65 results on '"Di Tommaso, M."'
Search Results
2. Echocardiographic measurements and cardiac anatomy in healthy Western hognose snakes (Heterodon nasicus)
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Oliveri, M, primary, Carnabuci, C, additional, Vignoli, M, additional, Di Feliciantonio, S, additional, Di Feliciantonio, M, additional, Della Salda, L, additional, Knotek, Z, additional, di Tommaso, M, additional, and Luciani, A, additional
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- 2023
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3. Safety of PGE2 induction of labor: results of a multicenter observational study
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Pellegrini, R., primary, Monari, F., additional, Bettini, C., additional, Tartarotti, E., additional, Lecis, S., additional, Lazzarin, S., additional, Vargiu, V., additional, Di Tommaso, M., additional, and Facchinetti, F., additional
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- 2023
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4. Is it time to change the diagnostic thresholds for Intrahepatic Cholestasis of pregnancy?
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Huri, M., primary, Seravalli, V., additional, Lippi, C., additional, Tofani, L., additional, Galli, A., additional, Petraglia, F., additional, and Di Tommaso, M., additional
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- 2023
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5. Placental expression of Tryptophan degradation enzymes and Angiotensin (1-7) in physiological pregnancies delivered at term
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Tartarotti, E., primary, Silvano, A., additional, Strambi, N., additional, Tofani, L., additional, Parenti, A., additional, Vannucci, G., additional, Seravalli, V., additional, and Di Tommaso, M., additional
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- 2023
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6. Prenatal diagnosis of tuberous sclerosis complex: a case report
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Nardi, E., primary, Castiglione, F., additional, Di Tommaso, M., additional, Pasquini, L., additional, and Seravalli, V., additional
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- 2023
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7. Dietary habits in twin pregnancies: what is the adherence to the Mediterranean diet?
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Ruotolo, A., primary, Nardone, L., additional, Paterno, I., additional, Renda, I., additional, Vallario, A., additional, Seravalli, V., additional, and Di Tommaso, M., additional
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- 2023
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8. Latency from premature preterm rupture of membranes to delivery and correlation with gestational age
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Colucci, C., primary, Barsanti, F., additional, Morucchio, A., additional, Lippi, C., additional, Baldassari, B., additional, Di Tommaso, M., additional, Petraglia, F., additional, and Seravalli, V., additional
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- 2023
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9. Neonatal outcomes in an expectantly managed prospective cohort of late preterm prelabor rupture of membranes
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Benuzzi, M., primary, Tramontano, A.L., additional, Menichini, D., additional, Semprini, M., additional, Del Villano, N., additional, Zinani, I., additional, Berardi, A., additional, Rigoli, F., additional, Costa, P., additional, Consonni, S., additional, Di Tommaso, M., additional, Orlandi, G., additional, Strambi, N., additional, Facchinetti, F., additional, Locatelli, A., additional, Chiossi, G., additional, and Monari, F., additional
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- 2023
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10. The familial pattern of spontaneous preterm birth: a case control study
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Huri, M., primary, Strambi, N., additional, Finazzi, M., additional, Manciucca, G., additional, Catalano, G., additional, Seravalli, V., additional, and Di Tommaso, M., additional
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- 2023
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11. Universal cervical length screening after 24 weeks is not useful (Winner of the SIMP Award, in memory of Professor J. Francesco Branconi)
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Abati, I., primary, Tartarotti, E., additional, Seravalli, V., additional, Strambi, N., additional, Tucci, C., additional, Petraglia, F., additional, and Di Tommaso, M., additional
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- 2023
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12. Vaccination coverage during pregnancy and factors associated with refusal
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Romualdi, I., primary, Checcucci, C., additional, Noferi, V., additional, De Blasi, C., additional, Di Tommaso, M., additional, and Seravalli, V., additional
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- 2023
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13. PO-1051 Analysis Of A Mono-Institutional Internal Procedure Protocol During Covid-19 Second Wave
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Lucarelli, M., primary, Caravatta, L., additional, Augurio, A., additional, Vinciguerra, A., additional, Di Tommaso, M., additional, and Genovesi, D., additional
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- 2022
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14. PO-1361 Systematic inflammation marker as predictor of response after neoadjuvant treatment in rectal cancer
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Rosa, C., primary, Gasparini, L., additional, Di Guglielmo, F.C., additional, Fasciolo, D., additional, Borgia, M., additional, Lucarelli, M., additional, Caravatta, L., additional, Di Tommaso, M., additional, Porreca, A., additional, Di Nicola, M., additional, and Genovesi, D., additional
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- 2022
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15. EP17.11: Microvascular function assessed by laser speckle contrast imaging in pregnancies complicated by pre‐eclampsia and fetal growth restriction.
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Seravalli, V., Huri, M., Abati, I., Vallario, A., Bartolini, C., Impastato, G., Santalucia, M., and Di Tommaso, M.
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SPECKLE interference ,FETAL growth retardation ,SPECKLE interferometry ,PREECLAMPSIA ,GESTATIONAL age ,ECLAMPSIA - Abstract
This article, published in the journal "Ultrasound in Obstetrics & Gynecology," examines the microvascular function in pregnancies complicated by pre-eclampsia and fetal growth restriction (FGR) compared to uncomplicated pregnancies. The study involved 25 women with pre-eclampsia and/or FGR and 25 uncomplicated pregnancies as controls. The researchers used laser speckle contrast imaging (LSCI) combined with post-occlusive reactive hyperemia (PORH) to assess microvascular function. The results showed that microvascular function was impaired in pregnancies with placental-related diseases, particularly pre-eclampsia. The authors suggest further investigation into the use of LSCI as a tool for predicting and diagnosing pre-eclampsia. [Extracted from the article]
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- 2024
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16. ZOOMICS: comparative metabolomics of red blood cells from dogs, cows, horses and donkeys during refrigerated storage for up to 42 days
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Miglio, A, Maslanka, M, Di Tommaso, M, Rocconi, F, Nemkov, T, Buehler, Pw, Antognoni, Mt, Spitalnik, Sl, and D’Alessandro, A.
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comparative biology, erythrocyte, hemolysis, metabolomics ,comparative biology ,erythrocyte ,hemolysis ,metabolomics - Abstract
The use of omics technologies in human transfusion medicine has improved our understanding of the red blood cell (RBC) storage lesion(s). Despite significant progress towards understanding the storage lesion(s) of human RBCs, a comparison of basal and post-storage RBC metabolism across multiple species using omics technologies has not yet been reported, and is the focus of this study.Blood was collected in a standard bag system (CPD-SAG-Mannitol) from dogs (n=8), horses, bovines, and donkeys (n=6). All bags were stored at 4°C for up to 42 days (i.e., the end of the shelf life in Italian veterinary clinics) and sampled weekly for metabolomics analyses. In addition, data comparisons to on our ongoing Zoomics project are included to compare this study's results with those of non-human primates and humans.Significant interspecies differences in RBC metabolism were observed at baseline, at the time of donation, with bovine showing significantly higher levels of metabolites in the tryptophan/kynurenine pathway; dogs showing elevated levels of high-energy compounds (especially adenosine triphosphate and S-adenosyl-methionine) and equine (donkey and horse) RBCs showing almost overlapping phenotypes, with the highest levels of free branched chain amino acids, glycolytic metabolites (including 2,3-diphosphoglycerate), higher total glutathione pools, and elevated metabolites of the folate pathway compared to the other species. Strikingly, previously described metabolic markers of the storage lesion(s) in humans followed similar trends across all species, though the rate of accumulation/depletion of metabolites in energy and redox metabolism varied by species, with equine blood showing the lowest degree of storage lesion(s).These results interrogate RBC metabolism across a range of mammalian species and improve our understanding of both human and veterinary blood storage and transfusion.
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- 2022
17. Relationship between relaxin-2 levels in serum and mode of conception in twin gestations: A prospective cohort study.
