ther Med 2017; 13:2115-2122. [PMID: 28565817 DOI: 10.3892/etm.2017.4289] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/06/2017] [Indexed: 01/01/2023] Open
Abstract
Testicular torsion or torsion of the spermatic cord is one of the most serious urological conditions. It causes testicular injury, which potentially leads to male subfertility. The turning of the spermatic cord and spermatic structures around themselves results in biochemical and histological changes; however, following testicular detorsion, tissues undergo reperfusion that causes more severe damage than that induced by ischemia. Since the primary causes of testicular damage are reactive oxygen species production, an increase in intra-mitochondrial calcium concentration and an increased rate of cellular apoptosis, different medications may potentially be effective. It seems that several medications, experimentally and sometimes clinically, serve an adjuvant role in the cellular damage that occurs following ischemia-reperfusion. Antioxidants, calcium channel blockers, phytotherapeutical medicinals, anaesthetics, hormones and platelet inhibitors may potentially create a solid basis for an adjuvant restoring therapy and ameliorate testicular function following torsion. The current study aimed to review the relevant literature and discuss the actions of a number of molecules that may protect the testes during ischemia/reperfusion injury.
Collapse
Affiliation(s)
- Salvatore Arena
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Unit of Paediatric Surgery, University of Messina, I-98125 Messina, Italy
| | - Roberta Iacona
- Department of Paediatric Surgery, John Radcliffe Hospital, Oxford University Hospital, Oxford OX3 9DU, UK
| | - Pietro Antonuccio
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Unit of Paediatric Surgery, University of Messina, I-98125 Messina, Italy
| | - Tiziana Russo
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Unit of Paediatric Surgery, University of Messina, I-98125 Messina, Italy
| | - Vincenzo Salvo
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Neonatal and Intensive Care Unit, University of Messina, I-98125 Messina, Italy
| | - Eloisa Gitto
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Neonatal and Intensive Care Unit, University of Messina, I-98125 Messina, Italy
| | - Pietro Impellizzeri
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Unit of Paediatric Surgery, University of Messina, I-98125 Messina, Italy
| | - Carmelo Romeo
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Unit of Paediatric Surgery, University of Messina, I-98125 Messina, Italy
| |
Collapse
|
19
|
Marseglia L, D'Angelo G, Impellizzeri P, Salvo V, Catalano N, Bruno R, Galletti C, Galletti B, Galletti F, Gitto E. Neonatal stridor and laryngeal cyst: Which comes first? Pediatr Int 2017; 59:115-117. [PMID: 28102625 DOI: 10.1111/ped.13192] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/30/2016] [Accepted: 10/12/2016] [Indexed: 11/30/2022]
Abstract
Neonatal stridor is a rare condition usually caused by laryngomalacia. Congenital laryngeal cyst represents an uncommon cause of stridor in the neonatal population and may be misinterpreted as laryngomalacia, leading to serious morbidity and mortality if diagnosis and treatment are delayed. Herein we report the case of a full-term infant with stridor, feeding problems and failure to thrive. Initially, direct laryngoscopy diagnosed only laryngomalacia. As stridor worsened, however, and respiratory distress appeared, repeat laryngoscopy showed vallecular laryngeal cyst, visible macroscopically. The patient was successfully treated with endoscopic marsupialization. There was no evidence of recurrence at follow up after 3 months. This case highlights the importance of laryngoscopic assessment for suspected laryngeal abnormalities in infants with stridor. If symptoms worsen, endoscopy should be repeated, because congenital laryngeal cysts may not be immediately visible macroscopically.
