Biomedical subjects

F De Seta

Publications and source records attributed to F De Seta.

32 records · Page 2Linked to original sources

PubMed1999

Inhibition of trophoblast adhesion to endothelial cells by the sera of women with recurrent spontaneous abortions.

PROBLEM: May anti-phospholipid or other autoantibodies interfere with trophoblast-endothelial cells interaction in women with unexplained pregnancy losses? METHODS OF STUDY: The sera of 72 women with recurrent spontaneous abortions (RSA) containing antibodies to endothelial cells (28), trophoblast (14), and cardiolipin (10) or lacking antibodies (25), and 26 controls were examined in an inhibition assay of trophoblast adhesion to endothelial cells using an ELISA based on the recognition of trophoblast by antibodies to cytokeratin. RESULTS: Adhesion of trophoblast to endothelial cells was time- and dose-dependent. Patients and control sera inhibited trophoblast adhesion with mean values of 37% and 7%, respectively. Inhibition above 2SD of the mean control value was still observed in 58% of the patients sera and 8% of the control sera. Sera containing antibodies to endothelial cells had higher inhibitory effect (38%) than those with antibodies to trophoblast (23%) and cardiolipin (28%) or lacking antibodies (26%). CONCLUSIONS: Antibodies and other undefined factors in the sera of women with RSA inhibit adhesion of trophoblast to endothelial cells.

Abortion, Habitual↗

PubMed1998

DDD pacing with rate drop response function versus DDI with rate hysteresis pacing for cardioinhibitory vasovagal syncope.

BACKGROUND: The effectiveness of cardiac pacing in preventing vasovagal syncope remains controversial. However, DDI pacing with rate hysteresis has been reported to prevent the recurrence of cardioinhibitory vasovagal syncope in up to 35% of affected subjects and to reduce the overall incidence of syncopal episodes in the others. Recently, DDD pacing with a new promising rate drop response function (Medtronic Thera-I model 7960) has become available in clinical practice. AIM OF THE STUDY: The aim of the present open trial was to test the effectiveness of this new pacing modality in patients with cardioinhibitory vasovagal syncope. STUDY POPULATION AND METHODS: The study population included 20 patients (12 males and 8 females; mean age 61.1 +/- 14 yrs) with recurrent syncope (mean number of prior episode = 6.8, range 5-11) and cardioinhibitory responses during two head-up tilt tests: the first diagnostic and the second during drug therapy with either beta-blockade or etilephrine. The study patients were randomized to receive either DDI pacing with rate hysteresis (8 patients) or DDD pacing with rate drop response function (11 patients). The head-up tilt test performed 1 month after pacemaker implantation was positive in 3 of 12 patients (25%) with DDD pacing with rate drop response function and in 5 of 8 patients (62.5%) with DDI pacing with rate hysteresis. The mean duration of follow-up was 17.7 +/- 7.4 months. During follow-up no patients with a DDD pacemaker with rate drop response function had syncope, while 3 of 8 patients with a DDI pacemaker with rate hysteresis had recurrence of syncope (P < 0.05). CONCLUSIONS: These data suggest that DDD pacing with rate drop response function is effective in cardioinhibitory vasovagal syncope and may be preferable to DDI pacing with rate hysteresis.

Cardiac Pacing, Artificial↗

PubMed1998

[Insulinemic response to oral glucose loading tests in screening for diabetes in pregnancy].

BACKGROUND AND AIMS: Given that an increased peripheral insensitivity to insulin represents the primum movens of gestational diabetes, it is reasonable to suppose that the determination and evaluation of the insulinemic response to an oral glucose loading test may represent a simple, effective and low cost screenign test. A method was devised which consisted in performing two assays of insulin and glycemia in venous blood; the first while fasting, the second one hour after the ingestion per os of 50 g glucose. METHODS: A group of 79 pregnant women, aged between 20 and 41 years old (mean age 30.5), was tested in around the 23rd week of gestation. All women were attending the Obstetric and Gynecological Clinic at Trieste University. RESULTS: Based on the results obtained, insulinemic parameters appear to be significantly correlated with data for the short glycemic curve according to O'Sullivan-Mahan. CONCLUSIONS: This study appears to confirm the need to include insulinemic tests as part of the new and more efficacious glucose tolerance tests and to perform prospective studies in order to identify the most reliable screening method in terms of sensitivity and specificity, also in relation to the cost-benefit ratio.

