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Biomedical subjects

L Bovicelli

Publications and source records attributed to L Bovicelli.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Successful treatment of essential thrombocythemia in a pregnancy with recombinant interferon-alpha 2a.

Essential thrombocythemia (ET) in pregnancy is associated with adverse perinatal outcome, which is likely due to thrombosis of the uteroplacental circulation. Obstetrical management is still controversial. Different therapeutic protocols have been adopted, including the use of aspirin, plateletpheresis, and interferon. We herein report a case of ET treated with interferon-2 alpha from 13 weeks gestation until term. Therapy was well tolerated, leading to a linear reduction of platelet and white blood cell count that rapidly returned within normal limits. A healthy, 3,020-g male infant was delivered at 40 weeks gestation. Albeit further experience is required, recombinant interferon-alpha 2a may play an important role in preventing complications in pregnant patients with ET.

Adult↗
PubMedDate not supplied

Genetic amniocentesis in twin pregnancy.

Among 1041 pregnancies 13 twin gestations were detected by routine ultrasonography prior to genetic amniocentesis at the Department of Prenatal Physiopathology of the University of Bologna. Clear amniotic fluid from both sacs was obtained in 12 of 13 sets of twins. All 12 sets were cytogenetically normal with normal levels of alpha-fetoprotein. Only one patient spontaneously aborted liveborn immature twins 30 days after the procedure. The technique used to obtain samples of fluid is described in detail and the need for additional counselling prior to amniocentesis in twins is stressed.

Amniocentesis↗
PubMedDate not supplied

Prenatal diagnosis of endocardial fibroelastosis.

In a case of fetal heart failure caused by endocardial fibroelastosis, prenatal echocardiography clearly demonstrated a thickened endocardium. We therefore suggest that an abnormal endocardium may be detected in utero by ultrasound, thus representing an important clue in the differential diagnosis of fetal nonimmune hydrops and in the evaluation of pregnancies at risk for endocardial fibroelastosis.

Adult↗
PubMedDate not supplied

Psychological reactions to fetoscopy: a controlled study.

Twenty woman at risk of carrying a fetus with homozygous beta-thalassemia who underwent fetoscopy and a matched control group of pregnant women were administered the Symptom Questionnaire to evaluate changes in distress. Women who were offered fetoscopy had significantly more anxiety, depression, somatic symptoms and hostility than the control group. Psychological distress significantly decreased after the results of fetoscopy were communicated to the patient, and the decrease was similar in normal control women. Five other patients had a diagnosis of homozygous beta-thalassaemia and their pregnancies were terminated. Their psychological distress increased when they learned the outcome of fetoscopy, but decreased again after termination. Psychological reactions to fetoscopy and amniocentesis appear to be similar, yet women who undergo fetoscopy suffer from more psychological distress.

Anxiety↗
PubMedDate not supplied

Combined Pap smear, cervicography and HPV DNA testing in the detection of cervical intraepithelial neoplasia and cancer.

OBJECTIVE: The sensitivity of the Pap smear (PAP) continues to be the subject of debate. During the past several years, cervicography (CER) and HPV DNA testing have been suggested as optional tools in the screening of cervical cancer precursors. STUDY DESIGN: The performance characteristics of PAP, CER and HPV DNA testing (hybrid capture test [HCT]) in all potential combinations were evaluated in a series of 1,030 women (aged 16-70, median, 33), subjected to colposcopy (COLPO) as the reference tool. RESULTS: Of the 992 evaluable cases, 402/992 (41%) had positive COLPO (i.e., an abnormal transformation zone). Of them, 298 women underwent directed punch biopsy, while of the COLPO negative patients, 18/93 positive by at least one of the three tests had endocervical curettage. Of the 402 COLPO positive women, 146 (36%) remained negative on all tests, whereas 256 (64%) had at least one positive test. There were 84 cervical intraepithelial neoplasia (CIN) 2 and 3 lesions and 6 invasive carcinomas. Of the former, 10 were detected by PAP alone, 4 by CER alone and 3 by HCT alone. Three of the 6 carcinomas were HCT negative. The predictive value (PPV) of a positive test was 45% for PAP, 51% for CER and 48% for HCT. The combinations of PAP with CER (for PAP negative cases) and PAP with HCT were more sensitive for CIN 2 and 3 (95% and 94%, respectively) as compared with PAP alone but were associated with a significant decrease in specificity (44% and 46% vs. 57%, respectively). However, both combinations retained a PPV (43%) similar to that of PAP alone (45%). CONCLUSION: The potential combinations of PAP with CER and with HCT were more sensitive in detecting CIN 2 and 3 as compared with PAP alone and retained a PPV similar to that of PAP.

