Search PubMed⌕ Search

Biomedical subjects

E V Cosmi

Publications and source records attributed to E V Cosmi.

At least 91 records · Page 5Linked to original sources
PubMed1996

Amniotic fluid endothelin-1 levels are increased in pregnancy-induced hypertension and intrauterine growth retardation.

Endothelin-1 (ET-1) is a potent vasoconstrictor released by vascular endothelium. Because endothelial cell damage is considered determinant in the pathophysiology of pregnancy-induced hypertension (PIH), this study was conducted to evaluate the role of ET-1 produced by feto-placental tissues in PIH. Amniotic fluid samples obtained by amniocentesis from patients with PIH (N = 33), intrauterine growth retardation (IUGR) (N = 16), and PIH associated with IUGR (N = 12) were evaluated for ET-1 and compared to 42 normotensive pregnancies using a specific radioimmunoassay. ET-1 levels were significantly increased in PIH (35.6 +/- 1.9 pg/ml) and IUGR groups (33.8 +/- 4.6 pg/ml) compared to controls (20.8 +/- 1.4 pg/ml) (P < 0.01). In patients with PIH associated with IUGR, ET-1 concentrations were higher (P < 0.05) with no correlation with the severity of IUGR. Our data indicate that in PIH and IUGR ET-1 production and/or secretion is enhanced in the amniotic compartment, suggesting that the peptide may contribute to the pathophysiologic modification observed in these conditions.

Adult↗
PubMed1996

Surfactant administration to the human fetus in utero: a new approach to prevention of neonatal respiratory distress syndrome (RDS).

Supplementary surfactant (80 mg in 1 ml) was administered intra-amniotically in proximity of the fetal mouth to 4 preterm fetuses (28 to 32 wks) with immature amniotic fluid indexes and whose delivery was imminent. Administration was preceded by a aminophylline infusion (loading dose of 240 mg and maintenance of 0.8 mg/kg/min) to the mother in order to elicit sustained fetal breathing movements. Following delivery by cesarean section, the absence of signs of respiratory distress in the infants along with a completely uneventful clinical course suggests that the present therapeutic approach has great potential for becoming a reliable option for the antenatal prevention of RDS.

Adult↗
PubMed1996

Fractal analysis: a new method for evaluating fetal heart rate variability.

In this report we describe how the technique of "deterministic chaos" can be successfully applied to the study of fetal cardiotocography (CTG). The CTG tracings were analysed, after identification as "normal" or "pathological" by experts and by a computerised system, to evaluate the correlation dimension (D2), and the graphic analysis of the attractors which visualize the phase-space of the system that generated the signal (of the state of the underlying hypothetical system). Thanks to this analysis of the traces, it is possible to detect the existence of chaos in the system that generates a certain signal in this case the fetal heart rate. Normal CTG traces at term (37-41 wks) show a fractal dimension (D2) index ranging from 4.22 to 5.22; highly pathological CTG tracings show a D2 ranging from 2.0 to 3.09. Moreover, we introduced recurrence plots in the study of CTG, as tool for non stationary signals, working in real time. To our knowledge this is one of the first attempts to apply fractal analysis and recurrence plots in the evaluation of fetal heart rate in pregnancy, using very small data sets.

Cardiotocography↗
PubMed1996

Doppler velocimetry of different sections of the fetal middle cerebral artery in relation to perinatal outcome.

To assess the standard curves of pulsatility index (PI) in different segments of middle cerebral artery (MCA): initial segment (MI) and subcortical segment (M2); to determine the variation of the flow velocity waveforms (FVW) of the M1 and M2 segments of MCA in presence of fetal distress and to establish the possible correlation between the two segments of MCA. 50 normal pregnancies from 25 weeks of gestation to term and 20 pregnancy with alteration of fetal growth rate were investigated with serial records of the FVW of the M1 and M2 segments of the MCA and of the umbilical artery (UA) with a colour Doppler system. Severe fetal distress was associated to cerebral-placental ratio below 1 (C/P < 1). The perinatal outcome was established on the basis: 1) abnormal intrapartum CTG, 2) emergency cesarean section, 3) Apgar score at 1st and 5th minute after birth and 4) birth eight centiles. In normal pregnancy P1 of M2 was always higher than that of M1: therefore M2/M2 resulted below 1, with a maximum peak near 32 weeks of gestation. In presence of moderate fetal distress only P1 of M2 was reduced (M1/M2 > 1). It exists a significant difference of PI in M1 and M2 segments of fetal MCA during gestation: thus MCA so it is important to identify the tract of fetal MCA when recording its FVW. Moreover we suppose that an initial "cerebral sparing" effect exists in order to protect the cortex by the initial hypoxic injury: this is shown by a M1/M2 > 1. The progression of fetal distress results in a greater haemodynamic modification, the so called "brain sparing" which is usually present when C/P < 1.

