Produzione scientifica durante il dottorato di ricerca in medicina prenatale

Nell’elaborato finale del Dottorato di Ricerca in Medicina Prenatale ho seguito principalmente due rami di ricerca clinica: 1. La ricerca sull’utilizzo e lo sviluppo della plicometria ultrasonogrfica fetale. 2. Lo studio delle associazioni tra mutazioni (o condizioni) trombofiliche e l’insorgere di patologie della gravidanza. Nella prima applicazione ho studiato alcuni dei nuovi parametri plicometrici fetali proposti in letteratura negli ultimi anni. Ho implementato la tecnica di misura, contribuendo alla sua standardizzazione. In seguito ho prodotto tavole biometriche di riferimento nelle successive epoche di gravidanza, sia in condizioni di normalità, sia in pazienti con diabete gestazionale. Ho condotto uno studio sui cambiamenti dei compartimenti corporei fetali in caso di ritardo di crescita. Ho inoltre studiato il potenziale beneficio (in termini di accuratezza diagnostica) dell’uso dei parametri plicometrici fetali nei preesistenti modelli di stima del peso fetale. Da ultimo ho prodotto un algoritmo per la predizione del peso alla nascita, introducendovi anche uno dei parametri plicometrici da me studiati. I risultati della mia ricerca in questo campo vengono esposti in 4 articoli editati su stampa internazionale dal 2003 al 2007, proprio in corso del Dottorato di Ricerca in oggetto. Nella seconda applicazione ho studiato l’associazione tra trombofilia ed esiti avversi della gravidanza. I due lavori presentati nel seguente documento hanno timbro epidemiologico e mostrano in comune lo stesso set di pazienti, ma differente analisi statistica. In questo attuale campo la mia ricerca sta procedendo. Due manoscritti sono in coso di valutazione e trattano dell’associazione tra trombofilia ed alterata funzione renale in gravidanza. Sempre nella stessa tesi di Dottorato di Ricerca mi preme mostrare alcuni case report relativi ad interessanti casi clinici occorsi alla mia visione nel corso di studi in oggetto, ed aventi come tema principale la patologia cordonale. Da ultimo presento gli atti del congresso ISUOG (International Society of Ultrasounds in Obst/Gyn) riguardanti nuove tecniche ecografiche di monitoraggio per interventi endoscopici in pazienti infertili.The results and conclusive reports of my Phellowship in Perinatal Medicine are enclosed within the final manuscript of the following thesis. My main research application fields were: 1. The study of fetal skinfolds by means of ultrasound evaluation. 2. The study of the impact of thrombophilias in pregnancy. My former research field dealed with the study of the fetal subcutaneous tissues and their detection by ultrasounds. I spent part of my Phellowship analyzing whether these innovative ultrasound parameters could add more informations to the worldwide used birthweight estimating conventional algorithms. Thus, the targets of my research in this first field were: to analyze the behaviour of fetal compartments in different physiological or pathological gestational conditions; to analyze the usefulness of the fetal skinfolds in ameliorating pre-existing birthweight estimating formulae; to build-up a mathematical model to predict term neonatal weight as a result of an integration between traditional and innovative fetal US parameters. The sum of my findings is elucidated in 4 published papers edited from year 2003 to year 2007. The latter research field deals with the correlation between connatal thrombophilias and the occurrence of adverse pregnancy outcomes. In fact by now I can show the result of this research by presenting two works that share the same setting with a different statistical viewpoint. The research is going on and other 2 manuscripts are away to be evaluated by the referees. Moreover, within the same document I show some clinical cases published as case reports (with or without a review), most of them dealing with umbilical cord pathologies. Eventually I bring also some proceedings from Congresses from the International Society of Ultrasound in Obstetrics and Gynaecology, also edited by the ISUOG official magazine

Severe Fetal Distress and Umbilical Cord Strangulation

We describe an extreme case of amniotic band syndrome, presented with fetal stress during labor and associated with strangulation of umbilical cord

