Gabriele Rossi

Adequate timing of fetal ultrasound to guide metabolic therapy in mild gestational diabetes mellitus: Results from a randomized study

Background. Ultrasound assessment of abdominal circumference early in the third trimester had been proposed to introduce insulin therapy in order to prevent fetal overgrowth in women with mild gestational diabetes mellitus. The purpose of this study was to investigate adequate weeks gestation timing for testing this parameter.

Evaluation of factors that affect analytic variability of urine protein-to-creatinine ratio determination in dogs

OBJECTIVE To determine whether preanalytic and analytic factors affect evaluation of the urinary protein-to-creatinine (UPC) ratio in dogs. SAMPLE 50 canine urine samples. PROCEDURES The UPC ratio was measured to assess the intra-assay imprecision (20 measurements within a single session), the influence of predilution (1:10, 1:20, and 1:100) for urine creatinine concentration measurement, and the effect of storage at room temperature (approx 20°C), 4°C, and -20°C. RESULTS The coefficient of variation at room temperature determined with the 1:20 predilution was < 10.0%, with the highest coefficients of variation found in samples with a low protein concentration or low urine specific gravity. This variability could result in misclassification of samples with UPC ratios close to the thresholds defined by the International Renal Interest Society to classify dogs as nonproteinuric (0.2), borderline proteinuric (0.21 to 0.50), or proteinuric (> 0.51). A proportional bias was found in samples prediluted 1:10, compared with samples prediluted 1:20 or 1:100. At room temperature, the UPC ratio did not significantly increase after 2 and 4 hours. After 12 hours at room temperature and at 4°C, the UPC ratio significantly increased. The UPC ratio did not significantly change during 3 months of storage at -20°C. CONCLUSIONS AND CLINICAL RELEVANCE The intra-assay precision of the UPC ratio was sufficiently low to avoid misclassification of samples, except for values close to 0.2 or 0.5. The optimal predilution ratio for urine creatinine concentration measurement was 1:20. A 1:100 predilution is recommended in samples with a urine specific gravity > 1.030. The UPC ratio must be measured as soon as samples are collected. Alternatively, samples should be immediately frozen to increase their stability and minimize the risk of misclassification of proteinuria.

Risk Factors for Spontaneous Preterm Birth: A Northern Italian Multicenter Case-Control Study

Preterm birth remains one of the most serious problems facing obstetricians. The aim of this study was to investigate the risk factors for spontaneous preterm birth in northern Italy. Nine different collaborating institutions participated in this multicenter case-control study. Cases were defined as women who were spontaneously delivered of a live singleton newborn between 20 and 37 weeks of gestation. One control was matched to each case by delivery date, maternal age and parity. Seven hundred and fifty-four cases and 754 controls were available for data analysis. Demographic and clinical characteristics were obtained using a standardized questionnaire. At the time of hospital admission, urine and cervico-vaginal samples were collected and tested for bacterial infections and bacterial vaginosis, respectively. Variables found to be statistically significant in the univariate analysis were entered in a multivariate model to examine their independent effects. In order of decreasing odds ratios (ORs), the factors that showed a significant association with preterm delivery were: previous preterm birth (OR 5.7, confidence interval (CI) 2.5–12.9); second-trimester miscarriages (OR 4.4, CI 1.3–15.3); genital bleeding before 24 weeks of gestation (OR 2.5, CI 1.6–3.8); bacterial vaginosis (OR 2.0, CI 1.3–3.1), and previous genital infections (OR 1.6, CI 1.1–2.5). This study confirms that infections play a role in the etiology of preterm birth and that reproductive history is still the most important factor in identifying women at increased risk.

Evaluation of equine hemograms using the ADVIA 120 as compared with an impedance counter and manual differential count.

