[Controlled clinical study of doxophylline versus aminophylline in the treatment of acute cardiorespiratory insufficiency syndromes]. / Studio clinico controllato doxofillina versus aminofillina nel trattamento delle sindromi da insufficienza acuta cardiorespirtoria.

Twenty patients of both sexes, hospitalized because they were suffering from acute cardiorespiratory syndromes, have been studied in a clinical blind test on unbalanced groups of patients. This research aims to evaluate the therapeutic efficiency and intravenous tolerance of doxophylline. Patients were observed for 24 hours. Signs and symptoms were recorded on a semi-quantitative scale, and the clinical situation, haemogasanalysis, blood pressure, cardiac frequency, and other analytic controls were performed in order to verify the systemic tolerability. We can conclude, in agreement with the literature, that the group treated with doxophylline showed a better reduction in cardiac frequency, while maintaining the same effects on the respiratory apparatus.

Scintigraphic recording of blood volume shifts.

UNLABELLED: A scintigraphic device consisting of small scintillation probes tightly fixed to the skin was developed to record intravascular blood volume shifts continuously and simultaneously at several sites. The aim of the present study was to ascertain the reliability of the measurements obtained, show the blood shifts induced by common daily activities in healthy subjects and clarify the mechanisms responsible for hemodynamic changes. METHODS: Measurements were made in three fields of the right lung, the liver, thighs and calves of 16 men during Valsalva maneuver, hyperventilation, various posture changes and treadmill walking. Some tests were repeated. RESULTS: The measured blood volume shifts were always in the expected direction and in accordance with those reported in the literature; they also were reproducible. Therefore, the measurements were reliable. A pattern of blood volume changes peculiar to some common daily activities was recorded in subjects moving freely. Insights were obtained on the mechanisms responsible for the blood volume shifts. CONCLUSION: Our noninvasive technique provides reliable continuous measurements of blood volume changes at several sites during common daily activities and could be applied not only in healthy subjects but also in patients.

[Chest pain similar to angina. Identification of patients at risk of developing acute coronary failure]. / Dolore toracico simil-anginoso. Identificazione dei pazienti a rischio di sviluppare una insufficienza coronarica acuta.

In order to improve the diagnostic procedure for patients with chest pain suspected of having acute ischemic heart disease we elaborated a mathematical model to predict ischemic risk and then compared its predictive capacity with that of the physician. From September 1989 to December 1992, 564 patients with a chief symptom of chest pain were seen at our Emergency Room (ER). Sixty-two percent of them were male, mean age was 58 +/- 13 years, and none had acute myocardial infarction or unstable angina. Clinical and historical data, serial sampling of enzymes and ECG patterns were collected for 4 hours after admission to the ER. At that point a decision was made to hospitalize or discharge that patient. Follow-up was completed within 2 months. At the end of follow-up, we observed that the physician's assessment resulted in 35% true positive, 55% true negative, 4.7% false positive, and 5.3% false negative judgments for acute ischemic heart disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Simultaneous recording of blood volume shifts in different vascular beds in man by a versatile scintigraphic method.

A device was developed to record the blood volume changes occurring in the lung and calf during postural changes, physical exercise, and the Valsalva maneuver in man. The changes in regional counting rates from the right middle lung and the calf mirrored the well-known changes in venous return that are expected to occur in response to the above-mentioned external stimuli. Thus a sustained decrease in lung blood volume was noted on assumption of the erect posture as well as during the forced expiration of the Valsalva maneuver. In addition a rapid increase and a sharp decrease in lung blood volume took place at the very onset and at the very end of walking, respectively. The calf blood volume declined immediately at the onset of walking, increased slightly in the ensuing two minutes, and returned to baseline quickly at the termination of walking. The authors' method enables real-time equilibrium blood pool scintigraphy to be recorded continuously and simultaneously from different districts over sustained periods of time irrespective of the posture and the physical activity performed by the patient. Their method might improve knowledge of the systemic circulatory responses to selective physiologic and therapeutic interventions in health and disease.

A new method for evaluating lung uptake of thallium-201 during stress myocardial scintigraphy.