Administration, Oral↗

PubMed1998

[Prevention of obstetrical damage to the perineum. Proposal for a fetal-pelvic index for the selection of parturients at risk].

BACKGROUND: According to some authors, vaginal delivery always causes denervation of perineum and the greater the damage the longer the second labour phase (the so-called "delivering phase"). Therefore, it is necessary to reduce the number of too prolonged labours, but it is equally important to avoid an uncontrolled increase of cesarean sections. In order to achieve this objective, it is important to carry out a careful selection among laboring women and choose those most at risk for whom cesarean section is strongly recommended. On the basis of the data collected by the medical literature and in consideration of the pathogenetic role of the outlet dystocia, we have tried to identify a simple and effective prognostic index resulting from the different pelvimetric and ultrasonographic parameters. METHODS: In 72 full-term pregnant women, we have taken into account the ultrasonographic parameters expressing the fetal dimension (cephalic diameters, cephalic and abdominal circumferences, estimated fetal weight according to Haddlok), the outlet pelvic diameters (trans-ischial and coccygeal-pubic) and a fetal-pelvic index derived from these parameters. RESULTS: If taken individually, these parameters do not seem to have any direct connection with the length of the delivering phase, but the combination of the cephalic and external pelvimetric diameters has produced a significative statistical coefficient. CONCLUSIONS: On the basis of the data collected, it is suggested that a careful evaluation of external pelvimetric and cephalic parameters would be useful from the clinical point of view.

Adult↗

PubMed1997

Steroid-eluting electrodes prevent chronic pacing threshold rise in the atrial chamber after oral propafenone administration.

The aim of the study was to evaluate chronic atrial pacing threshold increase after oral propafenone therapy. Fifty patients affected by advanced AV block and sick sinus syndrome were studied at least 6 months after pacemaker implantation, before and after oral propafenone therapy (450-900 mg/day based on body weight). The patients were subdivided into three groups as to the type of electrode implanted, all three unipolar: group I (20 patients) Medtronic CapSure 4003, group II (13 patients) Medtronic Target Tip 4011, group III (17 patients) Medtronic 4057 screw-in leads. In all cases, Medtronic unipolar pacemakers were implanted with the same noninvasive autothreshold measurement method. Propafenone and 5-OH-propafenone blood levels were measured 3-5 hours after drug administration. The packing autothreshold was measured at 0.8, 1.6, and 2.5 V by reducing the pulse width. After propafenone, groups II and III showed a statistically significant threshold rise (P ranging from < 0.01 to 0.05), whereas no significant difference was found in group I. Propafenone and 5-OH-propafenone blood vessels did not show any significant difference among the three groups. Strength-duration curves were drawn for the three groups before and after propafenone: at baseline the curves shifted to the left with the steep part above the knee, clearly favoring CapSure over the other two groups. After propafenone, the curves shifted to the right, with the flat par progressively more evident in groups II and III. In the atrial chamber, steroid-eluting leads prevented threshold increase after propafenone therapy, in contrast with a significant threshold rise with conventional porous and screw-in leads.

Aged↗

PubMed1997

Eligibility criteria for labor induction with prostaglandins.

Particular conditions exist at the end of some pregnancies which cause an increase in maternal and fetal risk. A valid alternative for these pregnancies is represented by the administration of prostaglandins, in order to obtain labor induction. The goal of our study was to define the eligibility criteria and the epidemiological characteristics that correlate most with a favorable obstetrical outcome. The study was conducted on 133 informed, consenting patients subjected to labor-induced delivery with prostaglandins E2. The mode of delivery in relationship to parity demonstrated that the pluriparous patients had fewer difficulties in labor and in its induction: of the 43 pluriparous cases, none had a cesarean section for failed induction and 95.3% delivered vaginally. One hundred percent of the patients with a Bishop score of more than 4 went into labor, as opposed to 81% of the patients with a score of less than 4. Therefore, taking into consideration the cost of the method, we retain that choosing an active position is valid, respecting the eligibility criteria for the induction of labor described above.