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Silvano A, Ammar O, Parenti A, Strambi N, Seravalli V, Bani D, and Di Tommaso M
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- Humans, Female, Pregnancy, Adult, Prospective Studies, Fertilization physiology, Relaxin blood, Pregnancy, Twin blood
- Abstract
Aim: Relaxin is a peptide hormone commonly associated with pregnancy when it is thought to play a role in modulating various physiological processes to optimize maternal-fetal adaptation. In twin pregnancies these adaptive requirements are higher than in singleton pregnancies, therefore it is important to understand how circulating relaxin behaves in such conditions. This prospective cohort study aims to determine the serum relaxin-2 levels throughout gestation in twin pregnancies and to investigate its association with the mode of conception., Methods: Blood samples were collected during each trimester of gestation from 26 women with twin pregnancies obtained through spontaneous conception (SC, n = 18) or assisted reproductive technologies, specifically through intracytoplasmic sperm injection (ART, n = 8). Serum relaxin-2 levels were measured by a highly sensitive ELISA method., Results: The results indicated that serum relaxin-2 level peaks in the first trimester (491.05 ± 207.41 pg/mL), then decreases in the second trimester (446.27 ± 180.4 pg/mL; p < 0.057) and in the third trimester (422.19 ± 194.30 pg/mL; p < 0.025). Interestingly, the serum relaxin-2 level was higher in the spontaneous conception group with respect to the assisted reproductive technologies group (p < 0.001), when measured at each trimester of gestation. In addition, the multivariate regression analysis showed that only the assisted reproductive technologies had a significant impact on serum levels of relaxin-2 (p < 0.001), and no significant association was found with other women's clinical and demographic characteristics., Conclusions: These findings extend the current knowledge about the pattern of circulating relaxin-2 throughout gestation in twin pregnancies, providing a sensitive measurement of serum relaxin-2 levels and a description of its putative physiological roles in humans., (© 2024 The Author(s). Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.)
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- 2025
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18. Exploring basal metabolic rate and dietary adequacy in twin pregnancies: the VENERE study.
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Dinu M, Napoletano A, Giangrandi I, Lotti S, Ruotolo A, Renda I, Nardone L, Paternò I, Seravalli V, Tristan Asensi M, Pagliai G, Colombini B, Di Tommaso M, and Sofi F
- Abstract
Background: Twin pregnancies present unique challenges in maternal healthcare. However, current guidelines primarily address singleton pregnancies, resulting in a knowledge gap regarding their specific metabolic and dietary needs. This study aimed to follow women with twin pregnancies through all three trimesters, assessing basal metabolic rate (BMR), dietary intake, and diet quality., Methods: A two-year prospective observational study was conducted at AOU Careggi Hospital, Florence, Italy, involving 35 twin-pregnant women, with 32 completing the study. Participants underwent calorimetric, anthropometric, and dietary assessments during the first (8-13 weeks), second (14-27 weeks), and third trimesters (28-34 weeks). BMR was measured using indirect calorimetry and compared with predictive equations. Dietary intake was evaluated using 7-day food diaries and the Medi-Lite adherence score., Results: Indirect calorimetry revealed an increase in BMR by 16%, rising from 1479 ± 196 kcal in the first trimester to 1733 ± 224 kcal in the third trimester. Hronek's equation, previously validated for singleton pregnancies, was identified as the most accurate predictive tool for estimating BMR. Dietary analysis revealed that mean daily energy intake increased from 1660 ± 244 kcal in the first trimester to 1889 ± 262 kcal in the third trimester, consistently below recommendations, with insufficient macro- and micronutrient consumption. Poor diet quality was characterized by low intake of fruits, vegetables, legumes, and fresh fish, and high consumption of processed meats, cheese, and sugar-sweetened beverages. Adherence to the Mediterranean diet was moderate across all three trimesters., Conclusions: This study highlights the increased energy demands and nutritional inadequacies in twin pregnancies, underscoring the need for tailored dietary guidelines and interventions., Competing Interests: Declarations. Ethics approval and consent to participate: The study received ethical approval from the Ethics Committee (CEAVC 21644/OSS, date of approval 13/07/2022) of the Tuscany Region, Careggi University Hospital, Florence. The study adhered to the principles outlined in the Declaration of Helsinki and the Data Protection Act. Informed consent was obtained from all participants. Consent for publication: Patients signed informed consent regarding publishing their data. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)
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- 2024
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19. Schwann cell C5aR1 co-opts inflammasome NLRP1 to sustain pain in a mouse model of endometriosis.
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Titiz M, Landini L, Souza Monteiro de Araujo D, Marini M, Seravalli V, Chieca M, Pensieri P, Montini M, De Siena G, Pasquini B, Vannuccini S, Iannone LF, Cunha TM, Brancolini G, Bellantoni E, Scuffi I, Mastricci A, Tesi M, Di Tommaso M, Petraglia F, Geppetti P, Nassini R, and De Logu F
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- Animals, Female, Mice, Mice, Inbred C57BL, Apoptosis Regulatory Proteins metabolism, Apoptosis Regulatory Proteins genetics, Oxidative Stress, Complement C5a metabolism, Humans, Pain metabolism, Adaptor Proteins, Signal Transducing, Endometriosis metabolism, Endometriosis pathology, Schwann Cells metabolism, Inflammasomes metabolism, Disease Models, Animal, Interleukin-1beta metabolism, Receptor, Anaphylatoxin C5a metabolism, Receptor, Anaphylatoxin C5a genetics, Macrophages metabolism, TRPA1 Cation Channel metabolism, TRPA1 Cation Channel genetics
- Abstract
Over 60% of women with endometriosis experience abdominopelvic pain and broader pain manifestations, including chronic back pain, fibromyalgia, chronic fatigue, vulvodynia, and migraine. Although the imbalance of proinflammatory mediators, including the complement component C5a, is associated with endometriosis-related pain, the mechanisms causing widespread pain and the C5a role remain unclear. Female mice and women with endometriosis exhibit increased plasma C5a levels and pain. We hypothesize the Schwann cells involvement in endometriotic pain. Here, we show that silencing the C5a receptor (C5aR1) in Schwann cells blocks the C5a-induced activation of the NLRP1 inflammasome and subsequent release of interleukin-1β (IL-1β). Macrophages, recruited to sciatic/trigeminal nerves by IL-1β from Schwann cells, increase oxidative stress, which activates the proalgesic TRPA1 pathway, resulting in widespread pain. These findings reveal a pathway involving Schwann cell C5aR1, NLRP1/IL-1β activation, macrophage recruitment, oxidative stress, and TRPA1 engagement, contributing to pain in a mouse model of endometriosis., Competing Interests: Competing interests: R.N., F.D.L. and P.G. are founding scientists of FloNext Srl. G.B. is fully employed at FloNext Srl, Italy. Other authors declare no competing interests., (© 2024. The Author(s).)
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- 2024
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20. Assessment of skin microvascular response through pregnancy using laser speckle contrast imaging.
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Seravalli V, Huri M, Abati I, Santalucia M, Impastato G, Pasquini B, Tofani L, Di Tommaso M, and Petraglia F
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- 2024
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21. Safety of the use of dinoprostone gel and vaginal insert for induction of labor: A multicenter retrospective cohort study.
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Di Tommaso M, Pellegrini R, Ammar O, Lecis S, Huri M, and Facchinetti F
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Objective: To assess adverse obstetric and neonatal outcomes associated with the use of dinoprostone for induction of labor, with particular attention on categories for which caution is recommended by the Italian Medicines Agency and the European Medicine Agency., Methods: A retrospective multicenter observational study was conducted on a population of 1687 patients undergoing induction of labor with vaginal dinoprostone (gel or insert) between August 2019 and June 2022. Patients were subdivided based on maternal age, gestational age, and obstetric disorders. Data regarding the mode of delivery, the incidence of tachysystole, and the obstetric and perinatal outcomes were collected., Results: The main adverse event associated with the use of dinoprostone was tachysystole. However, tachysystole was not associated with an increased risk of cesarean section (CS), neonatal intensive care (NICU) admission, low 1-min Apgar, or umbilical cord acidosis. Maternal age greater than 35 years, gestational age greater than 40 weeks, and obstetric disorders were not associated with an increased rate of tachysystole, NICU admission, low 1- and 5-min Apgar scores, and cord acidosis. The only associated adverse outcomes in those categories were postpartum hemorrhage with age greater than 35 years and tachysystole with gestational diabetes mellitus and hypertensive disorders. Not a single case of severe outcome (disseminated intravascular coagulation, uterine rupture, maternal and fetal death) was reported in the cohort., Conclusion: Providing there is adequate maternal and fetal surveillance, in an inpatient setting, dinoprostone could be safely administered for the induction of labor and considered appropriate in high-risk pregnancies. Tachysystole can be self-identified by the patient and effectively managed., (© 2024 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)
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- 2024
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22. Prevention, diagnosis and pharmacological treatment of infections in pregnancy: The mobile app GAIA! for healthcare providers and patients.
