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Perugi S, Ciarcià M, Coviello C, Fusco M, Lunardi C, Remaschi G, Sarcina D, Sassudelli G, Pratesi S, Dani C. A structured programme to promote breastfeeding improved the rates in very preterm infants at discharge. Acta Paediatr 2024. [PMID: 38436515 DOI: 10.1111/apa.17184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024]
Abstract
AIM We developed the Promotion of Breastfeeding (PROBREAST) programme and evaluated what effect it had on the breastfeeding rate in infants born at less than 32 weeks of gestation or weighing ≤1500 grams. METHODS We compared the breastfeeding rate in two cohorts of patients who were born before (n = 72; January 2017 to June 2018) and after (n = 80; July 2018 to December 2019) the application of the programme. Moreover, we compared the correlation between type of feeding at discharge and post-discharge breastfeeding rate, between exclusive breastfeeding, postnatal growth and neurodevelopment. RESULTS Infants in the PROBREAST group had an exclusive breastfeeding rate at discharge higher (42 vs. 16%, p < 0.001) than that in the historical control group. Exclusive breastfeeding was negatively correlated with weight z-score at discharge, but not at 12 and 24 months corrected age, and was positively correlated with cognitive score at 24 months corrected age. CONCLUSION The application of a structured programme for the promotion of breastfeeding improved the breastfeeding rate in very preterm infants. We demonstrated that exclusive breastfeeding at discharge improved their neurodevelopment without impairing growth.
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Affiliation(s)
- Silvia Perugi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Martina Ciarcià
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Monica Fusco
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Clara Lunardi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Giulia Remaschi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Davide Sarcina
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Giovanni Sassudelli
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Simone Pratesi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
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Coviello C, Lori S, Bertini G, Montano S, Gabbanini S, Bastianelli M, Cossu C, Cavaliere S, Lunardi C, Dani C. Morphine exposure and prematurity affect flash visual evoked potentials in preterm infants. Clin Neurophysiol Pract 2024; 9:85-93. [PMID: 38371463 PMCID: PMC10869246 DOI: 10.1016/j.cnp.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/14/2023] [Accepted: 12/27/2023] [Indexed: 02/20/2024] Open
Abstract
Objective The present study aimed to explore first the impact of perinatal risk factors on flash-VEP waves and morphology in a group of preterm infants studied at term equivalent age (TEA). Second, to correlate VEP morphology with neurological outcome at 2 years corrected age (CA). Methods Infants with a gestational age (GA) at birth <32 weeks, without major brain injury, were enrolled. Multivariate regression analyses were performed, and the models were run separately for each dependent variable N2, P2, N3 latencies and P2 amplitude. Logistic regression was applied to study N4 component (present/absent) and VEP morphology (regular/irregular). The predictors were GA, bronchopulmonary dysplasia (BPD), postmenstrual age at VEP registration, cumulative morphine and fentanyl dose, and painful procedures. Lastly, linear regression models were performed to assess the relation between the Bayley-III cognitive and motor scores at 2 years CA and VEP morphology, in relation to GA, BPD, painful procedures and cumulative morphine dose. Results Eighty infants were enrolled. Morphine was the predictor of N2 (R2 = 0.09, p = 0.006), P2 (R2 = 0.11, p = 0.002), and N3 (R2 = 0.13, p = 0.003) latencies. Younger GA was associated with lower amplitude (R2 = 0.05, p = 0.029). None of the independent variables predicted the presence of N4 component, nor VEP morphology in the logistic analysis. VEP morphology was not associated with cognitive and motor scores at 2 years. Conclusions Morphine treatment and prematurity were risk factors for altered VEPs parameters at TEA. In our cohort VEP morphology did not predict neurological outcome. Significance Morphine administration should be evaluated according to potential risks and benefits, and dosage individually accustomed, according to pain and comfort scores, considering the possible risk for neurodevelopmental impairment.
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Affiliation(s)
- Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Silvia Lori
- Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy
| | - Giovanna Bertini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Simona Montano
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Simonetta Gabbanini
- Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy
| | - Maria Bastianelli
- Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy
| | - Cesarina Cossu
- Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy
| | - Sara Cavaliere
- Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy
| | - Clara Lunardi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy
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Luzzati M, Coviello C, De Veye HS, Dudink J, Lammertink F, Dani C, Koopmans C, Benders M, Tataranno ML. Morphine exposure and neurodevelopmental outcome in infants born extremely preterm. Dev Med Child Neurol 2023; 65:1053-1060. [PMID: 36649164 DOI: 10.1111/dmcn.15510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 01/18/2023]
Abstract
AIM To investigate the association between morphine exposure in the neonatal period and neurodevelopment at 2 and 5 years of age while controlling for potential confounders. METHOD We performed a retrospective, single-centre cohort study on 106 infants (60 males, 46 females; mean gestational age 26 weeks [SD 1]) born extremely preterm (gestational age < 28 weeks). Morphine administration was expressed as cumulative dose (mg/kg) until term-equivalent age. Neurodevelopmental outcome was assessed at 2 years with the Bayley Scales of Infant and Toddler Development, Third Edition, Dutch version and at 5 years with the Wechsler Preschool and Primary Scale of Intelligence, Third Edition, Dutch version. Multiple linear regression analysis was used to assess the association between morphine exposure and outcome. RESULTS Sixty-four out of 106 (60.4%) infants included in the study received morphine. Morphine exposure was not associated with poorer motor, cognitive, and language subscores of the Bayley Scales of Infant and Toddler Development, Third Edition, Dutch version at 2 years. Morphine exposure was associated with lower Full-Scale IQ scores (p = 0.008, B = -9.3, 95% confidence interval [CI] = -15.6 to -3.1) and Performance IQ scores (p = 0.005, B = -17.5, 95% CI = -27.9 to -7) at 5 years of age. INTERPRETATION Morphine exposure in infants born preterm is associated with poorer Full-Scale IQ and Performance IQ at 5 years. Individualized morphine administration is advised in infants born extremely preterm.
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Affiliation(s)
- Michele Luzzati
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- Division of Neonatology, University of Florence, Florence, Italy
| | | | - Henriette Swarenburg De Veye
- Department of Neonatology, Division of Perinatology and Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Division of Perinatology and Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Femke Lammertink
- Department of Neonatology, Division of Perinatology and Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Carlo Dani
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- Division of Neonatology, University of Florence, Florence, Italy
| | - Corine Koopmans
- Department of Neonatology, Division of Perinatology and Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Manon Benders
- Department of Neonatology, Division of Perinatology and Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maria Luisa Tataranno
- Department of Neonatology, Division of Perinatology and Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
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Dani C, Luzzati M, Corsini I, Poggi C, Vangi V, Coviello C, Pratesi S. Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants. Paediatr Drugs 2023:10.1007/s40272-023-00571-0. [PMID: 37204612 DOI: 10.1007/s40272-023-00571-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND In the neonatal period, cardiac hypertrophy (CH) has been commonly associated with hyperinsulinemic pathologies, and the first case of CH in an extremely preterm infant treated with insulin infusion has recently been reported. To confirm this association, we report a case series of patients who developed CH after insulin therapy. METHODS Infants with gestational age < 30 weeks and birth weight < 1500 g, born from November 2017 to June 2022, were studied if they developed hyperglycemia requiring treatment with insulin and had echocardiographic diagnosis of CH. RESULTS We studied 10 extremely preterm infants (24.3 ± 1.4 weeks) who developed CH at a mean age of 124 ± 37 h of life, 98 ± 24 h after the initiation of insulin therapy. All surviving patients had resolution of CH at discharge, while three of four (75%) of the deceased patients had persistent CH. CONCLUSIONS Our case series supports the association between the development of CH and insulin therapy in extremely preterm infants and suggests further caution and the need for echocardiographic monitoring when treating these fragile patients with insulin.
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Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50141, Florence, Italy.
