[A study of the distribution of some risk factors in patients with myocardial infarct. Different cardiovascular prevention methods in relation to age]. / Studio della distribuzione di alcuni fattori di rischio in pazienti con infarto del miocardio. Considerazioni per una differente prevenzione cardiovascolare in relazione all'età.

In order to evaluate whether a different method of preventive approach to ischemic cardiopathy is appropriate in relation to age, the distribution of some classic cardiovascular risk factors (cigarette smoke, cholesterol) and a stress-related risk factor (type of work) was studied in two groups of patients, aged respectively over and under 60, admitted to hospital for acute myocardial infarction. The most significant data were: blood cholesterol values less than 220 mg/ml, found mainly in older patients; a larger number of heavy smokers in the group of patients aged under 60; the majority of patients were employees. In the light of these results, the paper discussed the need for different forms of preventive intervention, both clinical and epidemiological, for Ischemic cardiopathy in relation to age.

[Assessment of eating disorders-related risk in a cohort of adolescents living in Northern Italy. Results from a multicenter study]. / Valutazione del rischio di disturbi del comportamento alimentare negli adolescenti del Nord Italia. Risultati di uno studio multicentrico.

BACKGROUND: Clinical evidence and epidemiological research show an increasing number of subjects trying to become lean and reaching consequently harmful weight conditions. Aim of this paper is to assess the risk for eating disorders during adolescence. METHODS: In a multicentric study high school students of 5 different districts of Northern Italy have been asked to fill up anonymously the Italian version of the American YRBSS (Youth Risk Behaviour Surveillance System) questionnaire. For each school a section has been selected and between January and March 1999, students of every level have been involved. The data enrollected have been analysed using EpiInfo6. RESULTS: The study involved 4135 adolescents (57% girls and 43% boys) coming from 260 classes and 47 different schools. The proportion of boys perceiving themselves as overweight and underweight was the same (22%), while the proportion of girls considering themselves overweight raised up to 42%. The majority of the girls (53%) is trying to slim making use of physical activity (48%), diets (32%), vomiting (8%) and drugs (5%). CONCLUSIONS: Our data suggest that specific projects focusing on primary and secondary prevention of eating disorders should be considered for high schools. In addition, further studies are suggested to understand characteristics and behaviours related to eating disorders.

Post-partum dilated cardiomyopathy in anti-phospholipid positive woman.

Recurrent fetal loss and pregnancy complications, especially severe early-onset preeclampsia, are frequently associated with anti-phospholipid antibodies. We report a case of post-partum cardiac involvement leading to dilated cardiomyopathy in a woman with a persistent positivity for anti-cardiolipin and anti-nuclear antibodies. Her clinical and obstetric record reported two previous fetal losses but no other signs characteristic of the anti-phospholipid syndrome or diagnostic for a systemic lupus erythematosus. Post-partum cardiomyopathy might be another cardiac presentation of the anti-phospholipid syndrome, in addition to the well known valvular involvement. In patients with persistent positivities for anti-phospholipid antibodies, a prompt identification of such a complication in the post-partum period should be taken into account by physicians. Adequate cardiologic treatment associated with antiaggregant and steroid therapy might be useful to prevent further complications in these patients.

Comparative evaluation of the effects of indomethacin and ibuprofen on cerebral perfusion and oxygenation in preterm infants with patent ductus arteriosus.

OBJECTIVE: To compare the effects on cerebral perfusion and oxygenation of intravenous ibuprofen and indomethacin as treatment for patent ductus arteriosus in preterm infants. STUDY DESIGN: Sixteen infants receiving mechanical ventilation (< 31 weeks gestation) with patent ductus arteriosus received either 0.2 mg/kg indomethacin (n = 8) or 10 mg/kg ibuprofen (n = 8) infused over 1 minute. Near-infrared spectroscopy was used to measure changes in cerebral blood volume and in oxidized cytochrome oxidase concentration. Cerebral blood flow velocity in the pericallosal artery was measured using Doppler ultrasonography. RESULTS: Indomethacin caused a significant reduction of CBV (maximal changes in cerebral blood volume: -320 +/- 171 microL/100 gm) and, in four of eight patients, a fall in oxidized cytochrome oxidase concentration (maximal change in oxidized cytochrome oxidase concentration in the eight patients: -0.68 +/- 0.98 mumol/L, NS). Cerebral blood flow velocity fell significantly. Ibuprofen caused no significant reduction of cerebral blood volume, oxidized cytochrome oxidase concentration, or cerebral blood flow velocity, whereas a significant increase of cerebral blood volume (+207 +/- 200 microL/100 gm) was observed after 60 minutes. Ductus closure was seen in six of eight infants after the first dose of indomethacin and in five of eight infants after the first dose of ibuprofen. The therapeutic cycle involved administration of a second and third dose, provided no side effects occurred. Treatment was effective in all infants. CONCLUSION: Compared with indomethacin, treatment with ibuprofen does not significantly reduce cerebral perfusion and oxygen availability; the observed increase in cerebral blood volume requires further investigation.

[Study of ultrasonographic image textures with second-order statistical methods]. / Analisi della tessitura delle immagini ecografiche con metodi statistici del secondo ordine.