BACKGROUND The ADVIA 120 is an automated laser cell counter widely used in veterinary medicine. Although specific software for equine samples is available and validated, only a few reports have been published comparing the ADVIA 120 with other methods for equine hemogram evaluation. OBJECTIVES The purpose of this study was to compare the hematologic values and reference intervals obtained on the ADVIA 120 with those obtained on an impedance cell counter and manual differential counts in healthy horses. METHODS EDTA-anticoagulated blood samples were obtained from 114 clinically healthy horses of various breeds, both sexes, and 2-6 years of age. Samples were stored for up to 12 hours at 4 degrees C and then analyzed on the ADVIA 120 and the Hemat 8. A 100-cell to 200-cell differential leukocyte count was performed by 3 independent observers on May-Grünwald-Giemsa-stained smears. Intra-assay precision of the ADVIA 120 was determined by analyzing 5 replicates each of 10 of the blood samples. RESULTS Results from the ADVIA were significantly higher than those from the impedance counter for RBC count, total WBC count, hemoglobin concentration, red cell distribution width, MCH, and MCHC, and significantly lower for HCT and platelet count. Significantly higher neutrophil and basophil counts and significantly lower lymphocyte counts were obtained with the ADVIA 120 compared with manual counts. Based on Passing-Bablok regression analysis, RBC and platelet counts were in good agreement between the 2 analyzers; a constant and proportional bias was present for other values. Coefficients of variation for erythrocyte parameters on the ADVIA were <1%, but were higher for platelet (6%), total WBC (2%), differential WBC (4%-30%), and reticulocyte (75%) counts. CONCLUSIONS Results obtained with equine samples on the ADVIA 120 were comparable with those obtained on an impedance counter; reference intervals differed statistically but overlapped. The ADVIA had poor precision for reticulocyte and differential leukocyte counts such that the latter should always be verified on smears.

Immunohistochemical localization of the growth hormone in human endometrium and decidua.

Problem:  Recent evidence of growth hormone (GH) receptor expression in rat endometrium and human myometrium have focused our attention on the role of the GH in endometrial development. We tested the expression of GH in the human endometrium throughout the menstrual cycle and during pregnancy.

Pregnancy outcome among HIV positive and negative intravenous drug users

OBJECTIVE To analyze determinants of pregnancy outcome, among HIV infected and uninfected intravenous drug users. STUDY DESIGN A total of 315 pregnant current intravenous drug users, IVDU (151 HIV infected and 164 HIV uninfected subjects) were referred to the Center for Pregnant Drug Addicts of the Mangiagalli Clinic, Milan, Italy, for internatal care and delivery between 1985 and 1993. RESULTS HIV uninfected and infected mothers did not differ significantly according to type of pregnancy, gestational age at childbirth, mode of delivery, pregnancy outcome and newborn weight, height, head circumference, sex and Apgar at 1 and 5 min. Out of 133 children (born to HIV infected mothers) for whom HIV status was available, 20 (15%) were HIV infected or developed AIDS-related signs and symptoms during a 24 months follow-up. The distribution of HIV infected and non infected infants was not significantly different as regards maternal CD4 lymphocyte count, week of gestation at birth, mode of delivery, infant weight, height, head circumference and Apgar at 1 and 5 min. CONCLUSION Our data show that HIV infected women in the early stages of HIV infection are not at a higher risk of adverse course of pregnancy than HIV uninfected women. Vertical transmission rates were not associated to newborn characteristics.

Dynamic aspects of endometriosis in a mouse model through analysis of implantation and progression.

Abstract The aim of this study was to use normal immunocompetent mice to set up a model for endometriosis which allowed to study the dynamic aspects involved in initiation and progression of the disease. Thirty mice were surgically transplanted with autologous endometrium and at 3 weeks showed evidence of endometriosis. Diagnosis of endometriotic lesions was hystologically confimed. Visual inspection using a caliper revealed that, after an initial decrease in size (from 33.44±2.33 mm2 to 24.24±2.37 mm2 (p<0.01)) detected at 3 weeks after transplantation, there was a significant increase of lesion area from 21.30±3.15 mm2 to 43.93±6.29 mm2 (p<0.05) in the following 4 weeks. When we compared these results to those obtained in mice which underwent bilateral annessiectomy, we observed that, when bilateral annessiectomy was performed simultaneously to endometrial transplantation, lesion surfaces were similar between mice which were or were not subjected to bilateral ovariectomy. On the other hand, when bilateral annessiectomy was performed at second laparotomy and then evaluated after 4 weeks, differently from what observed in control mice, surface values decreased from 21.24±2.29 mm2 to 10.58±3.40 mm2 (p<0.01). Finally, progression of lesions in estrogen supplemented mice seems less evident than in control mice since only a slight but not significant increase in size (from 21.32±3.32 mm2 to 26.18±6.98 mm2, p=0.32) was detected. The results presented herein demonstrate that surgically induced endometrial implants in mice are dynamic lesions and that implantation and progression of endometriosis represent different stages in the ethiopathogenesis of the disease. Moreover, we showed that progression, but not implantation, of ectopic endometrium is dependent upon the functionally and structurally integrity of the ovaries. This is a model of endometriosis established in normal immunocompetent mice, and, consequently, may represent a reliable tool for testing new immunological therapeutical approaches and studying the role of different genes using transgenic mice.

