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Biomedical subjects

U Nicolini

Publications and source records attributed to U Nicolini.

At least 127 records · Page 7Linked to original sources
PubMed1987

Can ultrasound be used to screen uterine malformations?

Eighty-nine patients were examined by ultrasound during the second phase of the menstrual cycle. The operators were not aware of the patients' history or results of previous ultrasonographic or radiologic investigations. The operators' aim was to diagnose uterine malformations graded as normal, suspected, or abnormal. Ultrasound identified 7 of 9 patients with a didelphic or complete septate uterus and 2 out of 3 with a bicornuate or partial septate uterus. Two other cases were suspected (one with a unicornuate, the other with a didelphic uterus). One false-positive case occurred, and 10 patients were not identified as having a malformed uterus (sensitivity, 42.9%; specificity, 97.8%). False-negatives involved mainly minor malformations.

Adult↗
PubMed1987

Persistent tubular resistance to aldosterone in infants with congenital hydronephrosis corrected neonatally.

Renal function of 18 infants who had undergone surgery in the neonatal period because of severe congenital hydronephrosis was followed up for 5 to 36 months (mean +/- SD 21 +/- 10 months). In all cases the diagnosis was made prenatally by sonography and confirmed at birth by intravenous urography. Creatinine clearance developed normally in all the children. Eight had a reduction in maximal urinary concentrating ability after intranasal DDAVP; this defect was transient and resolved after 4 to 5 months in all but one child, in whom it persisted. However, other tubular abnormalities were present. Throughout the observation period, patient serum potassium concentrations were significantly higher than normal, paralleled by a significant increase in plasma aldosterone concentration but with normal excretion fraction of sodium and potassium. There were no disturbances of acid-base balance. These findings may be accounted for by a persistent partial reduced sensitivity of the distal tubule to the action of aldosterone despite normal renal function. This alteration is usually mild, but may constitute a persistent metabolic risk despite successful surgical intervention.

Aldosterone↗
PubMed1987

Respiratory gases, acid-base balance and lactate concentrations of the midterm human fetus.

Respiratory gases, acid-base balance, and lactate and hemoglobin concentrations were measured in 14 fetal blood samples between 17 and 21 weeks of gestation. The samples were obtained at the time of fetoscopy performed for prenatal diagnosis. Results have been compared with two reference groups: (a) 4 patients in whom fetal cord blood sampling was performed at 32-36 weeks of gestation, and (b) 10 patients at the time of elective cesarean section, 35-39 weeks. PO2 and oxygen saturations were significantly higher and hemoglobin concentration lower in the mid-gestation fetus. Acid-base balance was not significantly different. There was a significant correlation between maternal and fetal hemoglobin concentrations. The oxygen affinity of fetal blood was not significantly different from that described for term fetuses with a oxygen saturation of less than 90%.

Acid-Base Equilibrium↗
PubMed1987

Perinatal management of fetal hydronephrosis with normal bladder.

This report covers 30 cases of prenatal diagnosis of uni- or bilateral hydronephrosis not associated with an overdistended bladder. Oligohydramnios was observed only in four cases while polyhydramnios occurred in three affected fetuses. In no case was fetal urine aspirated or drained prenatally. Early delivery was performed in four cases with oligohydramnios. Sixteen newborns required surgical correction of the lesion as it was confirmed by urography, following at least two sonographic examinations which confirmed a moderate to severe hydronephrosis after birth. The most frequent lesion was pyelo-ureteric junction obstruction (12 cases). Thirteen cases were normal at follow-up, and in two of these the dilation cleared up during intrauterine life. One case of severe hydronephrosis proved to be a multicystic kidney. In this series isolated hydronephrosis, both uni- or bilateral did not result in fetuses being at high risk for survival (only one infant died after surgery) nor as regards to associated malformations and perinatal morbidity. Provided a properly timed surgical correction was performed, renal function resulted to be good at follow-up.

