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Biomedical subjects

A Pachì

Publications and source records attributed to A Pachì.

At least 19 recordsLinked to original sources
PubMed1994

Prenatal echocardiographic diagnosis of right atrial isomerism.

A prenatal diagnosis of right atrial isomerism is often inferred through the recognition of a constellation of cardiac anomalies on the four-chamber view or by the detection of visceral heterotaxy and asplenia. However, the actual occurrence of discordance between the arrangement of the atria and thoracic and abdominal organs makes the identification of the morphology of both atrial appendages the only reliable way to make a final diagnosis of atrial isomerism. Three cases of right atrial isomerism with visceral heterotaxy and a complex cardiac defect, diagnosed in utero by cross-sectional and colour flow Doppler echocardiography, are reported. In all the patients, the right atrial isomerism was associated with an atrioventricular septal defect, a single aortic outlet from the right ventricle, and total anomalous venous return. The diagnosis of right atrial isomerism, always confirmed by neonatal re-evaluation and/or by post-mortem examination, was made through identifying two pyramidal atrial appendages in an echocardiographic transverse plane at the level of the atria and of the origin of the great arteries. This report demonstrates that a final intrauterine diagnosis of atrial isomerism is possible, whatever the visceral situs is.

Echocardiography, Doppler↗
PubMed1994

Activated and "memory" phenotype of circulating T lymphocytes in intrauterine life.

We examined the expression of T cell markers in the peripheral blood of five immunologically normal human fetuses at 18-20 weeks of gestational age. The distribution of T cells expressing CD1, CD3, CD4, CD8, CD56, and the alpha/beta and gamma/delta receptors for antigen was comparable to that of newborns and normal adults, except for the absence of gamma/delta cells expressing the delta TCS-1 epitope. The V beta repertoire, as evaluated by two-color flow cytometry using mAbs to specific V beta families, was also comparable to that of adult samples. A significant fraction (8.9 to 16.4%) of fetal CD3+ T cells expressed the alpha chain of IL-2R (CD25) in the absence of HLA-DR; this suggests that antigenic stimuli trigger, during intrauterine life, an unusual pathway of T cell activation. Consistent with this, 7 to 27% of fetal T cells were found to express the CD45R0 marker of "memory" cells.

Antigens, CD↗
PubMed1994

Management of human papilloma virus vulvo-perineal infection with systemic beta-interferon and thymostimulin in HIV-positive patients.

OBJECTIVES: To evaluate the effect of a combined therapy based on beta-interferon and thymostimulin in HIV-seropositive women with florid vulvoperineal condylomatosis. METHODS: Nineteen HIV-seropositive women affected by HPV florid vulvo-perineal infection were studied. Their ages ranged from 19 to 32 years (mean = 26); all were smokers; 11 (57.89%) were intravenous drug users with a mean period of drug addiction of 5 years. No patient was on AZT therapy. All patients underwent a combined medical therapy based on beta-interferon administration with doses of 3,000,000 IU i.m. daily for 7 days and subsequently on alternate days for 2 weeks associated with the administration of 70 mg i.m. of thymostimulin per day on alternate days for 30 days. RESULTS: Seven (36.84%) patients showed complete recovery at the end of follow-up; 5 (26.31%) patients showed partial recovery and 7 (36.84%) did not respond to therapy. CONCLUSION: A pro-host immunotherapy seems to be indicated in patients affected by immunodeficiency syndrome.

AIDS-Related Opportunistic Infections↗
PubMed1994

Obstetrical implications in multiple pregnancies.

In the present study 90 multiple pregnancies were examined. These were subdivided on the basis of the number of embryos involved (74 twins, 10 triplets, 6 quintuplets) and on whether they were followed at our clinic for the entire pregnancy or not. In each group we analysed certain variables, calculating the respective mean values and standard deviations. We used the ANOVA test to discriminate the eventual differences in the means of the variables analysed, operating a p < 0.05 significance value. In addition, significant differences were analysed by the test of Contrasts (Scheffe F-test). The concept that emerged from the data investigated is that careful management of these pregnancies, carried out in high-level structures, can reduce the incidence of complications on both the maternal and fetal side and thus prevent "minimal brain damage" in the newborn.

Abortion, Spontaneous↗
PubMed1994

Regression formula for estimation of fetal weight with use of abdominal circumference and femur length: a prospective study.