Collapse
Affiliation(s)
- Lucia Marseglia
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - Gabriella D'Angelo
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - Pietro Impellizzeri
- Unit of Paediatric Surgery, Department of Paediatrics, University of Messina, Messina, Italy
| | - Vincenzo Salvo
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - Natalia Catalano
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - Rocco Bruno
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - Claudio Galletti
- Department of Anesthesiology and Critical Care, University of Messina, Messina, Italy
| | - Bruno Galletti
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - Francesco Galletti
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - Eloisa Gitto
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| |
Collapse
|
20
|
D'Epiro S, Salvi M, Luzi A, Mattozzi C, Luci C, Macaluso L, Marzocca F, Salvo V, Cantisani C, Paolino G, Calvieri S, Richetta AG. Drug cutaneous side effect: focus on skin ulceration. Clin Ter 2016; 165:e323-9. [PMID: 25203350 DOI: 10.7417/ct.2014.1750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Skin ulcers are defined as tissue loss interesting the deeper layers of the dermis and hypodermis, with low tendency to spontaneous healing. They cause disability related to pain, risk of infection and amputation, chronic management, requiring working absence with notably economic burden. The major cause is often related to underlying vascular disease, infections, tumors, autoimmunity, trauma, even if literature occasionally reported several cases of drug inducing skin ulceration. Most of drugs involved are chemotherapy agents and more recently molecular target therapies. Evidences supporting these drugs as the major cause of skin ulcers include delay of onset after therapy initiation, improvement after withdrawal of the drug, recurrence after its reintroduction and, sometimes, simultaneous occurrence of other skin lesions that have previously been reported to be associated with these agents. Attention should be reserved to patients undergoing antineoplastic agents, especially if previously affected by predisposing comorbidities, considering such side effect as possible differential diagnosis for skin ulceration in neoplastic patients.
Collapse
Affiliation(s)
- S D'Epiro
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - M Salvi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - A Luzi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Mattozzi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Luci
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - L Macaluso
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - F Marzocca
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - V Salvo
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Cantisani
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - G Paolino
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - S Calvieri
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - A G Richetta
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| |
Collapse
|
21
|
Panebianco V, Barchetti F, Grompone MD, Colarieti A, Salvo V, Cardone G, Catalano C. Magnetic resonance imaging for localization of prostate cancer in the setting of biochemical recurrence. Urol Oncol 2016; 34:303-10. [PMID: 27012939 DOI: 10.1016/j.urolonc.2016.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/20/2016] [Accepted: 01/23/2016] [Indexed: 01/26/2023]
Abstract
The clinical suspicion of local recurrence of prostate cancer after radical treatment is based on the onset of biochemical failure. The use of multiparametric magnetic resonance imaging (MRI) for prostate cancer has increased over recent years, mainly for detection, staging, and active surveillance. However, suspicion of recurrence in the set of biochemical failure is becoming a significant reason for clinicians to request multiparametric MRI. Radiologists should be able to recognize the normal posttreatment MRI findings. Fibrosis and atrophic remnant seminal vesicles (SV) after radical prostatectomy are often found and must be differentiated from local relapse. Moreover, brachytherapy, external beam radiotherapy, and focal therapies tend to diffusely decrease the signal intensity of the peripheral zone on T2-weighted images due to the loss of water content, consequently mimicking tumor and hemorrhage. The combination of T2-weighted images and functional studies like diffusion-weighted imaging and dynamic contrast-enhanced imaging improves the identification of local relapse. Tumor recurrence tends to restrict on diffusion images and avidly enhances after contrast administration. The authors provide a review of the normal findings and the signs of local tumor relapse after radical prostatectomy, external beam radiotherapy, brachytherapy and focal therapies.
Collapse
Affiliation(s)
- Valeria Panebianco
- Departement of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
| | - Flavio Barchetti
- Departement of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | | | - Anna Colarieti
- Departement of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Salvo
- Departement of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | | | - Carlo Catalano
- Departement of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
22
|
Arena S, Barresi V, Manganaro A, Salvo V, Perrone P, Gitto E, Romeo C. Bladder Mass in Newborn: Case Report and Review of Literature. Urology 2015; 86:1004-7. [DOI: 10.1016/j.urology.2015.06.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/23/2015] [Accepted: 06/30/2015] [Indexed: 10/23/2022]
|
23
|
Salvo V, Lista G, Lupo E, Ricotti A, Zimmermann LJI, Gavilanes AWD, Barberi I, Colivicchi M, Temporini F, Gazzolo D. Noninvasive ventilation strategies for early treatment of RDS in preterm infants: an RCT. Pediatrics 2015; 135:444-51. [PMID: 25667244 DOI: 10.1542/peds.2014-0895] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is evidence that new methods of noninvasive ventilation (NIV) support have significantly changed respiratory distress syndrome (RDS) management in preterm infants. Further perspectives for neonatologists involve the assessment of different NIV strategies in terms of availability, effectiveness, and failure. This study evaluates the efficacy of 2 different NIV strategies for RDS treatment in very low birth weight (VLBW) infants: nasal synchronized intermittent positive pressure ventilation (NSIPPV), which is a modality of conventional ventilation with intermittent peak inspiratory pressure, and bilevel continuous positive airway pressure (BiPAP), not synchronized, with 2 alternate levels of continuous positive airway pressure. METHODS We conducted a 2-center randomized control study in 124 VLBW infants (<1500 g and <32 weeks of gestational age) with RDS who received NIV support (NSIPPV, n = 62; BiPAP, n = 62) within 2 hours of birth. We evaluated the performance of NIV strategies by selected primary outcomes (failure rate and duration of ventilation) and secondary outcomes. RESULTS The number of failures and duration of ventilation support did not differ between NSIPPV and BiPAP strategies (P > .05 for both). Moreover, no differences between groups were found regarding secondary outcomes (P > .05 for all). CONCLUSIONS The present data show no statistically significant differences between NSIPPV and BiPAP strategies in terms of duration of ventilation and failures, suggesting that both NIV techniques are effective in the early treatment of RDS in VLBW infants. Further randomized investigations on wider populations are needed to evaluate the effect of NIV techniques on long-term outcomes.