Adult↗

PubMed1997

Long-term haemodynamic and antiarrhythmic benefits of DDIR versus DDI pacing mode in sick sinus syndrome and chronotropic incompetence.

AIMS: The aim of this Italian multicentre study was to evaluate the haemodynamic and antiarrhythmic effects of DDIR versus DDI pacing mode in sick sinus syndrome with chronotropic incompetence. METHODS: Seventy-nine patients were implanted with a dual chamber rate-responsive pacemaker (Medtronic 7075) and centrally randomised to DDI or DDIR pacing mode. After six months, the pacing modality was crossed over. Follow-up included clinical data, rest ECG, echocardiography, Holter monitoring and exercise testing in DDIR. RESULTS: a) Haemodynamic effects. Comparing postimplant exercise testing in DDIR mode with preimplant tests, peak heart rate increased from 96 +/- 17 to 115 +/- 17 bpm (+20%, p < 0.0001), total work capacity from 7.0 +/- 3.5 to 8.8 +/- 4.3 minutes (+26%, p < 0.0001), peak oxygen uptake from 1238 +/- 406 to 1453 +/- 423 ml/min (+17%, p < 0.001) and oxygen uptake at anaerobic threshold from 977 +/- 343 to 1222 +/- 415 ml/min (+25%, p < 0.001). These benefits persisted unchanged during one-year follow-up. b) Antiarrhythmic effects. After six months, paroxysmal atrial fibrillation recurrence significantly decreased in the whole population: group I (DDI) 20.7 vs 48.3%, p < 0.02; group II (DDIR) 21.2 vs 36.4%, p < 0.05; group I + II (DDI + DDIR) 21.0 vs 41.9%, p < 0.001. After one year no significant differences were found between DDI and DDIR. Group I: DDI 23.8 vs DDIR 28.6%, ns; group II: DDI 22.7 vs DDIR 18.2%, ns. CONCLUSION: DDIR vs DDI significantly improves short- and long-term haemodynamic performance. Dual chamber pacing shows a significant reduction of paroxysmal atrial fibrillation recurrence, regardless of rate responsiveness.

Aged↗

PubMed1996

Reliability of a new algorithm for automatic mode switching from DDDR to DDIR pacing mode in sinus node disease patients with chronotropic incompetence and recurrent paroxysmal atrial fibrillation.

To evaluate the safety and efficacy of a new algorithm for automatic mode switching (AMS) from DDD-DDDR to DDIR, 26 patients, 16 females and 10 males, mean age 73 +/- 6 years of age, affected by sinus node disease, chronotropic incompetence, and recurrent paroxysmal atrial fibrillation (PAF) received the Medtronic Thera DR pacemaker. The device continuously calculates, in ms, the running average of the intrinsic atrial rate (MAR) and compares the current atrial interval (CAI) with the stored MAR. When the CAI is greater than the MAR it increases by 8 ms, and when the CAI is less than the MAR, it decreases by 23 ms. When MAR < or = 330 ms (182 beats/min), tachycardia is detected and AMS is activated. All patients had clinical evaluation, 12-lead ECG, Holter monitoring, and exercise testing after implantation and every 3 months for 1 year. The results were compared with the data stored in the pacemaker memory: AMS episodes number; the histogram of the last 14 episodes; and atrial electrogram recording. Twenty-two Holter recordings in 13 patients showed PAF and in all of them AMS occurred simultaneously. AMS lasted between 10 seconds and 20 hours, and MAR ranged from 195-400 beats/min. No episode of PAF and no AMS were recorded in 39 Holter recordings in 22 patients. Appropriate AMS was confirmed in five patients by stored atrial electrogram and in nine by 12-lead ECG and pacemaker event markers. Mean atrial sensing was 2.13 +/- 1.04 mV during PAF and 3.18 +/- 1.46 mV during sinus rhythm. No PAF episode and no AMS were recorded during exercise testing. In conclusion, this new algorithm was very reliable, sensitive, and specific.