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
| | - Michele Luzzati
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50141, Florence, Italy
| | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50141, Florence, Italy
| | - Chiara Poggi
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50141, Florence, Italy
| | - Venturella Vangi
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50141, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50141, Florence, Italy
| | - Simone Pratesi
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50141, Florence, Italy
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Masiero M, Vojtasova E, Boulos P, Zammarchi F, van Berkel P, Crake C, Coviello C, Rowe C. Ultrasound-induced cavitation enhances therapeutic efficacy of AXL-targeting ADC leading to improved survival in a human xenograft model of renal cancer. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ciarcià M, Corsini I, Miselli F, Luzzati M, Coviello C, Leonardi V, Pratesi S, Dani C. Is recombinant tissue plasminogen activator treatment a safe choice in very and extremely preterm infants with intracardiac thrombosis? Arch Dis Child 2022; 107:archdischild-2022-323789. [PMID: 35537825 DOI: 10.1136/archdischild-2022-323789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/22/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Martina Ciarcià
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, Firenze, Italy
| | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Firenze, Italy
| | - Francesca Miselli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, Firenze, Italy
| | - Michele Luzzati
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, Firenze, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Firenze, Italy
| | - Valentina Leonardi
- Division of Neonatology, Careggi University Hospital of Florence, Firenze, Italy
| | - Simone Pratesi
- Division of Neonatology, Careggi University Hospital of Florence, Firenze, Italy
| | - Carlo Dani
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, Firenze, Italy
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Dani C, Ciarcià M, Miselli F, Luzzati M, Coviello C, Azzarelli F, Ferrara M, Lori I, Pezzati M. The management of late preterm infants: effects of rooming-in assistance versus direct admission to neonatal care units. Eur J Pediatr 2022; 181:1643-1649. [PMID: 34993626 DOI: 10.1007/s00431-021-04337-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/08/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Abstract
Late preterm infants (LPIs) represent a significant percentage of all neonates (6-8%), but there are limited published data on their postnatal management. Our aim was to compare the frequency of neonatal intensive care unit (NICU) admission and the breastfeeding rate of LPIs born at 35+0-36+6 weeks of gestation who were cared for by initial rooming in strategy rather than directly admitted to the special care unit (SCU) and, eventually, to the NICU. We carried out a retrospective study in the perinatal centers of Careggi University Hospital (CUH) and San Giovanni di Dio Hospital in Florence, Italy, where the first and second strategies were applied, respectively. Main outcomes were LPIs admission rate at SCU/NICU and breastfeeding rate at discharge. We studied 190 LPIs born at SGDH and 240 born at CUH. The admission rate in SCU (81 vs. 43%; P < 0.001) and NICU (20 vs. 10%; P = 0.008) was higher in SGDH than in CUH, as was the exclusive breastfeeding rate (36 vs. 22%; P < 0.001). However, infants who were assisted in rooming-in at CUH and infants with similar clinical characteristics at SGDH had similar mixed (60 vs. 69%) and exclusive (35 vs. 31%) breastfeeding rates. Conclusion: Postnatal assistance of LPIs in rooming-in, eventually followed by admission in SCU/NICU based on their clinical conditions, allowed to safely halve their hospitalization. The assistance of infants in rooming-in did not negatively affect their breastfeeding rate. These results support the possibility of assisting LPIs in rooming-in. What is Known: • Late preterm infants represent a significant percentage of all neonates. • Early rooming-in and breastfeeding is recommended for late preterm infants. What is New: • Postnatal assistance of late preterm infants in rooming-in, followed when necessary by admission in neonatal units based on clinical conditions, allowed to safely avoid about half the number of hospitalizations in comparison with direct admission in neonatal units. • This strategy did not affect breastfeeding rate. Infants who were admitted to SCU/NICU after initial rooming-in had worst breastfeeding rate.
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Affiliation(s)
- Carlo Dani
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy. .,Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, Florence, 50141, Italy.
| | - Martina Ciarcià
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, Florence, 50141, Italy
| | - Francesca Miselli
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, Florence, 50141, Italy
| | - Michele Luzzati
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, Florence, 50141, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, Florence, 50141, Italy
| | | | - Marianna Ferrara
- Neonatal Intensive Care Unit, San Giovanni Di Dio Hospital, Florence, Italy
| | - Ilaria Lori
- Neonatal Intensive Care Unit, San Giovanni Di Dio Hospital, Florence, Italy
| | - Marco Pezzati
- Neonatal Intensive Care Unit, San Giovanni Di Dio Hospital, Florence, Italy
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Dani C, Ciarcià M, Miselli F, Luzzati M, Coviello C, Paladini A, Bottoni A, D’Andrea V, Vento G. Platelet Count and Volume and Pharmacological Closure with Paracetamol of Ductus Arteriosus in Preterm Infants. Children 2022; 9:children9010089. [PMID: 35053714 PMCID: PMC8774717 DOI: 10.3390/children9010089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/28/2021] [Accepted: 01/06/2022] [Indexed: 11/17/2022]
Abstract
Background: Low platelet count might promote resistance to pharmacological closure with indomethacin and ibuprofen of a hemodynamically significant patent ductus arteriosus (hsPDA). However, no studies have investigated if this occurs with paracetamol. Methods: We retrospectively assessed the correlation between platelet count, mean platelet volume (MPV), and plateletcrit (PCT), as well as the effectiveness of paracetamol in closing hsPDA in infants born at 23+0–31+6 weeks of gestation who were treated with 15 mg/kg/6 h of i.v. paracetamol for 3 days. Results: We studied 79 infants: 37 (47%) Had closure after a course of paracetamol and 42 (53%) did not. Platelet count and PCT did not correlate with paracetamol success or failure in closing hsPDA, while MPV was lower at birth (10.7 ± 1.4 vs. 9.5 ± 1.1; p < 0.001) and prior to starting therapy (11.7 ± 1.9 vs. 11.0 ± 1.6; p = 0.079) in refractory infants. Regression analysis confirmed that the low MVP measured prior to starting the treatment increased the risk of hsPDA paracetamol closure failure (OR 1.664, 95% CI 1.153–2.401). Conclusions: The greater MPV correlated positively with the effectiveness of paracetamol in closing hsPDA, while platelet count and PCT did not influence closure rates. Additional studies are needed to confirm our results.
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Affiliation(s)
- Carlo Dani
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
- Division of Neonatology, University of Florence, 50134 Florence, Italy; (M.C.); (F.M.); (M.L.); (C.C.)
- Correspondence: ; Tel.: +39-055-794-8421
| | - Martina Ciarcià
- Division of Neonatology, University of Florence, 50134 Florence, Italy; (M.C.); (F.M.); (M.L.); (C.C.)
| | - Francesca Miselli
- Division of Neonatology, University of Florence, 50134 Florence, Italy; (M.C.); (F.M.); (M.L.); (C.C.)
| | - Michele Luzzati
- Division of Neonatology, University of Florence, 50134 Florence, Italy; (M.C.); (F.M.); (M.L.); (C.C.)
| | - Caterina Coviello
- Division of Neonatology, University of Florence, 50134 Florence, Italy; (M.C.); (F.M.); (M.L.); (C.C.)
| | - Angela Paladini
- Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, 20123 Rome, Italy; (A.P.); (A.B.); (V.D.); (G.V.)
| | - Anthea Bottoni
- Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, 20123 Rome, Italy; (A.P.); (A.B.); (V.D.); (G.V.)
| | - Vito D’Andrea
- Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, 20123 Rome, Italy; (A.P.); (A.B.); (V.D.); (G.V.)
| | - Giovanni Vento
- Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, 20123 Rome, Italy; (A.P.); (A.B.); (V.D.); (G.V.)
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Bianchi A, Coviello C, Leonardi V, Luzzati M, Chiti S, Ermini D, Miele V, Fainardi E, Dani C, Scola E. In vivo magnetic resonance imaging evidence of olfactory bulbs changes in a newborn with congenital Citomegalovirus: a case report. Ital J Pediatr 2021; 47:227. [PMID: 34784934 PMCID: PMC8594161 DOI: 10.1186/s13052-021-01170-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/16/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Citomegalovirus (CMV) infects approximately 1% of live newborns. About 10% of the infants affected by congenital CMV infection are symptomatic at birth and up to 60% of these infants will develop permanent neurological disabilities. Depending on gestational age (GA) at the time of infection, the involvement of central nervous system (CNS) can lead to malformations of cortical development, calcifications, periventricular white matter lesions and cysts, ventriculomegaly and cerebellar hypoplasia. CASE PRESENTATION We report the MRI findings in a Caucasian female born at 32 weeks of post-menstrual age with post-birth diagnosis of congenital CMV infection showing an unusual and peculiar marked T2 hyperintensity of the inner part of olfactory bulbs in addition to the CMV related diffuse brain involvement. Despite the known extensively described fetal and neonatal Magnetic Resonance Imaging (MRI) findings in CMV infected fetuses and newborns, any in vivo MRI depiction of olfactory system damage have never been reported so far. Nevertheless, in murine studies CMV is known to infect the placenta during pregnancy showing particular tropism for neural stem cells of the olfactory system and previous neuropathologic study on CMV infected human fetal brains from 23 to 28 weeks of GA reported damage in the olfactory bulbs (OB) consisting in disseminated cytomegalic cells, inflammation, necrosis and neuronal and radial glial cell loss. Therefore, we assume an OB involvement and damage in congenital CMV infection. CONCLUSION To our knowledge this is the first in vivo MRI evidence of OB damage in a newborn with congenital CMV infection that may give new insights on CMV infection.
