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P Greco

Publications and source records attributed to P Greco.

At least 73 records · Page 4Linked to original sources
PubMed1997

Transvaginal color Doppler ultrasound for monitoring the response to neoadjuvant chemotherapy in advanced cervical cancer.

BACKGROUND: To evaluate the role of transvaginal color Doppler ultrasound in monitoring the response to neoadjuvant chemotherapy in patients with locally-advanced cervical cancer. METHODS: Fourteen patients with locally-advanced cervical cancer, scheduled for neoadjuvant chemotherapy, were investigated with transvaginal color Doppler ultrasonography before and at the completion of chemotherapy in order to study hemodynamic changes in cervical and intratumoral vessels. Twenty healthy women matched for age and parity served as a control group. Statistical analysis was performed with Student's t test for paired data. RESULTS: Statistically different blood flow recording between patients with cervical cancer and healthy controls could be observed only in intratumoral vessels. A significant increase of RI and PI values, recorded in both cervical artery and intratumoral vessels, have been observed in the group of patients responding to neoadjuvant chemotherapy. In patients with stable disease at the completion of chemotherapy, flow characteristics did not change significantly. CONCLUSION: Preliminary results of our study suggest that transvaginal color Doppler ultrasound evaluation of flow characteristics in the cervical and intratumoral vessels might be useful in monitoring the response to neoadjuvant chemotherapy in patients with invasive cervical cancer.

Aged↗
PubMed1997

Neutropenia in neonates delivered of women with pre-eclampsia.

OBJECTIVE: To show that neutrophil counts are decreased in neonates born of mothers with pre-eclampsia and that pre-eclampsia itself is an independent risk factor for perinatal neutropenia. METHODS: In a tertiary referral centre two groups of patients at high risk to have a neonate with neutropenia. All patients were delivered by elective caesarean section, group 1 because of pre-eclampsia, group 2 because of idiopathic fetal growth restriction. RESULTS: Neutrophil counts were significantly lower in infants of group 1 compared to group 2 and this difference was still present if the sub-group of less premature neonates (> 32 weeks of gestation) was considered. The rate of infections was also raised in the newborns of hypertensive mothers. CONCLUSION: Pre-eclampsia of the mother is an independent risk factor for neutropenia and infections in premature newborns. Early detection and prophylactic treatment of this high risk group of infants are probably necessary.

Adult↗
PubMed1997

Morphometric determination of AgNORs in breast carcinoma. Correlation with flow cytometry and proliferating cell nuclear antigen.

OBJECTIVE: To determine the relationship between argyrophilic nucleolar organizer regions (AgNORs), ploidy and proliferative activity in breast carcinomas. STUDY DESIGN: AgNOR staining was performed in 25 cases of infiltrating ductal carcinoma of the breast, and several features were quantified by image analysis: nuclear area, mean value of the number of AgNORs (M_N_Ag), area of AgNORs (A_Ag), area of AgNOR per nucleus (A_Ag/N), A_Ag variance (A_Ag_V) and coefficient of variation of AgNOR area per nucleus (CV_A_Ag/N). These findings were correlated with ploidy and proliferative activity obtained by flow cytometry, also quantifying the latter with proliferating cell nuclear antigen (PCNA). Comparison of AgNORs with size of the tumor and lymph node status was also made RESULTS: We observed a good correlation between M_N_Ag and A_Ag with ploidy (P < .001), M_N_Ag and A_Ag with S-phase fraction (SPF) (P < .001), A_Ag with S+G2M (P < .02) and PCNA with M_N_Ag (P < .05). The mean value of A_Ag allowed division of the cases into two groups: diploid (D) and near diploid (ND) with low SPF (A_Ag < or = 2.50 microns2), and D and ND with high SPF and aneuploidy (A) (A_Ag > 2.50 microns2) (P < .05). There was a statistically significant correlation between M_N_Ag and A_Ag and between tumor size and lymph node metastases (P < .05). CONCLUSION: AgNORs correlate with various cell cycle and clinicopathologic features and will be used eventually as prognostic markers in breast cancer.

Breast Neoplasms↗
PubMed1997

Should we treat minor degrees of glucose intolerance in pregnancy?

