Publications by authors named "Maria Carmela Muraca"

4 Publications

  • Page 1 of 1

Nitric oxide in neonatal hypoxemic respiratory failure.

J Matern Fetal Neonatal Med 2012 Apr 12;25 Suppl 1:47-50. Epub 2012 Mar 12.

Departments of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.

Nitric oxide (NO) is a cellular signaling molecule and a powerful vasodilator. NO modulates basal pulmonary vascular tone and it is important to reduce blood pressure and to treat hypoxemic respiratory failure, such as persistent pulmonary hypertension (PPHN) in newborns. PPHN is defined as a failure of normal pulmonary vascular adaptation at or soon after birth, resulting in a persisting high pulmonary vascular resistance. iNO therapy decreases the need of extracorporeal membrane oxygenation (ECMO) although it did not reduce mortality of these patients. Severe meconial aspiration syndrome is associated with PPHN, resulting in severe hypoxemia; iNO administration combined with HFV results in ameliorate oxygenation. The cause of hypoxemic respiratory failure in patients with congenital diaphragmatic hernia (CDH) is complex. CDH patients experienced oxygenation improvement after iNO therapy, but they can be often considered iNO poor responders. In some cases iNO therapy can reduce the need of ECMO in presurgical stabilization. The pathophysiology of respiratory failure and the potential risks differ substantially in preterm infants. Pulmonary hypertension can complicate respiratory failure in preterm babies. Current evidence does not support use of iNO in early routine, early rescue or layer rescue regimens in the care of preterm infants.
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http://dx.doi.org/10.3109/14767058.2012.665238DOI Listing
April 2012

Therapeutic hypothermia in a late preterm infant.

J Matern Fetal Neonatal Med 2012 Apr 7;25 Suppl 1:125-7. Epub 2012 Mar 7.

Department of Pediatrics, Obstetrics and Reproductive Medicine, Neonatal Pediatrics Section, Siena University Hospital, Siena, Italy.

Therapeutic hypothermia is a recognized treatment for term infants with hypoxic-ischemic encephalopathy (HIE) in reducing rate of death or neurodevelopmental disabilities. Little is known about applications of this treatment to preterm newborns. Studies in animal experimental models demonstrated the efficacy of hypothermia in preterm fetuses but clinical application to newborn infants are limited to restricted cases, as severe necrotizing enterocolitis (NEC). We present a case of therapeutic whole body cooling in a baby at 34 weeks and 6 days of gestational age with HIE.
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http://dx.doi.org/10.3109/14767058.2012.663172DOI Listing
April 2012

A child with vestibular neuritis. is adenovirus implicated?

Brain Dev 2006 Jul 28;28(6):410-2. Epub 2006 Feb 28.

Department of Pediatrics, Section of Pediatric Neurology, Policlinico Le Scotte, University of Siena, Siena, Italy.

Vertigo in children is relatively under examined in the literature. Among its causes, vestibular neuritis (VN) represents only 2% of cases, with its etiology remaining unknown. We report for the first time a 4-year-old boy with vestibular neuritis and serological results compatible with adenoviral infection. Serological diagnosis was performed on the basis of a rise and consequent normalization of complement fixation (CF) titers of the plasma antibodies. Although we were not able to detect exactly when the infection started, we were able to detect an increased level of adenovirus antibodies by CF titers, followed by a decrease (i.e. 1/16, then 1/8, then <1/4) during the recovery. This is typical of a resolving infection. Furthermore, that this increase in antibodies was specific to an adenovirus infection was suggested by the observation that we did not detect increases in antibodies to other common viruses (i.e. herpes simplex and zoster viruses, Epstein-Barr virus, cytomegalovirus, influenza and parainfluenza viruses). This allows us to exclude the chance of nonspecific antibody activation. We concluded that, although our data do not formally demonstrate an involvement of adenovirus in VN, they suggest such an involvement. This may be of interest, given that a viral etiology for VN has been proposed but not definitively proven.
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http://dx.doi.org/10.1016/j.braindev.2005.12.001DOI Listing
July 2006

Craniofacial dyssynostosis: case report and review.

Am J Med Genet A 2004 Sep;129A(3):300-2

Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.

Craniofacial dyssynostosis (CFD) is a rare disorder related to premature closure of the lambdoid suture and the posterior part of the sagittal suture. Epilepsy, mental retardation, abnormalities of the corpus callosum, and short stature have been reported. We studied a patient with CFD, hydronephrosis, and partially empty sella turcica; the latter two features are reported for the first time. We discuss the brain anomalies and their neurologic sequelae, which are part of the CFD phenotype.
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http://dx.doi.org/10.1002/ajmg.a.30186DOI Listing
September 2004