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Affiliation(s)
- Andrea Bianchi
- Department of Neuroradiology, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy
| | - Valentina Leonardi
- Division of Neonatology, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy
| | - Michele Luzzati
- Division of Neonatology, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy
| | - Stefano Chiti
- Department Health Professions, U.O. Research and Development, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy
| | - Daniele Ermini
- Department Health Professions, U.O. Research and Development, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Enrico Fainardi
- Department of Neuroradiology, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy.,Department of Scienze Biomediche, Sperimentali E Cliniche, Neuroradiology, University of Florence, Viale Morgagni, 50, Florence, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy
| | - Elisa Scola
- Department of Neuroradiology, Careggi University Hospital, Largo Piero Palagi 1, Florence, Italy.
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Dani C, Pratesi S, Luzzati M, Petrolini C, Montano S, Remaschi G, Coviello C. Cerebral and splanchnic oxygenation during automated control of inspired oxygen (FiO 2 ) in preterm infants. Pediatr Pulmonol 2021; 56:2067-2072. [PMID: 33773084 DOI: 10.1002/ppul.25379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/17/2021] [Accepted: 03/05/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Our aim in this study was to assess the effect of the Predictive Intelligent Control of Oxygenation (PRICO® ) system on cerebral (rSO2 C) and splanchnic (rSO2 S) oxygenation in a cohort of preterm infants with frequent desaturations. METHODS Twenty infants with gestational age <32 weeks (n = 20) were assigned in random sequence to 12 h of automated or manual adjustment of FiO2 . Over this period, they were studied continuously by near-infrared spectroscopy (NIRS). RESULTS We found that rSO2 C [68.0% (60.5%-74.7%) vs. 68.5% (62%-72%); p = .824] and rSO2 S [27.0% (17.3%-45.7%) vs. 27.0% (15%-53%); p = .878] were similar during automatic and manual control of FiO2 . Time spent with SpO2 90%-95% was higher during the automatic than manual control of FiO2 , while time spent with SpO2 <80% or >95% was lower. CONCLUSIONS Automated control of FiO2 with PRICO® system did not improve brain and splanchnic oxygenation in comparison with manual control in a cohort of preterm infants, but it significantly decreased SpO2 fluctuations and limited the duration of both hypoxemia and hyperoxemia.
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Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy
| | - Simone Pratesi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Michele Luzzati
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Chiara Petrolini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Simona Montano
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Giulia Remaschi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
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11
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Dani C, Coviello C, Panin F, Frosini S, Costa S, Purcaro V, Lepore D, Vento G. Incidence and risk factors of retinopathy of prematurity in an Italian cohort of preterm infants. Ital J Pediatr 2021; 47:64. [PMID: 33712037 PMCID: PMC7953747 DOI: 10.1186/s13052-021-01011-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/26/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Non-negligible differences in retinopathy of prematurity (ROP) and its risk factors between different neonatal intensive care units (NICUs) are reported. Our aim was to assess the incidence and risk factors for ROP development in a large cohort of very preterm infants who were assisted in two Italian NICUs. METHODS Preterm infants with gestational age between 23+ 0 and 29+ 6 weeks were stratified into subgroups of infants who developed ROP and those who did not; their clinical characteristics were compared with univariate and multivariable logistic regression analyses. RESULTS We studied a total of 178 infants of whom 67 (38%) developed ROP (stage 1: n = 12; stage 2: n = 41; stage 3: n = 14). Regression analysis demonstrated that maternal milk (OR 0.979, 95% Cl 0.961-0.998) decreased the risk of developing ROP, while intraventricular hemorrhage (IVH) (OR 2.055, 95% Cl 1.120-3.772) increased it. Moreover, maternal milk was found to decrease (OR 0.981, 95% Cl 0.964-0.997) the risk of ROP at discharge, while RBC transfusion increased it (OR 1.522, 95% Cl 1.208-1.916). CONCLUSIONS In our cohort the occurrence of ROP was similar to that previously reported. Strategies for promoting the use of mother's own milk, preventing IVH, and standardizing the approach to RBC transfusions could contribute to decreasing the risk of ROP in very preterm infants.
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Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital, Largo Brambilla 3, 50141, Florence, Italy.
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy.
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital, Largo Brambilla 3, 50141, Florence, Italy
| | - Fiorenza Panin
- Division of Neonatology, Careggi University Hospital, Largo Brambilla 3, 50141, Florence, Italy
| | - Saverio Frosini
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
| | - Simonetta Costa
- Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Velia Purcaro
- Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Domenico Lepore
- Department of Ophthalmology, Gemelli Foundation IRCSS, Catholic University of the Sacred Heart, Rome, Italy
| | - Giovanni Vento
- Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, Rome, Italy
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12
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Coviello C, Perrone S, Buonocore G, Negro S, Longini M, Dani C, de Vries LS, Groenendaal F, Vijlbrief DC, Benders MJNL, Tataranno ML. Isoprostanes as Biomarker for White Matter Injury in Extremely Preterm Infants. Front Pediatr 2021; 8:618622. [PMID: 33585368 PMCID: PMC7874160 DOI: 10.3389/fped.2020.618622] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/14/2020] [Indexed: 01/28/2023] Open
Abstract
Background and Aim: Preterm white matter is vulnerable to lipid peroxidation-mediated injury. F2-isoprostanes (IPs), are a useful biomarker for lipid peroxidation. Aim was to assess the association between early peri-postnatal IPs, white matter injury (WMI) at term equivalent age (TEA), and neurodevelopmental outcome in preterm infants. Methods: Infants with a gestational age (GA) below 28 weeks who had an MRI at TEA were included. IPs were measured in cord blood (cb) at birth and on plasma (pl) between 24 and 48 h after birth. WMI was assessed using Woodward MRI scoring system. Multiple regression analyses were performed to assess the association between IPs with WMI and then with BSITD-III scores at 24 months corrected age (CA). Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of pl-IPs for the development of WMI. Results: Forty-four patients were included. cb-IPs were not correlated with WMI score at TEA, whereas higher pl-IPs and lower GA predicted higher WMI score (p = 0.037 and 0.006, respectively) after controlling for GA, FiO2 at sampling and severity of IVH. The area under the curve was 0.72 (CI 95% = 0.51-0.92). The pl-IPs levels plotted curve indicated that 31.8 pg/ml had the best predictive threshold with a sensitivity of 86% and a specificity of 60%, to discriminate newborns with any WMI from newborns without WMI. IPs were not associated with outcome at 24 months. Conclusion: Early measurement of pl-IPs may help discriminate patients showing abnormal WMI score at TEA, thus representing an early biomarker to identify newborns at risk for brain injury.
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Affiliation(s)
- Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Serafina Perrone
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppe Buonocore
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simona Negro
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Mariangela Longini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Linda S. de Vries
- Department of Neonatology, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Floris Groenendaal
- Department of Neonatology, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Daniel C. Vijlbrief
- Department of Neonatology, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Manon J. N. L. Benders
- Department of Neonatology, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Maria Luisa Tataranno
- Department of Neonatology, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
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13
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Dani C, Coviello C, Montano S, Remaschi G, Petrolini C, Strozzi MC, Maggiora E, Sabatini M, Gazzolo D. Correction: Effect on splanchnic oxygenation of breast milk, fortified breast milk, and formula milk in preterm infants. Pediatr Res 2021; 89:249. [PMID: 33046837 DOI: 10.1038/s41390-020-1097-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy. .,Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy.
| | - Caterina Coviello
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Simona Montano
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Giulia Remaschi
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Chiara Petrolini
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | | | - Elena Maggiora
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Miriam Sabatini
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit G. D'Annunzio University of Chieti, Chieti, Italy
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14
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Dani C, Coviello C, Montano S, Remaschi G, Petrolini C, Strozzi C, Maggiora E, Sabatini M, Gazzolo D. Response to: "Letter to the Editor: Effect on splanchnic oxygenation of breast milk, fortified breast milk and formula milk in preterm infants". Pediatr Res 2021; 89:6. [PMID: 33045720 DOI: 10.1038/s41390-020-01164-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy. .,Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy.
| | - Caterina Coviello
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Simona Montano
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Giulia Remaschi
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Chiara Petrolini
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Chiara Strozzi
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Elena Maggiora
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Miriam Sabatini
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit, G. D'Annunzio University of Chieti, Chieti, Italy
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15
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Dani C, Coviello C, Montano S, Remaschi G, Petrolini C, Strozzi MC, Maggiora E, Sabatini M, Gazzolo D. Effect on splanchnic oxygenation of breast milk, fortified breast milk, and formula milk in preterm infants. Pediatr Res 2021; 89:171-174. [PMID: 32380507 DOI: 10.1038/s41390-020-0935-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/06/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Enteral feeding induces mesenteric hemodynamic changes in preterm infants, which may vary according to the milk used. Our aim in this study was to evaluate changes of splanchnic regional oxygenation (rSO2S) measured by near-infrared spectroscopy (NIRS) in infants fed with mother's own milk (MOM), fortified human milk (FHM), or preterm formula (PTF). METHODS Infants born at 25-31 weeks of gestational age (n = 54) received a bolus of MOM, FHM, or PTF. rSO2S and splanchnic fractional oxygen extraction ratio (FOES) were recorded 60 min before (T0), and 30 min (T1) and 120 min (T2) after the beginning of bolus feeding. RESULTS In the MOM group, rSO2S and FOES did not change during the study period. In the FBM group, rSO2S decreased from T0 to T1 and increased from T1 to T2, while FOES changed in reverse. In the PTF group, rSO2S decreased from T0 to T1 and from T1 to T2, while FOES changed in reverse. CONCLUSIONS Splanchnic oxygenation was not affected by MOM feeding, was transiently decreased by FBM feeding, and was persistently decreased by PTF. These results suggest that preterm infants who received PTF has higher splanchnic tissue oxygen extraction compared to those who received MOM or FBM. IMPACT Human milk feeding is associated to a lower splanchnic energy expenditure than preterm formula feeding. Fortified human milk transiently increases splanchnic energy expenditure. Preterm formula should be used only in the absence of human milk.