Homocysteine measurement by an enzymatic method and potential role of homocysteine as a biomarker in dogs.

In humans, homocysteine (Hcy) is employed to monitor renal, cardiovascular, and other diseases and their complications. The aim of the current study was to define the analytical performances of an enzymatic method not yet validated in dogs for measuring homocysteine, and to assess the possible clinical usefulness of Hcy measurement. Using conventional approaches, the analytical performances were investigated by assessing, imprecision, inaccuracy, and interference of hemoglobin, triglycerides, and bilirubin. The possible clinical usefulness of Hcy determination was assessed by comparing the results of healthy dogs (n = 8) with those of dogs with heart disease (n = 10), inflammation (n = 6), gastrointestinal disorders (n = 7), neoplasia (n = 8), renal failure (n = 4), trauma (n = 7), and other miscellaneous diseases (n = 6). Preliminary evaluation of this enzymatic method showed it to be precise at Hcy levels close to or higher than the values in dogs with renal or cardiac disorders that had the highest Hcy levels. By contrast, at low Hcy levels, which were recorded basically in control dogs, the method suffers from high imprecision. The sample of choice is serum. The use of icteric samples should be avoided, while hemoglobin and lipids have only a minor effect on Hcy measurement. In conclusion, the enzymatic method employed in the current study provides useful information in dogs and could be used to monitor cardiac and renal disorders, in which Hcy concentrations are elevated.

Haematological and biochemical reference intervals of four feline breeds.

Many feline breeds have been generated from a small number of ancestors. Thus, breed-specific peculiarities can be expected, which could include haematological and biochemical measurements. Despite this, there are only a few reports on breed-specific reference intervals (RI). This information is essential in routine practice where results from individual patients are usually compared with an RI. The aim was to compare haematological and biochemical data from clinically healthy Abyssinian, Holy Birman, Norwegian Forest and Siberian cats with published RIs to assess whether the published RIs are acceptable in these breeds. Comparison with established RIs using guidelines from the National Committee for Clinical Laboratory Standards and the American Society of Veterinary Clinical Pathology, revealed a number of breed-related clinicopathological differences. New RIs were established, but in most cases the new RIs overlapped with published RIs, and the use of the breed-specific data would minimally affect the clinical interpretation of laboratory results. Important differences that could result in misinterpretation of laboratory results were as follows: microcytosis and high α2-globulin concentrations in Abyssinian cats; high serum creatinine, α2-globulin and glucose concentrations in Holy Birman cats; high serum alkaline phosphatase activity and calcium and phosphate concentration in Norwegian Forest cats; low β2-globulin and γ-globulin concentrations in Norwegian Forest and Siberian cats. Breed-specific RIs should be used for these analytes. In addition, care should be taken in interpreting clinicopathological data in purebred cats for which specific RIs have not been established.

Serum concentrations of the derivatives of reactive oxygen metabolites (d-ROMs) in dogs with leishmaniosis

Leishmania infantum interferes with the oxidative metabolism of phagocytes. In order to assess whether derivatives of reactive oxygen metabolites (d-ROMs) decrease due to infection or increase due to inflammation, d-ROMs were measured in serum collected from control dogs (Group 1; n = 12), from dogs seropositive for Leishmania either symptomatic (Group 2; n = 27) or not (Group 3; n = 14), and from dogs with other diseases (Group 4; n = 16). The concentrations of d-ROMs in the four groups, expressed in Carratelli Units (U CARR) were, respectively, 75.4 ± 39.5 (median, 81.6), 108.2 ± 96.3 (73.4), 73.5 ± 62.2 (62.0), 127.7 ± 97.3 (94.3). There were no significant differences between groups, but dogs with values higher than the reference interval were found, mostly in Groups 2 and 4 (which had serum C-reactive protein levels consistent with inflammation), whilst low values were occasionally found in Groups 2 and 3. Inflammation may mask decreases in d-ROMs induced by Leishmania infection.