A Rare Case of Asymptomatic Postmenopausal Tubercular Endometritis in Italy

Introduction: Tuberculosis affects about a third of world population. Genitourinary tuberculosis is one of the most common manifestations of extra pulmonary tuberculosis. Postmenopausal tubercular endometritis is an uncommon condition that usually occurs with abnormal vaginal bleeding.&nbsp;Aim: The aim of the paper is to report a rare case of asymptomatic postmenopausal tubercular endometritis.&nbsp;Case report: Trans-abdominal and trans-vaginal ultrasound performed in a 59 years-old Romanian asymptomatic woman showed a huge hypo-echoic area centrally located in the uterine shape and a severe endometrial hypo-echoic thickness ( &gt; 2 cm). Color Doppler did not detect any vascularity into this area. Magnetic Resonance Imaging (MRI) of the lower abdomen confirmed the severe endometrial thickness. The histopathological diagnosis obtained by biopsy during hysteroscopy documented tubercular endometritis. The patient started a medical treatment for tuberculosis. Forty days later a control ultrasound showed the fluidization of the caseous material in the uterine cavity.&nbsp;Discussion: The main localizations of genitourinary tuberculosis are primarily the fallopian tubes, then it spreads towards endometrium, cervix, vagina and ovaries. In post-menopausal age patients with tubercular endometritis usually present with a story of vaginal bleeding; however, patients may be asymptomatic or they may present aspecific symptoms. This usually leads to a delay in diagnosis and therapeutical interventions.&nbsp;Conclusions: Tubercular endometritis is a severe disease that may affect both pre- and postmenopausal woman. Symptoms could be absent or aspecific. Diagnosis is not simple and it often needs laparoscopy, laparotomy or hysteroscopy. Histology is needful for the correct diagnosis. A standard medical anti-tubercular therapy of 6 months is often sufficient to obtain a complete therapeutical response. In some selected cases surgery may be necessary. In our paper, an asymptomatic woman in post-menopausal age, affected by endometrial tuberculosis showed clinical response after a standard antitubercular medical therapy.</p

Detailed Investigation of the Low Energy Secondary Electron Yield of Technical Cu and its Relevance for LHC

The detailed study of the Secondary Electron Yield (SEY) of technical Cu for very low electron landing energies (from 0 to 30 eV) is very important for electron cloud build up in high intensity accelerators and in many other fields of research. However, this question has been rarely addressed due to the intrinsic experimental complexity to control very low energy electrons. Furthermore, several results published in the past have been recently questioned for allegedly suffering from experimental systematics. In this paper, we critically review the experimental method used to study low energy SEY and define more precise energy regions, in which the experimental data can be considered valid. The new SEY curves are then fed into e-cloud simulation codes to address their impact for electron cloud predictions in the LHC

Interface Formation between Diethynyl-Zn-porphyrin and C60 Investigated by SR-induced Photoemission Spectroscopy

C60 doping of multilayer 2,8,12,18-tetraethyl-5,15-diethynyl-3,7,13,17-tetramethylporphyrinato-Zn(II) (Zn-Pf) has been accomplished. The sublimed Zn-Pf molecules initially lay flat on the Cu(111) substrate and progressively tilt their arrangement in order to be oriented with the molecular plane nearly perpendicular to the Cu(111) substrate surface, at both monolayer and multilayer coverage, as detected by NEXAFS spectroscopy at the N K-edge. It is noteworthy that C60 interacts with the Zn-Pf sample film producing a perturbation of the electronic structure reflected in the spectral changes at the C1s core level, at the N1s and shake-up satellites of Zn-Pf and in the VB region. By the strong spectral modification that occurs at the Zn-Pf multilayer sample C60 diffusion into the substrate is also argued, giving rise most probably to an intercalated composite assembly with C60 spheres in between two Zn-Pf planes. The observed changes are interpreted in terms of charge transfer taking place from C60 to Zn-Pf with a lowering of the band gap and presence of occupied states closer to EF