Collapse
Affiliation(s)
- Vincenzo Salvo
- Neonatal ICU, "G. Martino" University Hospital of Messina, Italy
| | - Gianluca Lista
- Neonatal ICU, V. Buzzi Children's Hospital, Milan, Italy
| | - Enrica Lupo
- Neonatal ICU, V. Buzzi Children's Hospital, Milan, Italy
| | - Alberto Ricotti
- Neonatal ICU, C. Arrigo Children's Hospital, Alessandria, Italy
| | - Luc J I Zimmermann
- Department of Pediatrics and Neonatology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, Netherlands; and
| | - Antonio W D Gavilanes
- Department of Pediatrics and Neonatology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, Netherlands; and Institute of Biomedicine, Catholic University of Guayaquil, Ecuador
| | - Ignazio Barberi
- Neonatal ICU, "G. Martino" University Hospital of Messina, Italy
| | | | | | - Diego Gazzolo
- Neonatal ICU, C. Arrigo Children's Hospital, Alessandria, Italy;
| |
Collapse
|
24
|
Ricotti A, Salvo V, Zimmermann LJI, Gavilanes AWD, Barberi I, Lista G, Colivicchi M, Temporini F, Gazzolo D. N-SIPPV versus bi-level N-CPAP for early treatment of respiratory distress syndrome in preterm infants. J Matern Fetal Neonatal Med 2013; 26:1346-51. [PMID: 23488612 DOI: 10.3109/14767058.2013.784255] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Non-invasive ventilation (NIV) for RDS in extremely/very low birth-weight infants represents the new challenge for neonatologists. In this regard, data comparing the effectiveness of Bi-Level-NCPAP (BiPAP) versus nasal synchronized intermittent positive pressure ventilation (NSIPPV) as primary mode of treatment for RDS are lacking. STUDY DESIGN We conducted a retrospective study from December 2007 to December 2010 in seventy-eight infants, who received NIV (N-SIPPV: 33; BiPAP: 45). The primary outcomes were the length and failure of NIV. Secondary outcomes were adverse short-long term pulmonary outcomes, multiple doses of surfactant and others. RESULTS There were no significant differences (p > 0.05) between the two different NIV modes. CONCLUSION The present findings suggest that N-SIPPV and BiPAP gives similar results in the RDS treatment. We did not find a benefit of one over the other ventilation mode and both could be constitute a valid option to conventional mechanical ventilation. The theoretical benefits of these two different methods of NIV are tidal volume enhancement, improvements of the functional residual capacity and of the mean airway pressure and reducing apnea episodes. Further randomized studies to assess the advantages and the efficacy of different methods of NIV for the treatment of the RDS are needed.