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Bonaiuti R, Zammarchi L, Giaché S, Modi G, Borchi B, Campolmi I, Trotta M, Ravaldi C, Ornaghi S, Di Tommaso M, Bartoloni A, Costa P, Lombardi N, Crescioli G, Vannacci A, and Levi M
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- Humans, Pregnancy, Female, Health Personnel, Italy, Mobile Applications, Pregnancy Complications, Infectious drug therapy, Pregnancy Complications, Infectious diagnosis
- Abstract
Objective: To develop and assess the GAIA! app, designed to assist pregnant women and healthcare professionals in managing infectious diseases during pregnancy, and to bridge the information gap between health professionals and expectant mothers., Study Design: This collaborative initiative in Italy involved partnerships with the University of Florence, Careggi University Hospital, and other institutions. The app, built on the Ionic framework, is available on both Apple and Google App Stores. It offers two distinct modes: "healthcare providers" and "patients." Content for the app was derived from extensive literature reviews and clinical guidelines., Results: Since its August 2022 launch, the GAIA! app has garnered over 2,500 downloads, indicating its effectiveness and acceptance within the community. The app differentiates itself from others, such as the Sanford Guide, by focusing specifically on the needs of pregnant women. It ensures cross-platform compatibility, a user-friendly interface, and offline functionality., Conclusions: The GAIA! app has successfully addressed a niche in infectious disease management for pregnant women, gaining significant traction within the community. While it has seen substantial success, challenges like continuous updates and potential language expansion remain. Future endeavors will address these challenges and further evaluate the app's impact on maternal and child health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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23. Changes in cytokine and sequestosome-1 levels during twin pregnancy progression: Association with outcome.
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Silvano A, Sisti G, Seravalli V, Strambi N, Parenti A, Amedei A, Witkin SS, and Di Tommaso M
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- Humans, Pregnancy, Female, Adult, Prospective Studies, Leukocytes, Mononuclear metabolism, Pregnancy Trimesters blood, Cytokines blood, Sequestosome-1 Protein metabolism, Pregnancy, Twin blood, Pregnancy Outcome
- Abstract
Background: Twin pregnancies are associated with complications and adverse outcomes. The number of twin pregnancies has increased in the last decades, due to the use of assisted reproductive techniques and delayed childbearing. Analysis of changes that occur during twin pregnancy progression and their association with outcome will lead to improved clinical interventions., Objective: We evaluated if the plasma concentration of select cytokines and the level of sequestosome-1 (p62) in peripheral blood mononuclear cells (PBMCs) during each trimester of twin gestations was predictive of pregnancy outcome., Study Design: This prospective, observational study was conducted at Careggi University Hospital, Florence, Italy. Plasma from 82 women with twin pregnancies was collected in each trimester for measurement of interleukin (IL)-1β, IL-6, IL-10, IL-12 and tumor necrosis factor (TNF)-α. The intracellular PBMC concentration of p62, a protein involved in autophagy, kinase activity and cell differentiation, was also determined., Results: IL-1β (p < 0.001), IL-6 (p < 0.001), TNF-α (p < 0.001) and p62 (p < 0.05) increased from the 1st to the 2nd to the 3rd trimester. The TNF-α level was correlated with the IL-1β concentration in the 1st and 3rd trimesters p < 0.01) and with the IL-6 concentration in each of the three trimesters (p < 0.01). The intracellular p62 level in PBMCs was negatively correlated with the concentration of IL-1β in the 2nd trimester (p < 0.05) and negatively correlated with the IL-6 level in the 3rd trimester (p < 0.05). The TNF-α level was significantly higher in the 2nd (p < 0.05) and 3rd (p < 0.001) trimester in women with a spontaneous preterm delivery. The TNF-α concentrations in the 2nd (p < 0.05) and 3rd (p < 0.01) trimester, respectively, and 3rd trimester IL-6 (p < 0.01), were negatively associated with gestational age at delivery. The concentration of IL-6 was highest in the 2nd (p < 0.05) and 3rd (p < 0.05) trimesters in women who utilized assisted reproductive technologies. An elevated IL-1β level in the 3rd trimester was associated with gestational diabetes mellitus (p < 0.05)., Conclusion: Variations in cytokine levels between individual women during the three trimesters of twin gestations are predictive of spontaneous preterm delivery and the onset of gestational diabetes., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mariarosaria Di Tommaso reports financial support was provided by Ente Cassa di Risparmio di Firenze. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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24. A case series of chorioangiomas in placentas with clinical indication for histological examination.
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Nardi E, Silvano A, Castiglione F, Olivo E, Abati I, Massi D, Seravalli V, and Di Tommaso M
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- Humans, Female, Pregnancy, Adult, Pregnancy Complications, Neoplastic pathology, Pregnancy Complications, Neoplastic diagnostic imaging, Young Adult, Ultrasonography, Prenatal, Hemangioma pathology, Hemangioma diagnostic imaging, Hemangioma diagnosis, Placenta Diseases pathology, Placenta Diseases diagnosis, Placenta Diseases diagnostic imaging, Placenta pathology, Placenta diagnostic imaging
- Abstract
Chorioangiomas are benign angiomas arising from chorionic tissue and they are the most common non-trophoblastic tumors of the placenta, as they are observed in 1% of all placentas examined. Most chorioangiomas are small and asymptomatic, often undetected during a prenatal ultrasound, and their clinical significance is still unknown. Large chorioangiomas, measuring more than 4-5 cm in diameter, can usually be detected prenatally by gray-scale or color Doppler sonography, and may be associated with maternal or fetal complications, such as preeclampsia, maternal mirror syndrome, preterm delivery, nonimmune fetal hydrops, fetal growth restriction and fetal demise. We herein describe the clinical-pathological features of a monocentric series of 30 placental chorioangiomas and discuss their clinical-pathological features and possible molecular mechanisms underlying their development., (Copyright © 2024 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.)
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- 2024
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25. Neutrophil gelatinase-associated lipocalin (NGAL) levels in twin pregnancy and association with gestational diabetes.
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Silvano A, Ammar O, Strambi N, Sisti G, Parenti A, Seravalli V, and Di Tommaso M
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- Humans, Pregnancy, Female, Adult, Diabetes, Gestational metabolism, Diabetes, Gestational blood, Diabetes, Gestational diagnosis, Pregnancy, Twin, Lipocalin-2 blood, Lipocalin-2 urine, Lipocalin-2 metabolism
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- 2024
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26. The role of family history of preterm delivery in the individual risk of spontaneous preterm delivery: a case-control study.
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Huri M, Strambi N, Finazzi M, Manciucca G, Catalano G, Seravalli V, and Di Tommaso M
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- Humans, Female, Pregnancy, Case-Control Studies, Adult, Retrospective Studies, Risk Factors, Siblings, Surveys and Questionnaires, Odds Ratio, Premature Birth epidemiology
- Abstract
Purpose: To investigate the role of family history of preterm delivery (PTD) in the individual risk of spontaneous preterm delivery., Methods: A retrospective case-control study was conducted on 354 patients who delivered between 2018 and 2020. 177 women who delivered preterm were matched with 177 controls who had full-term delivery. A questionnaire was administered to investigate the family history of PTD of both the patient and her partner. Cases and controls were matched for the anamnestic risk factors for PTD., Results: Seventeen of 173 women (9.8%) in the PTD group reported being born preterm, compared to five of 169 women (2.9%) in the control group (p = 0.01), with an odds ratio (OR) of 3.57 (95% confidence interval, CI 1.29-9.92). Women who delivered preterm also reported more frequently having a sibling who was born preterm (12.4% vs. 4.2%, p = 0.01), with an OR of 3.18 (95% CI 1.31-7.7). No association was found between the partner's family history of premature delivery and the patient's risk of preterm delivery in the present pregnancy., Conclusions: Pregnant patients who were born prematurely or who have siblings born preterm have an increased risk of preterm delivery in their own pregnancies. Assessment of female personal and family history of PTD should be used to identify women at risk of having a PTD in the present pregnancy., (© 2023. The Author(s).)
