Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy.

Context: The definition of what constitutes a normal TSH during pregnancy is in flux. Recent studies suggested that the first trimester upper limit of normal for TSH should be 2.5 mIU/liter.

Serum proteomic profile of cutaneous malignant melanoma and relation to cancer progression: association to tumor derived alpha-N-acetylgalactosaminidase activity.

Currently clinical outcome in melanoma is not predictable by known serum biomarkers. The only reliable tool for the diagnosis of this tumor is the histopathological assay after surgical removing. We used a proteomic approach in order to identify novel non-invasive serum biomarkers of melanoma.

Gross hematuria due to acquired haemophilia in hereditary hemorrhagic telangiectasia.

Hereditary haemorrhagic telangiectasia (HHT, Osler-Weber-Rendu syndrome) is a rare inherited disease; acquired haemophilia, caused by factor VIII inhibitors, is a rare autoimmune disorder. Both diseases cause bleeding manifestations. We report a case of a young woman affected by hereditary haemorrhagic telangiectasia who was admitted to our unit because of gross hematuria.

Endothelial effects of antihypertensive treatment: focus on irbesartan.

The endothelium is characterized by a wide range of important homeostatic functions. It participates in the control of hemostasis, blood coagulation and fibrinolysis, platelet and leukocyte interactions with the vessel wall, regulation of vascular tone, and of blood pressure. Many crucial vasoactive endogenous compounds are produced by the endothelial cells to control the functions of vascular smooth muscle cells and of circulating blood cells.

Selenium and thyroid autoimmunity.

The trace element selenium (Se) occurs in the form of the amino acid selenocysteine in selenoproteins. Selenoproteins exerts multiple physiological effects in human health, many of which are related with regulation of reduction-oxidation processes. In fact, the selenoenzyme families of glutathione peroxidase (GPx) and thioredoxin reductase (TRx) display the ability to act as antioxidants, protecting cells from oxidative damage.

Morphological MRI and 3D Myelocisternography MRI in Spontaneous Intracranial Hypotension. A Report of Four Cases.

Spontaneous intracranial hypotension (SIH) is a polyhedric syndrome whose common denominator is postural headache. We describe four cases of spontaneous intracranial hypotension, their clinical-iconographic aspects, and emphasize the use of morphological MRI in the diagnosis and follow-up of this condition. In addition, we propose 3D myelocisternography MRI as a further contribution in cerebrospinal fluid losses causing postural headache.

Modified transmanubrial osteomuscular sparing approach for resection of T1 vertebral tumor.

We report a technical modification of the classic transmanubrial osteomuscular sparing approach described by Grünenwald and Spaggiari for the treatment of a T1 vertebral tumor. The goal of the surgical treatment for spinal tumors of the cervico-thoracic area is to excise the vertebral tumor, reconstruct the spinal column, and place an internal fixation device to achieve immediate stabilization. The procedure was necessary for treating a patient who presented with an invasion of T1 vertebral body by multiple myeloma with initial neurological symptoms of epidural spinal cord compression.

Early experiences of intraoperative ultrasound guided angioplasty of the arterial stenosis during upper limb arteriovenous fistula creation.

In recent years the high prevalence of diabetes and atherosclerosis in elderly uremic patients starting hemodialysis (HD) has led to the increase in the risk of vascular access (VA) failure caused by pre-existing arterial diseases, including both VA slow maturation and early failure, and upper limb ischemic symptoms. Recently, in performing radial (R), brachial (B) and ulnar (U) artery (A) percutaneous transluminal angioplasty (PTA) in HD patients affected by access thrombosis, with insufficient blood flow and severe upper limb ischemia, good outcomes have been reported. Nevertheless, these procedures were performed after arteriovenous fistula (AVF) creation.

Preoperative integrated imaging in paediatric cochlear implantation.

