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A Del Vecchio

Publications and source records attributed to A Del Vecchio.

At least 19 recordsLinked to original sources
PubMed2005

Early postnatal changes in the perfusion index in term newborns with subclinical chorioamnionitis.

BACKGROUND: Chorioamnionitis (HCA) in term newborns is often subclinical and associated with neonatal morbidity and mortality. OBJECTIVE: To assess the value of the pulse oximetry perfusion index (PI) in the early prediction of subclinical HCA in term newborns. METHODS: PI cut-off values were first identified in 51 term newborns with HCA and 115 matched controls, retrospectively categorised on the basis of placental histology (study phase 1). The PI thresholds obtained were subsequently tested on an unselected case series of 329 prospectively recruited, term newborns (study phase 2). PI was evaluated during the first five minutes after delivery. Initial illness severity and short term clinical outcomes were determined. RESULTS: In study phase 1, newborns with HCA had lower PI one and five minutes (p<0.0001) after delivery, lower one minute Apgar score (p = 0.017), lower cord blood base excess (p = 0.0001), together with higher rates of admission to neonatal intensive care unit (p = 0.0001) and endotracheal intubation (p = 0.017), and higher SNAP-PE (p<0.0001) and NTISS (p<0.0001) scores than those without HCA. In the prospective validation phase of the study, the PI cut-off values generated (one minute < or =1.74, five minutes < or =2.18) showed 100% sensitivity, 99.4% specificity, 93.7% positive predictive value, and 100% negative predictive value in identifying subclinical HCA. Early identification of HCA was associated with a decreased rate of admission to intensive care (p = 0.012), as well as lower initial illness severity (p< or =0.0001) and therapeutic intensity (p = 0.0006) than the newborns with HCA in phase 1. CONCLUSION: These findings suggest that early PI monitoring is helpful in identifying HCA in term newborns.

Apgar Score↗
PubMed2004

Foetal growth of kidneys, liver and spleen in intrauterine growth restriction: "programming" causing "metabolic syndrome" in adult age.

BACKGROUND/AIMS: Epidemiological studies in humans link adult disease to abnormal growth in utero. In addition to general malnutrition of the foetus, preferential blood flow to the brain and heart may furthermore deprive organs such as the liver, spleen and kidneys of oxygen and macro- and micronutrients. As a consequence, these organs may not develop normally, which predisposes the individual to the so-called metabolic syndrome (syndrome X) in later life. The effects of foetal undernutrition on the growth of some abdominal organs were investigated by comparing the volume of the kidneys, spleen and liver in small-for-gestational-age (SGA) newborn infants with that in appropriate-for-gestational-age (AGA) newborn infants. METHODS: In 25 randomly selected AGA infants and 25 SGA infants, who were subdivided into three gestational age groups (<30, 30-36 and 37-40 wk) the volumes of the liver, kidneys and spleen were determined by ultrasonography. Organ volumes were estimated using the standard ellipsoid formula (longitudinal x anteroposterior x transverse diameter x pi/6). Liver/kidney, liver/spleen and kidney/spleen volume ratios were also determined. RESULTS: The volumes of the kidneys and liver differed significantly between AGA and SGA infants in all three gestational age groups (p < 0.0018 and p < 0.029, respectively). The fact that the spleen volume differed only in the 37-40 wk group (p = 0.0002) may indicate that there is a graded relationship across the whole range of normal birthweight. The correlation between the liver volume and birthweight differed significantly between SGA and AGA infants (r = 0.56 vs 0.84, p = 0.04). On the other hand, the volume ratios between the three organs were the same in all groups (p > 0.15). CONCLUSION: In intrauterine growth retarded infants, foetal growth of the liver and kidneys is more impaired than the body as a whole. Retarded foetal development of these organs may cause metabolic dysfunction, which predisposes to the group of diseases included in the so-called metabolic syndrome or syndrome X.

Autopsy↗
PubMed2004

Detection of free and plankton-associated Helicobacter pylori in seawater.