We examined the pregnancy outcome of 112 women classified as minor degrees of glucose intolerance (MDGI) in pregnancy in a screening program based on Carpenter and Coustan's criteria. The MDGI group comprised 49 women with abnormal oral glucose challenge test (OGCT) followed by normal OGTT (group A), and 63 with "borderline" OGTT (1 abnormal value, group B). No treatment was offered to 88 MDGI women, while 26 received dietary advice and metabolic monitoring. A control group was constituted from 112 age- and BMI-matched negative screenees. Similar rates of cesarean sections and macrosomia, but higher rate of large for gestational age (LGA) babies (25.9% vs 14.3%) were found in MDGI, without difference between groups A and B. When comparing treated and untreated MDGI, lower LGA incidence (11.5% vs 30.2%) and no macrosomia were found in the former. In conclusion, untreated MDGI may present excessive fetal growth, which can be normalized by dietary treatment and metabolic monitoring.

Adult↗
PubMed1996

Lipoperoxidation and antioxidant enzymes activity in pregnancy complicated with hypertension.

OBJECTIVE: To assess maternal circulating levels of lipid peroxidation breakdown products and antioxidant enzymes activity in pregnancies complicated with hypertension. STUDY DESIGN: Ten women with uncomplicated pregnancies and nine women with hypertension antedating pregnancy were prospectively sampled. Eight women, who had developed preeclampsia, were also cross-sectionally included. Twenty healthy non pregnant volunteers were the control group. Thiobarbituric acid reactive substances (TBA-RS), as lipid peroxidation products, and the activity of catalase (CAT), glutathione peroxidase (GPX) and superoxide dismutase (SOD), as antioxidant enzymes, were assayed in red blood cell hemolysates. A prooxidant/antioxidant (P/A) ratio (TBA-RS/CAT + GPX + SOD) was determined from the mean value of the volunteers. RESULTS: In women with chronic hypertension, TBA-RS levels were higher than those in normal pregnant women, whereas antioxidant enzymes activities were either stable or decreased. Therefore the P/A ratio was progressively lower in the second and third trimester. Similar result were found in patients with preeclampsia. CONCLUSIONS: Normal gestation induces an increase of lipid peroxidation products, whereas antioxidant activity seems stable. In pregnancies complicated by chronic hypertension, a deficiency of the oxidative system balance is detectable, which consistently progresses in the second and third trimester, strongly suggesting a failure of the protective mechanisms.

Adult↗
PubMed1996

Pathological significance of first-trimester fetal nuchal oedema.

The pathological mechanism that causes the transient phenomenon sonographically defined as "nuchal translucency' is still poorly understood. Seven pregnancies in which the fetuses clearly presented this ultrasonic sign at 10-14 weeks' gestation were terminated because of an abnormal fetal karyotype. The pathological specimens, compared by morphometric analysis with normal fetuses of the same gestational age, showed oedema and dilatation of lymphatic capillary vessels. No particular relationship was found with any structural abnormality. We speculate that nuchal oedema is a transient non-specific phenomenon which is probably related to an early disarrangement of lymphatic connections.

Aneuploidy↗
PubMed1996

[Gonadal function after chemotherapy for acute lymphoblastic leukemia].

Object of this study was to verify long term effects on gonadal function in pre- and pubertal patients affected by acute lymphoblastic leukemia (ALL). The population examined was represented by 15 patients, 10 males and 5 females, who came to our Unit after a period of time ranging from 4.5 to 6.2 years. All the patients underwent combined chemotherapy without alkylating agents, such as cyclophosfamide and citosine arabinoside, and intrathecally radiotherapy for a mean period of two years. All the patients were off-therapy and without symptoms of relapse except for one case. The examination of the male and female gonadal function was done on the basis of hormonal assay, ultrasonographic examinations, Tanner's determination of the pubertal development, monitoring of the ovulation and seminal fluid evaluation. The clinical results obtained showed an absence of negative effects both on the gonadal function and on pubertal development. Combined chemotherapy for ALL during pre- and pubertal stage without alkylating agents does not alter the normal gonadal function during the following ten years. Prospective studies will establish the risk of partial follicular atresia and the incidence of premature gonadal failure.

Adolescent↗
PubMed1996

[Transvaginal color-Doppler sonography for monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer].