Aged↗

PubMed1994

Asymptomatic genitourinary Chlamydia trachomatis infection in women seropositive for human immunodeficiency virus infection.

OBJECTIVE: To evaluate the prevalence of asymptomatic Chlamydia trachomatis genitourinary infection in women with human immunodeficiency virus (HIV) infection. METHODS: The prevalence of asymptomatic chlamydial genitourinary infection in HIV-seropositive women was compared with both HIV-seronegative controls and women with unknown HIV status. Chlamydia trachomatis was isolated in cell culture from endocervical and urethral specimens. RESULTS: The prevalence of genitourinary C trachomatis infection among HIV-seropositive women was 18.3% (21 of 115), a rate significantly higher than in both HIV-negative women (11 of 136; P = .016) and controls with unknown HIV status (18 of 326; P = .0001). Crude odds ratios for endocervical and urethral chlamydial infection in HIV-seropositive women compared to HIV-seronegative controls were 2.6 (95% confidence interval [CI] 1.13-6.08) and 3.3 (95% CI 1.15-9.67), respectively. After adjustment for variables related to sexual habits, there was no difference in the risk of cervical C trachomatis infection between HIV-seropositive cases and HIV-seronegative controls (Mantel-Haenszel odds ratio 1.04, 95% CI 0.93-1.14; P = .41). Finally, in HIV-seropositive patients, both the severity of immunosuppression evaluated by CD4+, CD8+, and total lymphocyte counts and the detection of p24 HIV-related antigen did not correlate with the presence of chlamydial infection. CONCLUSIONS: Women infected with HIV are at high risk for asymptomatic genitourinary chlamydial colonization. To prevent a possible "epidemic" of pelvic inflammatory disease, appropriate screening programs and therapeutic strategies should be planned.

Adult↗

PubMed1993

Langerhans' cell counts and cervical intraepithelial neoplasia in women with human immunodeficiency virus infection.

The mean counts of Langerhans' cells were evaluated in cervical biopsies obtained from 30 patients with human immunodeficiency virus (HIV) infection and cervical intraepithelial neoplasia (CIN) and from 30 HIV-seronegative control patients. Each HIV-seronegative control was matched to a seropositive case with respect to grade of CIN, age, and smoking habits. Langerhans' cells were identified by immunohistochemical staining for S-100 protein. In situ hybridization with biotinylated probes was performed to detect human papillomavirus (HPV) DNA 6/11, 16/18, and 31/35/51. The mean counts of S-100 positive cells per 100 basal cells were lower in HIV-seropositive patients than in controls (0.99 +/- 0.08 vs 1.9 +/- 0.2 P = 0.024). These differences occurred independent of any coexisting HPV infection. Positive correlations between S-100 positive cell counts and CD4+ and CD8+ cell counts were found in HIV-infected women. AIDS patients had lower Langerhans' cell counts compared both to patients with AIDS-related complex or asymptomatic HIV infection. Our results suggest that local cervical immunity, as evaluated by Langerhans' cell counts, is impaired in HIV-seropositive women. The severity of impairment seems to correlate with the stage of the HIV disease.

Carcinoma in Situ↗

PubMed1993

Do steroid-eluting electrodes really have better performance than other state-of-the-art designs? The Italian Multicenter Study Group on Low Output Stimulation.