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Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy. .,Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy.
| | - Caterina Coviello
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Simona Montano
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Giulia Remaschi
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Chiara Petrolini
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | | | - Elena Maggiora
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Miriam Sabatini
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit G. D'Annunzio University of Chieti, Chieti, Italy
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16
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Coviello C, Remaschi G, Becciani S, Montano S, Corsini I, Mussa F, Basile M, Dani C. Erratum: Neonatal Cerebellar Hemorrhage and Facial Nerve Palsy: An Unusual Association. AJP Rep 2020; 10:e1. [PMID: 33654577 PMCID: PMC7906837 DOI: 10.1055/s-0041-1726119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
[This corrects the article DOI: 10.1055/s-0040-1715162.][This corrects the article DOI: 10.1055/s-0040-1715162.].
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Affiliation(s)
- Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Giulia Remaschi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Sabrina Becciani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Simona Montano
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Federico Mussa
- Department of Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - Massimo Basile
- Interdisciplinary Specialist Department, Radiology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Italy
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17
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Coviello C, Remaschi G, Becciani S, Montano S, Corsini I, Mussa F, Basile M, Dani C. Neonatal Cerebellar Hemorrhage and Facial Nerve Palsy: An Unusual Association. AJP Rep 2020; 10:e262-265. [PMID: 33094015 PMCID: PMC7571563 DOI: 10.1055/s-0040-1715162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/30/2019] [Indexed: 11/16/2022] Open
Abstract
Cerebellar hemorrhage is rare in term newborns and is most often seen after traumatic birth. Lifelong sequelae include motor and cognitive impairment. We report the uncommon case of a late preterm infant born by spontaneous delivery who showed right peripheral facial palsy at 24 hours of life. Cranial ultrasound showed lateral ventricles dilatation and a diffuse hyperechoic round lesion in the right cerebellar hemisphere. The computed tomography scan confirmed a hemorrhagic lesion in the right cerebellar hemisphere and in the vermis with midline shift and intraventricular bleeding. Ommaya reservoir was inserted and used for a few days. The facial palsy gradually recovered to a complete remission after 6 weeks. Follow-up examinations at 12 and 18 months evidenced infant's delayed motor function, hyperreflexia, tremors, and speech delay.
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Affiliation(s)
- Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Giulia Remaschi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Sabrina Becciani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Simona Montano
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Federico Mussa
- Department of Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - Massimo Basile
- Interdisciplinary Specialist Department, Radiology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Italy
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18
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Coviello C, Tataranno ML, Corsini I, Leonardi V, Longini M, Bazzini F, Buonocore G, Dani C. Isoprostanes as Biomarker for Patent Ductus Arteriosus in Preterm Infants. Front Pediatr 2020; 8:555. [PMID: 33014939 PMCID: PMC7506157 DOI: 10.3389/fped.2020.00555] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/31/2020] [Indexed: 11/13/2022] Open
Abstract
Context: It has been reported that isoprostanes (IPs) have a role in the pathophysiology of ductus arteriosus during the fetal and neonatal period. Our aim in this study was to assess if urinary IPs (uIPs) levels correlate with the risk of developing a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Materials and methods: Infants with 23 + 0 - 33 + 6 weeks of gestational age and respiratory distress syndrome (RDS) were consecutively enrolled. Urine samples were collected on the 2nd and 10th day of life (DOL) for uIPs measurement. Echocardiography for hsPDA diagnosis was performed between 24 and 48 h of life. Regression analysis was performed to assess the correlation between uIPs and hsPDA. Receiver operating characteristic (ROC) curve analysis was used to evaluate the accuracy of the uIPs in predicting the occurrence of hsPDA. Results: Sixty patients were studied: 33 (55%) developed a hsPDA, 27 (45%) had ibuprofen hsPDA closure, and six (10%) required surgical closure. uIPs levels decreased from the 2nd to the 10th DOL. Adjusted regression analysis demonstrated that uIPs on the 2nd DOL were associated (p = 0.02) with the risk of developing a hsPDA. A cut-off level of 1627 ng/mg of creatinine of uIPs predicted the development of a hsPDA with a sensitivity of 82% and a specificity of 73%. Conclusion: Early measurement of uIPs on the 2nd DOL is a reliable biomarker of hsPDA development and, alone or combined with other markers, might represent a non-invasive tool useful for planning the management of PDA in preterm infants.
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Affiliation(s)
- Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | | | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Valentina Leonardi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Mariangela Longini
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy
| | - Francesco Bazzini
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy
| | - Giuseppe Buonocore
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy
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19
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Corsini I, Parri N, Coviello C, Leonardi V, Dani C. Lung ultrasound findings in congenital diaphragmatic hernia. Eur J Pediatr 2019; 178:491-495. [PMID: 30666398 DOI: 10.1007/s00431-019-03321-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/04/2019] [Accepted: 01/09/2019] [Indexed: 11/30/2022]
Abstract
Congenital diaphragmatic hernia (CDH) occurs in approximately 1 in 2500 to 5000 infants. The use of lung ultrasound (LUS) for its diagnosis has been reported in only two case reports. The aim of this study was to report the LUS pattern of CDH in a case series of infants with respiratory distress. This case series was part of a cohort enrolled in a larger prospective observational study. LUS was performed at the point-of-care during the first 24 h of life of the neonates and its operation time was measured. Seven cases (six left and one right CDH) were diagnosed. We found that the pattern of LUS for CDH diagnosis includes (1) partial absence of the hyperechoic line representing the normal diaphragmatic profile, (2) partial absence of the pleural line in the affected hemithorax, (3) absence of A lines in the affected area, (4) presence of multi-layered area with hyperechoic contents in motion (normal gut), and (5) possible presence of parenchymatous organs inside the thorax (i.e., liver or spleen).Conclusion: A description of LUS pattern in infants with CDH is provided. LUS at the point-of-care may allow the prompt diagnosis of CDH and this is particularly useful in cases of missed prenatal diagnosis. What is Known: • Congenital diaphragmatic hernia occurs in approximately 1 in 2500 to 5000 infants but the use of lung ultrasound for its diagnosis has been reported in only two case reports. What is New: • Research provided a description of lung ultrasound pattern in infants with congenital diaphragmatic hernia. • Lung ultrasound at the point-of-care may allow a prompt diagnosis of congenital diaphragmatic hernia, particularly useful in cases of missed prenatal diagnosis.
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Affiliation(s)
- Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50134, Florence, Italy.
| | - Niccolò Parri
- Department of Pediatric Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Valentina Leonardi
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50134, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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20
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Corsini I, Parri N, Gozzini E, Coviello C, Leonardi V, Poggi C, Giacalone M, Bianconi T, Tofani L, Raimondi F, Dani C. Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates. Neonatology 2019; 115:77-84. [PMID: 30304736 DOI: 10.1159/000493001] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 08/17/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Respiratory distress (RD) is the most common neonatal illness. Lung ultrasound (LUS) is a technique previously tested in neonatal studies on RD, but literature regarding its routine clinical applicability is still lacking. OBJECTIVE To assess the concordance between LUS performed by neonatologists with different training levels and chest X-ray (CXR) for the diagnosis of RD in newborns during the first 24 h of life. METHODS We enrolled newborns with RD during the first 24 h of life. Patients underwent LUS and CXR. LUS and CXR diagnosis were compared to evaluate concordance. Twenty percent of patients received two LUS (one from an experienced and one from a novice sonographer) to calculate the interobserver agreement. The difference in time needed to reach a diagnosis with LUS and CXR, and from novice and expert operators, was measured. RESULTS We studied 124 patients; 134 diagnoses were reported. The concordance between LUS and CXR diagnosis was 91% (95% CI 86-96%) with a κ statistic of 0.88 (95% CI 0.81-0.94). The median time to diagnosis was shorter for LUS (9.5 min, IQR 5-15) than for CXR (50 min, IQR 33-64) (p < 0.0001). In 25/124 patients, LUS was performed by both novice and experienced sonographers with complete concordance. The median time to diagnosis was shorter for expert (9 min, IQR 5-15) than novice operators (15 min, IQR 10-20) (p < 0.0002). CONCLUSION LUS and CXR have a high concordance in the differential diagnosis of neonatal RD in the first 24 h of life. LUS has a shorter operation time than CXR.