Ultrasonographic fetal measurements from 293 singleton pregnancies were obtained within 7 days of delivery. Biparietal diameter, abdominal circumference, femur length, and actual birth weight data of the first 93 fetuses in the study were used as variables to determine the best mathematical model for relating estimated fetal weight to biparietal diameter, abdominal circumference, and femur length. With the aid of a computer, three regression equations were derived. The best model was Log10 (weight) = 0.77125 + 0.13244 (AC) - 0.12996 (FL) - 1.73588 (AC x AC)/1000 + 3.09212 (FL x AC)/1000 + 2.18984 (FL/AC); (R2 = 0.987). The accuracy of this formula was then compared prospectively, first with the formulas published by Shepard and coworkers, Rose and McCallum, and Hadlock and colleagues in the entire sample of 200 patients, second in 46 large, 101 appropriate, and 53 small for gestational age fetuses, and then in 44 fetuses of pregnancy complicated by diabetes. The difference between actual and estimated birth weights generated by the study formula had no systematic error (Student's t-test, P > 0.05) in cumulative data, and in small or appropriate and large for gestational age fetuses. As this derived formula is very cumbersome to manipulate, tables have been prepared with computer assistance to read the estimated fetal weight directly.

Abdomen↗
PubMed1994

Low-risk endometrial hyperplasia: hysteroscopy and histologic evaluation after treatment with LH-RH analogue.

Endometrial hyperplasia is an endometrial pathologic condition often found at perimenopausal age. Abnormal uterine bleeding (A.U.B.) is the most frequent symptom of endometrial hyperplasia. The combination of hysteroscopy and endometrial biopsy is the most suitable approach for the diagnosis of endometrial hyperplasia in symptomatic patients. We have studied endometrial modifications due to LHRH-analogue in 75 patients with AUB and with a hysteroscopic and histologic picture of low-risk endometrial hyperplasia. LHRH analogue is a valid treatment for all estrogen induced pathologies, because of its suppressive action on hypothalamic-hypophysary gonadotropins. The administration of LHRH for 4 months induced an improvement of the menstrual cycle within the first month of treatment in 53.3% of cases. At the end of treatment 100% of the patients were in amenorrhea. The hysteroscopic follow-up at 3 months showed an endometrial thinning with a tendency to hypoatrophy of the mucosa in 72% of cases. Three months after the end of treatment 20 patient had regular menstrual cycles and hysteroscopic and a histologic picture of normal endometrium. Only 30 patients had persistent amenorrhea with a consequent hysteroscopic and histologic picture of endometrial hypoatrophy. The use of LHRH analogue seems to have a great impact on the management of estrogen-dependent gynaecological benign diseases.

Adult↗
PubMed1989

Prenatal diagnosis of adult polycystic kidney disease with DNA markers on chromosome 16 and the genetic heterogeneity problem.

A prenatal diagnosis of adult polycystic kidney disease by DNA testing is reported. Evidence showing a linkage between the disease and the 3'HVR and 24.1 restriction fragment length polymorphisms (RFLPs) on chromosome 16 was obtained in the proband's family by linkage analysis of data and homogeneity testing with Italian families of the linked type. Fetal genotype prediction based on both flanking markers was confirmed by histological and ultrastructural findings in fetal kidneys.

Adult↗
PubMed1989

Ultrasound diagnosis of fetal annular pancreas.

A case of fetal "duodenal" obstruction was brought to our attention at 37 weeks gestation. The patient was referred to our Prenatal Diagnosis Center with an ultrasound finding of "double bubble" in the abdominal area of the fetus. We submitted the patient to an aimed ultrasound examination in order to establish the etiopathogenetic mechanism and to perfect the diagnosis. The ultrasound scans of the epigastric region strongly suggested the presence of annular pancreas. The diagnosis of duodenal stenosis due to annular pancreas was confirmed at birth and the infant underwent corrective surgery: duodeno-jejunostomy was successfully performed. We would like, in this context, to stress again the powerful diagnostic value of ultrasound investigation, when dealing with complex fetal malformations. The present report shows that high resolution echographic equipment and the ever-increasing qualification of medical staff make it possible to envisage the presence of annular pancreas already in prenatal life.

Adult↗
PubMed1984

Acute fatty liver of pregnancy. Description of a case of survival.

The Authors describe a case of acute fatty metamorphosis of the liver in pregnancy in a patient who survived and delivered a living female child. Clinical and istopathologic features, possible etiologic factors and possible treatment for the mother and fetus are discussed. The Authors, finally, think that acute fatty liver of pregnancy is more frequent than expected and that it should be considered in all cases of jaundice in pregnancy.

Acute Disease↗