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- 2024
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27. Effect of leukoreduction on the omics phenotypes of canine packed red blood cells during refrigerated storage.
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Miglio A, Rocconi F, Cremoni V, D'Alessandro A, Reisz JA, Maslanka M, Lacroix IS, Di Francesco D, Antognoni MT, and Di Tommaso M
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- Dogs, Animals, Refrigeration, Phenotype, Blood Preservation veterinary, Erythrocytes metabolism, Leukocyte Reduction Procedures veterinary
- Abstract
Background: Red blood cell (RBC) storage promotes biochemical and morphological alterations, collectively referred to as storage lesions (SLs). Studies in humans have identified leukoreduction (LR) as a critical processing step that mitigates SLs. To date no study has evaluated the impact of LR on metabolic SLs in canine blood units using omics technologies., Objective: Compare the lipid and metabolic profiles of canine packed RBC (pRBC) units as a function of LR in fresh and stored refrigerated (up to 42 days) units., Animals: Packed RBC units were obtained from 8 donor dogs enrolled at 2 different Italian veterinary blood banks., Study Design and Methods: Observational study. A volume of 450 mL of whole blood was collected using Citrate-Phosphate-Dextrose-Saline-Adenine-Glucose-Mannitol (CPD-SAGM) transfusion bags with a LR filter to produce 2 pRBC units for each donor, without (nLR-pRBC) and with (LR-pRBC) LR. Units were stored in the blood bank at 4 ± 2°C. Sterile weekly samples were obtained from each unit for omics analyses., Results: A significant effect of LR on fresh and stored RBC metabolic phenotypes was observed. The nLR-pRBC were characterized by higher concentrations of free short and medium-chain fatty acids, carboxylic acids (pyruvate, lactate), and amino acids (arginine, cystine). The LR-pRBC had higher concentrations of glycolytic metabolites, high energy phosphate compounds (adenosine triphosphate [ATP]), and antioxidant metabolites (pentose phosphate, total glutathione)., Conclusion and Clinical Importance: Leukoreduction decreases the metabolic SLs of canine pRBC by preserving energy metabolism and preventing oxidative lesions., (© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)
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- 2024
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28. Vaccination coverage during pregnancy and factors associated with refusal of recommended vaccinations: An Italian cross sectional study.
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Seravalli V, Romualdi I, Ammar O, De Blasi C, Boccalini S, Bechini A, and Di Tommaso M
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Background: The vaccines recommended during pregnancy are the Tdap, the influenza vaccine, and, during the SARS-CoV-2 pandemic, the vaccine against COVID-19. This survey aimed at determining vaccination coverage among pregnant women and adverse events, reasons for vaccine refusal, and factors associated with vaccine uptake., Methods: A single-center cross-sectional study was conducted on women who delivered between March and April 2022 at Careggi University Hospital in Florence, Italy. Information on the vaccinations (Tdap, influenza and COVID-19) received during pregnancy were collected through in-person interviews., Results: Among 307 enrolled women (response rate 99 % on a study population of 310 eligible women), 74 % of patients were vaccinated with Tdap, 82 % against COVID-19, and only 33 % against influenza. Vaccination coverage for Tdap and COVID-19 was significantly higher among Italian than foreign patients (80 % vs 51 %, p < 0.001 and 86 % vs 69 %, p = 0.002, respectively), and for Tdap was higher among patients followed in the private vs public care setting. The main reasons behind refusal of vaccinations were low risk perception of influenza (41 %), insufficient information received from the prenatal care provider regarding the Tdap (35 %), and, for the COVID-19, fear of vaccine side effects (64 %), and concerns about effects on the fetus (70 %)., Conclusions: Adherence to the influenza vaccine was low because of reduced perception of the disease risks. The difference in vaccination coverage between Italians and foreigners is an example of healthcare disparity. Better information provided to patients about vaccines' efficacy and safety is advisable to increase acceptance of recommended vaccines., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)
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- 2024
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29. Effect of leukoreduction on the metabolism of equine packed red blood cells during refrigerated storage.
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Miglio A, Rocconi F, Cremonini V, D'Alessandro A, Reisz JA, Maslanka M, Lacroix IS, Tiscar G, Di Tommaso M, and Antognoni MT
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- Animals, Horses, Blood Transfusion veterinary, Leukocyte Reduction Procedures veterinary, Metabolome, Blood Preservation veterinary, Erythrocytes metabolism
- Abstract
Background: Understanding of the biochemical and morphological lesions associated with storage of equine blood is limited., Objective: To demonstrate the temporal sequences of lipid and metabolic profiles of equine fresh and stored (up to 42 days) and leukoreduced packed red blood cells (LR-pRBC) and non-leukoreduced packed RBC (nLR-pRBC)., Animals: Packed RBC units were obtained from 6 healthy blood donor horses enrolled in 2 blood banks., Methods: Observational study. Whole blood was collected from each donor using transfusion bags with a LR filter. Leukoreduction pRBC and nLR-pRBC units were obtained and stored at 4°C for up 42 days. Sterile weekly sampling was performed from each unit for analyses., Results: Red blood cells and supernatants progressively accumulated lactate products while high-energy phosphate compounds (adenosine triphosphate and 2,3-Diphosphoglycerate) declined. Hypoxanthine, xanthine, and free fatty acids accumulated in stored RBC and supernatants. These lesions were exacerbated in non-LR-pRBC., Conclusion and Clinical Importance: Leukoreduction has a beneficial effect on RBC energy and redox metabolism of equine pRBC and the onset and severity of the metabolic storage lesions RBC., (© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)
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- 2024
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30. Universal cervical length screening for preterm birth is not useful after 24 weeks of gestation.
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Seravalli V, Abati I, Strambi N, Tofani L, Tucci C, Tartarotti E, and Di Tommaso M
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- Infant, Newborn, Pregnancy, Female, Humans, Cohort Studies, Cervix Uteri diagnostic imaging, Pregnancy Outcome, Cervical Length Measurement methods, Premature Birth diagnosis, Premature Birth prevention & control
- Abstract
Introduction: Cervical length measurement using transvaginal sonography at 18
+0 -24+0 weeks of gestation is used to identify women at risk of preterm delivery, who may benefit from treatment with progesterone to prevent premature birth. Few and conflicting data exist regarding the predictive value of cervical length measurement performed at later gestational ages. The primary objective of this study was to evaluate the predictive accuracy for spontaneous preterm birth of a single cervical length measurement performed between 24 and 32 weeks of gestation in asymptomatic singleton pregnancies at low risk for spontaneous preterm birth. The secondary objective was to test the predictive accuracy of different cervical length thresholds in the same population., Material and Methods: This was a historical cohort study conducted in a tertiary referral hospital. A total of 2728 asymptomatic women with singleton pregnancy at low risk for spontaneous preterm birth were recruited. Of these women, 1548 had cervical length measured at 24+0 -27+6 weeks of gestation and 2191 women at 28+0 -32+0 weeks. In all, 1010 women were present in both gestational age windows. Maternal demographics, medical and obstetrical history, and pregnancy outcome were reviewed. The predictive value of cervical length for spontaneous preterm birth was evaluated through logistic regression analysis. Results were adjusted for confounding factors., Results: Overall, spontaneous preterm birth occurred in 53/2728 women (1.9%). In both the 24+0 -27+6 and 28+0 -32+0 weeks groups, a shorter cervical length was significantly associated with spontaneous preterm birth (p < 0.01), but it had a low predictive value, as shown by the receiver operating characteristics curve analysis (areas under the curve 0.62, 95% CI 0.50-0.74 for the 24+0 -27+6 weeks group, and 0.61, 95% CI 0.52-0.70 in the 28+0 -32+0 weeks group). When the predictive accuracy for preterm delivery of different cervical length cut-offs was evaluated, the sensitivity and positive predictive value were low in both gestational age windows, irrespective of the threshold used., Conclusions: In asymptomatic women with singleton pregnancy at low risk for spontaneous preterm birth, the predictive value of cervical length after 24+0 weeks of gestation is low. Therefore, cervical length screening in these women should be discouraged., (© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)- Published
- 2023
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31. A 10-Year Observational Study on Twin Pregnancy: Role of Fetal Sex Pairing on Obstetric Outcome.