A novel, multipurpose device has been designed that allows thallium activity to be continuously studied from a given lung area at rest and at peak exercise. The information gained from this technique proves to be relevant and reliable because lung thallium activity is displayed in real time and the interpretation of thallium distribution is not based on qualitative or quantitative comparison with that in the myocardium or mediastinum. The time-activity curves obtained in our study group are reported and the relation of peak activity to plateau activity (peak/plateau ratio) is proposed as an index that is easy to obtain for identifying patients with normal and impaired left ventricular function.

[Acute renal damage caused by ampicillin. Description of a case]. / Danno renale acuto da ampicillina. Descrizione di un caso.

Approximately one week after a cycle of antibiotic therapy using ampicillin for pulmonary inflammation, an 82-year-old woman developed symptoms of acute renal insufficiency reminiscent of nephrotic syndrome. Symptoms were completely reversible and normal renal function was recovered (even after 14 months of follow-up). The Authors conclude by attributing this to acute tubulo-interstitial nephropathy due to hypersensitivity to ampicillin.

[Renovascular hypertension: a clinical dilemma]. / L'ipertensione nefro-vascolare: un dilemma clinico.

The case of a 63-year-old patient in whom serious hypertension of recent onset was recalcitrant to conventional anti-hypertensive therapy is reported. Clinical and biohumoral data suggested a form of nephro-vascular hypertension. This clinical case led to a review of the clinical and diagnostic criteria of this by means rare form of secondary hypertension. The correctness of the diagnostic and therapeutic approach was confirmed by the normalisation of plasma renin levels and by the good control of arterial pressure after right nephrectomy (rendered indispensable after the angiographic finding of complete stenosis of the right renal artery).

[Recurrence of pernicious anemia. Description of 2 cases]. / La recidiva dell'anemia perniciosa. Descrizione di due casi.

Two cases of pernicious anaemia both recurring after 14 years are examined. Both patients had voluntarily suspended parenteral vitamin-B12 intake a few months after their first hospitalisation. The earliest signs of B12 deficiency and the clinical and biological alterations arising during the recurrence are reviewed.

[Hypopotassemia and megaloblastic anemia. Presentation of a case]. / Ipopotassiemia ed anemia megaloblastica. Presentazione di un caso.

A case of megaloblastic anaemia probably caused by malabsorption is analysed. Blood potassium levels were monitored before and during treatment with vitamin B12. It is concluded that low potassium levels in chronically hypoxic patients may be dangerous and that blood potassium should be monitored constantly during the treatment of this type of anaemia.

[Statistical survey of the hourly incidence of acute myocardial infarction: reduction of frequency during the nighttime hours]. / Rilevazione statistica dell'incidenza oraria dell'infarto miocardico acuto: riduzione di frequenza nelle ore notturne.

The time of onset of acute myocardial infarction was analysed in 245 patients admitted to the Fatebenefratelli Hospital in Milan over 18 months. A significant decrease in the incidence of this pathology (P less than 0.01) was noted between midnight and 6 am. No significant difference was noted over the rest of the day. These results suggest the existence of a period of relative protection against the onset of myocardial infarction during the day.

[Electrocardiographic changes in acute carbon monoxide poisoning]. / Alterazioni elettrocardiografiche in corso di intossicazione acuta da monossido di carbonio.

Various electrocardiographic alterations (variations in the repolarisation phase, disturbed conduction, arrhythmias) have been reported in acute carbon monoxide poisoning. In the 44 cases of this poisoning examined, electrocardiographic alterations are also considered in relation to the degree of poisoning (expressed as plasmatic levels of carboxyhaemoglobin-HbCO). In 68% of these cases alterations were presented by signs of subepicardiac or subendocardiac damage. Attacks of atrial fibrillation, premature beats and episodes of sinusal tachycardia were also observed. Almost all these electrocardiographic alterations were quickly reversible. It is concluded that there is no correlation between HbCO levels and electrocardiographic alterations (that were in fact more frequent in the slight poisoning cases).

[A case of recurrence of pernicious anemia]. / Su un caso di recidiva di anemia perniciosa.

A case of pernicious anaemia recurring after 14 years in a patient who had suspended parenteral vitamin B12 treatment two months after the first hospitalisation is described. The earliest haematological signs of vitamin B12 deficiency are examined and the apparent failure to absorb the vitamin B12 regularly taken with the diet when no longer administered parenterally is discussed.