A multicenter study evaluated the performance of atrial and ventricular unipolar leads with porous steroid-eluting and platinized grooved electrodes. A total of 563 leads were implanted in 451 patients. These included 311 ventricular and 97 atrial steroid-eluting electrodes; and 112 ventricular and 43 atrial leads with platinized electrodes. Mean follow-up was > or = 1 year. At implant there were no significant differences in threshold parameters in either chamber. Chronically, however, the steroid-eluting lead consistently had significantly lower pacing thresholds in both chambers. For example, after 360 days implant, steroid-eluting electrodes had 0.23 +/- 0.10 msec ventricular thresholds at 0.8 V compared to 0.45 +/- 0.3 msec in the platinized group (P < 0.0001). In the atrium, the steroid-eluting lead's 6-month thresholds at 0.8 V were 0.15 +/- 0.06 msec compared to 0.9 +/- 0.8 msec for the platinized electrode (P < 0.01). The chronic ventricular QRS amplitudes were significantly greater for the steroid-eluting electrode (P < 0.0005). There were no significant differences in atrial sensing and no incidence of atrial undersensing in the study. The low and consistent thresholds of the steroid-eluting electrodes would have permitted pacing in the ventricle at < or = 2.5 V without compromising safety factor in 99.4% of the patients. The other 0.6% required 5 V temporarily. In the atrium, 100% of the patients could have been paced safely at reduced output. In spite of this, 63% of the implanters lacked the confidence to use reduced outputs.

Dexamethasone↗

PubMed1993

Epidemiologic characteristics of women with idiopathic recurrent vulvovaginal candidiasis.

OBJECTIVE: To evaluate risk factors related to anamnestic variables, sexual behavior, feminine hygiene habits, and microbiologic findings in women with idiopathic recurrent vulvovaginal candidiasis. METHODS: We conducted a multivariate observational study comparing sociodemographic, anamnestic, clinical, and microbiologic variables between 86 patients with recurrent vaginal candidiasis and 180 controls with nonrecurrent infection. RESULTS: In logistic regression analysis, women with recurrent candidal vaginitis were more likely than controls to use contraceptive pills (adjusted odds ratio 2.0, 95% confidence interval [CI] 1.02-3.91; P = .04) and commercially available solutions for either vulvoperineal cleansing (adjusted odds ratio 2.2, 95% CI 1.25-3.88; P = .007) or vaginal douching (adjusted odds ratio 1.8, 95% CI 1.0-3.26; P = .05). The rate of isolation of non-albicans candida species was significantly higher among cases than controls (adjusted odds ratio 3.0, 95% CI 1.50-6.04; P = .005). Finally, increasing frequency of monthly sexual intercourse was significantly correlated (chi 2 for trend = 4.87; P = .027) with recurrent infection. CONCLUSION: Several behavioral factors seem to influence the occurrence of relapses in recurrent vulvovaginal candidiasis. Appropriate counseling about contraception, sexual activity, and personal hygiene habits could be an important preventive measure in these cases.

Adult↗

PubMedDate not supplied

Does amniotic fluid alpha-fetoprotein have diagnostic or prognostic value at the time of second midtrimester genetic amniocentesis?

In order to assess the usefulness of amniotic fluid alpha-fetoprotein (AFP) levels at the time of midtrimester genetic amniocentesis, 4,430 cases were retrospectively studied to compare the high, normal or low AFP values with the karyotype characteristics and fetal anatomy using ultrasound (US) scanning and confirmed by postnatal evaluation or necroscopy in the case of termination of pregnancy. All the cases presenting malformations were correctly diagnosed by US examinations. AFP levels over the 2nd standard deviation (SD) were found in 112 cases (2.52%) and below the 2nd SD in 11 cases (0.24%). The characteristics of these cases are presented and discussed. According to our results, it is concluded that routine assessment of AFP at the time of midtrimester genetic amniocentesis, if coupled with optimal US scanning, is no longer justified.

Abortion, Spontaneous↗

PubMedDate not supplied

[Post-traumatic diaphragmatic hernia with late symptoms].

The authors report a case of post-traumatic diaphragmatic hernia with non specific clinical findings. They consider the etiopathogenetic factors, clinical findings, therapy and underline the importance of well-performed remota anamnestic procedure to recognise the illness fastly.

Adult↗