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Vannuccini S, Bolzonella S, Colucci C, Nicchi C, Strambi N, and Di Tommaso M
- Abstract
Fetal sex contributes to the determination of obstetric outcome, as pregnancies carrying male babies seem to have an increased risk of maternal-fetal complications. Most studies have been conducted on singleton pregnancies, whereas less evidence is available for twins. A 10-year retrospective observational study was conducted on a cohort of 1180 women with twin pregnancy delivered at a single tertiary hospital. Clinical data on maternal characteristics, and obstetric and neonatal outcomes were collected, and the analysis was performed on monochorionic (MC) and dichorionic (DC) diamniotic twins separately. The group of DC twins included 837 cases, and those conceived by assisted reproductive technologies (ART) were more likely to have one or both female fetuses rather than males. The incidence of hypertensive disorders of pregnancy (HDP) was higher in same-sex pairs than in opposite-sex pairs. No differences were found regarding other obstetric and neonatal outcomes among the three sex-pairing groups. The MC twins group included 228 cases, and in female-carrying pregnancies a higher incidence of gestational diabetes (GDM) was observed compared to the male group. Furthermore, male pairs had significantly lower Apgar scores than females. Fetal sex seems to have a mild effect in twins compared to singleton pregnancies, suggesting a more complex set of factors contributing to pregnancy outcome in multiple pregnancies. However, we observed a higher incidence of HDP among same-sex DC pairs, a higher rate of GDM among MC female-female pairs, and a worse adaptation to extrauterine life among male-male pairs in MC twins.
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- 2023
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32. Exploring Plasma-Level Gut Microbiota Mediators and Pro-Inflammatory Markers in Pregnant Women with Short Cervix and Gestational Diabetes Mellitus.
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Silvano A, Niccolai E, Baldi S, Seravalli V, Strambi N, Nannini G, Pallecchi M, Bartolucci G, Parenti A, Amedei A, and Di Tommaso M
- Subjects
- Infant, Newborn, Pregnancy, Humans, Female, Pregnant People, Cervix Uteri, Dysbiosis, Diabetes, Gestational, Gastrointestinal Microbiome, Premature Birth
- Abstract
The composition of the gut microbiota (GM) undergoes significant changes during pregnancy, influenced by metabolic status, energy homeostasis, fat storage, and hormonal and immunological modifications. Moreover, dysbiosis during pregnancy has been associated with preterm birth, which is influenced by factors such as cervical shortening, infection, inflammation, and oxidative stress. However, dysbiosis also affects the levels of lipopolysaccharide-binding protein (LBP), short-chain fatty acids (SCFAs), and free fatty acids (FFA) in other tissues and the bloodstream. In this study, we investigated the plasmatic levels of some pro-inflammatory cytokines, such as matrix metalloproteinases-8 (MMP-8), interleukin-8 (IL-8), heat shock protein 70 (Hsp70), and microbial markers in pregnant women with a short cervix (≤25 mm) compared to those with normal cervical length (>25 mm). We examined the differences in the concentration of these markers between the two groups, also assessing the impact of gestational diabetes mellitus. Understanding the relationship between GM dysbiosis, inflammatory mediators, and cervical changes during pregnancy may contribute to the identification of potential biomarkers and therapeutic targets for the prevention and management of adverse pregnancy outcomes, including preterm birth.
- Published
- 2023
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33. Maternal Oxygen Administration during Labor: A Controversial Practice.
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Abati I, Micaglio M, Giugni D, Seravalli V, Vannucci G, and Di Tommaso M
- Abstract
Oxygen administration to the mother is commonly performed during labor, especially in the case of a non-reassuring fetal heart rate, aiming to increase oxygen diffusion through the placenta to fetal tissues. The benefits and potential risks are controversial, especially when the mother is not hypoxemic. Its impact on placental gas exchange and the fetal acid-base equilibrium is not fully understood and it probably affects the sensible placental oxygen equilibrium causing a time-dependent vasoconstriction of umbilical and placental vessels. Hyperoxia might also cause the generation of radical oxygen species, raising concerns for the developing fetal cells. Moreover, this practice affects the maternal cardiovascular system, causing alterations of the cardiac index, heart rate and vascular resistance, and unclear effects on uterine blood flow. In conclusion, there is no evidence that maternal oxygen administration can provide any benefit in the case of a non-reassuring fetal heart rate pattern, while possible collateral effects warn of its utilization. Oxygen administration during labor should be reserved for cases of maternal hypoxia.
- Published
- 2023
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34. Antepartum unscarred uterine rupture caused by placenta percreta: a case report and literature review.
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Nardi E, Seravalli V, Abati I, Castiglione F, and Di Tommaso M
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- Female, Pregnancy, Infant, Newborn, Humans, Hysterectomy, Pelvis, Risk Factors, Placenta Accreta surgery, Uterine Rupture etiology, Uterine Rupture surgery
- Abstract
The main risk for uterine rupture is the presence of a uterine scar due to prior cesarean delivery or other uterine surgery. However, rupture in an unscarred uterus is extremely rare, and risk factors include multiple gestations, trauma, congenital anomalies, use of uterotonics and placenta accreta spectrum., Placenta accreta spectrum, also known as morbidly adherent placenta, is becoming increasingly common and is associated with significant maternal and neonatal morbidity and mortality., We report a case of unscarred uterine rupture due to placenta percreta in a multiparous woman that required emergency peripartum hysterectomy., (Copyright © 2023 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.)
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- 2023
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35. ZOOMICS : comparative metabolomics of red blood cells from dogs, cows, horses and donkeys during refrigerated storage for up to 42 days.
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Miglio A, Maslanka M, Di Tommaso M, Rocconi F, Nemkov T, Buehler PW, Antognoni MT, Spitalnik SL, and D'Alessandro A
- Subjects
- Female, Horses, Humans, Animals, Cattle, Dogs, Erythrocytes metabolism, Metabolomics methods, Glycolysis, Equidae, Blood Preservation methods
- Abstract
Background: The use of omics technologies in human transfusion medicine has improved our understanding of the red blood cell (RBC) storage lesion(s). Despite significant progress towards understanding the storage lesion(s) of human RBCs, a comparison of basal and post-storage RBC metabolism across multiple species using omics technologies has not yet been reported, and is the focus of this study., Materials and Methods: Blood was collected in a standard bag system (CPD-SAG-Mannitol) from dogs (n=8), horses, bovines, and donkeys (n=6). All bags were stored at 4°C for up to 42 days (i.e., the end of the shelf life in Italian veterinary clinics) and sampled weekly for metabolomics analyses. In addition, data comparisons to our ongoing Zoomics project are included to compare this study's results with those of non-human primates and humans., Results: Significant interspecies differences in RBC metabolism were observed at baseline, at the time of donation, with bovine showing significantly higher levels of metabolites in the tryptophan/kynurenine pathway; dogs showing elevated levels of high-energy compounds (especially adenosine triphosphate and S-adenosyl-methionine) and equine (donkey and horse) RBCs showing almost overlapping phenotypes, with the highest levels of free branched chain amino acids, glycolytic metabolites (including 2,3-diphosphoglycerate), higher total glutathione pools, and elevated metabolites of the folate pathway compared to the other species. Strikingly, previously described metabolic markers of the storage lesion(s) in humans followed similar trends across all species, though the rate of accumulation/depletion of metabolites in energy and redox metabolism varied by species, with equine blood showing the lowest degree of storage lesion(s)., Discussion: These results interrogate RBC metabolism across a range of mammalian species and improve our understanding of both human and veterinary blood storage and transfusion.
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- 2023
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36. The Interplay of Perceived Risks and Benefits in Deciding to Become Vaccinated against COVID-19 While Pregnant or Breastfeeding: A Cross-Sectional Study in Italy.
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Gavaruzzi T, Caserotti M, Bonaiuti R, Bonanni P, Crescioli G, Di Tommaso M, Lombardi N, Lotto L, Ravaldi C, Rubaltelli E, Tasso A, Vannacci A, and Girardi P
- Abstract
The present study examined the role of the perception of risks and benefits for the mother and her babies in deciding about the COVID-19 vaccination. In this cross-sectional study, five hypotheses were tested using data from a convenience sample of Italian pregnant and/or breastfeeding women (N = 1104, July-September 2021). A logistic regression model estimated the influence of the predictors on the reported behavior, and a beta regression model was used to evaluate which factors influenced the willingness to become vaccinated among unvaccinated women. The COVID-19 vaccination overall risks/benefits tradeoff was highly predictive of both behavior and intention. Ceteris paribus, an increase in the perception of risks for the baby weighed more against vaccination than a similar increase in the perception of risks for the mother. Additionally, pregnant women resulted in being less likely (or willing) to be vaccinated in their status than breastfeeding women, but they were equally accepting of vaccination if they were not pregnant. COVID-19 risk perception predicted intention to become vaccinated, but not behavior. In conclusion, the overall risks/benefits tradeoff is key in predicting vaccination behavior and intention, but the concerns for the baby weigh more than those for the mother in the decision, shedding light on this previously neglected aspect.