AIMS: To detect both free and plankton-associated Helicobacter pylori in seawater samples collected on the Italian coast of the Adriatic Sea using a nested-PCR. METHODS AND RESULTS: Dissolved oxygen, pH, salinity and chlorophyll 'a' were the parameters recorded together with the characterization of zooplanktonic organisms. Plankton-associated H. pylori DNA was searched for in water samples filtered through 200 and 64 microm nylon nets whereas free bacteria were retained with the subsequent filtration through 0.22 microm pore-size membranes. Nested-PCR using primers for the glmM (ureC) gene was performed to reveal the presence of H. pylori. The DNA sequencing of amplified products confirmed the specificity of the assay. The sensitivity of the nested-PCR assay for H. pylori detection was 62 CFU per 100 ml in spiked water samples. Helicobacter pylori either free or bound to planktonic organisms was found in seven of 12 monthly samples. In particular, free bacteria were detected during the summer sampling and in November, December and March associated to planktonic cells. CONCLUSIONS: The presence of free and plankton-associated H. pylori in seawater suggests that it can be a significant reservoir and a potential route of transmission for the microorganism. SIGNIFICANCE AND IMPACT OF THE STUDY: Our study seems to provide a promising background to define new and effective strategies for surveillance of this human pathogen.

Animals↗
PubMed2003

Status epilepticus and neurodevelopmental outcome at 2 years of age in an extremely low birth weight infant.

Neonatal status epilepticus (SE) is very rare and, to date, very little information exists on SE in preterm infants. Here, we report recurrent SE as a result of hypoxic-ischemic encephalopathy in an extremely low birth weight (ELBW) infant, who had favorable neurodevelopment at a corrected age of 2 years. This clinical observation seems to indicate that recurrent SE does not exclude normal long-term neurodevelopment, even in ELBW infants.

Birth Weight↗
PubMed2003

Exposure to Di(2-ethylhexyl)phthalate in humans during pregnancy. A preliminary report.

BACKGROUND: Di(2-ethylhexyl)phthalate (DEHP), the most commonly used plasticizer, is a widespread ubiquitous environmental contaminant. The potential health hazards from exposure to DEHP and its main metabolite, mono(2-ethylhexyl)phthalate (MEHP), have been well documented. Exposure to DEHP and MEHP in humans at risk, such as pregnant women and human fetuses, has not been tested. METHODS: Plasma DEHP and MEHP concentrations were measured in a total of 24 consecutive mother-infant pairs by high performance liquid chromatography. Associations between DEHP/MEHP and infant characteristics were tested using Fisher's exact test, unpaired t tests and univariate linear regression analysis. RESULTS: Measurable DEHP and MEHP concentrations were found in 17/24 (70.8%) and 18/24 (75%) maternal plasmas, respectively, and in 11/25 (44%) and 18/25 (72.0%) cord samples, respectively. Either DEHP or MEHP were detectable in 21/24 (87.5%) maternal plasmas and 19/25 (76%) cord samples. The mean DEHP concentrations in maternal and cord plasmas were 1.15 +/- 0.81 and 2.05 +/- 1.47 microg/ml, respectively. The mean MEHP concentrations were 0.68 +/- 0.85 and 0.68 +/- 1.03 microg/ml, respectively. No significant correlations were found between maternal and cord blood DEHP, maternal and cord blood MEHP, maternal DEHP and cord blood MEHP, or maternal MEHP and cord blood DEHP plasma concentrations. CONCLUSION: Although the effects of perinatal exposure to phthalates need further research, our findings: (i) confirm the high frequency of DEHP and/or MEHP exposure in human pregnancies; (ii) indicate that the exposure to these environmental contaminants begins during intrauterine life, and (iii) suggest that fetal exposure is closely related to the maternal exposure.

Adult↗
PubMed2002

Use of the bleeding time in the neonatal intensive care unit.

