Publications by authors named "Federica Marchesotti"

13 Publications

  • Page 1 of 1

The Mitral INsufficiency Echocardiographic score: A severity classification of myxomatous mitral valve disease in dogs.

J Vet Intern Med 2021 May 5;35(3):1238-1244. Epub 2021 May 5.

Department of Cardiology, Anicura Istituto Veterinario Novara, Granozzo con Monticello, Italy.

Background: There is no commonly shared severity score for myxomatous mitral valve disease (MMVD) based on routinely acquired echocardiographic variables.

Hypothesis/objectives: To propose an easy-to-use echocardiographic classification of severity of MMVD in dogs.

Animals: Five hundred and sixty dogs with MMVD.

Methods: This was a retrospective, multicenter, observational study. The proposed Mitral INsufficiency Echocardiographic (MINE) score was based on 4 echocardiographic variables: left atrium-to-aorta ratio, left ventricular end-diastolic diameter normalized for body weight, fractional shortening, and E-wave transmitral peak velocity. Specific echocardiographic cutoffs were defined based on previous prognostic studies on MMVD, and severity scores were assigned as follows: mild (score: 4-5), moderate (score: 6-7), severe (score: 8-12), late stage (score: 13-14).

Results: Median survival time was significantly different (P < .05) between the proposed severity classes: mild (2344 days, 95% confidence interval [CI] 1877-2810 days), moderate (1882 days, 95% CI 1341-2434 days), severe (623 days, 95% CI 432-710 days), and late stage (157 days, 95% CI 53-257 days). A MINE score >8 was predictive of cardiac death (area under the curve = 0.85; P < .0001; sensitivity 87%, specificity 73%). In the multivariable analysis, all the echocardiographic variables of the MINE score were independent predictors of death because of heart disease (P < .001).

Conclusions And Clinical Importance: The MINE score is a new easy-to-use echocardiographic classification of severity of MMVD, which has been proven to be clinically effective as it is associated with survival. This classification provides prognostic information and could be useful for an objective echocardiographic assessment of MMVD.
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http://dx.doi.org/10.1111/jvim.16131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8163114PMC
May 2021

Repair of a rectovesical fistula following laparoscopic radical prostatectomy with Martius fat pad flap interposition: a proposal of a new technique.

Turk J Urol 2021 Jan 26;47(1):81-85. Epub 2020 Oct 26.

Department of Urology, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.

Rectovesical fistula (RVF) is defined as an abnormal communication between the rectum and the urinary bladder, most commonly after an iatrogenic injury during pelvic surgery. Patients with RVF may have various clinical presentations, ranging from fecaluria, pneumaturia, to urine leakage through the anus. The quality of life for patients with this pathology is adversely affected owing to the associated psychological burden. Surgery is the preferred treatment given the low success rates reported for conservative or minimally invasive approaches. Herein, we present a case of a 65-year-old man with RVF after radical prostatectomy successfully treated by a transperineal approach using a modified Martius procedure.
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http://dx.doi.org/10.5152/tud.2020.20356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815234PMC
January 2021

Urologic surgery and invasive procedures during coronavirus pandemic: Retrospective comparison of risk infection in a referral Covid hospital and in a free-Covid hospital.

Urologia 2020 May 10:391560320927106. Epub 2020 May 10.

Department of Urology, ASST FBF Sacco, Milan, Italy.

Introduction: On 21 February 2020, 'Luigi Sacco' Hospital was identified as a Covid-19 referral Hospital in Lombardy. The Department of Urology of our Healthcare Institution consists of two Urology Units, one at 'L.Sacco' Hospital (hereinafter referred to as Covid-19 hospital) and one at 'Fatebenefratelli' Hospital (hereinafter referred to as Covid-19-free hospital). The Healthcare System's Administration communicated to all personnel the implementation of a planned 'biological risk protocol' at the Covid-19 hospital, while the Covid-19-free hospital followed regular government recommendations. We evaluated the risk of Sars-Cov-2 infection in the patients treated for surgical or invasive urologic procedures during the epidemic in the two different hospitals.

Materials And Methods: At the Covid-19 hospital, 12 patients underwent surgery and 51 patients invasive diagnostic procedures between 22 February and 8 March 2020; in the same period, at the Covid-19-free hospital, 21 patients underwent surgery and 56 patients invasive diagnostic procedures. We compared the incidence of Sars-Cov-2 infection among the patients who were accessed in the two Urology Units in the period of different restrictive measures after the outbreak of the epidemic.