- Published
- 2023
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37. Vaginal Microbiome in Pregnant Women with and without Short Cervix.
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Silvano A, Meriggi N, Renzi S, Seravalli V, Torcia MG, Cavalieri D, and Di Tommaso M
- Subjects
- Pregnancy, Humans, Female, Pregnant People, Vagina, Metagenome, Cervix Uteri, Microbiota
- Abstract
Cervical shortening is a recognised risk factor for pre-term birth. The vaginal microbiome plays an essential role in pregnancy and in maternal and foetal outcomes. We studied the vaginal microbiome in 68 women with singleton gestation and a cervical length ≤25 mm and in 29 pregnant women with a cervix >25 mm in the second or early third trimester. Illumina protocol 16S Metagenomic Sequencing Library Preparation was used to detail amplified 16SrRNA gene. Statistical analyses were performed in R environment. Firmicutes was the phylum most represented in all pregnant women. The mean relative abundance of Proteobacteria and Actinobacteriota was higher in women with a short cervix. Bacterial abundance was higher in women with a normal length cervix compared to the group of women with a short cervix. Nonetheless, a significant enrichment in bacterial taxa poorly represented in vaginal microbiome was observed in the group of women with a short cervix. Staphylococcus and Pseudomonas, taxa usually found in aerobic vaginitis, were more common in women with a short cervix compared with the control group, while Lactobacillus iners and Bifidobacterium were associated with a normal cervical length. Lactobacillus jensenii and Gardenerella vaginalis were associated with a short cervix.
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- 2023
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38. Neonatal Outcomes of Term Infants Born with Meconium-Stained Amniotic Fluid.
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Dani C, Ciarcià M, Barone V, Di Tommaso M, Mecacci F, Pasquini L, and Pratesi S
- Abstract
Background Meconium-stained amniotic fluid (MSAF) is considered an alarming sign of possible fetal compromise and it has recently been reported that neonatal outcome correlates with the degree of meconium thickness. Methods We retrospectively studied 400 term infants allocated in clear amniotic fluid and grade 1, 2, and 3 MSAF groups on the basis of color and thickness of AF. Multivariable logistic regression analysis was performed to evaluate the potential independent effect of delivery with MSAF of different severity on the risk of a composite adverse neonatal outcome. Results We found that delivery with grade 2 (OR 16.82, 95% Cl 2.12-33.52; p = 0.008) and 3 (OR 33.79, 95% Cl 4.24-69.33; p < 0.001) MSAF is independently correlated with the risk of adverse neonatal outcome, such as the occurrence of at least one of the following: need of resuscitation in the delivery room, blood cord pH < 7.100, occurrence of meconium aspiration syndrome (MAS), persistent pulmonary hypertension (PPH), transient tachypnea of the newborn (TTN), acute respiratory distress syndrome (ARDS), hypoxic-ischemic encephalopathy (HIE), and sepsis. Conclusions There is a positive correlation between the severity of amniotic fluid meconium staining and thickness and the outcomes of term infants. Therefore, the evaluation and grading of MSAF during labor is useful in order to plan for the presence of a neonatologist at delivery for immediate and proper neonatal care.
- Published
- 2023
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39. Diagnostic criteria for intrahepatic cholestasis of pregnancy: Should the timing of total bile acids measurement be established?
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Huri M, Lippi C, Seravalli V, and Di Tommaso M
- Subjects
- Pregnancy, Female, Humans, Bile Acids and Salts, Pregnancy Complications diagnosis, Cholestasis, Intrahepatic diagnosis
- Published
- 2023
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40. Amniotic Fluid Disorders: From Prenatal Management to Neonatal Outcomes.
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Huri M, Di Tommaso M, and Seravalli V
- Abstract
Amniotic fluid volume assessment has become standard in the surveillance of fetal well-being, especially in high-risk pregnancies. Amniotic fluid disorders are a frequent and important topic in fetal and perinatal medicine. However, although important advances have been achieved, many important and challenging questions remain unanswered to date. An abnormally low amniotic fluid volume, referred to as oligohydramnios, has been traditionally considered a possible indicator of placental insufficiency or fetal compromise and is associated with an increased rate of obstetric interventions. An excess of amniotic fluid, referred to as polyhydramnios, may be secondary to fetal or maternal conditions and has been associated with a variety of adverse pregnancy outcomes, especially when it is severe. The ultrasonographic detection of an amniotic fluid disorder should prompt a proper workup to identify the underlying etiology. Data on the association of isolated oligohydramnios or idiopathic polyhydramnios with adverse obstetric and perinatal outcomes are conflicting. While the management of secondary oligohydramnios is usually guided by the underlying condition, the management of isolated oligohydramnios is poorly defined. Similarly, the management of idiopathic and secondary polyhydramnios is not yet standardized. There is an urgent need for randomized clinical trials to provide stronger recommendations on the management of these two common conditions.
- Published
- 2023
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41. Tryptophan degradation enzymes expression in the placenta and the Kynurenine/Tryptophan ratio in maternal plasma after elective cesarean section.
- Author
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Silvano A, Seravalli V, Strambi N, Vallario A, Tofani L, Parenti A, and Di Tommaso M
- Subjects
- Humans, Pregnancy, Female, Cesarean Section, Tryptophan Oxygenase genetics, Placenta metabolism, RNA, Messenger, Indoleamine-Pyrrole 2,3,-Dioxygenase genetics, Indoleamine-Pyrrole 2,3,-Dioxygenase metabolism, Tryptophan metabolism, Kynurenine metabolism
- Abstract
Indoleamine 2,3-dioxygenase 1 (IDO1) and tryptophan 2,3-dioxygenase (TDO) metabolize tryptophan in the kynurenine pathway. We evaluated these enzymes' mRNA expression in maternal and fetal sides of the placenta of uncomplicated, unlabored full-term pregnancies after elective cesarean section and compared it with that of placentas obtained from vaginal delivery. Tryptophan and kynurenine plasmatic levels after cesarean section were measured, to investigate their possible correlation with IDO1 and TDO mRNA (TDO2) expression. The results suggested that IDO1 and TDO2 expression was higher in the maternal side of the placenta and that labor significantly affects TDO2 expression and the plasma Kynurenine/Tryptophan ratio., Competing Interests: Conflict of Interest The author have no conflict of interest to disclose., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
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42. A Questionnaire Integrated with the Digital Medical Record Improved the Coverage of a Control Program for Congenital Chagas Disease in Tuscany, Italy.
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Barbiero A, Mazzi M, Mantella A, Trotta M, Rossolini GM, Antonelli A, Bordonaro P, Colao MG, Speciale AR, Di Benedetto T, Di Tommaso M, Mantengoli E, Petraglia F, Galli L, Pezzati M, Dani C, Caldes Pinilla MJ, Berni C, Dannaoui B, Albajar Viñas P, Bartoloni A, and Zammarchi L
- Abstract
The leading route of Chagas disease transmission in nonendemic countries is congenital. However, policies concerning screening, prevention, and management of congenital Chagas disease are rare in these settings. Since 2012, serological screening for Chagas disease should be provided for pregnant women at risk in Tuscany, Italy according to a Regional resolution. Due to difficulties in the implementation, in November 2019, a checklist aimed at identifying pregnant women at risk for Chagas disease was introduced in digital clinical records at Careggi University Hospital, Florence, Italy. In order to evaluate the effectiveness of the "Chagas checklist", data about the number of deliveries by women at risk and their screening coverage between 2012 and June 2022 were collected. Out of 1348 deliveries by women at risk, 626 (47%) Trypanosoma cruzi serology tests were performed during the study period. The annual screening coverage increased from an average of 40.3% between 2012 and 2019 to 75.7% between 2020 and June 2022, underlining the big impact of the checklist. Four Chagas disease serological tests out of 626 (0.6%) resulted positive, corresponding to 2 affected women. No cases of congenital transmission occurred. The study showed that a simple digital tool led to a tangible improvement in the coverage of the screening program; its application in a setting where digital charts are available will contribute to the control and elimination of congenital Chagas disease., Competing Interests: The authors declare no conflict of interest.