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Affiliation(s)
- Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Florence,
| | - Niccolò Parri
- Department of Pediatric Emergency Medicine and Trauma Center, Meyer University Children's Hospital, University of Florence, Florence, Italy
| | - Elena Gozzini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Valentina Leonardi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Chiara Poggi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Martina Giacalone
- Department of Health Sciences, Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Tommaso Bianconi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Lorenzo Tofani
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
| | - Francesco Raimondi
- Division of Neonatology, Department of Translational Medical Sciences, Università Federico II di Napoli, Naples, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy
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Coviello C, Popple Martinez M, Drovandi L, Corsini I, Leonardi V, Lunardi C, Antonelli C, Pratesi S, Dani C. Painful procedures can affect post-natal growth and neurodevelopment in preterm infants. Acta Paediatr 2018; 107:784-790. [PMID: 29341252 DOI: 10.1111/apa.14222] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/21/2017] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Abstract
AIM This Italian study evaluated whether painful procedures during the first four weeks of life were related to subsequent weight gain, head circumference (HC) and neurodevelopmental outcomes in preterm infants, METHODS: We evaluated the number of invasive procedures that infants born at less than 32 weeks of gestational age (GA) underwent in the Neonatal Intensive Care Unit of Careggi Hospital, Florence, from January to December 2015. Weight and HC were recorded at birth, 36 weeks of PMA and six and 12 months of CA. Neurological outcomes were assessed at six and 12 months of CA using the Bayley Scales of Infant and Toddler Development - Third Edition. RESULTS We studied 83 preterm infants with a GA of 28 ± 2 weeks and birth weight of 1098 ± 340 g. A higher number of invasive painful procedures were related to a lower HC standard deviation score at 36 weeks of PMA and six and 12 months of CA and with lower cognitive scores at six months. At 12 months, the relationship only remained significant for infants born at less than 28 weeks (p < 0.001). CONCLUSION Invasive painful procedures affected regular HC growth and short-term cognitive scores in preterm infants in the first year of life.
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Affiliation(s)
- Caterina Coviello
- Division of Neonatology; Careggi University Hospital of Florence; Florence Italy
| | | | - Livia Drovandi
- Division of Neonatology; Careggi University Hospital of Florence; Florence Italy
| | - Iuri Corsini
- Division of Neonatology; Careggi University Hospital of Florence; Florence Italy
| | - Valentina Leonardi
- Division of Neonatology; Careggi University Hospital of Florence; Florence Italy
| | - Clara Lunardi
- Division of Neonatology; Careggi University Hospital of Florence; Florence Italy
| | - Carla Antonelli
- Neurology Unit; A. Meyer Children's Hospital of Florence; Florence Italy
| | - Simone Pratesi
- Division of Neonatology; Careggi University Hospital of Florence; Florence Italy
| | - Carlo Dani
- Division of Neonatology; Careggi University Hospital of Florence; Florence Italy
- Department of Neurosciences, Psychology, Drug Research and Child Health; Careggi University Hospital of Florence; Florence Italy
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Bassi A, Coviello C, Martino MD, Cutrone M, Dani C. Aplasia cutis congenita and 'vanishing twin' caused by iatrogenic fetal reduction. Arch Dis Child Fetal Neonatal Ed 2018; 103:F270. [PMID: 29353258 DOI: 10.1136/archdischild-2017-314630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 01/02/2018] [Accepted: 01/02/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Andrea Bassi
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.,Department of Pediatric Medicine, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Maurizio de Martino
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.,Department of Pediatric Medicine, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | - Mario Cutrone
- Pediatric Dermatology Unit, Ospedale Dell'Angelo, Venezia, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
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Abstract
Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes occurring within 6 months from birth. NDM can be permanent or transient (TNDM). We report the case of a preterm infant with TNDM due to an ABCC8 mutation identified by next-generation sequencing. The pancreatic adenosine triphosphate (ATP)-sensitive K+ (K-ATP) channel is a key regulator of insulin secretion. Gain-of-function mutations in the genes encoding the Kir6.2 (KCNJ11) and SUR1 (ABCC8) subunits of the channel cause neonatal diabetes. The patient was successfully managed with insulin lispro at a 1:100 dilution, drawn up in an insulin pen injector with a 4-mm needle. The insulin lispro dilution allowed administration of the exact insulin doses, obtaining a good glycemic control and minimizing the burden of injections. At 2 months, corrected age insulin doses were progressively decreased until discontinuation.
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Affiliation(s)
- Barbara Piccini
- Tuscany Regional Centre of Pediatric Diabetes, Meyer University Children's Hospital, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Livia Drovandi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Artuso Rosangela
- Medical Genetics Unit, Meyer University Children's Hospital, Florence, Italy
| | - Francesca Monzali
- Pediatric Dietology Unit, Meyer University Children's Hospital, Florence, Italy
| | | | - Sabrina Giglio
- Medical Genetics Unit, Meyer University Children's Hospital, Florence, Italy.,Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - Sonia Toni
- Tuscany Regional Centre of Pediatric Diabetes, Meyer University Children's Hospital, Florence, Italy
| | - Carlo Dani
- Department of Neuroscience, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy
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Corsini I, Cecchi A, Coviello C, Dani C. Erratum to: Perfusion index and left ventricular output correlation in healthy term infants. Eur J Pediatr 2017; 176:1019. [PMID: 28580509 DOI: 10.1007/s00431-017-2939-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Iuri Corsini
- Division of Neonatology, Careggi University Hospital, University of Florence School of Medicine, Florence, Italy
| | - Alessandra Cecchi
- Division of Neonatology, Careggi University Hospital, University of Florence School of Medicine, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital, University of Florence School of Medicine, Florence, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital, University of Florence School of Medicine, Florence, Italy.
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy.
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25
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Bertini G, Coviello C, Gozzini E, Bianconi T, Bresci C, Leonardi V, Dani C. Change of Cerebral Oxygenation during Surfactant Treatment in Preterm Infants: "LISA" versus "InSurE" Procedures. Neuropediatrics 2017; 48:98-103. [PMID: 28245505 DOI: 10.1055/s-0037-1598647] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives The aim of the study was to compare the effects on cerebral oxygenation in preterm infants of two different procedures for surfactant administration: the LISA (low-invasive method of surfactant administration) and the InSurE (Intubation, SURfactant administration, Extubation). Study Design Twenty premature infants with respiratory distress syndrome were assigned to receive surfactant either by "LISA" (n = 10) or "InSurE" (n = 10) procedure. Patients were continuously studied by near-infrared spectroscopy (NIRS) for the measurement of cerebral regional oxygenation (rSO2C) and calculation of cerebral fractional oxygen extraction rate (cFTOE), and NIRS data were recorded 30 minutes before (T0) surfactant administration, during the procedure (Tproc), and 30 (T1), 60 (T2T2), and 120 minutes (T3) afterward. Cerebral blood flow velocity (CBFV) was studied in the anterior cerebral artery at T0, T1, and T3. Results SpO2 significantly decreased at Tproc in comparison with T0, T1, T2, and T3 and the decrease was higher in the LISA than in the InSurE group. rSO2C was lower at tproc and T3 in the LISA than in the InSurE group. cFTOE was higher at tproc, t2, and t3 in the LISA group than in the InSurE group. CBFV did not change during the study periods in both groups. Conclusions The LISA and InSurE procedures transiently decreased rSO2C in our population, and the decrease was higher in the LISA group. Consistently, there was a contemporary increase in cFTOE that was higher in the LISA than in the InSurE group, suggesting that it represents a compensatory mechanism.
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Affiliation(s)
- Giovanna Bertini
- Division of Neonatology, Careggi University Hospital, Florence, Italy
| | - Caterina Coviello
- Division of Neonatology, Careggi University Hospital, Florence, Italy
| | - Elena Gozzini
- Division of Neonatology, Careggi University Hospital, Florence, Italy
| | - Tommaso Bianconi
- Division of Neonatology, Careggi University Hospital, Florence, Italy
| | - Cecilia Bresci
- Division of Neonatology, Careggi University Hospital, Florence, Italy
| | | | - Carlo Dani
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, Italy
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Pratesi S, Corsini I, Coviello C, Perugi S, Dani C. Resuscitation with Intact Placental Circulation in a Preterm Infant with Hydrops Fetalis. AJP Rep 2017; 7:e28-e30. [PMID: 28367357 PMCID: PMC5374276 DOI: 10.1055/s-0037-1598200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A preterm infant with prenatal diagnosis of hydrops fetalis was spontaneously delivered at 30 weeks of gestational age in a tertiary level hospital. Prenatal echography pointed out severe bilateral pleural effusions and diffused subcutaneous edema. A neonatologist team, alerted at the expulsion stage of labor, assisted the neonate immediately after birth and bilateral hydrothorax was drained with intact placental circulation to avoid a nonrespiratory period and its possible detrimental hemodynamic effects. The newborn was well stabilized in the delivery room before cutting the umbilical cord and starting mechanical ventilation. Unfortunately, our patient died due to refractory respiratory failure on the fourth day of life. However, the intact placental circulation procedure was performed without adverse effects to the infant and might represent a promising option in addition to other resuscitation procedures for the management of this type of patient.
