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Biomedical subjects

A Cecchi

Publications and source records attributed to A Cecchi.

At least 19 recordsLinked to original sources
PubMed2004

Role of oxidative stress as physiopathologic factor in the preterm infant.

Oxidative stress usually occurs when the production of damaging free radicals (ROS) and other oxidative molecules exceeds the capacity of the body's antioxidant defenses. This process is supposed to begin after the delivery, but it can even affect the fetus when maternal pregnancy diseases (i.e.: pre-eclampsia, eclampsia, maternal infections) occur and in the case of preterm delivery. Most living organisms have developed well integrated antioxidant defenses to prevent the potential negative role of the ROS, in order to scavenge them and to control their concentration. These mechanisms are deficient in preterm newborn. Many illnesses in preterm infants, including bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), brain injury such as hypoxic/ischemic encephalopathy, and intraventricular hemorrhage (IVH) are thought to be related to the action of ROS. This presumably occurs due to the fact that the antioxidant system of preterm infants is at the same time highly stressed and incompletely developed. Unfortunately, the clinical trials which tried to prevent oxidative stress using antioxidant agents failed their objective and therefore they cannot be considered as an effective therapy. The objective of this review is to clarify the role of oxidative stress in the development of the previous severe diseases in preterm infants, and its possible correlation with hyperbilirubemia.

Bronchopulmonary Dysplasia↗
PubMed1997

In vivo antiviral activity and pharmacokinetics of (-)-cis-5-fluoro-1-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]cytosine in woodchuck hepatitis virus-infected woodchucks.

The (-) enantiomer of cis-5-fluoro-1l-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]cytosine [(-)-FTC)], a substituted oxathiolane compound with anti-hepatitis B virus activity in vitro, was assessed for its efficacy in woodchucks with naturally acquired woodchuck hepatitis virus (WHV) infection. Pharmacokinetics and in vitro anabolism were also determined. (-)-FTC was anabolized to the 5'-triphosphate in a dose-related fashion, reaching a maximum concentration at about 24 h in cultured woodchuck hepatocytes. Following administration of a dose of 10 mg/kg of body weight intraperitoneally (i.p.), the clearance of (-)-FTC from plasma was monoexponential, the terminal half-life was 3.76 +/- 1.4 h, and the systemic clearance was 0.12 +/- 0.06 liters/h/kg. The antiviral efficacy of (-)-FTC in the woodchuck model was assessed by quantitation of serum WHV DNA levels and by WHV particle-associated DNA polymerase activity at two dosages, 30 and 20 mg/kg given i.p. twice daily (b.i.d.), respectively. The level of WHV DNA in serum was reduced 20- to 150-fold (average, 56-fold) in the 30-mg/kg-b.i.d. treatment group and 6- to 49-fold (average, 27-fold) in the 20-mg/kg-b.i.d. treatment group. Viral DNA polymerase levels diminished accordingly. One week after treatment was discontinued, WHV levels returned to pretreatment levels in both studies. These animals were biopsied before and following treatment with 30 mg of (-)-FTC per kg. Their livers were characterized by a mild increase in cytoplasmic lipid levels, but this change was not associated with altered liver enzyme levels. Serum chemistry and hematology results were within the normal ranges for all treated animals. We conclude that (-)-FTC is a potent antihepadnaviral agent and that it has no detectable toxic effects in woodchucks when given for up to 25 days. Further development of (-)-FTC as an anti-hepatitis B virus therapy for patients is warranted.

Animals↗
PubMed1997

Deformation analysis of brain regions.

The analysis of 2D and 3D deformations applied to structures having non regular geometry is presented. Deformations are studied in order to understand complex dynamic problems coded into image sequences. In particular, methods have been developed suitable to control the reconstruction and the spatial deformation of cerebral structures, in their different aspects of morphometry, isometry and densitometry. Finally, a simulation process of brain deformation caused by a neoplasia in a real relevant clinical case has been performed.

Brain↗
PubMed1995

[Autologous blood collection in pregnancy. Prospective study].