UNLABELLED: Impairments of primary hemostasis are frequently responsible for serious bleeding in sick infants in the neonatal intensive care unit (NICU). Therefore, a rational approach to these infants with hemorrhagic manifestations, in addition to an accurate medical history, a careful physical examination and routine screening coagulation tests, may include a bleeding time. The bleeding time is the traditional in vivo test for assessing primary hemostasis. It is a useful clinical tool to detect quantitative or qualitative platelet disorders or microvascular defectiveness. Its diagnostic value in neonates is controversial, mainly owing to limited experience in executing the test, which is performed uncommonly in the NICU. Using a template device expressly adapted for neonates (Surgicutt Newborn), a small incision 2.5 mm long and 0.5 mm deep provides a standardized, reproducible and sensitive bleeding time, with minimal scarring and pain. Various hereditary or acquired maternal and neonatal diseases, as well as some antepartum medications given to the mother or drugs commonly used to treat NICU patients, such as indomethacin, ibuprofen, penicillin compounds and theophylline, can impair primary hemostasis and consequently prolong the bleeding time in neonates. Furthermore, other factors distinctive to neonates, including gestational age, the increased von Willebrand factor concentration and function, high hematocrit, the large size of erythrocytes and platelet hyporeactivity in the first 10 d of life, affect platelet-vessel wall interaction and influence the interpretation of bleeding time results in newborn infants. Because the clinical evaluation of primary hemostasis consists of complex laboratory testing, largely reserved for specialized laboratories and currently not routinely performed in newborn infants, automated bleeding time devices specifically generated to make standardized and acceptably small incisions in newborn infants have become a surrogate. CONCLUSION: With awareness of its value and limitations, the bleeding time can be included in the baseline evaluation of neonates in the NICU, for guiding diagnosis and treatment of primary hemostatic disorders.

Bleeding Time↗
PubMed2002

Case report. Ultrasound and CT findings in lipoma of the inferior vena cava.

Several cases of a fat mass-like lesion adjacent to and/or projecting into the inferior vena cava have been presented as a normal variant of perioesophageal fat distribution or as intravascular lipoma. We report a case of a lipoma of the inferior vena cava, studied with coronal reformatted CT images, ultrasound and colour Doppler imaging, in a 78-year-old female patient.

Aged↗
PubMed2002

[Gorlin's syndrome. Case report].

The authors present a case of Gorlin's Syndrome, more satisfactorily defined as nevoid basal cell carcinoma syndrome (NBCS), a rare genetic disorder characterized mainly by multiple basal cell carcinomas and odontogenic keratocysts and other less frequent skeletal, sexual and neurological manifestations. Patient 75 years old, male. Previously treated surgically for multiple cutaneous basal cell carcinomas, comes to our Department to remove a suspected asymptomatic keratocyst. Clinical examination reveals cutaneous alterations of hands and feet (webbed hands and feet), a little progenism and multiple nevi and basal cell carcinomas on the body and the head. The oral cavity is free of alterations or clinical signs. NBCS is probably caused by chromosomal abnormalities of chromosome 5 and 9. The abnormalities seen in the latter are similar to those seen in people exposed for long periods to UV radiation. These abnormalities could determine malignant cutaneous tumors removing anti neoplastic protection. The association with odontogenic keratocysts, however not clearly understood, appears in more than 90% of cases. All the other disorders are less frequent. Juvenile basal cell carcinomas, especially if associated with odontogenic keratocysts suggest, the hypothesis of NBCS; if confirmed, this diagnosis makes further familial investigations necessary, to diagnose other cases, at the time unknown.

Aged↗
PubMed2002

Census of radiological machines in Radiodiagnostic Services of public and recognized hospitals in the Campania Region.