Collapse
Affiliation(s)
- Alberto Ricotti
- Neonatal Intensive Care Unit, C. Arrigo Children's Hospital, Alessandria, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Bellissima V, Borghesi A, Bozzetti V, Dessì A, Fabiano A, Risso FM, Salvo V, Satriano A, Silvagni D, Varrica A, van Bel F, Visser GHA, Vles HJ, Zimmermann LJI, Gavilanes ADW, Gazzolo D. Italia-Netherland PhD Program: the I.O. PhD Research Program. J Matern Fetal Neonatal Med 2011; 24 Suppl 1:111-3. [PMID: 21878061 DOI: 10.3109/14767058.2011.607662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In the framework of long-term scientific collaboration among the founder members coming from Holland and Italy there was a growing consensus to activate a philosophical doctorate (PhD) program, involving young Italian researchers in the field of perinatal medicine, neonatology and pediatrics. The aims were to promote excellence in research, offering to young Italian physicians the opportunity to maturate an International research experience leading to PhD degree, and to promote human and technological improvement energies in perinatal, neonatal and pediatrics research. Thus, an official collaboration among the Dutch Universities from Maastricht and Utrecht and the Italian Children's Hospital from Alessandria, has been activated on March 1st 2010, finalized to the PhD program. The experimental phase included the selection of projects and relative candidates after an interview-selection focusing on their scientific attitudes and the availability on their research projects. Candidates' selection started on May 2010 and on September 29th ten projects and candidates have been approved by the scientific commission. Research topics included: perinatal asphyxia, aging and the origin of adulthood neurodegenerative disease, neuroprotective strategies, biochemical pulmonology, intrauterine growth retardation and perinatal teratology. To date, all projects have been approved by local Ethics Committee from the University/Hospital of origin of the candidates. Five manuscripts have been published and/or submitted to international Journals regarding pneumology, perinatal asphyxia and teratology, whilst about 60-70% of data regarding clinical studies have already been collected.
Collapse
Affiliation(s)
- Valentina Bellissima
- Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children's Hospital, Alessandria, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Ussia GP, Tina LG, Scarabelli M, Nigro F, Li Volti G, Cavallaro D, Salvo V, Mulè M, Caruso E, Tamburino C, Gazzolo D. Nitric oxide test during cardiac catheterization decreases the serum concentrations of S100B protein in adult patients with idiopathic pulmonary hypertension. Scand J Clin Lab Invest 2007; 67:668-72. [PMID: 17891653 DOI: 10.1080/00365510701286202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Cardiac catheterization (CC) is a life-threatening procedure in adult patients. Complicated by idiopathic arterial pulmonary hypertension (IPAH), there is a potential risk of central nervous system (CNS) damage. We measured serum levels of a well-established brain damage marker, namely S100B, collected before, during and after CC in adult patients in whom the nitric oxide (NO) test had been performed. MATERIAL AND METHODS In 12 adult patients who had undergone CC for IPAH diagnosis, we recorded clinical and standard monitoring procedures (laboratory variables and echocardiographic patterns) and serum concentrations of S100B before (time 0), during (time 1) and after the NO test (time 2) and at 24 h after (time 3) the procedure in samples obtained from the systemic and pulmonary circulation. Patients were subdivided into NO test responders (n=6) and non-responders (n=6). Neurological evaluation was performed at admission and at discharge from hospital. RESULTS Adult patients subjected to CC showed no overt neurological injury at discharge from hospital. No significant differences (p > 0.05 for all) in S100B serum levels between groups at times 0, 1 and 3 have been shown independently from the sampling site. It was noteworthy that the concentration of protein in the responders group at time 2 was significantly decreased (p < 0.05, for all) compared to the responder group and to baseline values. A significant correlation was found between arterial oxygen partial pressure and individual S100B concentration in the pulmonary and systemic bloodstream in the entire study group (R = -0.66 and R = 0.71, respectively; p < 0.05, for both). CONCLUSIONS The data suggest that S100B protein assessment, as well as the NO test, may be useful when monitoring possible CNS damage during CC in patients with IPAH, and may also be valuable in relation to brain functions, especially when performed as an emergency procedure in severely hypoxic patients.
Collapse
Affiliation(s)
- G P Ussia
- Department of Heart, Ferrarotto Hospital, University of Catania, Catania, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Greco F, Salvo V, Sorge A, Perrini S, Garozzo R, Sorge G. Co-infection with Mycoplasma pneumoniae and cytomegalovirus resulting in an acute demyelinating polyneuropathy in a pediatric patient. Turk J Pediatr 2007; 49:331-333. [PMID: 17990593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A co-infection with Mycoplasma pneumoniae and cytomegalovirus (CMV) resulting in an acute demyelinating polyneuropathy is reported in an immunocompetent girl. Two months following a respiratory infection, the patient showed a symptomatology consisting of weakness in lower limbs, followed by facial asymmetry and arm weakness. Serum M. pneumoniae antibodies were elevated and active CMV infection was diagnosed by polymerase chain reaction (PCR) performed on cerebrospinal fluid. Treatment with oral clarithromycin, intravenous immunoglobulins and ganciclovir was associated with rapid improvement and complete recovery. It is very probable that clinical findings were secondary to the reactivation of CMV caused by persistent M. pneumoniae infection in the respiratory tract. This may be the first report in the pediatric literature of a co-infection of M. pneumoniae and CMV resulting in peripheral nervous system involvement.
