Biomedical subjects

Lorenza Pugni

Publications and source records attributed to Lorenza Pugni.

6 recordsLinked to original sources

PubMed2006

Multicity Italian study of congenital cytomegalovirus infection.

BACKGROUND: Cytomegalovirus (CMV) infection is the most frequent congenital infection in humans. Its prevalence and the frequency of disabling sequelae must be assessed in different populations to permit the formulation or assessment of preventive measures. OBJECTIVES: To check the prevalence of congenital infection and seroprevalence in Italy; to verify the rate of sensorineural hearing loss (SNHL) in infected infants; and to assess the proportion of children with SNHL attributable to congenital CMV infection. METHODS: Diagnosis of congenital CMV infection was sought in 9032 children born between March 2002 and February 2003 by testing for viral DNA [CMV dried blood spot (DBS) test] in each newborn's Guthrie card and confirmation by isolation of CMV from urine collected in the first 3 weeks of life; CMV IgG testing in 1200 women of childbearing age; clinical and audiologic tests in the first 24 months for infected children; CMV DBS tests on the Guthrie cards collected from screening centers for 77 children (3 months-5 years) presenting SNHL of 40 dB or more. RESULTS: CMV infection was diagnosed in 14 asymptomatic and 2 symptomatic newborns (0.18%). CMV seroprevalence was 80%. In 2 infected infants, transient, unilateral SNHL was found. Nineteen of the 71 children with SNHL >70 dB were congenitally infected. CONCLUSIONS: The prevalence of congenital CMV infection is low in Italy. Population characteristics limiting the circulation of CMV strains in adult women might explain this. The fact that CMV contributes to significant SNHL highlights the need for preventive measures.

Adult↗

PubMed2005

Immunogenicity, safety and tolerability of heptavalent pneumococcal conjugate vaccine administered at 3, 5 and 11 months post-natally to pre- and full-term infants.

We assessed the immunogenicity, safety and tolerability of heptavalent pneumococcal conjugate vaccine (PCV7) administered three, five and 11 months post-natally to 46 pre-term (PT) and 46 full-term (FT) infants. After each dose, there was no significant difference between the groups in antibody levels for any of the vaccine serotypes. After the second dose, the majority of subjects in both groups showed titres of > or =0.35 microg/mL, whereas an antibody concentration of > or =1.0 microg/mL was usually reached in both PT and FT infants after the third dose. Safety and tolerability was also similar in the groups. These findings support the use of the simplified schedule that includes three doses of PCV7 in both PT and FT infants, and suggest that this may reduce costs, as well as problems related to vaccine supply and administration.

Female↗

PubMed2005

The Milan Project: a newborn hearing screening programme.

AIM: Since 1997 a newborn hearing screening programme has been implemented by the U.O. Neurologia-Neurofisiopatologia and Dipartimento di Neonatologia of the Istituti Clinici di Perfezionamento ICP in Milan for both babies with no risk and those at risk of hearing impairment. This programme was named the Milan Project. METHODS: The protocol for no-risk babies consisted of three stages: in the first two stages, newborns were tested with transient click-evoked otoacoustic emissions (TEOAE), in the third one with conventional auditory brainstem responses (ABR). The first TEOAE test was performed by 36 h of age, before discharge, the second one after 15-30 d in case of referral, and the third one, by ABR, for those babies who failed the second TEOAE stage. Newborns at audiological risk were submitted to conventional ABR before the third month of corrected age. Some of this latter population was also submitted to the TEOAE test. The entire tested population (no-risk babies and newborns at audiological risk) consisted of 19 777 babies: 19 290 without risk ("no risk") and 487 at risk ("at risk"). RESULTS: During the course of the Milan Project, hearing impairment (ABR threshold equal to or greater than 40 dB nHL) was identified in 63 newborns (19 from the no-risk and 44 from the at-risk population), with a prevalence of 0.32%. Bilateral hearing impairment (BHI) was found in 33 newborns (10 from the no-risk and 23 from the at-risk population), corresponding to 0.17%. Among infants with bilateral hearing impairment, 30.3% had no risk factors. The prevalence of hearing impairment was determined on days 15-30 after birth. CONCLUSIONS: The results show that the implementation of a hospital-based, universal neonatal hearing screening programme for babies with and without audiological risk is feasible and effective. The effectiveness of the programme has increased as a function of the years since its inception, with a strong decrease in the referral rate. Further improvement is obtained if the TEOAE measurements are repeated in cases of referral scoring before discharge.

