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Scioscia C.,University of Bari | Scioscia M.,Sacro Cuore Don Calabria General Hospital | Scioscia M.,University of Rome Tor Vergata | Anelli M.G.,University of Bari | And 3 more authors.
Clinical and Experimental Rheumatology | Year: 2011

Objectives: Rheumatoid arthritis is associated with an increased risk of adverse pregnancy outcomes. TNF inhibitors are effective in the treatment of signs and symptoms of the disease although their safety during pregnancy is debated. Methods: Two cases of women with rheumatoid arthritis in complete remission of the disease with etanercept who decided to continue the therapy throughout their pregnancy are presented. A longitudinal evaluation of the disease activity showed a satisfactory control and good pregnancy outcomes were obtained. A flare of the disease after delivery was not observed. Conclusions: Etanercept seems to be safe during pregnancy and lactation. Good control of the activity of the disease was reported throughout the pregnancy and during puerperium, when a reactivation of rheumatoid arthritis is often observed. © Clinical And Experimental Rheumatology 2011.

Scardapane A.,University of Bari | Lorusso F.,University of Bari | Scioscia M.,Sacro Cuore Don Calabria General Hospital | Ferrante A.,University of Bari | And 2 more authors.
European Radiology | Year: 2014

Objective: To compare the capabilities of standard pelvic MRI with low-resolution pelvic MRI using fast breath-hold sequences to evaluate deep infiltrating endometriosis (DIE).Methods: Sixty-eight consecutive women with suspected DIE were studied with pelvic MRI. A double-acquisition protocol was carried out in each case. High-resolution (HR)-MRI consisted of axial, sagittal, and coronal TSE T2W images, axial TSE T1W, and axial THRIVE. Low-resolution (LR)-MRI was acquired using fast single shot (SSH) T2 and T1 images. Two radiologists with 10 and 2 years of experience reviewed HR and LR images in two separate sessions. The presence of endometriotic lesions of the uterosacral ligament (USL), rectovaginal septum (RVS), pouch of Douglas (POD), and rectal wall was noted. The accuracies of LR-MRI and HR-MRI were compared with the laparoscopic and histopathological findings.Results: Average acquisition times were 24 minutes for HR-MRI and 7 minutes for LR-MRI. The more experienced radiologist achieved higher accuracy with both HR-MRI and LR-MRI. The values of sensitivity, specificity, PPV, NPV, and accuracy did not significantly change between HR and LR images or interobserver agreement for all of the considered anatomic sites.Conclusions: LR-MRI performs as well as HR-MRI and is a valuable tool for the detection of deep endometriosis extension. © 2014, European Society of Radiology.

Scioscia M.,Sacro Cuore Don Calabria General Hospital | Scioscia F.,Polytechnic of Bari | Scioscia G.,IBM | Bettocch S.,University of Bari
Archives of Gynecology and Obstetrics | Year: 2015

Purpose The accuracy of sonographic estimation of birth weight (EBW) is compromised by the precision of the biometrical measurements and the quality of the algorithms. This prospective study was to evaluate technical aspects to derive new equations for the EBW. Methods Three consecutive phases were carried out (1) to recruit a homogenous population, (2) to derive eight new algorithms using a multiple stepwise mathematical/statistical method, and (3) to test the accuracy of the developed equations. Only those patients with a singleton pregnancy who delivered within 48 h from the scan were considered for the analysis. Results The study population was made of 473 women. Four polynomial, two square root and two logarithmic algorithms were derived from a balanced study group of 200 women selected from the original study population. These formulas were subsequently applied and compared between them and showed a significant correlation with birth weight (p\0.0001) and satisfactory statistical performances (r[0.9), nevertheless they performed similarly to other equations previously published. Conclusions The present findings define better the limitations associated with the intrinsic properties of algorithms and highlight that the possibility to improve the precision of sonographic measurements remains the only point at issue to increase the accuracy in the prediction of birth weight. © Springer-Verlag Berlin Heidelberg 2014.

Scioscia M.,Sacro Cuore Don Calabria General Hospital | Siwetz M.,Medical University of Graz | Fascilla F.,University of Bari | Huppertz B.,Medical University of Graz
Placenta | Year: 2012

Abnormalities in glucose metabolism linked to d-chiro-inostol phosphoglycans (IPGs) have been described in human placentas of preeclamptic women. In this study, a semi-quantitative approach to assess the histological assessment of IPGs revealed no significant differences between early and late onset preeclampsia and gestational age matched controls. However, there was a tendency towards higher values in early onset preeclampsia for villous stroma and placental vessels. Moreover, in control cases staining of plasma in placental vessels was present only in one part of vessels of mature intermediate villi while in preeclamptic specimens all placental vessels showed a similar staining. The tendencies of more staining in villous stroma associated with a differential staining of placental vessels only in preeclamptic specimens support a vectoral movement of d-chiro-inositol phosphoglycans from the fetus to the placenta. © 2012 Elsevier Ltd. All rights reserved.

Ceci O.,University of Bari | Cantatore C.,University of Bari | Scioscia M.,Sacro Cuore Don Calabria General Hospital | Scioscia M.,University of Rome Tor Vergata | And 4 more authors.
Journal of Obstetrics and Gynaecology Research | Year: 2012

Aim: A common anatomical consequence of low-segment cesarean section is the presence of a pouch on the anterior uterine wall that can be detected by sonography or hysteroscopy. Different suturing techniques have been compared (single vs double layer) and showed no substantial differences. This prospective longitudinal study was aimed at evaluating the outcome of the cesarean scar, comparing two different types of single-layer sutures by transvaginal ultrasound and hysteroscopy. Material and Methods: The study sample consisted of two groups of 30 singleton primiparae at term who delivered by elective low segment cesarean section. In the first group, uterine closure was done with locked continuous single-layer sutures and in the second group, with single-layer interrupted sutures. Patients were assessed by transvaginal ultrasound and hysteroscopy, between the 6th and the 12th month after delivery, and again at the 24th month. Ultrasound measurements were made of the pouch area, if present. Results: A bell-shaped uterine wall defect was seen at ultrasound in 36 (85.71%) of 42 patients who completed the follow up at the 24th month. It was larger in the group of patients with closure by continuous sutures (6.2 [2.1-14.7] mm2) as compared to interrupted sutures (4.6 [1.9-8.2] mm2, P = 0.03). Hysteroscopy confirmed the presence of the wall defect in all 36 cases, but different hysteroscopic outcomes were observed. Conclusion: Locked continuous sutures seem to cause a larger defect as compared to interrupted sutures, probably due to a greater ischemic effect exerted on the uterine tissue © 2012 The Authors.

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