Cesarean Section↗
PubMed1986

Routine obstetric ultrasound: effectiveness of cross-sectional screening for fetal growth retardation.

Sonographic detection of fetal growth retardation was evaluated on a sample of 778 patients routinely scanned over a 16-month period. From the 29th week to term, the sensitivity of abdominal circumference measurement progressively increased from 41% to 88% (P less than 0.01). Higher rates were achieved by using the biparietal diameter but false-positive diagnoses were twice as frequent as with the abdominal measurements. When the limitations in precision of abdominal circumference were considered, the screening rate of this parameter increased about 16%. Moreover, 50% of the false-negative diagnoses were made on fetuses weighing between the fifth and 10th centiles at birth. These diagnostic indices for biparietal diameter and abdominal circumference evaluated on a retrospective series proved to be lower than those reported for the prospective selected series. However, the results yielded by routine ultrasound were better than those obtained with clinical or traditional biochemical methods. These findings underline the importance of sonography not only in serial control of high-risk pregnancies but also in cross-sectional screening programs.

Diagnostic Errors↗
PubMed1986

Accuracy of an average ultrasonic laboratory in measurements of fetal biparietal diameter, head circumference and abdominal circumference.

Twenty patients between 14 and 28 gestational weeks were scanned on three occasions during a single day by six operators with different ultrasonic experience (three use a compound scanner and three a real-time equipment). On each occasion every operator had to measure in a "blind" manner the fetal biparietal diameter (BPD), head circumference and abdominal circumference (HC and AC); a coded copy of head and abdominal circumference was subsequently measured by one of the members of the staff. Statistical analysis was carried out on the 1800 measurements, and it was concluded that the accuracy was not dissimilar from that reported by pilot studies. The reproducibility of the parameters studied did not change throughout pregnancy and real-time and compound scanner yielded homogeneous results.

Abdomen↗
PubMed1986

Treatment of diabetic pregnant women with monocomponent insulins.

Very little immunological research has been undertaken in pregnant diabetic women in relation to insulin therapy. We investigated the relations between treatment with insulins of varied immunogenic character and the presence of immune factors such as insulin antibodies, immune complexes and insulin antiinsulin complexes as well as some maternal and neonatal complications of diabetic pregnancy. 128 insulin treated diabetic pregnant women and 121 of their newborns were included in the study. The incidence of insulin antibodies, immune complexes and insulin antiinsulin complexes was lower in patients treated with highly purified insulins than in those treated with conventional insulins. The insulin antibody levels were significantly related to the occurrence of maternal and neonatal morbidity. The presence of insulin antiinsulin complexes in the cord blood of infants of diabetic mothers was related to the presence of these complexes in their mothers. Our results seem to indicate that the use of highly purified insulin could favour the outcome of diabetic pregnancy.

Antigen-Antibody Complex↗
PubMed1985

The diagnostic value of perinatal ultrasound monitoring for foetal abdominal mass.

In the past two years seven cases of foetal abdominal mass were observed prenatally and operated on within 30 days of life. In four of seven cases no abdominal mass was ever palpable neither at birth nor under anaesthesia just before laparotomy, whereas in all cases it was both sonographically and surgically detected. The authors stress the importance of perinatal ultrasound monitoring to cope early with clinically undetectable abdominal mass. Furthermore, they emphasise that the necessary condition for definition of a mass should by now be that it is palpable and seen via ultrasound, but a perinatal ultrasound image of mass is sufficient to warrant careful detailed clinical evaluation.

Abdominal Neoplasms↗
PubMed1985

[Consequences from prenatal sonography of urinary tract abnormalities].