- Published
- 2023
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43. Hot mixing: Mechanistic insights into the durability of ancient Roman concrete.
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Seymour LM, Maragh J, Sabatini P, Di Tommaso M, Weaver JC, and Masic A
- Abstract
Ancient Roman concretes have survived millennia, but mechanistic insights into their durability remain an enigma. Here, we use a multiscale correlative elemental and chemical mapping approach to investigating relict lime clasts, a ubiquitous and conspicuous mineral component associated with ancient Roman mortars. Together, these analyses provide new insights into mortar preparation methodologies and provide evidence that the Romans employed hot mixing, using quicklime in conjunction with, or instead of, slaked lime, to create an environment where high surface area aggregate-scale lime clasts are retained within the mortar matrix. Inspired by these findings, we propose that these macroscopic inclusions might serve as critical sources of reactive calcium for long-term pore and crack-filling or post-pozzolanic reactivity within the cementitious constructs. The subsequent development and testing of modern lime clast-containing cementitious mixtures demonstrate their self-healing potential, thus paving the way for the development of more durable, resilient, and sustainable concrete formulations.
- Published
- 2023
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44. DWI-MR and PET-CT Functional Imaging for Boost Tumor Volume Delineation in Neoadjuvant Rectal Cancer Treatment.
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Rosa C, Gasparini L, DI Guglielmo FC, Caravatta L, DI Tommaso M, Pizzi AD, Martino G, Castaldi P, Mazza R, Porreca A, DI Nicola M, Calcagni ML, and Genovesi D
- Subjects
- Humans, Neoadjuvant Therapy, Tumor Burden, Diffusion Magnetic Resonance Imaging methods, Positron-Emission Tomography methods, Fluorodeoxyglucose F18, Radiopharmaceuticals, Positron Emission Tomography Computed Tomography, Rectal Neoplasms diagnostic imaging, Rectal Neoplasms radiotherapy
- Abstract
Background/aim: T2 weighted magnetic resonance (MR) imaging is the gold standard for locally advanced rectal cancer (LARC) staging. The potential benefit of functional imaging, as diffusion-weighted MR (DWI) and positron emission tomography-computed tomography (PET-CT), could be considered for treatment intensification strategies. Dose intensification resulted in better pathological complete response (pCR) rates. This study evaluated the inter-observer agreement between two radiation oncologists, and the difference in gross tumor volume (GTV) delineation in simulation-CT, T2-MR, DWI-MR, and PET-CT in patients with LARC., Patients and Methods: Two radiation oncologists prospectively delineated GTVs of 24 patients on simul-CT (CT
GTV ), T2-weighted MR (T2GTV ), echo planar b1000 DWI (DWIGTV ) and PET-CT (PETGTV ). Observers' agreement was assessed using Dice index. Kruskal-Wallis test assessed differences between methods., Results: Mean CTGTV , T2GTV , DWIGTV , and PETGTV were 41.3±26.9 cc, 25.9±15.2 cc, 21±14.8 cc, and 37.7±27.7 cc for the first observer, and 42.2±27.9 cc, 27.6±16.9 cc, 19.9±14.9cc, and 34.8±24.3 cc for the second observer, respectively. Mean Dice index was 0.85 for CTGTV , 0.84 for T2GTV , 0.82 for DWIGTV , and 0.89 for PETGTV , representative of almost perfect agreement. Kruskal-Wallis test showed a statistically significant difference between methods (p=0.009). Dunn test showed there were differences between DWIGTV vs. PETGTV (p=0.040) and DWIGTV vs. CTGTV (p=0.008)., Conclusion: DWI resulted in smaller volume delineation compared to CT, T2-MR, and PET-CT functional images. Almost perfect agreements were reported for each imaging modality between two observers. DWI-MR seems to remain the optimal strategy for boost volume delineation for dose escalation in patients with LARC., (Copyright © 2023, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)- Published
- 2023
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45. Patient safety implications of wearing a face mask for prevention in the era of COVID-19 pandemic: a systematic review and consensus recommendations.
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Balestracci B, La Regina M, Di Sessa D, Mucci N, Angelone FD, D'Ecclesia A, Fineschi V, Di Tommaso M, Corbetta L, Lachman P, Orlandini F, Tanzini M, Tartaglia R, and Squizzato A
- Subjects
- Child, Humans, Child, Preschool, Aged, SARS-CoV-2, Pandemics prevention & control, Masks adverse effects, Patient Safety, Consensus, COVID-19 prevention & control
- Abstract
In the past, the use of face masks in western countries was essentially limited to occupational health. Now, because of the COVID-19 pandemic, mask-wearing has been recommended as a public health intervention. As potential side effects and some contraindications are emerging, we reviewed the literature to assess the impact of them in daily life on patient safety and to provide appropriate guidelines and recommendations. We performed a systematic review of studies investigating physiological impact, safety, and risk of masks in predefined categories of patients, which have been published in peer-reviewed journals with no time and language restrictions. Given the heterogeneity of studies, results were analyzed thematically. We used PRISMA guidelines to report our findings. Wearing a N95 respirator is more associated with worse side effects than wearing a surgical mask with the following complications: breathing difficulties (reduced FiO
2 , SpO2 , PaO2 increased ETCO2 , PaCO2 ), psychiatric symptoms (panic attacks, anxiety) and skin reactions. These complications are related to the duration of use and/or disease severity. Difficulties in communication is another issue to be considered especially with young children, older person and people with hearing impairments. Even if benefits of wearing face masks exceed the discomfort, it is recommended to take an "air break" after 1-2 h consecutively of mask-wearing. However, well-designed prospective studies are needed. The COVID-19 pandemic could represent a unique opportunity for collecting large amount of real-world data., (© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)- Published
- 2023
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46. Ductus venosus Doppler assessment: do the results differ between the sagittal and the transverse approach?
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Seravalli V, Masini G, Ponziani I, Di Tommaso M, and Pasquini L
- Subjects
- Pregnancy, Female, Humans, Infant, Umbilical Veins diagnostic imaging, Gestational Age, Abdomen, Blood Flow Velocity, Ultrasonography, Prenatal methods, Ultrasonography, Doppler methods
- Abstract
Objective: To compare the ductus venosus (DV) pulsatility index for veins (PIV) obtained in a mid-sagittal plane with that obtained in an oblique transverse plane of the fetal abdomen., Methods: Prospective observational study in singleton uncomplicated pregnancies undergoing an ultrasound examination between 24 and 34 weeks of gestation. Pregnancies complicated by fetal anomalies, fetal growth restriction, or oligohydramnios were excluded. Two consecutive recordings of DV Doppler waveform were obtained in each woman: one in a mid-sagittal plane, and the other in an oblique transverse plane of the fetal abdomen. The peak velocity during ventricular systole (S-wave) and diastole (D-wave), the velocity during atrial contraction (a-wave), and the time-averaged maximum velocity (TAmax) were measured, and the PIV was calculated. The paired t -test was used to compare results obtained with the two approaches. A change of the DV-PIV of 0.10 or more was considered clinically relevant., Results: The DV waveform was successfully obtained in 53 women (mean gestational age 28.5 weeks). The mean DV-PIV was 0.57 (±0.16 SD ) in the sagittal plane and 0.54 (±0.16 SD ) in the transverse plane. The mean difference (0.03) was statistically significant ( p = .04), but not clinically relevant. The sagittal S-, D-, and a-wave velocities and TAmax were significantly higher in the sagittal plane compared to the transverse plane, with an increase of 12, 8, 8, and 10%, respectively ( p < .05)., Conclusions: The difference in the DV-PIV obtained in a mid-sagittal plane compared to a transverse plane of the fetal abdomen is small and not clinically significant. The higher DV flow velocities observed in the sagittal plane are likely the result of a better alignment with the vessel obtained using this plane. These findings have implications for clinical practice and for research.
- Published
- 2022
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47. Effectiveness of cervical pessary in women with arrested preterm labor compared to those with asymptomatic cervical shortening.