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Affiliation(s)
- Simone Pratesi
- Neonatology and Intensive Care Unit, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy
| | - Iuri Corsini
- Neonatology and Intensive Care Unit, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy
| | - Caterina Coviello
- Neonatology and Intensive Care Unit, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy
| | - Silvia Perugi
- Neonatology and Intensive Care Unit, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy
| | - Carlo Dani
- Neonatology and Intensive Care Unit, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy
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27
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Cassano N, De Benedittis M, Petruzzi M, Carbonara M, Agnusdei C, Alessandrini G, Bellini M, Callea A, Carriera M, Coviello C, Gasparro EC, Dattola S, Ferrari A, Gabellone M, Gravante M, Ligori P, Liguori G, Mancino A, Manco S, Martina G, Pietrantonio V, Postorino F, Saviozzi A, Schiraldi G, Sodo M, Stasi R, Tortora G, Zoccali A, Vena G. Topical Vitamin E Acetate for the Treatment of Cheilitis: A Multicentre Experience. EUR J INFLAMM 2016. [DOI: 10.1177/1721727x0300100306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Treatment of cheilitis is usually difficult and often disappointing. We evaluated the effects of a topical preparation containing vitamin E acetate (VEA® lipogel) in 254 patients (mean age, 29.5) with cheilitis of various nature and etiology, involving the vermilion region and/or the perioral skin. The most frequent form of cheilitis was that induced by oral isotretinoin; other forms were irritant contact dermatitis, atopic cheilitis, and contact allergy. Patients were instructed to apply VEA® lipogel daily; the number of daily applications was modulated on the basis of the severity of symptoms (two or three times a day in the majority of cases). After 4 weeks of treatment, clinical examination showed that the severity of symptoms and signs significantly improved (P<0.001). The response to treatment was reported as particularly rapid by 32% of patients. Patient's assessment of overall effectiveness and acceptability was positive in the majority of cases. Treatment was well tolerated; local adverse reactions were observed in 2.75% of patients and were mostly transient and mild. Our experience suggests that VEA® lipogel is an effective and safe approach to cheilitis. The safety of this preparation is also due to the presence of only a few excipients and the absence of fragrances, preservatives and colouring agents.
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Affiliation(s)
| | | | - M. Petruzzi
- Department of Odontostomatology and Surgery, University of Bari
| | - M. Carbonara
- Unit of Occupational Medicine, University of Bari
| | | | | | | | | | | | - C. Coviello
- Department of Internal Medicine, Immunology and Infectious Diseases, Unit of Dermatology, University of Bari
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - G.A. Vena
- Department of Internal Medicine, Immunology and Infectious Diseases, Unit of Dermatology, University of Bari
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28
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Vena G, Cassano N, Agnusdei C, Bellini M, Calabretta S, Centofanti S, Cervadoro G, Coviello C, Curia S, Dattola S, De Caro C, Del Brocco L, Donato L, Favero L, Ferrari A, Gianfaldoni R, Liguori G, Loconsole F, Lopreiato R, Malara G, Massimino S, Nannipieri A, Pettinato M, Postiglione D, Postorino C, Pronesti' M, Provenzano E, Guerra AP, Ricciuti F, Ruggiero G, Scudero A, Spitaleri S, Armati FT, Valenti G, Vernaci R, Verrina F, Zagni G, Zappala' F. Treatment of Psoriasis Vulgaris with Calcipotriol Betamethasone Dipropionate Combination Followed by Calcipotriol and Assessment of the Adjuvant Basic Use of Urea-Based Emollients. EUR J INFLAMM 2016. [DOI: 10.1177/1721727x0500300108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A new combination product containing betamethasone dipropionate and calcipotriol (Dovobet® ointment) has been proven very effective and well tolerated in patients with psoriasis vulgaris. Emollients are adjunctive modalities commonly used in psoriasis; however, their actual role in combination with topical drugs as well as well as their compatibility with these drugs have not been well elucidated. In 313 adult patients with psoriasis vulgaris, we studied the efficacy and tolerability of treatment with Dovobet® ointment combined with urea-based emollients (Excipial U®) for 4 weeks, followed by treatment with calcipotriol (Daivonex®) either alone (group A) or combined with urea-containing emollients (Excipial U®, group B) for 8 weeks. Clinical evaluations were performed at baseline, at 4 and 12 weeks, assessing the clinical score for erythema, scaling, infiltration and pruritus, graded on the basis of a 5-point scale. After the initial 4-week treatment, a significant improvement of all clinical parameters was observed (p<0.05). Overall, clinical results improved further during the maintenance treatment phase; significant changes (p<0.05) were observed in each group. Most patients considered treatment efficacy positively at both 4 weeks and 12 weeks. Interestingly, at the end of the study, a greater percentage of patients in group B than in group A judged the efficacy as excellent. Treatment was very well tolerated. Only two patients complained of mild and transient burning sensation during the first days of treatment. The results of this study confirm the great efficacy and tolerability of sequential treatment with Dovobet®, and Daivonex® in psoriasis vulgaris and show the enhanced acceptability of this treatment associated with urea-based emollients.
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Affiliation(s)
- G.A. Vena
- 2nd Unit of Dermatology - MIDIM Department, University of Bari, Italy
| | - N. Cassano
- 2nd Unit of Dermatology - MIDIM Department, University of Bari, Italy
- Istituto Dermopatico dell'Immacolata, Rome, Italy
| | - C.P. Agnusdei
- Italian Group for the Study of Emollients in Psoriasis
| | - M. Bellini
- Italian Group for the Study of Emollients in Psoriasis
| | - S. Calabretta
- Italian Group for the Study of Emollients in Psoriasis
| | - S. Centofanti
- Italian Group for the Study of Emollients in Psoriasis
| | - G. Cervadoro
- Italian Group for the Study of Emollients in Psoriasis
| | - C. Coviello
- 2nd Unit of Dermatology - MIDIM Department, University of Bari, Italy
| | - S. Curia
- Italian Group for the Study of Emollients in Psoriasis
| | - S. Dattola
- Italian Group for the Study of Emollients in Psoriasis
| | - C. De Caro
- Italian Group for the Study of Emollients in Psoriasis
| | - L. Del Brocco
- Italian Group for the Study of Emollients in Psoriasis
| | - L. Donato
- Italian Group for the Study of Emollients in Psoriasis
| | - L. Favero
- Italian Group for the Study of Emollients in Psoriasis
| | - A. Ferrari
- Italian Group for the Study of Emollients in Psoriasis
| | | | - G. Liguori
- Italian Group for the Study of Emollients in Psoriasis
| | - F. Loconsole
- 2nd Unit of Dermatology - MIDIM Department, University of Bari, Italy
| | - R. Lopreiato
- Italian Group for the Study of Emollients in Psoriasis
| | - G. Malara
- Italian Group for the Study of Emollients in Psoriasis
| | | | - A. Nannipieri
- Italian Group for the Study of Emollients in Psoriasis
| | - M. Pettinato
- Italian Group for the Study of Emollients in Psoriasis
| | | | - C. Postorino
- Italian Group for the Study of Emollients in Psoriasis
| | | | | | | | - F. Ricciuti
- Italian Group for the Study of Emollients in Psoriasis
| | - G. Ruggiero
- Italian Group for the Study of Emollients in Psoriasis
| | - A. Scudero
- Italian Group for the Study of Emollients in Psoriasis
| | - S. Spitaleri
- Italian Group for the Study of Emollients in Psoriasis
| | | | - G. Valenti
- Italian Group for the Study of Emollients in Psoriasis
| | - R. Vernaci
- Italian Group for the Study of Emollients in Psoriasis
| | - F. Verrina
- Italian Group for the Study of Emollients in Psoriasis
| | - G.F. Zagni
- Italian Group for the Study of Emollients in Psoriasis
| | - F. Zappala'
- Italian Group for the Study of Emollients in Psoriasis
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Feliciani C, Amerio P, Pour SM, Allegretti T, Proietto G, Coviello C, Amerio P, Vena G. IL-1α, IL-6 and TNF-α in Cutaneous Lesions of Lupus Erythematosus are Inhibited by Topical Application of Calcipotriol. Int J Immunopathol Pharmacol 2016. [DOI: 10.1177/039463209500800306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Lupus Erythematosus (LE) is an autoimmune disorder with an unknown etiology and pathogenesis. Skin lesions of LE express several cytokines which correlate to histological findings such as IL-1 and IL-6 which are mediators of epidermal growth and proliferation. Skin lesions of LE are generally treated with immunosuppressive agents such as oral or topically applied corticosteroids. Recently a new drug, calcipotriol, a vitamin D3 analogue has been useful in treatment of psoriasis with no ad verse effect on calcium metabolism. This drug shares immunomodulatory effects with vit. D3 by inhibiting several cytokines produced by keratinocytes. In order to test the clinical effectiveness of calcipotriol in cutaneous lesions of LE we have investigated several proinflammatory cytokines such as: IL-1α, IL-1β, IL-4, IL-5, IL-6, IL-8, MCP-1, TNF-α. Using an avidin-biotin immunoperoxidase system we have found IL-1 in both forms, IL-6 and TNF-α in basal keratinocytes in patients affected with LE, after treatment they were reverted to normal. This inhibition is induced at a molecular level as demostrated by reduced IL-1, IL-6 and TNFα mRNA expression. This is the first report showing that calcipotriol is effective in cutaneous lesions of LE and suggesting that this action is due to an inhibition of protein synthesis and mRNA expression for IL-1α, IL-6 and TNFα.