AIM: The present study provides a census of equipment in use by Radiodiagnostic Services in public hospitals and institutes recognized by the Region of Campania in the year 2000. The type, date of installation and distribution of the equipment were considered in relation to the number of hospital beds and the resident population. MATERIALS AND METHODS: A census was taken of all the public hospitals and institutes recognized by the Region of Campania in the period running from January 1999 to April 2000. Data were collected using an appropriate form asking for details of the number of machines and the model, manufacturer and year of installation, under six categories: traditional radiology, mammography, US, CT, MR and angiography. The data were analyzed by provinces, combining the different machines into five-year periods depending on the date of their installation. RESULTS: Traditional radiology equipment accounts for 71% of the total. The mean for the Region stands at 23 machines per 1000 beds. The mean date of installation was 1986. Mammography machines account for 8% of the total. The mean for the Region stands at 2.6 machines per 1000 beds. The mean date of installation was 1991. Echography machines account for 10.3% of the total. The mean for the Region stands at 3.4 machines per 1000 beds. The mean date of installation was 1992. Angiography machines account for 3.2% of the total. The mean for the Region stands at 1.1 machines per 1000 beds. The mean date of installation was 1985. CTs account for 6.4% of the total. The mean for the Region stands at 2.1 machines per 1000 beds. The mean date of installation was 1993. MR account for 1.1% of the total. The mean for the Region stands at 0.4 machines per 1000 beds. The mean date of installation was 1995. CONCLUSIONS: Technological and scientific improvements and growing attention to the quality of medical care expected by patients mean that constant modification and adaptation are needed to meet demands. In planning measures designed to provide new radiological equipment and modernize existing equipment in the Region it would certainly be useful to eliminate the unevenness of the services provided. In conclusion, it is crucial that the local administrations and health authorities in the Campania Region establish a regular census, with proper assessment of the obsolescence of radiological equipment and its distribution throughout the area, in order to comply with international standards.

Equipment and Supplies↗
PubMed2001

Platelet transfusions in the neonatal intensive care unit:factors predicting which patients will require multiple transfusions.

BACKGROUND: Previous studies suggest that recombinant thrombopoietin (rTPO) will increase platelet production in thrombocytopenic neonates. However, the target populations of neonates most likely to benefit should be defined. Studies suggest that rTPO will not elevate the platelet count until 5 days after the start of treatment. Therefore, the neonates who might benefit from rTPO are those who will require multiple platelet transfusions for more than 5 days. This study was designed to find means of prospectively identifying these patients. STUDY DESIGN AND METHODS: A historic cohort study of all patients in the neonatal intensive care unit (NICU) at the University of Florida who received platelet transfusions from January 1, 1997, through December 31, 1998, was conducted. RESULTS: Of the 1389 patients admitted to the NICU during the study period, 131 (9.4%) received platelet transfusions. Seventeen were treated with extracorporeal membrane oxygenation and were excluded from further analysis. Of the remaining 114 patients, 55 (48%) received one transfusion and 59 (52%) received more than one transfusion (21 had >4). None of the demographic factors examined predicted multiple platelet transfusions. However, two clinical conditions did; liver disease and renal insufficiency. Neonates who received one platelet transfusion had a relative risk of death 10.4 times that in neonates who received none (p = 0.0001). Neonates who received >4 platelet transfusions had a risk of death 29.9 times that in those who received no transfusions (p = 0.0001). CONCLUSION: NICU patients with liver disease or renal insufficiency who receive one platelet transfusion are likely to receive additional transfusions. Therefore, these patients constitute a possible study population for a Phase I/II rTPO trial.

Cohort Studies↗
PubMed2000

Cognitive impairment in old rats: a comparison of object displacement, object recognition and water maze.