Adolescent↗
PubMedDate not supplied

[The percutaneous treatment of uterine fibromas by means of transcatheter arterial embolization].

INTRODUCTION: We report our preliminary experience with arterial embolization of uterine fibroids in seven women, focusing on the technical aspects of the procedure and the clinical and morphological results during the follow-up. MATERIAL AND METHODS: February to December 1999 seven women (mean age 47) underwent transcatheter arterial embolization of both uterine arteries as a permanent treatment for fibroids. We included in this study single or multiple, bleeding and/or large fibroids, symptomatic on compression, contraindicated for myomectomy because of high surgical or anesthesiologic risks or myomata in which myomectomy could probably be converted into hysterectomy. Fibroids enlarging the uterus to the size of 25 weeks' pregnancy or more, pedunculated myomata or small submucous fibroids--smaller than 5 cm--were excluded. Uterine arterial embolization was performed bilaterally, till a total blockage of flow, by injecting permanent embolization material: polyvinyl-alcohol (PVA) particles of increasing size from 150 to 500 mu and in varying amounts from 10 to 24 mL, depending on fibroid size and degree of vascularization. RESULTS: A technical success was achieved in all cases and no late complications were seen. At 6-month clinical follow-up all compressive symptoms had disappeared; regular menses had returned in 57% of patients, milder hyper-dysmenorrhea was present in 28% compared to pretreatment symptoms; only in one case (14%) was permanent amenorrhea observed. The 3-month and 6-month US follow-up studies showed an average 40.7% (range 10-50%) and 51% (range 25-83%) reduction in the fibroid size, respectively. All the small myomata (about 2 cm in size) were unidentifiable at 6-month US follow-up. In no cases did new fibroids appear. DISCUSSION: Surgery is the traditional treatment for symptomatic uterine fibroids (hysterectomy, myomectomy). More recently, hormone therapy and operative endoscopy (laparoscopy and hysteroscopy) have been introduced as alternatives, together with uterine embolization previously applied preoperatively in extensive bleeding neoplasms or to control post-partum hemorrhage. Transcatheter embolization of the uterine arteries feeding large fibroids is a minimally invasive technique which could be safely used as an alternative to surgery, and a valuable in the definitive treatment of symptomatic, large or multiple, intramural or submucosal fibroids. In agreement with literature findings, in the present series symptoms resolved completely in over 85% of cases after embolization, with an average reduction in fibroid size over 50% at 6-month follow-up in large fibroids, whereas smaller size myomata were no longer detectable at US and no new fibroids had formed. CONCLUSIONS: Our preliminary experience confirms that arterial embolization is a promising alternative to surgery in the definitive treatment of fibroids, thanks to its high efficacy and safety, also reducing patient hospitalization and costs.

Adult↗
PubMedDate not supplied

Ultrasonographic appearance of the mega cisterna magna in the newborn.

The mega cisterna magna is a congenital developmental malformation which in the majority of instances is symptomless and does not require further study or surgical treatment. However, differential diagnosis with other cerebellar diseases is often necessary especially in newborn infants. Ultrasonographic recognition of the mega cisterna magna in a newborn infant is reported. The reported case demonstrates the usefulness of the ultrasonographic technique in the study of the posterior cranial fossa abnormalities of newborn infants.

Cisterna Magna↗