Apgar Score↗
PubMed1996

A comparison of the shake test, optical density, L/S ratio (planimetric and stechiometric) and PG for the assessment of fetal lung maturity.

Our aim was to determine the diagnostic accuracy and reliability of four tests for the assessment of fetal lung maturity (FLM): shake test, optical density at 650 nm (OD650), lecithin to sphingomyelin ratio (L/S) by planimetry and stechiometry, and presence of phosphatydylglycerol. Amniotic fluid was obtained from 74 patients at various gestational ages. The shake test and the OD650 were performed according to published methods L/S was determined by TLC (thin-layer chromatography) and the ratio assessed by planimetry and stechiometrically by measurement of organic phosphorus from the chromatographic spots. PG was assessed similarly by TLC. When correlated with gestational age at amniocentesis, all tests correlated positively: shake test (r = 0.46, p < 0.005); OD650 (r = 0.31, p < 0.005); planimetric L/S (r = 0.77, p < 0.005); stechiometric L/S (r = 0.52, p < 0.005) and PG (r = 0.54, p < 0.005). The diagnostic accuracy of each test was as follows: the shake test and the OD650 had a sensitivity of 50%, while the steciometric L/S had a sensitivity of 75%, the planimetric L/S and the presence of PG were 100%. All four tests demonstrated a specificity greater than 64%, the highest for the PG presence being (83%) and the shake test (86%). Predictive negative values for lung maturity were > 93% for all tests, with the highest for the planimetric L/S and presence of PG being (100%). The study confirms that the determination of L/S ratio is still superior to other tests in terms of overall diagnostic accuracy. In addition, it was found that presence of PG was highly associated with the absence of respiratory complications in the newborn.

Adult↗
PubMed1996

Laparoscopic treatment of ovarian endometrioma. One year follow-up.

Thirty-six women with ultrasonographic diagnosis of ovarian endometrioma (bilateral in nine of them), have been treated laparoscopically. After the surgical procedure the patients were assigned to one of the following regimes: Gn-RH-a for 3 months, oral contraceptives if they wanted to avoid pregnancy, or nothing. The follow-up consisted in 1-3-6-12 months ultrasound. The first recurrences were observed at the 6-month ultrasound with an overall recurrence rate after 12 months of 11%. Improvement of pain symptoms occurred in 87% of the patients and fertility rate was 45%.

Adult↗
PubMed1996

Transvaginal ultrasonographic diagnosis of adenomyosis in female patients suffering from uterine fibromatosis.

Adenomyosis is an underestimated pathology frequently responsible of unknown origin pelvic pain and uterine enlargement. It is hyperestrinic condition with poor specific symptomatology and preoperative diagnostic tools are very few. The most important of them, ultrasound, has improved its diagnostic capacity with the introduction of transvaginal way of examination. However, for the ultrasound resemblance, the common etiopathogenetic origin and the symptomatologic likeness between adenomyosis and uterine leiomyomatosis, a problem still open is the differential diagnosis between these two pathologies especially when both are present in the same subject. In our study where the preoperative ultrasound was followed by surgical finding, we try to give some ultrasonographical guidelines to discern among these two pathologic conditions.

Diagnosis, Differential↗
PubMed1995

Effect of low-dose oral triphasic contraceptives on blood viscosity, coagulation and lipid metabolism.

The purpose of the study was to determine the relationship between hemorheological profile, i.e. blood viscosity, and other risk factors for cardiovascular and thrombotic diseases in women taking oral contraceptives and if blood viscosity may be considered a marker of cardiovascular risk in OC users. Plasma levels of coagulation parameters, serum lipids, blood viscosity and RBC deformability were determined in a group of 10 women taking OC vs. 10 controls. The blood parameters were evaluated before OC use and thereafter at 3 and 6 months. A significant change in the partial thromboplastin time, fibrinogen, HDL and apolipoprotein A-I was observed, while the other parameters remained unchanged. Plasma viscosity was significantly increased during OC treatment; whole blood viscosity and RBC deformability remained unchanged. However, although some parameters were significantly modified during OC treatment, all alterations remained within the normal range of laboratory values. The data confirm that low-dose triphasic OC therapy does not affect significantly the coagulation system, serum lipid metabolism and blood viscosity. Plasma viscosity measurement may be considered as a marker for monitoring women using OC because it is apparently the most sensitive parameter.

Adolescent↗
PubMed1995

Evaluation of second generation CA 125 assays.