Sensorineural hearing loss affects one to two children out of 1000 born apparently healthy and 9% approximately of those born with the risk of different pathologies. The origin of premature deafness is unknown in 25% of children whereas it is genetic in some cases. Prevention and early diagnosis, possibly within six to eight months, aim to avoid deafness becoming a cause of disability.

Equine pericardium for dural grafts: clinical results in 200 patients.

Aim: Serous sheets are currently used in Neurosurgery as dural substitute. The aim of this study is to demonstrate that the horse pericardium, which has the essential charasteristics of reabsorbable membranes and moreover is BSE-free, is an excellent dural substitute.

Methods: 200 patients, 53 suffering from cranial traumatic conditions and 97 from cranial and craniospinal neoplastic pathologies, underwent a surgical procedure with the application of horse pericardium as a dural prosthesis.

Extra-laryngeal manifestations of gastro-oesophageal reflux.

Of the various otorhinolaryngological disorders for which it has been recognized that gastro-oesophageal reflux is a possible causal or associated aetiological factor, those manifestations localized in the rhino-sinus and auricular district are certainly the "least studied". Herein, therefore, these manifestations are described, focusing on the physio-pathological aspects and the more important pathogenic hypotheses of the cough, as well as other lung manifestations.

Cervical anterior hyperostosis: a rare cause of dysphagia. Report of 3 cases.

Disorders of the cervical spine rarely cause dysphagia and/or dysphonia. Exuberant osteophytosis, secondary to diffuse idiopathic skeletal hyperostosis, also referred to as Forestier's disease, seems to be the predominant cause. Forestier's disease is a non inflammatory enthesopathy, of unknown etiology, ossifying the anterior longitudinal ligament of the spine, sparing the discs, and usually affecting older men.

Ultrasound guided brachial arterial angioplasty during the creation of a radio-cephalic arteriovenous fistula: a case report.

Unlabelled: To prevent arteriovenous fistula (AVF) early failure, due to radial or brachial artery stenosis, ultrasound guided angioplasty performed while surgically creating the AVF could be an effective procedure.

Case Report: A 76-year-old diabetic male patient, on hemodialysis (HD) for 15 months, presented extensive thrombosis of the radio-cephalic AVF at the right arm, which had lasted for about 10 days. Ultrasound examination showed a 40% brachial artery stenosis with eccentric calcified plaque.

Cauda equina melanoma presenting with subarachnoid hemorrhage. A case report.

The case of a 57-year-old woman with a primary melanoma of the cauda equina is reported. The peculiarity of the case is the very rare clinical presentation mimicking a subarachnoid hemorrhage. The patient underwent surgical excision of the mass.

The microsurgical approach to extraforaminal lumbar disc herniations. An analysis of 15 cases.

Aim: Extraforaminal lumbar disc herniations are uncommon, but thanks to recent progress in imaging procedures, they may be easily diagnosed. Several surgical approaches have been described and employed to remove these herniations. The aim of this study is to evaluate the clinical, radiological and surgical features which differentiate the treatment of this type of hernia from the more common surgical approaches to other types of lumbar disc hernias.

Placement of peritoneal dialysis catheter by percutaneous method with the Veress needle.

In our center, a total of 451 peritoneal dialysis catheters were implanted in 424 uremic patients from 1986 to 1999. All catheters were implanted by the percutaneous method of Di Paolo. From 1986 to May 1997 (period A), we inserted 389 catheters using the Weston-Roberts catheter armed with a metallic sharp mandrel for the first access to the peritoneal cavity.

Multifocal extraovarian serous carcinoma. A histochemical and immunohistochemical study.

Three cases of multifocal extraovarian serous carcinoma are presented. This rare, interesting tumor is characterized by a peritoneal carcinosis with ascites and by a histological pattern similar to one of the ovarian serous carcinoma without primary involvement of the ovaries. The pathological criteria for a differential diagnosis between this condition and a localization of ovarian carcinoma are discussed.