[Cardiac rhabdomyoma in tuberous sclerosis. A report of five cases and review of the literature]. / Il rabdomioma cardiaco nella sclerosi tuberosa. Descrizione di cinque casi e revisione della letteratura.

Five children with tuberous sclerosis (TS), a polysystemic disease, had cardiac tumors detected by B-mode echocardiography. In a fetus, sonography performed at the eighth month showed the presence of a cardiac mass and of polycystic kidneys: the diagnosis of TS was confirmed postnatally because of the presence of calcified cerebral nodules. A newborn dichorial twin had paroxysmal tachycardia at ten days. B-mode echocardiography showed the presence of seven intracardiac tumors, and cerebral CT the presence of multifocal periventricular calcifications. An absence in a nine month old baby prompted an electrocardiogram that proved abnormal; a B-mode echocardiography showed large apical cardiac tumor; again cerebral CT showed periventricular calcified nodules. Two girls, 9 and 10 y.o. respectively, affected by TS, with normal electrocardiograms, both presented a small, asymptomatic, intracardiac mass demonstrated sonographically. In recent years, prenatal sonography and B-mode echocardiography in patients with TS demonstrated with increasing frequency the association of cardiac tumors (rhabdomyomas) with TS. Tumor detection often precedes the appearance of the cutaneous and neurological signs typical of the disease. This paper emphasizes the role of echocardiography in detecting cardiac tumors, as an early sign for the diagnosis of tuberous sclerosis, and to depict the natural history of cardiac rhabdomyoma with its variable clinical presentation and prognosis.

[Persistent bradycardia and apnea due to hypothyroidism in a very low-weight newborn infant]. / Bradicardia persistente e apnea da ipotiroidismo in un neonato di peso molto basso.

Alterations in thyroid function are quite heterogeneous in VLBW preterm neonates. The case of a 1160-g newborn is reported, affected by severe RDS and persistent bradycardia during the first week of life, who later developed symptoms and signs of low-output cardiac failure. ECG showed low QRS. Echocardiography revealed small pericardial effusion. Therapy with L-thyroxine led to rapid improvement of clinical conditions and to normalization of ECG and echocardiographic pattern. Levels of thyroid hormones should be monitored in VLBW infants, since their deficiency may play a role in compromised clinical conditions.

[Intra-abdominal foreign bodies following laparotomy interventions: report of a case]. / Il problema dei corpi estranei endoaddominali dopo intervento laparotomico: considerazioni su un caso.

The authors report their own observation of a case of post-laparotomic endoabdominal foreign body, which for a long period had remained asymptomatic. Starting from the clinical case, they effect a short study of such iatrogenic pathology, and state the diagnostic and therapeutic criteria thereabout. They subsequently dissertate on the possible preventing means.

[Study of the inotropic effect of potassium-canrenoate by systolic time intervals technique (author's transl)]. / Studio sulla attivita' inotropa del canrenoato di potassio mediante la tecnica dei tempi sistolici.

Systolic time intervals (TS) were determined before and after intravenous injection of 400 mg of Potassium-Canrenoate (CK) in 33 patients 30 days after acute myocardial infarction, in order to evaluate the inotropic effect of this drug. It was observed a reduction of the pre-ejection period (I. PEP) and of the pre-ejection period/left ventricle ejection time (PEP/LVET) ratio without any significant changes in the electromechanical systole (I. Q-2), left ventricle ejection time (I. LVET) and isometric contraction time (ICT). These results do not allow to attribute positive inotropic effect to CK. In fact drugs which share this activity, like digitalis glycosides, shorten also I. Q-S2, I. LVET and ICT, with a reduction of I. PEP and PEP/LVET ratio by far greater than that determined by CK. TS determination, in 10 patients, 15, 30 and 45 min after the injection of CK yields results confirming these conclusions.