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Nicola Morelli,
Michelangelo Mancuso,
Gianfranco Cafforio,
Simone Gallerini,
Lorenzo Pittiglio,
Sandra Tonelli,
Norberto Pozzetti,
Luana Benedetti,
Claudia Tavarelli,
Cesare Capellini, Antonio Tartaglione
Neurological Sciences 12/2008; 29(6):497-8. · 1.32 Impact Factor
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Mariella Dono,
Paola Ferro,
Luana Benedetti,
Cesare Capellini,
Michele Moroni,
Paolo Dessanti,
Bartolomeo Bacigalupo, Antonio Tartaglione,
Enrico Battolla,
Franco Fedeli,
Silvio Roncella
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ABSTRACT: Leptomeningeal (LM) carcinomatosis is an increasing clinical complication in patients with advanced breast cancer (BC). The LM carcinomatosis diagnostic procedures rely mainly on cerebrospinal fluid (CSF) cytology, although both the amount of CSF and the number of malignant cells remain limiting factors. Therefore, efforts should be made to design new highly sensitive diagnostic tools to detect malignant cells in CSF of BC patients with LM carcinomatosis. In this study, the human Mammaglobin (hMAM) mRNA amplification by RT-PCR was employed to detect metastatic cells in CSF and thus, to diagnose LM carcinomatosis in a BC patient. Our data demonstrate that hMAM transcripts are expressed in the CSF of a BC patient with LM carcinomatosis, hence making RT-PCR for hMAM a potentially suitable test to identify occult BC cells in the brain.
Journal of Neuro-Oncology 11/2008; 91(3):295-8. · 3.21 Impact Factor
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Maria G Russo,
Dario Paladini,
Giuseppe Pacileo,
Concetta Ricci,
Giovanni Di Salvo,
Maria Felicetti,
Laura Di Pietto, Antonio Tartaglione,
Maria T Palladino,
Giuseppe Santoro,
Giuseppe Caianiello,
Carlo Vosa,
Raffaele Calabrò
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ABSTRACT: Congenital heart diseases are the most common prenatal and postnatal malformations. Nowadays, fetal echocardiography is a widely practiced technique; however, the impact of prenatal diagnosis on prognosis of the newborns affected by congenital heart disease remains uncertain.
To assess the outcome and the changes in the spectrum of prenatally detected congenital heart disease in our tertiary care centre in 12 years of activity (1995-2006).
We detected 705 congenital heart diseases: 32% (223) were associated with extracardiac or chromosomal anomalies or both, and 68% (482) were isolated. Termination of pregnancy was chosen in 81% for associated anomalies and 37% for isolated anomalies (P<0.001). Of these, more than one-third occurred in hypoplasic left heart cases. The general survival rate was 72%; it was significantly lower in the group with associated heart diseases (46 vs. 80%, P<0.001). Over 12 years we noticed a reduction in the number of multimalformed fetuses and of the hypoplasic left heart cases, and a higher number of aortic arch anomalies detected. During the past 6 years of activity the survival rate obtained has significantly increased (55 to 84%, P<0.05), the termination rate has significantly decreased (35 to 14%, P<0.001) and the number of neonatal deaths has significantly decreased (39 to 10%, P<0.001).
The survival and the voluntary termination of fetuses with prenatally detected congenital heart diseases are strongly influenced by disease severity and by associated extracardiac or chromosomal anomalies, or both. Over 12 years, the spectrum of fetal congenital heart disease has changed and their outcome has significantly improved.
Journal of Cardiovascular Medicine 09/2008; 9(9):910-5. · 1.51 Impact Factor
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Muscle & Nerve 08/2008; 38(2):1076-7. · 2.37 Impact Factor
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Headache The Journal of Head and Face Pain 05/2008; 48(4):637-8. · 2.52 Impact Factor
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ABSTRACT: Headache is the most common symptom in patients with cervical artery dissection. This symptom, however, rarely occurs in isolation, and more commonly is associated with other neurological symptoms and signs. Visual symptoms associated with vertebral artery dissection (VD) have also been observed, but do not typically mimic the migraine aura. Here, we report a young patient who presented VD, embolic ischemic lesions, and visual symptoms with the features of aura, followed by migraine headache. The suggestion of VD dissection should be kept in mind in those cases complaining of the first attack of headache that mimics migraine with aura. In these cases, an extensive neuroimaging study is advisable.