Results: We registered no cases of Sars-Cov-2 infection in the patients hospitalized in that period in Covid-19 hospital, despite three cases of swab positivity in the Covid-19-free hospital.

Conclusion: The early implementation of extraordinary measures to restrict the spread of the virus offers a good protection also in a Covid-19 referral Hospital. The adoption of safety measures may be considered even after the end of the pandemic in all the health systems.
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http://dx.doi.org/10.1177/0391560320927106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549281PMC
May 2020

Left atrial anteroposterior diameter in dogs: reference interval, allometric scaling, and agreement with the left atrial-to-aortic root ratio.

J Vet Med Sci 2019 Dec 14;81(11):1655-1662. Epub 2019 Oct 14.

Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy.

Left atrial enlargement (LAE) is a well-known negative prognostic factor in dogs with myxomatous mitral valve disease (MMVD). Left atrial-to-aortic root ratio (LA/Ao) is the most commonly used method to evaluate left atrial (LA) size in dogs, while the left atrial anteroposterior diameter (LAD) has been proposed as an additional measurement of LA size in different species. The aim of this study was to establish a normal reference range of LAD normalized to body weight (LADn) in dogs using allometric scales, and to evaluate the agreement between LADn and LA/Ao in the detection of LAE in dogs with MMVD. This was a retrospective, multicenter, observational study. We included 330 healthy dogs, 30 dogs with MMVD in ACVIM stage B1, 30 dogs in ACVIM stage B2, and 30 dogs in ACVIM stage C. The reference range for the LAD, depending on body weight, was between 16.91 mm and 49.68 mm. The reference range for the LADn in healthy dogs was between 10.49 and 15.72. LADn was significantly greater in dogs with MMVD compared to healthy dogs, and a significant difference in LADn was noted between different ACVIM stages (P<0.001). The most accurate cut-off value of LADn to differentiate between dogs in groups B2 and C was 20.3 (sensitivity, 83.3%; specificity, 83.3%). There was a misclassification rate of 37% between LADn and LA/Ao in the detection of LAE in group B1. This study provides a normal reference range for LAD in dogs, which can be used as an additional tool to assess LAE in dogs with MMVD.
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http://dx.doi.org/10.1292/jvms.19-0240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895628PMC
December 2019

Combined interventional procedure and cardiopulmonary bypass surgery in a dog with cor triatriatum dexter, patent foramen ovale, and pulmonary stenosis.

J Vet Intern Med 2019 Sep 5;33(5):2227-2234. Epub 2019 Aug 5.

Istituto Veterinario di Novara, Novara, Italy.

A 2-year-old American Pit Bull dog was presented for surgical evaluation of imperforate cor triatriatum dexter (CTD) and patent foramen ovale (PFO). Echocardiography identified an imperforate CTD associated with a right-to-left shunting PFO and valvular pulmonary stenosis. A 2-step interventional and surgical approach was used. Initially, a pulmonary balloon valvuloplasty was performed, and subsequently the dog underwent a surgical correction of the atrial anomaly under cardiopulmonary bypass.
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http://dx.doi.org/10.1111/jvim.15580DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766562PMC
September 2019

Left shift of the ventricular mean electrical axis in healthy Doberman Pinschers.

J Vet Med Sci 2019 Apr 11;81(4):620-625. Epub 2019 Mar 11.

Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy.

In canine electrocardiography, the reference interval of the ventricular mean electrical axis (MEA) is between +40° and +100°. MEA values in dogs can be influenced by the patient position as well as by the shape of the thorax. The aim of this study was to evaluate the MEA in healthy Doberman Pinschers, hypothesizing that some present a left shift of the MEA. In this retrospective study, 41 healthy, client-owned Doberman Pinschers were included. Echocardiography and standard six-lead ECG examination were performed in all dogs. The MEA was calculated using the isoelectric method. The morphology of the QRS complex and the Q/R ratio in lead II were also evaluated. The median MEA was +45° and ranged from -45° to +90°. MEA was deviated in 16/41 dogs (39%), all presenting a left axis deviation (range, -45° to + 30°). Age was significantly associated with the MEA (P=0.008), showing a negative linear correlation. A deep Q wave in lead II was present in 26/41 (63%) dogs. The Q/R ratio was higher in dogs presenting left shift of the MEA (0.66; range, 0.28-1.35) in comparison to dogs with a MEA within reference range (0.44; range, 0.04-0.73; P<0.001). In conclusion, a significant number of healthy Doberman Pinschers present a left shift of the MEA compare to the reference range, and dogs with MEA deviation show a higher Q/R ratio in lead II. This data should be considered when electrocardiographic evaluation is performed in Doberman Pinschers.
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http://dx.doi.org/10.1292/jvms.18-0699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483916PMC
April 2019