Collapse
Affiliation(s)
- Filippo Greco
- Department of Pediatrics, University of Catania, Catania, Italy
| | | | | | | | | | | |
Collapse
|
28
|
Abstract
Mycoplasma pneumoniae is an important bacterial agent that causes pneumonia in pediatric patients; it can also affect other organs or systems. Extrapulmonary manifestations include neurological, cardiac, hematologic, renal, gastrointestinal, osteoarticular, cutaneous, and ocular involvement. This report presents a 7-year-old male affected with cutaneous and retinal vasculitis due to M pneumoniae infection without pulmonary detection. The available literature on cutaneous vasculitis and M pneumoniae infection is also reviewed.
Collapse
Affiliation(s)
- Filippo Greco
- Department of Pediatrics, University of Catania, Catania, Italy.
| | | | | | | |
Collapse
|
29
|
Ussia GP, Caruso E, Mulè M, Tamburino C, Tina LG, Nigro F, Cavallaro D, Salvo V, Gazzolo D, Li Volti G. S100B protein blood concentrations in pulmonary and systemic circulation: Correlations with oxygenation status and sampling modalities. Clin Chim Acta 2007; 380:243-4. [PMID: 17328881 DOI: 10.1016/j.cca.2007.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2006] [Revised: 01/09/2007] [Accepted: 01/09/2007] [Indexed: 11/30/2022]
|
30
|
Smilari P, La Spina M, Salvo V, Romeo MG, Sanges G. [Esophageal atresia and malformative association. Clinical contribution]. Minerva Pediatr 2005; 57:289-96. [PMID: 16205614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
AIM Esophageal atresia (EA) is a congenital malformation with an incidence of 1/3,000-3,500 live birth, due to anomalies of the foregut. Although an interstitial deletion of chromosome 17 (q22q23.3) has been identified, the etiology seems to be multifactorial and not only genetic. The aim of this retrospective study is to evaluate the association of EA with chromosomal pathologies and/or malformation syndromes. METHODS The authors report 18 cases of EA admitted to the UTIN of the Pediatric Department, University of Catania, between January 1998 and January 2001, and discuss the phases of preoperative stabilization, the operation, postoperative complications and the follow-up at 12 months. RESULTS The results obtained concerning the association of EA with chromosomal diseases and malformation syndromes are described in the ''Results'' section of the paper. CONCLUSIONS The results obtained, notwithstanding the low number of patients, show that the association of EA with chromosomal pathologies and malformation syndromes is relevant both from a numerical and prognostic point of view in comparison to the data published in the literature.
Collapse
Affiliation(s)
- P Smilari
- Unità di Terapia Intensiva e Subintensiva Neonatale (UTIN), Università degli Studi di Catania, Azienda Policlinico, Catania
| | | | | | | | | |
Collapse
|
31
|
Smilari P, La Spina M, Lentini L, La Mantia I, Salvo V, Pappalardo MG, Romeo MG, Serra A. [Neonatal vocal cord palsy. Clinical and therapeutical approaches]. Minerva Pediatr 2002; 54:153-60. [PMID: 11981530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Between 1998 and 2000, four newborns have been observed for laryngeal stridor occurred some hours after birth. Otorhinolaryngologic examinations, as well as cardiac, neuroradiologic and serologic investigations have been performed to formulate the diagnosis and verify the etiology. The fiberoptic laryngoscopy showed a bilateral paralysis of the vocal cord in two newborns, a monolateral paralysis of the left vocal cord in another and in the last one, instead, a bilateral cordal hypomobility. The follow-up performed till the age of one year showed a complete remission of the symptomatology in two newborns, respectively in the one with monolateral paralysis and in the other affected by hypomobility of the vocal cords; of the two newborns with bilateral paralysis, instead, one is dead because of Haemophilus Influenzae epiglottitis, three weeks after discharge without physicians' consensus, while in the other patient, affected by lobar holoprosencephaly, it was necessary to perform a tracheotomy because of a severe obstructive apnea. The lobar holoprosencephaly, is a cerebral malformation characterized by the partial separation of the cerebral hemispheres, and it is described for the first time associated with bilateral vocal cords paralysis.
Collapse
Affiliation(s)
- P Smilari
- Dipartimento di Specialità Medico-Chirurgiche, Divisione di Otorinolaringoiatria, Azienda Garibaldi, Catania
| | | | | | | | | | | | | | | |
Collapse
|