Acoustic Stimulation↗

PubMed2003

Endogenous nitric oxide production in the airways of preterm and term infants.

Few studies have measured endogenous nitric oxide exhaled from the respiratory system of newborn infants. We measured exhaled nitric oxide (eNO) in the first 48 h of life in 24 (13 preterm, 11 term) spontaneously breathing (online method) newborns using a chemoluminescence analyzer. There was a significant difference in the eNO concentration between term and preterm healthy infants in the first 2 days of life (repeated measures analysis of variance, p < 0.05). In term infants there is a peak eNO production in the first hours of life, suggesting a potential role in postnatal adaptation, while in preterm infants eNO production is almost absent at birth, and then gradually increases.

Analysis of Variance↗

PubMed2003

Blood withdrawal and infusion via umbilical catheters: effect on cerebral perfusion and influence of ibuprofen.

Withdrawal and infusion of blood via umbilical catheters can affect cerebral blood flow in preterm infants. We compared the effects on cerebral perfusion of 3 ml/kg blood withdrawal and infusion via umbilical arterial (UAC) and venous (UVC) catheters in 16 infants < or =32 weeks gestation, age <24 h, on mechanical ventilation. Near infrared spectroscopy was used to monitor changes in cerebral oxy- and deoxyhemoglobin, total cerebral hemoglobin (an index of cerebral blood volume; CBV) and HbD (an index of cerebral intravascular oxygenation). In 10 infants the study was repeated 1 h after intravenous administration of 10 mg/kg ibuprofen as prophylaxis against PDA. Withdrawal and infusion via the UVC caused significant MABP and concordant HbD and CBV changes. Smaller modifications were seen following blood withdrawal and infusion via the UAC. Ibuprofen attenuated cerebral hemodynamic changes associated with withdrawal, but not infusion, from UAC and UVC.

Arteries↗

PubMed2002

Effect of changes in inspired oxygen tension on indexes of oxygenation in ventilated neonates.

OBJECTIVE: Several indexes are used to quantify the severity of hypoxemia, including the arterial to alveolar oxygen ratio (a/APO(2)), the alveolar-arterial difference P(a-a)o(2), the ratio Pao(2)/Fio(2), and the oxygenation index (OI = mean airway pressure x Pao(2)/Fio(2)). This study was carried out to test how stable these indexes are when small changes in Fio(2) are made in ventilated neonates. DESIGN: Open prospective clinical study. SETTING: Level III neonatal intensive care unit of a teaching hospital. PATIENTS: Forty studies were performed in 31 clinically stable ventilated neonates (median birth weight, 1450 g; median gestation, 30.6 wks), monitored by transcutaneous Pao(2)-oxygen saturation (Sao(2)). INTERVENTIONS: If hyper- or hypoxemia without derangements of Paco(2) or pH were detected in a blood sample taken from an indwelling arterial catheter, Fio(2) was changed (median change, 0.05; range, -0.3 to 0.25) and another arterial blood sample was obtained 26-83 mins (median, 42) after. The indexes were calculated in the two blood samples, and for each index the changes between baseline and the value after Fio(2) change were analyzed. MEASUREMENTS AND MAIN RESULTS: Median baseline P(a-a)o(2) was 211.7 torr, median a/APO(2) was 0.24, median Pao(2)/Fio(2) was 161 torr, and median OI was 6.14. After the Fio(2) change, the coefficients of variation (sd/mean) were calculated, and they were 27.5%, 23.8%, 24.5%, and 31.6% for P(a-a)o(2), a/APO(2), Pao(2)/Fio(2), and OI, respectively. Changes in the value of each index were correlated to changes in Fio(2), indicating a dependency on Fio(2). When data were analyzed as "high Fio(2)" (approximate Sao(2) 95%) vs. "low Fio(2)" (approximate Sao(2) 90%), differences were statistically significant for all indexes except for a/APO(2). CONCLUSIONS: All the indexes tested showed a dependency on the value of Fio(2): increasing Fio(2) spuriously made neonates appear less hypoxemic. The a/APO(2) appeared to perform better than other indexes in this study, with a lower variability and a lower oxygen dependency.

Journal Article↗