Changes in blood flow characteristics, observed with transvaginal color-Doppler ultrasonography have recently been reported in patients with advanced cervical cancer. In order to evaluate the reliability of TVCDUS in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer, a prospective study was undertaken on the blood flow characteristics of the cervical vessels. Pulsatility Index (PI) and Resistance Index (RI) of the uterine and cervical arteries of 12 patients with histologically proven advanced cervical cancer, scheduled for neoadjuvant chemotherapy were evaluated at diagnosis, during every cycle of chemotherapy and before surgery. A significantly lower value of mean PI and RI between cervical and uterine arteries was observed in patients with cervical cancer (PI = 1.671 +/- 0.18 vs 2.159 +/- 0.24)-(RI = 0.43 +/- 0.17 vs 0.72 +/- 0.22). Mean RI and mean PI of the descending branches of the uterine arteries were significantly lower in patients with cervical cancer, compared to healthy control women. No difference in blood flow parameters could be detected between stage I vs stage II-III, and between left and right cervical artery in patients with cervical cancer. Both RI and PI values appeared strictly related to the tumor response to chemotherapy. In fact in 8 patients in which treatment resulted in tumor regression, evaluated by pelvic examination and MR imaging, a significant (p < 0.01) increase of resistance indices was observed (PI = 1.671 +/- 0.18 vs 2.158 +/- 0.22)-(RI = 0.43 +/- 0.17 vs 0.79 +/- 0.16). On the other side 4 patients not responding to chemotherapy, had stable values of both PI and RI. Transvaginal color-Doppler ultrasonography might be useful in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical carcinoma.

Aged↗
PubMed1995

Angiogenesis in pre-eclampsia.

OBJECTIVE: To study the angiogenetic activity of decidua basalis from primigravid women with pre-eclampsia. STUDY DESIGN: Fresh fragments of decidua basalis from 10 primigravid women with pre-eclampsia and from 10 healthy, control primigravid women, were grafted onto the chick embryo chorioallantoic membrane (CAM) at the 6th incubation day. Four days later the CAMs were fixed and the angiogenic response of the CAMs was assessed on histologic sections by a planimetric point-count method. RESULTS: Decidua from pre-eclamptic pregnancies induced angiogenesis to a greater extent than that from normotensive pregnancies. CONCLUSIONS: Angiogenesis might be stimulated in pre-eclampsia through endothelia and decidua changes induced by the pathological condition which, in turn, would lead to a greater expression of angiogenic factors also present in normal condition.

Allantois↗
PubMed1995

I get by with a little help from my family and friends: adolescents' support for diabetes care.

Evaluated and compared the support provided by family members and friends for adolescents' diabetes care. Family and friend support also were examined in relation to other measures of social support, to demographic variables (age, gender, duration of diabetes) and to adherence. Using a structured interview, 74 adolescents with diabetes described the ways that family members and friends provided support for diabetes management (insulin shots, blood glucose monitoring, eating proper meals, exercise), and for helping them to "feel good about their diabetes." Families provided more support than friends for three management tasks (insulin injections, blood glucose monitoring, meals); this support was largely instrumental. In contrast, friends provided more emotional support for diabetes than families. Greater family support was related to younger age, shorter disease duration, and better treatment adherence. Implications of the findings include encouraging parents to remain involved in adolescents' treatment management, and involving peers as supportive companions for meals and exercise.

Adolescent↗
PubMed1995

[Pharmacologic induction of fetal immobilization for prenatal diagnostic-therapeutic procedures].

Neuro-muscular blocking agents are currently administered to the fetus during intrauterine procedures, in order to freeze fetal movements and to avoid traumatic effects. The authors have evaluated three drug regimens (Pancuronium, Vecuronium, Atracurium), both via the intramuscular and the intravascular route of administration to the fetus. The time lapse between injection and disappearance of movements and the duration of paralysis have shown no significant differences for each group. The duration of fetal immobilization, on the other hand, has resulted excessively long for the necessity of the procedure. The authors speculate that immaturity of fetal metabolism can be responsible for the prolonged action of the drug. No side effect related to paralysis have been recorded at birth and after two years follow-up.

Atracurium↗
PubMed1994

Magnetic resonance imaging in pregnancy: study of fetal cerebral malformations.