BACKGROUND: We report the sonographic image texture of the neonatal heart in different stages of development by calculating numerical parameters extracted from the gray scale cooccurrence matrix. To show pixel values differences and enhance texture structure, images were equalized, and then the gray level range was reduced to 16 to allow for sufficiently high occupancy frequency of the cooccurrence matrix. MATERIALS AND METHODS: We measured B-mode US images, all acquired with the same unit, using the same setup (gain, frequency, constant TGC). For each case measurements were made on 3 diastolic images by selecting a 32 x 64 pixel on the interventricular septum ROI. This procedure was applied to 3 different examinations made at birth, at 3 days, and after a month of life. For each 8 bit image we obtained a coocurrence matrix by sampling adjacent pixels at 0 degree, from which we calculated entropy; then the images were equalized and converted to 4 bit format; on these processed images we calculated 4 gray scale coocurrence matrix samplings adjacent pixels at angles of 0 degree, 45 degrees, 90 degrees, and 180 degrees. Parameters obtained from different angles cooccurrence matrix were averaged to get a numerical parameter independent of sampling angles. RESULTS: The one-way analysis of variance and Student's "t"-test were performed on the parameters obtained from 3 different examinations and the differences among different developmental stages are 95% significant. No significance was obtained comparing images at birth with those at 3 days. CONCLUSIONS: Differences are so little significant that they may be due to different factors affecting image texture and the variability introduced by manual ROI positioning; therefore no definitive conclusions can be drawn as to considering this kind of analysis capable of discriminating different stages of myocardial development. To apply this analysis to routine US examinations, different correction factors for range, azimuth, and focal dependence of texture must be considered.

[Methods of determination of stroke volume from M-mode echocardiogram of the aortic valve and aortic root. A comparative evaluation]. / Metodi di determinazione della gettata sistolica dall'ecocardiogramma M-mode della valvola aortica e della radice aortica. Una valutazione comparativa applicata.

The purpose of this study is to evaluate four methods of determining left ventricular stroke volume (SV) from aortic valve (AV) and aortic root (AR) M-mode echocardiogram (Table I, formulas 1-4); secondly, to study relations between echocardiographic aortic variables and SV. We studied 20 patients (Pts) in our Coronary Unit, 14 men and 6 women; their ages ranged from 38 to 76 (mean 53.4) years. Seventeen Pts had acute myocardial infarction; two Pts had previous myocardial infarction and heart failure; one Pt had dilated cardiomyopathy and heart failure. Three out of the twenty Pts, had mitral insufficiency (Table II, clinical and hemodynamic data). Patients were studied with high quality M-mode echocardiography. Immediately after the examination repeated measurements of cardiac output by thermodilution technique (TD) were carried out, and values of SV calculated (SV-TD). Twenty-five complete procedures were accomplished. The formulas were applied to every patient's echocardiographic data, and results (SV-ECHO) compared with SV-TD (Table III). Echocardiographic variables, whether single or multiple (terms), were also studied with regard to their relation with SV-TD (Table IV). Mean +/- SD value of SV-TD of the study group was 60.3 +/- 24.7 ml; range 22.7 to 108 ml. Mean +/- SD values of SV-ECHO were as follows: Yeh's formula, based on squared mean AV opening and LVET, 56 +/- 22.6 (ml), r = 0.8278, SEE 12.98; Jacobs' formula, based on aortic box planimetry, 68 +/- 32.5 (ml), r = 0.7129, SEE 23.31.(ABSTRACT TRUNCATED AT 250 WORDS)

Medium-chain triglyceride loading test in carnitine-acylcarnitine translocase deficiency: insights on treatment.

The results of a medium-chain triglyceride loading test in a patient with severe carnitine-acylcarnitine translocase deficiency clearly demonstrated impaired in vivo utilization of medium-chain triglycerides. The loading test was performed at the ages of 7 and 36 months. The diet was adjusted accordingly. The clinical course has been favourable and the child is now in very good condition at age 4 years. We conclude that the utilization of medium-chain triglycerides is only partial in carnitine-acylcarnitine translocase deficiency and cannot reasonably be considered an optimal source of energy for these patients. Careful adjustment of dietetic treatment may help to improve prognosis.

Neutrophil function and opioid receptor expression on leucocytes during chronic naltrexone treatment in humans.

We report that neutrophil function was impaired in former heroin addicts on chronic naltrexone maintenance. Of the subjects, 62.5% had elevated plasma ACTH, 25% had elevated plasma cortisol and one subject had increased urinary cortisol. All subjects showed enhanced expression of opioid receptors on monocytes, neutrophils and lymphocytes. In vitro, incubation with therapeutically relevant concentrations of naltrexone induced a slow increase of neutrophil cytoplasmatic free Ca(2+)concentrations ([Ca(2+)]()E2>i) and slowed down the [Ca(2+)]()E2>i rise induced by N-formyl-methionyl-leucyl-phenylalanine. Neither naltrexone nor its metabolite beta-naltrexol affected human neutrophil function in vitro. We conclude that impairment of neutrophil function during chronic naltrexone may be related to opioid receptor overexpression. With this regard, the possible role of naltrexone-induced [Ca(2+)]()E2>i changes deserves further investigation. 1999 Academic Press.