At the Gynaecologic Clinic of the University of Milan/Italy from 1979-1983, pathological changes of the urinary tract were diagnosed in 55 foeti on the occasion of routine sonography of pregnants. In 23 children prenatal diagnosis was confirmed. 5 neonates had another disease than the disease of the urinary tract assumed during the prenatal period. In 19 neonates the first diagnosis had to be rescinded because of a second examination showing normal findings. 8 neonates could not be examined a second time. Advantages of an intrauterine diversion of urine could not be verified. Therefore, the following diagnostic and therapeutic consequences from the prenatal examination by sonography are recommended: Immediate check and analysis of prenatal findings in the neonatal period by further examinations. Short-term checks to clarify indication for operation. Avoidance of early complications and other kidney changes by early therapy.

Diagnosis, Differential↗
PubMed1985

Validity and limitations of ultrasonography in monitoring therapeutic response in ovarian carcinoma.

The effectiveness of ultrasound in the follow-up of tumor masses during chemotherapy was investigated over a period of 3 years in 74 patients with proven ovarian cancer. 47 had stage 3 disease, and 22 showed recurrence. Two or more examinations were performed in 65% of the patient. A correlation with surgical second look showed a correct diagnosis in 67.6%. The results of ultrasonographic follow-up when compared with clinical monitoring showed 75% concordant judgments on the therapeutical tumor response. The validity and limitations of this technique are discussed.

Evaluation Studies as Topic↗
PubMed1985

The contribution of sonographic evaluation of ovarian size in patients with polycystic ovarian disease.

The ovarian size of 44 patients with clinical and endocrinologic findings suggesting polycystic ovarian disease (PCOD) was studied by ultrasound examination. Reproducibility of the ovarian parameters (transverse, longitudinal, and anteroposterior diameters, and volume) was also evaluated. The endocrine status of each patient was evaluated by assay of blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, 17 beta-estradiol (17 beta E2), and serum prolactin (PRL). Ovarian size was also investigated in 40 women with normal cycles, following the same ultrasound procedure. The mean ovarian volume of the normal controls was statistically different from the mean of patients with PCOD. Only 34 per cent of the patients affected by PCOD were above the second standard deviation of normal ovarian size. A correlation between endocrinologic findings and ovarian size was observed in women whose ovarian size fell within normal limits; these women had higher, though not statistically different, values of LH and testosterone and lower values of 17 beta E2 and PRL compared with patients with enlarged ovaries. Responsiveness to treatment was more easily observed in patients with ovarian enlargement.

Adolescent↗
PubMed1984

Sinusoidal rhythm caused by fetal hemorrhage during fetoscopy.

The sinusoidal fetal heart rate pattern has been reported to be associated with fetal anemia, hypoxia, administration of alphaprodine while, in other cases, it has been followed by good fetal outcome. In this case study fetoscopy was performed in a patient with thalassemia trait for prenatal diagnosis of thalassemia. Following the insertion of the trocar, bloodstained amniotic fluid was aspirated which resulted to be all fetal in origin. Estimation of feto-maternal hemorrhage was 5.7 ml while the amount of intra-amniotic bleeding could not be assessed. Fetal heart rate, which was recorded throughout fetoscopy, showed a sinusoidal pattern starting two minutes after the fetal hemorrhage which lasted more than ten minutes. Two hours later the fetal heart rate was normal. The pregnancy continued uneventfully and a healthy female baby weighing 3100 g was delivered at 38 weeks' gestation. Review of the literature suggests that a sinusoidal pattern may be caused either by a hemodynamic disturbance or fetal acidosis. In any case it does not always indicate impending fetal death.

Adult↗
PubMed1983

Perinatal ultrasound monitoring: early detection and treatment of congenital uropathy.

In childhood, delay in the diagnosis of congenital obstructive or refluxing urinary tract pathology can contribute to progressive renal failure. Ultrasound examination is a safe and reliable means of investigating the urinary system pre- and post-natally. We describe 13 children investigated with ultrasound during the perinatal period. In 10, pathology was identified in utero, confirmed after birth and treated surgically within 1 month. This indicates that perinatal ultrasonography is a valuable technique.

Constriction, Pathologic↗