OBJECTIVE: This study was performed in order to evaluate and compare the serum CA 125 values obtained using an immunoradiometric (IRMA-II) and an immunoenzymatic (ETI-II) second generation assay, and to establish whether or not the two methods may be used interchangeably. STUDY DESIGN: Serum CA 125 levels were measured in parallel using IRMA-II and ETI-II CA 125 assays (Sorin Biomedica), in 82 women with benign or malignant gynecological diseases. Statistical analysis was performed by linear regression analysis and Wilcoxon's test. RESULTS: Serum CA 125 levels measured using the immunoenzymatic method were lower than those obtained by the immunoradiometric assay. The largest discrepancies between the two methods were found at concentrations of 35-100 U/ml, within which fall cutoff values for the immunoradiometric assay. The cutoff values of 35 or 65 U/ml, frequently used in the original immunoradiometric assay and retained for the immunoradiometric second generation assay, corresponded to 18 and 47 U/ml in the immunoenzymatic second generation assay. CONCLUSION: The discrepancies in CA 125 results obtained by the two detection methods imply that the cutoff values used in the immunoenzymatic procedure should have a lower reference value in order to eliminate high rates of false negative results. Furthermore, their interchangeable use should be avoided in the monitoring of ovarian cancer and other gynecological diseases.

CA-125 Antigen↗
PubMed1995

No evidence of the hook effect in peritoneal fluid CA 125 measurement using immunoenzymatic second generation assays: comparison with immunoradiometric assays.

OBJECTIVE: To monitor the occurrence of the hook effect in measurements of peritoneal fluid CA 125 levels using two different immunoenzymatic second generation assays (ETI-II and EIA-II), and to compare these results with those obtained using the respective immunoradiometric versions of the assays (IRMA-II and ELSA-II). STUDY DESIGN: CA 125 levels were determined in peritoneal fluid and serum samples obtained from 45 women with gynecological diseases. The assays were carried out using IRMA-II and ETI-II (Sorin Biomedica) and ELSA-II and EIA-II (CIS Bio International) assays. Occurrence of the hook effect and linearity of the assays were evaluated. Statistical analyses were performed by Wilcoxon's test and linear regression analysis. RESULTS: Undiluted peritoneal fluids, assayed for their CA 125 content, showed falsely underestimated values of the antigen when IRMA-II and ELSA-II assays were performed. The phenomenon disappeared only at high dilutions of the sample (> 50). Conversely, immunoenzymatic ETI-II and EIA-II assays performed on undiluted peritoneal fluids did not show underestimated CA 125 values. CA 125 values obtained by immunoenzymatic assay were lower than those obtained using their respective immunoradiometric versions at a dilution of 1:100 (P < 0.001). A good correlation was observed between ELSA-II and EIA-II (r = 0.929) CA 125 values. CONCLUSION: The EIA-II immunoenzymatic assay appears to be more suitable for CA 125 measurement in peritoneal fluid in that it is not subject to the hook effect and its results correlated well with those obtained via its immunoradiometric version.

Ascitic Fluid↗
PubMed1995

Immunohistochemical localization of endothelin-1 in placenta and fetal membranes in term and preterm human pregnancy.

PROBLEM: The aim of the study was to determine the ET-1 localization on human placenta and fetal membranes and to compare its distribution between term and preterm pregnancies in laboring and non-laboring tissues. METHODS: Tissues obtained from nine term elective cesarean section, eight spontaneous vaginal term delivery, and 13 preterm delivery from both cesarean section (N = 6) and vaginal delivery (N = 7) were studied by immunohistochemistry. RESULTS: Immunoreactive ET-1 (IR-ET-1) was detected in villous and nonvillous trophoblast in all groups, although laboring tissues showed strong staining in the syncytiotrophoblast of the villi. ET-1 immunostaining of endothelial cells was observed in all placental villous vessels with a considerable variability within groups. In the fetal membranes, intensive immunopositive staining was observed in the chorionic trophoblast following vaginal deliveries in term and preterm tissues. CONCLUSIONS: This is the first study to report the localization of IR-ET-1 in human fetal membranes and placenta, and suggests that amnion and trophoblast represents a source of ET-1 production or, alternatively, a site for ET-1 binding.

Endothelins↗
PubMed1995

Menstrual patterns, pain symptoms, body mass index and smoking habits in women with endometriosis.