Home monitoring of heart rate and heart rhythm with a smartphone-based ECG in dogs.

Vet Rec 2019 Jan 17;184(3):96. Epub 2018 Dec 17.

Department of Cardiology, Istituto Veterinario di Novara, Novara, Italy.

The feasibility of the home monitoring of heart rate (HR) and rhythm through ECG tracings recorded by owners with a smartphone ECG device was evaluated in dogs. Smartphone ECG tracings were recorded by owners at home using a single-lead ECG device and sent via email for interpretation. A questionnaire was prepared to assess the owner's opinion regarding this home monitoring service. Recordings were evaluated by two operators, and agreement was evaluated for HR and rhythm diagnosis. Thirty-three dogs were included. Thirty-one owners (94 per cent) felt that the recording technique was easy to learn and that the smartphone ECG device was easy to use. A total of 15 owners (45 per cent) required a second person to hold the dog during recording. Of the 150 smartphone ECG tracings that were received, 134 (89 per cent) were interpretable. The median difference between the two operators to assess the mean HR on the smartphone tracings was 10 bpm (-10, +25 bpm). Perfect agreement (κ=1) between operators was observed in the heart rhythm evaluation. Most owners sent adequate ECG tracings for interpretation via email from their smartphone. Home monitoring of HR and heart rhythm may represent an additional tool in the management of dogs with arrhythmias.
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http://dx.doi.org/10.1136/vr.104917DOI Listing
January 2019

Echocardiographic evaluation of the right ventricular dimension and systolic function in dogs with pulmonary hypertension.

J Vet Intern Med 2018 Sep 14;32(5):1541-1548. Epub 2018 Sep 14.

Department of Veterinary Sciences, University of Pisa, Pisa, Italy.

Background: Right ventricular (RV) enlargement and dysfunction are associated with prognosis in humans with pulmonary hypertension (PH).

Hypothesis/objectives: To assess RV size and systolic function in dogs with PH and to determine if they are associated with disease severity and right-sided congestive heart failure (R-CHF).

Animals: 89 dogs with PH and 74 healthy dogs.

Methods: Prospective observational study. PH was classified according to the tricuspid regurgitation pressure gradient. RV end-diastolic area (RVEDA) index was calculated as RVEDA divided by body surface area. RV systolic function was assessed with the tricuspid annular plane systolic excursion (TAPSE) and the RV fractional area change (FAC) normalized for body weight (TAPSEn and FACn, respectively).

Results: RVEDA index was higher in dogs with moderate PH (10.8 cm /m ; range, 6.2-14.4 cm /m ) and severe PH (12.4 cm /m ; range, 7.7-21.4 cm /m ) than in those with mild PH (8.4 cm /m ; range, 4.8-11.6 cm /m ) and control dogs (8.5 cm /m ; range, 2.8-11.6 cm /m ; P < .001). RVEDA index was significantly higher in dogs with R-CHF (13.7 cm /m ; range, 11.0-21.4 cm /m ) than in dogs without R-CHF (9.4 cm /m ; range, 4.8-17.1 cm /m ; P < .001). The severity of tricuspid regurgitation (TR) was the only independent predictor of the RVEDA index (P < .001). TAPSEn and FACn were not significantly different among varying degrees of PH severity and between dogs with and without R-CHF.

Conclusions And Clinical Importance: The RVEDA index can be used to evaluate RV size in dogs. It can provide additional information in dogs with PH and predict R-CHF. Severity of TR is the main determinant of RV enlargement in dogs with PH.
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http://dx.doi.org/10.1111/jvim.15253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189358PMC
September 2018

ECG of the Month.