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Affiliation(s)
| | | | | | | | | | - C. Coviello
- Department of Dermatology, University of Bari, Italy
| | | | - G.A. Vena
- Department of Dermatology, University of Bari, Italy
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Cassano N, Loconsole F, Amoruso A, Coviello C, Filieri M, Filotico R, Del Vecchio S, Vena GA. Infliximab Monotherapy for Refractory Psoriasis: Preliminary Results. Int J Immunopathol Pharmacol 2016; 17:373-80. [PMID: 15461871 DOI: 10.1177/039463200401700317] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Tumour necrosis factor (TNF)-alpha plays an important role in the pathogenesis of psoriasis. Infliximab is an anti-TNF-alpha chimeric monoclonal antibody, which is licensed for the treatment of rheumatoid arthritis and Crohn's disease. Some reports have shown the efficacy of infliximab, either in monotherapy or in combination with methotrexate, for the treatment of psoriatic arthropathy and psoriasis. The efficacy and tolerability of infliximab monotherapy was evaluated in 29 patients with moderate to severe psoriasis, unresponsive to conventional treatments. Fourteen patients suffered from concomitant arthropathy. Patients received intravenous infliximab, 5mg/kg, at weeks 0, 2, and 6. After this 3-dose-induction regimen, patients were followed-up at monthly intervals and retreated with a single-dose infusion in case of relapse of signs and symptoms. Clinical assessment was performed using the psoriasis area and severity index (PASI) to monitor psoriasis activity; pruritus and joint pain were assessed on a scale of 0 to 3. A marked improvement of skin lesions and subjective symptoms was noted in the majority of patients; an excellent reduction of PASI score (⩾75%) was observed in 13.8% of cases at week 2, 71.4% at week 6 and 78.6% at week 10. During the follow-up period, some patients maintained satisfactory clinical results without requiring any additional infusions. In general, skin lesions showed a trend towards a more prolonged and sustained improvement as compared with subjective symptoms. Treatment was well tolerated and no serious adverse events occurred.
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Affiliation(s)
- N Cassano
- Istituto Dermopatico dell'Immacolato, I.D.I, I.R.C.C.S., Rome, Italy
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31
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Abstract
OBJECTIVES To measure burnout in a cohort of neonatologists and to explore its association with several psychological and biographic factors. MATERIALS AND METHODS A total of 110 neonatologists filled in a personal questionnaire composed of four parts: (a) biographic data, (b) personal beliefs, (c) attitudes toward clinical decisions and (d) a validated tool (the Link Burnout Questionnaire [LBQ]) to assess their burnout. The LBQ categorizes burnout into four subscales: psycho-physical exhaustion, relationship deterioration, sense of professional failure and disillusion. Scores of each subscale range from 6 (minimum) to 36 (maximum). Burnout values were matched with the data of the personal questionnaire. RESULTS Most neonatologists (60%-65%) were in the "at risk" range for burnout. High burnout was experienced by 30% of the neonatologists. Having no children is associated with low rates of burnout; work experience of less than 5 years, believing that living with a physical disability is unworthy and having recurrent death ideation are associated with high rates of burnout. The attitude to resuscitating a 24-week baby is inversely correlated with the disillusion rate. CONCLUSION In our cohort, burnout exceeds the alarm threshold in one-third of cases. Some of the risk factors we examined were correlated with burnout and should be considered in future prevention programs.
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Affiliation(s)
- Carlo V Bellieni
- Department of Pediatrics, Obstetrics and Reproduction Medicine, University of Siena, Sienna, Italy.
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Perrone S, Coppi S, Coviello C, Cecchi S, Becucci E, Tataranno ML, Buonocore G. Efficacy of Arnica Echinacea powder in umbilical cord care in a large cohort study. J Matern Fetal Neonatal Med 2012; 25:1111-3. [PMID: 21923308 DOI: 10.3109/14767058.2011.624217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Today healthy newborns are discharged after 48 h-72 h of life until umbilical cord (UC) detachment. Complications due to an inappropriate management are: erythema, edema, bleeding, omphalitis and sepsis. Hence the importance of a safe, effective, easy to do, and cheap method. AIM This study tests the effects and the efficacy of arnica echinacea powder by evaluating the time of cord detachment and the risk of side effects in a large cohort of newborns. METHODS 6323 babies were treated with Arnica Echinacea powder twice a day until cord stump detachment. Medications started in hospital ward and continued at home until stump detachment. RESULTS The UC stump detachment occurred in 89.09% of newborns during the first 4 days of life. This percentage increase to 96.13% at 6 days. CONCLUSIONS Our study demonstrates the efficacy and the safety of arnica echinacea in UC separation. No infections or even bacterial colonizations were found. The use of arnica echinacea reduces hospital costs as a consequence of complications. In addition arnica use is well received by medical staff and parents. In conclusion due to its potential benefits, low cost and feasibility, we recommend the use of arnica echinacea powder as routine procedure in all nurseries.
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Affiliation(s)
- Serafina Perrone
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy
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Coviello C, Rodriquez DC, Cecchi S, Tataranno ML, Farmeschi L, Mori A, Buonocore G. Different clinical manifestation of cow's milk allergy in two preterm twins newborns. J Matern Fetal Neonatal Med 2012; 25 Suppl 1:132-3. [PMID: 22339360 DOI: 10.3109/14767058.2012.663171] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Adverse reactions to cow's milk in the first year of life occur in 2-7%. There is an increase in the incidence of cow's milk protein allergy (CMA) in newborn population including premature infants. We report two cases of CMA in preterm twins. The first one developed recurrent episodes of proctocolitis and the second one two necrotizing enterocolitis (NEC) -like episodes. Our cases demonstrate different clinical presentations of the same disease and add to literature the peculiarity of the early onset, the recurrence of episodes of enterocolitis associated with increasing systemic eosinophilia and episodes clinically and radiologically mimicking NEC.
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Affiliation(s)
- Caterina Coviello
- Department of Pediatrics, Obstetrics and Reproductive Medicine, Neonatal Pediatrics Section, University Hospital of Siena, Italy
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Laura F, Mori A, Tataranno ML, Muraca MC, Rodriquez DC, Giomi S, Coviello C, Buonocore G. Therapeutic hypothermia in a late preterm infant. J Matern Fetal Neonatal Med 2012; 25 Suppl 1:125-7. [DOI: 10.3109/14767058.2012.663172] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Vena G, Coviello C, Mastrolonardo M, Foti C, Angelini G. Topical 5-fluorouracil in the treatment of discoid lupus erythematosus. Preliminary study over two years. J DERMATOL TREAT 2009. [DOI: 10.3109/09546639609086880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pipoli M, D'Argento V, Coviello C, Dell'Osso A, Mastrolonardo M, Vena G. Evaluation of topical immunotherapy with squaric acid dibutylester, systemic interferon alpha and the combination of both in the treatment of chronic severe alopecia areata. J DERMATOL TREAT 2009. [DOI: 10.3109/09546639509097159] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cassano N, Loconsole F, Coviello C, Vena GA. Infliximab in recalcitrant severe atopic eczema associated with contact allergy. Int J Immunopathol Pharmacol 2006; 19:237-40. [PMID: 16569363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
Infliximab is an anti-tumour necrosis factor (TNF)-alpha chimeric monoclonal antibody which is effective in diseases associated with a T-helper (Th) 1 response, such as rheumatoid arthritis, Crohn's disease and psoriasis. There are sporadic case reports of atopic dermatitis (AD) induced or precipitated by anti-TNF-alpha therapy, which have been attributed to the switch towards Th2-mediated reactions. We report the case of a 30-year-old man with long-standing severe AD associated with contact allergy and poorly responding to conventional treatments. The use of infliximab resulted in a dramatic amelioration of AD lesions and pruritus, persisting at follow-up examinations over a 3-year period. Probably, the unexpected response to infliximab therapy in this case might be due to some peculiar features of AD in our patient (i.e. chronic-continuous course and concomitant contact allergy) which could have been responsible for a more preponderant recruitment of Th1 cells as compared to common forms of AD.