- Author
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Seravalli V, Campana D, Strambi N, Vialetto D, and Di Tommaso M
- Subjects
- Pregnancy, Infant, Newborn, Humans, Female, Infant, Pessaries, Cervix Uteri diagnostic imaging, Retrospective Studies, Cervical Length Measurement, Premature Birth epidemiology, Premature Birth prevention & control, Obstetric Labor, Premature epidemiology, Obstetric Labor, Premature prevention & control, Uterine Cervical Incompetence
- Abstract
Objective: To determine whether the effectiveness of cervical pessary is different in women who experienced cervical shortening after a threatened preterm labor episode compared to those with asymptomatic short cervix., Methods: Retrospective study on singleton pregnancies at risk for preterm delivery (PTD) due to cervical length <25 mm before 28 weeks, who were treated with Arabin cervical pessary. Two groups of patients were compared: those who had contractions causing shortening of the cervix, prior to pessary placement, and those who had asymptomatic cervical shortening. Patients carrying a multiple pregnancy and those who underwent iatrogenic PTD were excluded. The primary outcome was the incidence of PTD at different gestational ages. Secondary outcome was the rate of preterm premature rupture of membrane (pPROM). The groups were compared using univariate and multivariate analyses., Results: 115 patients that met the inclusion criteria were identified. Of these, 91 (79%) had asymptomatic cervical shortening, while 24 (21%) had an episode of threatened preterm labor that resolved, and the pessary was placed after the contractions had stopped. The two groups were similar for maternal characteristics, obstetric history, mean gestational age and length of the cervix at the time of pessary insertion. The median gestational age at delivery was significantly lower (36.4 vs 38.0 weeks, p = .02), and the incidence of PTD significantly higher (58.3% vs 30.8%, OR 4.69, 95% CI 1.68-13.1, p < .01) among women who had arrested preterm labor before the pessary was placed compared to the asymptomatic group, after controlling for confounders. The incidence of PTD before 34 and before 32 weeks was also significantly higher in the symptomatic group ( p = .02 and p = .005, respectively). Women with asymptomatic cervical shortening had a longer interval between the placement of the pessary and delivery (median 15 weeks). pPROM occurred with a similar incidence in both groups., Conclusions: Arabin cervical pessary to prevent preterm delivery seems be less effective in women with a short cervix following an episode of threatened preterm labor than in those with asymptomatic cervical shortening in the second trimester. This finding may help physicians to select patients in which cervical pessary is more likely to be effective, and to improve patient's counseling about this intervention.
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- 2022
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48. A study on the placenta in stillbirth: an evaluation of molecular alterations through next generation sequencing.
- Author
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Nardi E, Seravalli V, Serena C, Mecacci F, Massi D, Bertaccini B, Di Tommaso M, and Castiglione F
- Subjects
- Pregnancy, Female, Humans, Fetal Death etiology, Retrospective Studies, High-Throughput Nucleotide Sequencing, Stillbirth genetics, Stillbirth epidemiology, Placenta pathology
- Abstract
Introduction: Placental dysfunction is one of the most common causes of Intrauterine Fetal Demise (IUFD). Due to its characteristics, the placenta may be the target of molecular research aimed to investigate potential causes of IUFD. In the literature, there are no studies on human placentas that have investigated possible associations between somatic mutations and the occurrence of IUFD. The aim of this study was to identify the presence of gene mutations in placental tissues in a series of cases of IUFD and to evaluate potential correlations with placental microscopic findings., Materials and Methods: Thirty-seven samples of formalin-fixed and paraffin-embedded placental tissues were retrospectively selected from pregnancies ending in IUFD between 23rd to 40th week. Six control placentas of physiological pregnancies were included as controls. After sampling, made according to standardized protocol and conventional histopathological examination, placental tissues were subjected to DNA extraction and sequencing by means of Next Generation Sequencing with a 56-gene panel., Results: The most frequent mutation observed in 32/37 IUFD cases (86.5%) and absent in any of the 6 control placentas was in c-KIT gene, which is implicated in placental tissue differentiation. However, no significant correlation was found between the presence of individual gene mutations and placental histopatological findings., Discussion: As the present study found an elevated frequency of c-KIT mutation in IUFD, it further supports the hypothesis that c-KIT is involved in abnormal tissue differentiation leading to altered placental vascularization and function., Competing Interests: Declaration of competing interest The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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49. Obstetric and Neonatal Outcomes in Mild Idiopathic Polyhydramnios.
- Author
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Pasquini L, Ponziani I, Pallottini M, Masini G, Seravalli V, Dani C, and Di Tommaso M
- Abstract
Background: Idiopathic polyhydramnios is a controversial clinical condition, as data on perinatal outcomes are conflicting and vary depending on the severity of the condition. The aim of the present study was to compare obstetric and neonatal outcomes between pregnant women with mild idiopathic polyhydramnios and a control population. Methods : A retrospective cohort study was performed at a single university hospital comparing the obstetrics and neonatal outcomes of pregnancies with mild idiopathic polyhydramnios ( n = 109) and control pregnancies ( n = 2550). Results : Cesarean section (CS) was significantly increased in the group with polyhydramnios compared to controls (46% vs. 32%, respectively, p = 0.047) due to a higher rate of emergency CS in the polyhydramnios group ( p = 0.041) because of abnormal cardiotocography (7.3% vs. 2.9%; p = 0.018) or labor dystocia (8.2% vs. 2.9%; p = 0.006). No statistically significant difference was found in the Apgar score, in the rate of neonatal hypoxia, or in the incidence of macrosomia between groups. In four cases, additional diagnoses of anomalies were made after birth, with a rate of 3.2%, which is comparable to the general population. Conclusion : Besides an increased risk of CS, patients with mild idiopathic polyhydramnios should be reassured regarding maternal and feto-neonatal outcomes. The management of pregnancies with stable mild idiopathic polyhydramnios should not differ from uncomplicated pregnancies, except for the need for increased labor surveillance.
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- 2022
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50. Intrahepatic cholestasis of pregnancy - Time to redefine the reference range of total serum bile acids: A cross-sectional study.
- Author
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Huri M, Seravalli V, Lippi C, Tofani L, Galli A, Petraglia F, and Di Tommaso M
- Subjects
- Bile Acids and Salts, Cross-Sectional Studies, Female, Humans, Pregnancy, Reference Values, Cholestasis, Intrahepatic diagnosis, Pregnancy Complications diagnosis
- Abstract
Objective: To establish pregnancy-specific reference ranges for fasting and postprandial total serum bile acid (TSBA) concentrations., Design: Cross-sectional study., Setting: Tertiary-care university hospital., Population: Healthy pregnant women at term admitted to the Obstetrics Department over a period of 1 year. Exclusion criteria were an established diagnosis of intrahepatic cholestasis of pregnancy (ICP) or any coexisting condition of increased risk for ICP., Methods: Both fasting (after 8-14 h of fasting) and postprandial (2 h after meal) TSBA concentrations were measured in 612 women (with 528 fasting samples and 377 postprandial samples) by automated enzymatic spectrophotometric assay., Main Outcome Measures: Fasting and postprandial TSBA concentrations in 612 women., Results: Reference intervals of 4.4-14.1 μmol/L for fasting TSBA and 4.7-20.2 μmol/L for postprandial TSBA were established. The postprandial values were significantly higher than the fasting values, with a median increase of 1.0 μmol/L (p < 0.0001). A correlation between fasting TSBA concentrations and postprandial concentrations was found, as well as correlations with fetal sex, parity and assisted reproductive technologies. A seasonal pattern was noticed for both fasting and postprandial TSBA, with the highest values measured in the winter season (p < 0.01 and 0.02, respectively) CONCLUSIONS: Normal pregnancy is associated with mild hypercholanaemia, and therefore a higher threshold should be considered for the diagnosis of ICP. We suggest using the upper reference limits observed in our healthy pregnant population (14 μmol/L for fasting TSBA and 20 μmol/L for postprandial TSBA). As the fasting measurement is more specific for the diagnosis, and the postprandial measurement is essential for the assessment of severity, it is recommended to measure both values rather than use random sampling., Tweetable Abstract: Normal pregnancy is associated with mild hypercholanaemia, a higher threshold should be considered for the diagnosis of ICP., (© 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)
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- 2022
- Full Text
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