Epidemiologic studies have investigated the risk factors for endometriosis, but currently the results are still controversial. The aim of this study is to evaluate the incidence of some of the risk factors that have been involved with endometriosis to better understand the natural history and evolution of this disease. The medical records of 186 women with laparoscopic diagnosis of endometriosis were studied. We analysed the characteristics of the menstrual cycle, the presence of pain symptoms and the familiarity for endometriosis. Moreover, the body mass index of all patients and the average cigarettes smoked per day were calculated. Despite the fact that some of the data collected resulted to be statistically significant when compared among the four stages of endometriosis, the roles of the many factors that have been associated with the risk or the evolution of pelvic endometriosis still remain unknown.

Adult↗
PubMed1994

Management of postmenopausal osteoporosis.

More than 25% of postmenopausal women are at risk of osteoporosis. In order to avoid its consequences, it is necessary to find an appropriate prevention and/or treatment. We studied: (1) 15 postmenopausal women treated with percutaneous estradiol (50 micrograms/24 h) plus MPA (10 mg/10 days/month); (2) 15 postmenopausal women treated with synthetic calcitonin nasal spray at the daily dose of 100 IU; (3) 10 postmenopausal women treated with nandrolone decanoate (50 mg every 3 weeks); (4) 10 postmenopausal women treated with ipriflavone (600 mg/day); and (5) 10 postmenopausal women treated with sodium fluoride (20 mg) plus calcium (600 mg). Clinical examination, bone mass measurement (total BMD), hematochemical and urinary parameters of bone metabolism (calcium, urinary hydroxyproline, PTH) and growth factors (as IGF-I and TNF-beta) were evaluated. After 6 months of therapy, a complete prevention of bone resorption was achieved. In agreement with current literature, we observed that the various therapeutic approaches have all some positive effect on BMD, with different results on pain, blood biochemical parameters and growth factors' concentrations.

Aged↗
PubMed1994

Serum and peritoneal fluid CA-125 levels in patients with endometriosis.

OBJECTIVE: To evaluate CA-125 in peritoneal fluid (PF) as an indicator of endometriosis. DESIGN: CA-125 levels in paired serum and PF were determined by the one-step immunoradiometric assay. For peritoneal samples, high dilution of the sample (1:100) was used to avoid false low results, caused by the "hook effect" phenomenon. PATIENTS: Forty-one women with and without endometriosis, undergoing laparoscopy or laparotomy during the follicular phase of the menstrual cycle, were selected. SETTING: 2nd Institute of Obstetrics and Gynecology, University of Rome "La Sapienza," Rome, Italy. MAIN OUTCOME MEASURE: Peritoneal fluid CA-125 levels obtained using diluted samples were significantly higher than those found using undiluted ones. RESULTS: CA-125 levels in PF were approximately 100 times higher than those found in paired serum, ranging from 970 to 10,636 U/mL. In patients with endometriosis, CA-125 levels in PF were significantly elevated when compared with the control group. In serum, CA-125 levels increased only in advanced stages of endometriosis. CONCLUSIONS: The sensitivity of the CA-125 test for endometriosis in PF is greater than in serum. Therefore, the measurement of CA-125 levels in PF could be useful in the detection of early stage endometriosis, which tends to be overlooked by the CA-125 serum test.

Adolescent↗
PubMed1994

The cholesterol to phospholipids ratio (C/PL) of the erythrocyte membrane in normotensive, hypertensive pregnant and in cord blood as assessed by a simple enzymatic method.

The study described was conducted to evaluate a simple enzymatic method for the study of the cholesterol/phospholipids ratio in erythrocyte membrane (C/PL) in a group of normal pregnant, of hypertensive pregnant, in non-pregnant controls and in cord blood. Subjects consisted of 28 normotensive pregnant women (NT), 14 women with pregnancy induced hypertension (PIH), 10 non-pregnant normotensive women (Non-Preg) and 14 samples obtained from umbilical cord (C) at delivery from normotensive pregnant. Red blood cells were isolated from heparinated blood samples. Lipids were extracted from erythrocytes by isopropanol/chloroform, without preparation of cell ghosts. Cholesterol content was evaluated by cholesterol oxidase and phospholipids were estimated as organic phosphorus in the total lipid extract. We found a significant difference of C/PL between the PIH group and the NT group (1.01, SD 0.11 vs. 0.76, SD 0.10, 95% CI 0.74-0.78; p < 0.001) and the Non-Preg group (0.83, SD 0.11, 95% CI 0.80-0.86; p < 0.001). Cord blood C/PL was significantly elevated with respect to NT (1.25, SD 0.13 vs. 0.76, SD 0.10; p < 0.001). The method was proven to be fast, reliable and of value for the study of the pathophysiology of the alteration of the lipid composition, i.e., the increased cholesterol content, of the red cell membrane found in hypertensive pregnant patients.

Adult↗