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Biomedical subjects

M Di Mario

Publications and source records attributed to M Di Mario.

At least 19 recordsLinked to original sources
PubMed1999

Sacro-coccigeal teratoma: antenatal diagnosis and management.

We report a case of sacro-coccygeal teratoma (ScT) in a 29 years old primigravida at 19 weeks of gestation. Ultrasonographic evaluation in antenatal management of these abnormalities is discussed. The main sonographic criteria appear to be two: dimension and rapid growth of the tumour. Cariotype must be performed to exclude aneuploidy, frequently associated.

Abortion, Induced↗
PubMed1998

Antenatal molecular diagnosis of X-linked ichthyosis by maternal serum screening for Down's syndrome.

A case of X-linked ichthyosis diagnosed antenatally by molecular analysis of fetal DNA is described. The diagnosis was made at 16 weeks gestation, following the finding of a maternal serum unconjugated estriol level lower than 0.1 MoM when performing a triple test. Fetal DNA was obtained from cultured amniocytes; two specific regions were amplified by polymerase chain reaction at 5' and 3' ends of the steroid sulfatase (STS) gene on Xp22.3 region. Analysis showed complete deletion of the STS gene on the distal tip of the X-chromosome short arm.

Amniocentesis↗
PubMed1998

Risk for spontaneous preterm delivery by combined body mass index and gestational weight gain patterns.

BACKGROUND: To investigate whether maternal anthropometric factors interact with one another or with other risk factors, thus modifying the risk of spontaneous preterm delivery. METHODS: We carried out a case-control study of 230 spontaneous preterm births with intact membranes between 24 and 35 weeks gestation and 460 control term births. All the patients had prenatal care at the same institution. Logistic regression analysis was used to test for possible interactions adjusting for potential confounders. RESULTS: A pre-pregnancy body mass index < or = 19.5 Kg/m2 (odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.20-2.38) and a rate of weight gain < or = 0.37 Kg/week during the second and third trimesters (OR = 2.4, 95% CI = 1.69-3.42) were associated with an increased risk of spontaneous preterm delivery. The risk of spontaneous preterm delivery associated with a low second/third trimester weight gain was greater among patients with a body mass index < or = 19.5 (OR = 5.63, 95% CI = 2.35-13.8) compared to those with a body mass index > 19.5 (OR = 2.45, 95% CI = 1.60-3.75, adjusted p value for interaction = 0.05). The risk of spontaneous premature delivery associated with a maternal pre-pregnancy weight < or = 48 Kg was higher among smokers (OR = 5.81, 95% CI = 1.60-22.9) than among non-smokers (OR = 2.4, 95% CI = 1.53-3.74, adjusted p value for interaction = 0.05). CONCLUSIONS: The risk of spontaneous preterm delivery associated with a low pre-pregnancy body mass index is greater among patients with low rate of gestational weight gain during the second and third trimesters compared to those with a higher rate. The results of this study support the recommendation for increased rates of weight gain to patients with low body mass index compared to those with a higher body mass index.

Adult↗
PubMed1997

Antenatal and delivery risk factors simultaneously associated with neonatal death and cerebral palsy in preterm infants.

To evaluate the simultaneous effects of antenatal and delivery risk factors on neonatal death and cerebral palsy in preterm infants, we conducted a cohort study of 363 singleton pregnancies delivered between 24 and 33 weeks gestation. Neurodevelopmental outcome of the infants was evaluated at 2 years of corrected age. Risk factors associated with death or cerebral palsy were analysed by politomous logistic regression. Overall, the mortality rate was 14.6% (53/363) and the prevalence of cerebral palsy among surviving infants was 12.3% (38/310). Decreasing gestation and meconium-stained amniotic fluid were the only antenatal factors associated with increased odds for both death and cerebral palsy. The effect magnitude and the predictive value of gestational age were greater for death than for cerebral palsy. After adjustment for confounders, prolonged (> or = 48 h) rupture of membranes (odds ratio 2.98, 95% confidence interval 1.12-7.96) and male sex of the infant (odds ratio 3.01, 95% confidence interval 1.32-6.71) were significantly associated only with cerebral palsy. We conclude that neonatal death and cerebral palsy share few common antenatal risk factors. The characteristics of antenatal risk factors for cerebral palsy suggest that bacterial infestation of the amniotic cavity may be implicated in the etiology of the cerebral impairment.

Birth Weight↗
PubMed1995

[Echographic diagnosis of thyroid hemiagenesis].