Headache The Journal of Head and Face Pain 05/2008; 48(4):621-4. · 2.52 Impact Factor
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Giovanni Di Salvo,
Maria Giovanna Russo,
Dario Paladini,
Maria Felicetti,
Biagio Castaldi, Antonio Tartaglione,
Laura di Pietto,
Concetta Ricci,
Carmela Morelli,
Giuseppe Pacileo,
Raffaele Calabrò
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ABSTRACT: Previous reports have demonstrated that myocardial velocities are not sufficiently sensitive in foetal heart studies. Strain (S) imaging is a new non-invasive ultrasonic technique able to quantify regional myocardial deformation properties. Strain imaging has a superior sensitivity than myocardial velocity for non-invasive assessment of ventricular function. However, Doppler-derived strain imaging has been used to quantify myocardial deformation properties in the foetal heart with rather limited results, because of angle dependency, sensitivity to extracardiac movement, the need for good-quality images, long and time-consuming post-processing and the low reproducibility of Doppler-derived strain. Recently, a novel method for motion estimation based on two-dimensional (2D) tissue tracking strain (2D-S) echocardiography using time-domain processing has been developed, providing rapid assessment of regional myocardial strain that is independent of both cardiac translation and angle dependency, with a very good reproducibility. However, no information on 2D-S in human foetuses has so far been provided.
We studied 100 consecutive normal foetuses (gestation range: 20-32 weeks; no evidence of structural cardiovascular disease by 2D echo and Doppler study) using 2D-S imaging. Left ventricle (LV) and right ventricle (RV) peak myocardial negative strain values were obtained.
Strain data were obtained from all the studied subjects, the duration of post processing was 3 +/- 2 min for each patient dataset. Peak longitudinal deformation parameters were homogeneous in all the three studied walls (strain: septum = -25 +/- 5%; lateral wall = -25 +/- 4%; RV free wall = -24 +/- 4%; P = NS). There were significant correlations between gestational age and peak longitudinal strain (P < 0.001; R: -0.73). Inter and intra-observer variability for strain was good, <3 and <6%, respectively.
This study demonstrated that 2D-S is a feasible and reproducible approach to assess regional ventricular function in the foetal heart, ready for the clinical application.
European Heart Journal – Cardiovascular Imaging 04/2008; 9(6):754-6. · 2.32 Impact Factor
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Michele D'Alto,
Maria Giovanna Russo,
Dario Paladini,
Giovanni Di Salvo,
Emanuele Romeo,
Concetta Ricci,
Maria Felicetti, Antonio Tartaglione,
Dominga Cardaropoli,
Giuseppe Pacileo,
Berardo Sarubbi,
Raffaele Calabrò
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ABSTRACT: The present study aimed to evaluate the management of fetal cardiac dysrhythmias based on prior identification of the underlying electrophysiological mechanism.
We studied 36 consecutive fetuses with cardiac dysrhythmia. Rhythm diagnosis was based on M-mode, pulsed wave Doppler and tissue Doppler imaging (TDI). Only fetuses with: (i) incessant tachycardia (> 12 h) and mean ventricular rate > 200 beats/min, (ii) signs of left ventricular dysfunction, or (iii) hydrops, were treated using oral maternal drug therapy.