This paper reports 15 examinations by magnetic resonance imaging (MRI) performed in pregnant women whose fetuses had cerebral malformations identified by sonography. In all the cases the fetuses were immobilized by ultrasound-guided intravenous or intramuscular curarization. The diagnoses by MRI and ultrasound differed only in one case where an occipital meningocele had first been suggested. No cerebral abnormalities were demonstrated in this case by the MRI study, and this was confirmed at birth. In the remaining 14 cases, MRI confirmed the ultrasound diagnosis of cerebral malformation. In four of these cases, MRI added some additional information to the ultrasound diagnosis of ventriculomegaly by detecting agenesis of the corpus callosum in two fetuses, one Chiari malformation and one triventricular hydrocephalus. Another two ultrasound diagnoses of microcephaly actually proved to be semilobar holoprosencephaly with MRI. In the following cases, the MRI diagnoses concurred with those of ultrasound, and was therefore used unnecessarily despite providing further anatomical details of the lesions: two cases of agenesis of the corpus callosum, one case of anencephaly, a cystic hygroma of the neck, an alobar holoprosencephaly, a Dandy-Walker malformation and a mild isolated hydrocephalus associated with diaphragmatic hernia. In one case of iniencephaly, sonography offered closer approximation to the correct diagnosis. The results obtained unequivocally confirm the high sensitivity of ultrasound examinations in the prenatal screening of cerebral malformations and show that MRI proves to be complementary in uncertain cases or when more accurate anatomical detail is required.

Journal Article↗
PubMed1994

Does gestational diabetes represent an obstetrical risk factor?

In order to assess the clinical consequences of gestational diabetes in the index pregnancy, a group of patients with positive oral glucose challenge test and their matched controls have been closely followed up. No differences in perinatal outcome have been pointed out, except for the higher rate (p < 0.01) among diabetic patients of preterm delivery and pregnancy-induced hypertension. The prevalence of the latter has shown no relationship to maternal obesity. In view of these data, the future risk of cardiovascular disease of this cohort of patients needs to be assessed with a follow-up study.

Diabetes, Gestational↗
PubMed1993

The diagnostic potential of fetal renal biopsy.

The feasibility of fetal renal biopsy has been investigated in order to assess the diagnostic value of the histological specimen. Two fetuses with a severe bilateral renal abnormality (multicystic dysplastic kidney, Meckel-Gruber syndrome with polycystic kidney) and one fetus with Down syndrome (no detectable structural anomaly) were sampled. Histological findings in the biopsy specimens of cases 1 and 2 were diagnostic of an early obstructive renal disease. In case 3, the findings were consistent with normal development for gestational age of the kidney. Fetal renal biopsy is technically feasible; histological examination of the samples showed a good correlation with postnatal findings. Further studies of its diagnostic value are required.

Adult↗
PubMed1993

Lipid peroxidation products and antioxidant enzymes in red blood cells during normal and diabetic pregnancy.

Oxygen free radicals produced during normal aerobic metabolism have been implicated in several pathophysiological mammalian processes. The importance of free radical-mediated fatty acid oxidation has received much attention. The generation of active oxygen species may lead to lipid peroxidation and formation of reactive products, which may be involved in severe damage of cell molecules and structures. Free radical metabolism in pregnancy and in diabetes mellitus is still unclear. To add new insights to the question, changes in lipid peroxidation products and activities of three antioxidant enzymes: catalase (CAT), glutathione peroxidase (GPX) and superoxide dismutase (SOD) in maternal red blood cells haemolysates were evaluated in pregnant women with insulin-dependent diabetes mellitus (IDDM-PW) and in healthy pregnant women (HPW). Healthy non-pregnant women were the control group for IDDM-PW and HPW, respectively. Pregnancy provoked an increase of lipoperoxidation products and an high SOD activity since early pregnancy, while CAT and GPX activities did not change during gestation. IDDM-PW showed higher content of lipoperoxidation breakdown products and lower SOD activity at each trimester, if compared with HPW; moreover, a slight increase of CAT and SOD activity is reported during late diabetic pregnancy. IDDM-PW were in very good metabolic control at time of sampling. The variations reported suggest an easier membrane lipoperoxidability and, consequently, an easier membrane damage during diabetic gestation.

Adult↗
PubMed1993

[Clinical and instrumental findings in cardiac amyloidosis].

The clinical findings of 2 male patients, aged 58 and 60 years with cardiac amyloidosis are described. Congestive heart failure was present in both. Electrocardiograms were abnormal in both cases. Echocardiographic examination showed increased myocardial echogenicity and ventricular hypertrophy, pericardial effusion and decreased ventricular function. Cardiac catheterization was performed in 1 patient. Rectal biopsies were obtained from both patients; endomyocardial biopsy was executed in only 1 patient; all specimens were positive. Our data demonstrate, in agreement with the literature, that clinical features of cardiac amyloidosis are polymorphous and therefore often unidentified.

Amyloidosis↗