Autologous blood predonation during pregnancy, with the aim of autotransfusion after delivery, has gained increasing consensus over the last few years. However, there are still some controversial aspects. In particular, the cost/benefit ratio of institutionalizing the above mentioned practice would appear altogether unfavourable (too many women would be really in need of transfusion after delivery). The aim of the present study is to assess the results of our experience using autotransfusion in obstetrics. This longitudinal and prospective study was carried out on a sample of 29 pregnant women who donated 1 unit of blood during the last month of their pregnancy. Phlebotomy was preceded by a verification of the permitting conditions (Hb > or = 11 g/dl; Ht > or = 33%). Before, during and after phlebotomy, the patients underwent cardiotocographic monitoring and periodic observation of vital parameters. The hematologic parameters registered during the various test (before predeposit, before delivery, in puerpery) were statistically analysed. The hemochromo values appeared satisfactory in all cases at the time of admittance for labour. As a consequence of a hematic loss higher than usual at the moment of delivery, in many cases the hemoglobin values during puerpery did not enable us to exclude a priori the advisability of a transfusion. From the study we see how the cost/benefit ratio of the predeposit practice in obstetrics is less unfavourable than commonly thought.

Adult↗
PubMed1995

[The role of prostaglandin E2 in cervix maturation and labor induction. Clinical experience].

In obstetrics there are sometimes situations that require a prompt induction of labour. The possibility of employing prostaglandins instead of oxytocin would seem to increase the prospects of success. The aim of the present study is to strike a preliminary balance of our experience on how the use of exogenous PGE2 (dinoprostone) helps to start the labour in term pregnant women. The study considered retrospectively a sample of 40 women that underwent one or more attempts to induct labour through intracervical application of PGE2 gel during the period 01/12/1992-01/04/1994. The results of the attempts were evaluated according to numerous parameters. In addition, we tried to define the prognostic value that could be attached to the characteristics of the tocogram an hour after dinoprostone had been administered. The percentage of success (88.89%) was high, while the incidence of instrumental deliveries and/or complications proved unimportant. The results of the attempts were positively linked to the Bishop score and to the regularity of the uterine contractions an hour after the application of PGE2. The utilization of dinoprostone proved effective and free from risks, authorising its clinical employment and the experimentation of new protocols.

Adult↗
PubMed1995

[Labor and delivery in a pregnancy involving fetal macrosomia].

The alleged connection between fetal magalosomia and the increased risk of maternal and perinatal morbidity justifies the lively discussion that has developed about the management problems caused by a big unborn child. The aim of this study is to offer a contribution to the definition of the more or less peculiar problems associated with labour and delivery in a pregnant women with a megalosomic fetus. The study was retrospectively carried out on a sample of 45 women who, during the period 1190-1993, delivered a fetus weighing at least 4 kg. This sample was statistically compared with a numerically identical standard sample, selected at random. The main characteristics of labour and delivery were examined in the two groups under study. The most considerable differences observed concern the length of the labour, greater in the sample than in the standard group, and the frequency of dystocic events, similarly more considerable in the pregnant women with a megalosomic fetus. Maternal and perinatal outcomes, in spite of the small number of cesarean sections performed, were anyway very good in both the examined groups. In our experience, the risks associated with fetal megalosomia were rather limited, but this is not a reason to minimize beyond measure the problem we are talking about.

Adult↗
PubMed1995

[Fetal megalosomia: clinical and prognostic value of main risk factors].

Fetal megalosomia associates with an increased risk of maternal and perinatal pathology. However it is right to make a clear distinction between "physiologic" megalosomia, expression of a high genetic potential of growth from the fetus, and megalosomia referable to any maternal pathology. While the first one entails problems of obstetric management at the most, the second one compels to take measures in order to reduce its incidence. A sample of 45 fetuses with megalosomia was studied retrospectively and compared with a standard sample, randomly selected among the fetuses, term delivered, who in the same period considered (January 1990-January 1994) weighed less than 4 kg at birth. This was done in order to verify which of the risk factors of fetal megalosomia reported in the medical literature affects the most the people who address our Institute. Important risk factors resulted, besides maternal height and postdatism, pre-gestational overweight and obesity. The prognostic significance of the factors, such as advanced maternal age, multiparity, male sex of the unborn child, excessive maternal weight gain during pregnancy, previous megalosomia, was of more difficult interpretation. In our experience, gestational diabetes didn't play the role, universally recognized to it, of the most important risk factor of fetal megalosomia.

Female↗
PubMed1994

[The prevention of nitrate tolerance in angina patients treated with transdermal nitroglycerin: a comparison of 2 therapeutic regimens (therapeutic outlook versus dosage reduction)].