Thyroid hemiagenesis is a rare anomaly with an uncertain incidence, since some patients have been found in a euthyroid state without abnormalities. Females account for 75% and males account for 25% of the cases, giving a female to male ratio of 3:1. The left lobe is absent in 80% of cases and the right lobe is absent in 20% of cases (a left to right hemiagenesis ratio of 4:1). The isthmus is absent in 50% of the patients. A variety of pathological conditions have been found in the remaining thyroid tissue in association with thyroid hemiagenesis: hyperthyroidism, multinodular goiter, hypothyroidism, benign adenoma, adenocarcinoma, Grave's disease. The differential diagnosis would include unilateral inflammatory disease and infiltrative disease, such as amyloidosis. We present two cases diagnosed in pediatric age, with absence of the left lobe and of the isthmus. Thyroid hemiagenesis has been found in association with congenital hypothyroidism in one case. The other patient was found to be in a euthyroid state without abnormalities. The diagnosis of thyroid hemiagenesis should be considered in any patients where, on physical examination, no apparent thyroid tissue is noted on one side of the neck. Sonography demonstrates an absent lobe, an eventually absent isthmus, and an eventually coexiting pathological condition in the remaining thyroid tissue. Sonography may be useful in distinguish between unilateral thyroiditis or other infiltrative processes and true hemiagenesis. Scintigraphy shows the remaining thyroid tissue uptake, and may reveal ectopic thyroid tissue not seen by ultrasound. Ultrasound may be useful in monitoring asymptomatic patients according to the high frequency of pathological condition associated with thyroid hemiagenesis.

Child↗
PubMed1994

[Echinococcosis/hydatidosis in children: combined medical and surgical treatment].

The outcome of 5 children with visceral hydatid cysts treated with Albendazole and surgical therapy is reviewed. The diagnoses were confirmed by immunological tests, X-ray, ultrasound scanner (US) and computer tomography. The therapeutic approach was correlated to the type of infection pictures. Immunological tests, X-ray and US were performed with the aim to evaluate the response to the therapeutic protocol. Combination of pharmacological and surgical treatment resulted in a complete resolution for all patients without any recurrence and further dissemination of infection.

Albendazole↗
PubMed1992

[Persistent multiple urachal complex. Echographic-surgical correlations].

Urachus is a tubular structure lined between foetal bladder and the umbilicus and is susceptible to complete or partial involution after birth. Persistence of the urachus results in a wide spectrum of anomalies: patent urachus, vesicourachal diverticulum, urachal sinus and cysts are more frequently seen than rare multiple urachal remnants. This kind of pathology focuses the problem of differential diagnosis (tumours, omental and ovarian cysts, vesical diverticulum or duplication) and may be complicated by a superinfection. The Authors discuss a bizarre multiple urachal remnant, presenting with urinary tract symptoms, which may be clinically confused with acute appendicitis or Meckel's diverticulitis. Contribution of sonography for a complete diagnosis is stressed, such as the precise correlation with surgical findings.

Adolescent↗
PubMed1992

Contribution of ultrasonography in the diagnosis of achalasia.

We present a case of achalasia diagnosed with the aid of ultrasonography (US). After having examined the clinical-radiological characteristics of the disease, and after having noted the diagnostic possibilities of manometry and endoscopy, we emphasize the use of US to clearly show the thickening of the muscular wall and the dilatation of the distal esophagus. In those of pediatric age, particularly, US permits differential diagnosis with the esophageal leiomyoma, which is difficult to obtain with other techniques. We suggest, therefore, including US in the study of patients with stenosis of the third distal section of the esophagus.

Child, Preschool↗
PubMed1991

[The echographic diagnosis of Candida albicans cystitis in childhood].

Candida albicans infections are opportunistic and range from asymptomatic infections to life-threatening involvement, with a wide spectrum of clinical manifestations. Urinary tract involvement is usually secondary to systemic infection, although the kidney or the bladder may be primarily infected without other organs being involved. Renal fungus infections, most commonly due to Candida, are usually seen in patients with altered host resistance due to diabetes, malignancy, other chronic illnesses, or prolonged antibiotic, corticosteroid or immunosuppressive therapy. Herein we report on an immunosuppressed 12 years-old girl with Candida albicans cystitis diagnosed with US. Sonography demonstrated a discrete dense fluid-fluid interface within the bladder, mobile with changes in position. US was used to monitor the progress of therapy. Treatment is usually conservative, related to removing the precipitating factors (catheters, antibiotics, steroids). Indeed, in our case, the immunosuppressed patient needed aggressive therapy: i.v. fluconazole. Sonography 15 days after treatment showed a normal bladder, without significant sequelae or the formation of vesical concretions.

Candidiasis↗
PubMed1990

[Echography in the follow-up of neonatal adrenal hemorrhage. The presentation of 14 cases].

Fourteen cases are reported of monolateral adrenal hemorrhage in newborns who were submitted to US exam at 1 week, 2 weeks, 3 weeks, and 3 months of age. The variability is emphasized of US and pathologic findings according to the patients' age. A concise terminology is suggested allowing the description of morphological and echo-structural patterns in adrenal hemorrhage. Being familiar with US spectrum of neonatal adrenal hemorrhage appearances can provide useful data in the cases with atypical clinical features. Moreover, the differential diagnosis becomes easier of neonatal adrenal hemorrhage and other diseases such as neonatal neuroblastoma, adrenal abscess, cystic neuroblastoma, cortical renal cyst, and obstructed upper cortical renal cyst, and obstructed upper excretory tract in duplicated kidney. The most effective criterion for US differential diagnosis is probably the chronological variability of US findings. Sonography is stressed as an useful and effective imaging modality in the diagnosis and follow-up of adrenal hemorrhage which helps avoid X-ray investigations and unnecessary laparotomies.

Adrenal Gland Diseases↗