[ Long-term evaluation of the effect of a chemotherapy protocol using vincristine, adriamycin, procarbazine and prednisone (VAPP) on advanced Hodgkin's disease]. / Valutazione a distanze dell'attività sul morbo di hodgkin evoluto di un protocollo chemioterapico utilizzante vincristina, adriamicina, procarbazina, prednisone (VAPP).

A chemotherapeutic combination associating vincristine, adriamycin, procarbazine and prednisone (VAPP) was evaluated in Hodgkin's disease. Subjects were either far advanced cases or relapsing after MOPP and/or radiation therapy. 50 cases were evaluable. After 6 months of treatment 80% of the cases achieved a complete remission. After 30 months 87% of the patients still survive and 60% were still in complete remission. The good tolerance of this chemotherapeutic combination and the results described above, suggest that VAPP may be useful in all cases when MOPP is not well tolerated or is not active.

[Acute pancreatitis and hyperlipoproteinemia]. / Pancreatite acute e iperlipoproteinemia

About 10 patients admitted with acute pancreatitis were also, found to have Fredrikson type V hyperlipoproteinaemia. Eight were males aged less than 45 yr. Awareness of the aetiopathogenetic and metabolic aspects of this increasingly common association and its clinical identification form the sine qua non in the prevention of recurrences via marked dietary restriction of fats.

Progressive supranuclear palsy and In111-DTPA cisternography.

Three cases of progressive supranuclear palsy are reported in which In111-DTPA cisternography showed slow diffusion, ventricular reflux and failure of isotope clearance. The clinical diagnosis of progressive supranuclear palsy was confirmed histologically in two of these patients. The possible causes of the cisternographic changes and their relationship to the changes of CSF dynamics in progressive supranuclear palsy are discussed.

Specialty-related differences in the epidemiology, clinical profile, management and outcome of patients hospitalized for heart failure; the OSCUR study. Oucome dello Scompenso Cardiaco in relazione all'Utilizzo delle Risore.

AIMS: This study was designed to identify potential specialty-related differences in the epidemiology, clinical profile, management and outcome of patients hospitalized for congestive heart failure in departments of cardiology or internal medicine. METHODS AND RESULTS: From 1 July to 31 December 1998, we prospectively recorded epidemiological and clinical data from patients with congestive heart failure consecutively admitted to 11 departments of cardiology and 12 departments of internal medicine in Liguria, a northern area of Italy. The overall study population included 749 patients; 22% were treated by cardiologists and 78% by internists (P<0.0001). Patients managed by cardiologists were more likely to undergo echocardiography (92% vs 37%), Holter monitoring (25% vs 3%) and exercise stress testing (20% vs 0.5%) than those managed by internists (P=0.001). At discharge, patients treated by cardiologists were more likely to be prescribed beta-blockers (41% to 4%) and ACE inhibitors (100% to 74%) than those treated by internists (P<0.0001), and the latter medication at higher dosages by cardiologists than internists. In addition, patients followed by cardiologists were younger (70+/-9 to 79+/-1 years;P<0.0001), more likely to be male (61% to 50%;P=0.011) and to have coronary artery disease (57% to 45%;P<0.006) than those followed by internists. Conversely, patients followed by internists were more likely to have diabetes, chronic obstructive pulmonary disease, atrial fibrillation and renal failure (P<0.03). In the overall study population, 53 patients (7%) died during hospitalization. Patients treated by cardiologists had a mortality not significantly different from that of patients treated by internists (10% and 6%, respectively;P=0.067), although congestive heart failure was more severe on admission in patients treated by cardiologists. CONCLUSION: Cardiologists follow published guidelines for congestive heart failure more strictly than internists, but treat a smaller number of patients who are younger, have more severe congestive heart failure and fewer co-morbidities than those managed by internists.