The mean gestational age at diagnosis was 24.3 +/- 4.5 weeks. Twenty-one fetuses had tachycardia with a 1: 1 atrial-ventricular (AV) conduction. Based on ventricular-atrial interval, prenatal diagnosis was: permanent junctional reciprocating (n = 6), atrial ectopic (n = 6) or atrial-ventricular re-entry tachycardia (n = 9). One had atrial flutter, one ventricular tachycardia and four congenital AV block. Nine showed premature atrial or ventricular beats. Fifteen fetuses with incessant tachycardia, left ventricular dysfunction or hydrops were prenatally treated with maternal administration of digoxin, sotalol or flecainide. The total success rate (sinus rhythm or rate control) was 14/15 (93%). Seven fetuses were hydropics. Three of these died (one at 28 weeks of gestation, two in the first week of life). The prenatal diagnosis of dysrhythmia was confirmed at the birth in 31 of 35 live-born. No misdiagnosis was made using TDI. At 3 +/- 1.1-year follow-up, 33/35 children were alive and well.
Fetal echocardiography could clarify the electrophysiological mechanism of fetal cardiac dysrhythmias and guide the therapy.
Journal of Cardiovascular Medicine 02/2008; 9(2):153-60. · 1.51 Impact Factor
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ABSTRACT: Objectives of this study are (1) to describe how to obtain the in-plane view of the inter-ventricular septum, (2) to assess its feasibility in a population of fetuses referred for fetal echocardiography, (3) to demonstrate its effectiveness in the characterization of VSD in the fetus.
The in-plane view of the inter-ventricular septum is conducted in a plane almost perpendicular to that of the long axis of the left ventricle, tilting the transducer towards the right ventricle, paying attention not to 'enter' the right ventricular chamber. Its feasibility has been assessed in 41 fetuses referred for fetal echocardiography, by recording the visualization/failure rates by fetal lie and acoustic window. The in-plane view of the inter-ventricular septum was then employed in healthy fetuses and diseased fetuses with VSDs.
The success rates in obtaining the in-plane view of the inter-ventricular septum was dependent upon fetal lie; visualization rates were 100, 36 and 0% in case of posterior, lateral and anterior spine, respectively. When used in the anatomic characterization of VSDs, this view provided significant additional information.
The in-plane view of the inter-ventricular septum represents a new echocardiographic view that can be used to enhance the assessment of the inter-ventricular septum of the fetal heart. Its use should be considered whenever the presence of a VSD is suspected during fetal echocardiography, and in these cases it often provides additional information.
Prenatal Diagnosis 01/2004; 23(13):1052-5. · 2.11 Impact Factor
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ABSTRACT: Cardiac myxomas have been reported in the neonate but never in the fetus. We present the prenatal diagnosis of such a tumor.
The patient had been referred for fetal echocardiography for a right atrial mass. At 23 weeks' gestation, the tumor was initially located in the left atrium. Then it crossed the foramen ovale and began moving between the right atrium and ventricle. It appeared as a soft, moderately echogenic mass with a long peduncle attached to the right atrial wall. It was followed until delivery and removed at 20 days of life.
This case shows that myxomas can also arise in the fetus. Such a diagnosis should be taken into consideration when a soft, echogenic, pedunculated mass is seen within the fetal heart.
Obstetrics and Gynecology 12/2003; 102(5 Pt 2):1174-6. · 4.73 Impact Factor
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ABSTRACT: Toriello-Carey syndrome is a rare malformative complex, described for the first time in 1988, characterized by agenesis of the corpus callosum, facial anomalies, cardiac defects and hypotonia. Relatively few neonatal cases have been reported. We describe here the first prenatal ultrasound diagnosis of the syndrome based on the detection of agenesis of the corpus callosum and spongious cardiomyopathy in a 22-week-old fetus of a couple with positive family history. The first sib of the couple was diagnosed with Toriello-Carey syndrome at 1 year of age, and had, in addition to the typical facial anomalies not detectable by ultrasound, agenesis of the corpus callosum and the same heart lesion (spongious cardiomyopathy). This report demonstrates that prenatal diagnosis of Toriello-Carey syndrome is feasible in the second trimester of pregnancy.
Prenatal Diagnosis 01/2003; 22(13):1185-7. · 2.11 Impact Factor