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Affiliation(s)
- N Cassano
- Department of Internal Medicine, Immunology and Infectious Diseases, II Unit of Dermatology, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
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Vena GA, Cassano N, Filieri M, Filotico R, D'Argento V, Coviello C. Fexofenadine in chronic idiopathic urticaria: a clinical and immunohistochemical evaluation. Int J Immunopathol Pharmacol 2002; 15:217-224. [PMID: 12575922 DOI: 10.1177/039463200201500308] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fexofenadine is a non-sedating selective third-generation antihistamine, which also exerts an anti-inflammatory action. The aim of this study was to evaluate the influence on the expression of inflammatory skin mediators, together with the efficacy and tolerability, of fexofenadine in chronic idiopathic urticaria (CIU). Fexofenadine 180mg was administered once daily for 4 weeks after a placebo run-in phase of 3 to 7 days. Efficacy paramaters were obtained from patients' assessment of urticaria symptoms. Non-lesional skin of patients with active CIU was studied immunohistochemically before and after treatment. The expression of the following mediators was evaluated: adhesion molecules (ICAM-1, ELAM-1, VCAM-1); mast cell proteases (chymase and tryptase) and proinflammatory cytokines (IL-1beta, IL-3, IL-6 and TNF-alpha). Of the 20 subjects enrolled, 3 dropped out of the study. Treatment proved successful in most cases (88.2%) (p <0.01) and a significant improvement of all symptoms was registered. Treatment was well-tolerated by all patients; adverse events, neither serious nor drug-related, occurred in any case. Immunochemistry revealed at the baseline a significant expression of ELAM-1, VCAM-1, tryptase, chymase, and TNF-alpha (p= 0.05) in non-lesional skin of patients compared to normal controls. After treatment with fexofenadine, there was a significant decrease in the expression of ELAM-1 (p= 0.02), VCAM-1 (p= 0.04) and tryptase (p= 0.04), whereas no relevant change was observed for the other parameters examined. This work confirms the efficacy and tolerability of fexofenadine HCl 180mg in CIU. These preliminary data show a trend towards a decrease in the expression of tryptase and some adhesion molecules after treatment, suggesting an anti-inflammatory activity of fexofenadine.
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Affiliation(s)
- G. A. Vena
- Unit of Dermatology, University of Bari, Italy
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Cassano N, Filotico R, D'Argento V, Filieri M, Coviello C, Vena G. In vivo anti-inflammatory effects of fexofenadine in chronic idiopathic urticaria. J Eur Acad Dermatol Venereol 2002; 16:421-2. [PMID: 12224713 DOI: 10.1046/j.1468-3083.2002.00570_8.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Affiliation(s)
- R Filotico
- 2nd Department of Dermatology, University of Bari, Italy
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Zuppa AA, Vento G, Tornesello A, Papacci P, Micanti M, Coviello C, Palusci A, Mazzotta M, Fundarò C, Romagnoli C. [Current validity of the exchange transfusion intervention by the classic indication. Our 15 years' experience]. Minerva Pediatr 1990; 42:135-41. [PMID: 2115969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In this paper the Authors report their personal experience of the use of exchange transfusion, secondary to classic indication, in the treatment of neonatal hyperbilirubinemia, in order to: 1) determine the trend over the past wears in the number of exchange transfused neonates, both from a global point of view and in relation to indications; 2) critically assess the risks, in terms of complications and mortality, correlated to exchange transfusion. Four hundred and eighty-eight neonates, who were subjected to 693 exchange transfusions in the Pediatric Clinic and Neonatal Division of the Policlinico Gemelli in Roma, were studied over a period of 15 years (1972-1986), according to the following indications: 214 cases of neonatal hyperbilirubinemia with MEN-Rh, 106 cases of neonatal hyperbilirubinemia with MEN-ABO and 168 cases of idiopathic hyperbilirubinemia. The total number of exchange transfused neonates decreased drastically from 304 in the period 1972-76 to 65 in the period 1982-86. The frequency of exchange transfused neonates because of idiopathic hyperbilirubinemia decreased significantly (p greater than 0.001), booth in comparison to the number of live births and in comparison to the number of exchange transfused neonates, probably due to the gradual introduction of phototherapy. The frequency of exchange transfused neonates with iso-Rh and iso-ABO decreased or remained stationary on account of the confirmed relative lesser efficacy of phototherapy on hemolytic jaundice. With regard to mortality and morbidity, 27 out of 488 neonates died during the neonatal period, but only 4 within six hours of exchange transfusion; the majority of those who died had a reduced gestational age and low birthweight, and were affected by a severe associated pathology.
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Affiliation(s)
- A A Zuppa
- Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, Roma
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Vena GA, Coviello C, Angelini G. [Use of oral isotretinoin in the treatment of cutaneous lupus erythematosus]. GIORN ITAL DERMAT V 1989; 124:311-5. [PMID: 2630441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Twenty-four in- or out-patients (12 males and 12 females) with chronic cutaneous (CCLE) (n = 19) or subacute cutaneous (SCLE) (n = 5) lupus erythematosus have been treated with oral isotretinoin. The initial dose 0.15 mg/kg/day was progressively increased to a maximum of 0.50 mg/kg/day; the total treatment period was 16 weeks. One female patient with SCLE stopped the therapy for sudden fever. None of the other known side effects induced interruption of treatment. In 20 subjects (86.9%) isotretinoin therapy was associated with clearing or improvement of clinical lesions and histopathologic changes. Best responses with isotretinoin therapy was seen in patients with CCLE. No changes were observed in the laboratory parameters before, during, and at the end of the study. In the light of these results, isotretinoin can be considered as an effective and well-tolerated drug in the treatment of cutaneous lupus erythematosus.
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Lomuto M, Sinisi D, Coviello C, Rantuccio F. [PUVA therapy. Considerations on a 7-year follow-up]. GIORN ITAL DERMAT V 1986; 121:457-60. [PMID: 3557541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Conte A, Coviello C, Rantuccio F. [Pruritus sine materia and prurigo. II. Prurigo]. GIORN ITAL DERMAT V 1986; 121:383-8. [PMID: 3557532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Coviello C, Conte A, Rantuccio F. [Pruritus sine materia and prurigo. I. Pruritus sine materia]. GIORN ITAL DERMAT V 1986; 121:15-20. [PMID: 3699845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Rantuccio F, Sinisi D, Coviello C, Conte A, Scardigno A. Histological changes in rabbits after application of medicaments and cosmetic bases (III). Contact Dermatitis 1984; 10:212-9. [PMID: 6734180 DOI: 10.1111/j.1600-0536.1984.tb00102.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
An experimental study is reported of the irritant potential of oil of purcellin , isopropyl palmitate, nonyl phenol, Modulan , Amerchol and Acetulan when massaged in fixed amounts into the rabbit's skin daily for 30 days. Skin biopsies provided data on the number of epithelial cell layers, cell counts of the superficial dermis, and the fibre and basement membrane changes. All the test compounds induced changes in the form of increased number of epithelial cell layers and of the papillary dermis cell count, more marked for Acetulan or Amerchol . The difficulties in the evaluation of the results and their applications to human pathology are discussed.
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Rantuccio F, Coviello C, Sinisi D, Scardigno A, Conte A. Experimental sensitization of guinea pigs by drugs. Comparison of the maximization test with the wholly intradermal test. Contact Dermatitis 1983; 9:479-83. [PMID: 6653105 DOI: 10.1111/j.1600-0536.1983.tb04467.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The capacity of tegobetain, pyrrolnitrin, tolcyclate and chlorquinaldol to induce delayed-type contact sensitization was studied in guinea pigs in 2 series of tests using the method of Magnusson & Kligman and the authors' modification of the wholly intradermal Draize technique. Histological examination of skin biopsies obtained from the test area demonstrated that tegobetain, pyrrolnitrin and tolcyclate are potential sensitizers.
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Sinisi D, Coviello C, Carnimeo L, Scardigno A, Rantuccio F. [Our experience in psoriasis PUVA therapy. Observations on 60 cases followed-up for 2 years]. GIORN ITAL DERMAT V 1983; 118:189-94. [PMID: 6546248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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