J Am Vet Med Assoc 2018 Apr;252(7):808-810

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http://dx.doi.org/10.2460/javma.252.7.808DOI Listing
April 2018

Computed tomography, radiology and echocardiography in cats naturally infected with Aelurostrongylus abstrusus.

J Feline Med Surg 2017 Apr 9;19(4):446-453. Epub 2016 Jul 9.

1 Department of Diagnostic Imaging, Istituto Veterinario di Novara, Novara, Italy.

Objectives The aims of the study were to describe the radiographic and computed tomographic features in cats naturally infected with Aelurostrongylus abstrusus, and to identify signs of pulmonary hypertension with echocardiography. Methods Fourteen cats positive on Baermann test for A abstrusus were included in the study. All cats underwent thoracic radiography, CT and echocardiography. Results The most common clinical signs were coughing (10/14) and dyspnoea (5/14). Radiographic findings included a generalised unstructured interstitial pulmonary pattern (8/14), mixed bronchointerstitioalveolar pattern (3/14) and bronchointerstitial pattern with bronchial wall thickening (3/14). Sternal lymphadenopathy was detected on thoracic radiographs in six cats. On CT, features were mixed bronchointerstitioalveolar pattern with ground-glass appearance in six cats, interstitioalveolar with multiple pulmonary nodules in five, interstitial ground-glass infiltrates in three, regional lymph node enlargement in 11 (10 sternal, three cranial mediastinal and three tracheobronchial lymph nodes) and subpleural thickening in four. None of the thoracic radiographs revealed subpleural thickening. In all cases, pulmonary vessels were normal in terms of size, shape and attenuation on both radiography and CT. Pulmonary hypertension and cardiac abnormalities were not observed in any cat during echocardiography. Conclusions and relevance CT provided a more thorough characterisation of pulmonary and mediastinal lesions compared with thoracic radiographs in cats naturally infected with A abstrusus. Although feline aelurostrongylosis has been previously associated with histopathological lesions in lung arteries, in this cohort clinical evidence of pulmonary hypertension was not documented.
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http://dx.doi.org/10.1177/1098612X16636419DOI Listing
April 2017

Effect of potential renal acid load of foods on urinary citrate excretion in calcium renal stone formers.

Urol Res 2006 Feb 20;34(1):1-7. Epub 2006 Jan 20.

Urology Unit, Lecco Hospital, Lecco, Italy.

The aim of this study was to investigate the influence of the potential renal acid load (PRAL) of the diet on the urinary risk factors for renal stone formation. The present series comprises 187 consecutive renal calcium stone patients (114 males, 73 females) who were studied in our stone clinic. Each patient was subjected to an investigation including a 24-h dietary record and 24-h urine sample taken over the same period. Nutrients and calories were calculated by means of food composition tables using a computerized procedure. Daily PRAL was calculated considering the mineral and protein composition of foods, the mean intestinal absorption rate for each nutrient and the metabolism of sulfur-containing amino acids. Sodium, potassium, calcium, magnesium, phosphate, oxalate, urate, citrate, and creatinine levels were measured in the urine. The mean daily PRAL was higher in male than in female patients (24.1+/-24.0 vs 16.1+/-20.1 mEq/day, P=0.000). A significantly (P=0.01) negative correlation (R=-0.18) was found between daily PRAL and daily urinary citrate, but no correlation between PRAL and urinary calcium, oxalate, and urate was shown. Daily urinary calcium (R=0.186, P=0.011) and uric acid (R=0.157, P=0.033) were significantly related to the dietary intake of protein. Daily urinary citrate was significantly related to the intakes of copper (R=0.178, P=0.015), riboflavin (R=0.20, P=0.006), piridoxine (R=0.169, P=0.021) and biotin (R=0.196, P=0.007). The regression analysis by stepwise selection confirmed the significant negative correlation between PRAL and urinary citrate (P=0.002) and the significant positive correlation between riboflavin and urinary citrate (P=0.000). Urinary citrate excretion of renal stone formers (RSFs) is highly dependent from dietary acid load. The computation of the renal acid load is advisable to investigate the role of diet in the pathogenesis of calcium stone disease and it is also a useful tool to evaluate the lithogenic potential of the diet of the individual patient.
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http://dx.doi.org/10.1007/s00240-005-0001-9DOI Listing
February 2006