We studied the long-term antianginal and anti-ischemic effects of two dosage regimens designed to prevent tolerance to transdermal nitroglycerin (TNTG): (1) 10 mg TNTG applied for 16 h with a 'nitrate-free' interval of 8 h; (2) 10 mg TNTG applied for 16 h followed by a 'nitrate-low' interval of 5 mg applied for 8 h. 129 patients completing a 3-month study period were evaluated by repeated exercise tests. Both regimens significantly increased maximum exercise duration at 3 months, from 699.1 +/- 23.4 to 833 +/- 21.9 s and from 686.1 +/- 20 to 789.6 +/- 22.6 s, respectively, reduced the number of patients with 1 mm S-T segment depression and increased the time duration to 1 mm S-T segment depression. Marked reductions in anginal attacks was observed in both groups: from 6.5 to 0.15 attacks per week and from 6.0 to 0.15 attacks per week, respectively. No statistically significant differences were found between the groups, and both regimens were well tolerated. In conclusion, our results demonstrate sustained antianginal efficacy, without tolerance, of either 'nitrate-free' of 'nitrate-low' interval therapy with transdermal nitroglycerin.

Administration, Cutaneous↗
PubMed1994

[Autologous transfusion in obstetrics and fetal safety].

It is common knowledge that for modern medicine transfusion therapy represents a precious resource and an often mandatory option. It is equally known that autohemotransfusion (or autologous transfusion) provides further advantages: certainty of blood availability when necessary, absence of transfusion reactions, elimination of the risk of infections that is still associated with the traditional homologous transfusions. In its most widespread application, autotransfusion provides for the donation of one or more units of autologous blood, mostly before elective surgery. Even in obstetrics the practice of autologous blood donation with the aim of autotransfusion is finding increasing employment. However, there are still controversial aspects and the need is pointed out for more authoritative verifications as refers to the alleged innocuity to the fetus of acute maternal blood loss. The present study was performed to contribute personal experience to a better definition of the possible interactions between autologous blood donation during pregnancy and unborn child welfare. To this end, 80 term pregnant women underwent fetal heart rate electronic monitoring before, during and after the donation of one unit of autologous blood. Both during and after the phlebotomy there were no cardiotocographic signs of fetal hypo-oxygenation. Even the non stress tests performed at a distance of 24 hours and those that were periodically repeated afterwards were normal, confirming the safety of autologous predonation during pregnancy. However, the authors think that in obstetrics it is still premature to consider the experimental phase of autotransfusion as definitively exhausted.

Blood Donors↗
PubMed1993

[Thrombosis of a Bjork-Shiley mitral valve prosthesis: its thrombolytic treatment with rt-PA].

A 62-year-old woman with a Bjork-Shiley prosthetic mitral valve, presented with pulmonary edema and cardiogenic shock. Doppler echocardiography showed a significant increase of trans-prosthetic gradient due to a thrombotic obstruction. Successful treatment with rt-PA is described. From a subsequent analysis of previous echocardiograms a longstanding asymptomatic thrombus is hypothesised.

Chronic Disease↗
PubMed1993

[Use of a new type of permanent caval filter in a case of recurrent pulmonary embolism].

We describe a case of postoperative recurrent pulmonary embolism, treated with a percutaneous caval filter ("Double hooks DF 06-Filcard"), that was useful for stemming the tide of venous thromboembolism starting from right leg deep venous thrombosis. We discuss diagnostic protocols, current indications to caval filtration, and the characteristic of an ideal caval filter.

Aged↗
PubMed1984

Controlled clinical investigation of dimetophrine versus midodrine in the management of moderately decreased arterial blood pressure.

An open, controlled study was carried out in 30 in-patients with low arterial pressure syndrome to compare the effectiveness and tolerance of dimetophrine and midodrine in restoring blood pressure to normal levels and relieving symptoms. Patients were allocated at random to receive treatment for 15 days with either 100 mg dimetophrine tablets or 2.5 mg midodrine tablets and dosage was adjusted according to each patient's condition. Blood pressure and heart rate were monitored daily, symptoms were assessed every 8 days, and laboratory tests carried out before and after treatment. The results showed that both drugs significantly increased systolic and diastolic pressure to normal levels during the trial period and no patient failed to respond. Dimetophrine showed a significantly faster onset of action in increasing systolic pressure and levels reached a plateau significantly earlier than with midodrine. No significant differences were observed between the effects of the two drugs on diastolic pressure, although there was a smoother and more progressive increase in dimetophrine-treated patients. Neither drug significantly modified the heart rate. Both drugs were effective in relieving symptoms but, although there was no significant difference between treatments, patients on dimetophrine experienced somewhat faster and greater relief than those receiving midodrine. At the end of the treatment period, only 11% of dimetophrine-treated patients still complained of mild symptoms compared with 33% of those on midodrine. The mean daily dosage was 3.7 tablets of dimetophrine and 4.9 tablets of midodrine. Both drugs were well tolerated; no side-effects were reported and there were no abnormalities in the laboratory tests.

Adult↗