The behavioral performance of young and aged rats was studied in a repeated-trials test. Young animals reacted to both spatial displacement and novelty, whereas most aged rats lost the ability to react to novelty although maintaining spatial memory. The cluster analysis procedure performed on all the tested subjects enabled the recognition of a consistent group of the aged sample (35%) with a mild degree of spatial and non-spatial memory impairment. Spatial memory impairment of some of the aged animals was also evaluated in the Morris water maze test. On the fifth day of the task, we observed a very low percentage of impaired aged animals, which partially corresponded to the impaired group identified by the object recognition test. In contrast, the subgroup of mildly impaired rats performed similarly to the young animals. We advance that the Morris water maze might represent a stressful experimental condition for aged rats, enhancing the motivational level of animals subjected to this procedure. This condition may alter the cognitive responses. As a consequence, the "mildly impaired" rats, which may be considered an interesting group for investigating memory-enhancing drugs, will infrequently be recognized with the Morris water maze test. Cognitive impairment in aged rats should be studied utilizing a sensitive test in which motivation does not substantially influence the results of the test.

Aging↗
PubMed2000

Performing and interpreting the bleeding time in the neonatal intensive care unit.

In summary, the bleeding time is a helpful clinical tool to detect and investigate certain hemostatic defects in neonates and to evaluate the adequacy of treatments. A prolonged bleeding time alone is sometimes not sufficient to diagnose specific conditions requiring further investigations. Platelet hyporeactivity in the first days of life, gestational age, platelet dysfunction secondary to various neonatal or maternal pathologic conditions, neonatal or maternal drug administration, and hematocrit must be considered for the correct interpretation of the bleeding time test in neonates. In addition, reliable test results can be ensured only by the scrupulous execution of the procedure.

Bleeding Time↗
PubMed2000

Evaluation and treatment of thrombocytopenia in the neonatal intensive care unit.

Thrombocytopenia is a very frequent problem among sick neonates, affecting up to 35% of all infants admitted to the NICU. Although multiple clinical conditions have been causally associated with neonatal thrombocytopenia, the cause of the thrombocytopenia is unclear in up to 60% of affected neonates. This article provides neonatologists with a practical approach to the thrombocytopenic neonate, with an emphasis on conditions that could be life-threatening or could have significant implications for further pregnancies. An overview of the current therapeutic modalities is also presented, including a discussion of the possible use of recombinant thrombopoietic cytokines to treat certain groups of thrombocytopenic neonates.

Humans↗
PubMed2000

Metastasis to the male breast from carcinoma of the urinary bladder.

We report a case of male breast metastasis from a urothelial carcinoma. Only two cases of this type of metastasis have been previously reported, and these were in the female breast. Clinical examination showed a progressive swelling of the left mammary region, with periareolar skin infiltration. Both mammography and ultrasound showed a rounded mass. Only histological examination with immunohistochemical staining permitted the correct diagnosis to be made. A particular feature of the present case is the absence of contralateral gynaecomastia, normally seen in cases of metastatic tumour to the breast from prostatic carcinoma.

Aged↗
PubMed2000

[Spiral computerized tomography without perfusion of contrast media as first line investigation in patients with renal colic].

INTRODUCTION: We investigated the diagnostic accuracy of unenhanced helical CT in the detection of stones in patients with suspected renal colic from ureteral stones and compared CT findings with the results of plain abdominal film and US. MATERIAL AND METHODS: We reviewed the findings relative to 80 patients (age range 24-75) who came to our observation to the Emergency Department with acute flank pain. All patients had been examined with plain abdominal radiography, US and unenhanced helical CT. RESULTS: While abdominal radiography showed the presence of radiopaque stones in 38 patients only (47.5%), US demonstrated ureter dilatation in 72 patients and detected stones in 36 of them (45%). Helical CT performed best, depicting a stone in 72 patients (90%), with high sensitivity and specificity. Mean stone size was 3 mm, with 7 mm-1 mm range. The biggest stones were seen in 3 cases and the smallest ones in 34. In 8 patients with no signs of stones we found other extraurinary conditions, namely pancreatitis, diverticula, renal cancer. We also found a case of urinary tract infection. CONCLUSIONS: Thanks to its short execution time and accuracy, helical CT makes the examination of choice in patients with acute flank pain due to renal colic. It is also a most valuable tool in the differential diagnosis of other pathological causes of pain such as abdominal or pelvic masses and inflammatory conditions.

Adult↗