Postphlebitic syndrome: clinical activity and tolerability of desmin, new LMW dermatan sulfate.

One hundred patients suffering from postphlebitic syndrome of the lower limbs were enrolled in an open, randomized, and multicenter (six centers) trial for a period of eighteen months. Patients were randomly assigned to three treatment groups to receive (for ninety consecutive days) Desmin, a new low-molecular-weight dermatan sulfate, at the dose, respectively, of 100 mg once daily by subcutaneous (SC) route (36 patients), 100 mg twice a day by SC route (33 patients), and 200 mg once daily by intramuscular (IM) route (31 patients). The general and local tolerability and the clinical efficacy of the drug were evaluated by means of clinical, instrumental, and laboratory parameters. Desmin is effective in the decompensation stage of postphlebitic syndrome; this was demonstrated by a significant reduction in the severity of a number of typical symptoms as well as by the drug's positive effect on venous tone as confirmed by phlebotensiometric examination. The daily dose of 200 mg (either SC or IM) was more effective than the 100 mg dose. The results obtained at the end of the trial (ninety days) were statistically better than those obtained after thirty days of treatment. This trial demonstrated that both the systemic and the local (at the site of injection) tolerability of the drug, administered for three months, were good and without significant variations in the laboratory parameters monitored.

[Ambulatory angiologic diagnosis using the Doppler c.w. (continuous wave) method]. / Diagnostica angiologica ambulatoriale nel territorio con Doppler c.w.

A one year clinical activity of instrumental angiological diagnostics (doppler c.w. examinations) was evaluated and analysed. 970 outpatient continuous wave doppler have been performed: 37% examinations of epiaortic vessels (TSA), 31% examinations of lower limb veins, 28% examinations of lower limbs arteries. The question has been inappropriate (normal exam) in 81% of TSA, in 67% of AIA and in 52% of AIV. The authors think that the reasons for these results are a large misinformation from the physicians postulant and a consequent abuse of the instrumental method. It's therefore necessary to put a clinical filter to regulate the access to the instrumental (high technological) examinations, too often unnecessary.

[Cardiovascular adjustments in hypertensive patients. An echocardiographic study]. / Adattamenti cardiovascolari in ipertesi. Studio ecocardiografico.

Echocardiography was used to asses parameters of cardiovascular function in order to identify the main cardiac adjustment mechanisms to arterial hypertension. In addition to morphological parameters of septal and parietal thickness and diameter, telesystolic (Ses) and telediastolic (Spk) stress, EF, Vcfm, the index of left ventricular mass (ILVM), hypertrophy ratio (h/r), contractility index (Do), peripheral resistances (RPT) and Tarazi's index (SAC) were evaluated. In comparison to control subjects, higher levels of PwTs, h/r, SAC, RPT and ILVM (at the limit of significance) were found in hypertensive patients, which were reflected by higher Spk and Do values. From the further analysis of data to identify patients with signs of left ventricular hypertrophy (h/r greater than 0.40 and/or ILVM greater than 140) it was concluded that the hypertrophy ratio (h/r) is the functional parameter which most closely reveals the type of myocardial adjustment. Irrespective of absolute values of ILVM, the adequacy of myocardial hypertrophy to the dimensions of the cavity is accompanied by the normalisation of stress and the return of Do values close to normal levels. Hearts with low h/r those with the highest stress levels, as well as preesting the lowest EF and the highest Do values.

[Effects of short-term administration of ibopamine on hemodynamic parameters]. / Studio degli effetti dell'ibopamina nella somministrazione a breve termine su alcuni parametri dell'emodinamica.

Ibopamine was administered in a dose of 100 mg every 8 hours for three days to 18 hospitalised heart patients of NYHA class I and II. ECHO examination, polygraphic examination, rheographic examination and carotid CW Doppler were carried out under basal conditions and at the end of treatment. B.P. did not show significant changes whereas H.R. showed a slight tendency to rise. PEPc fell significantly whereas LVETw did not change, with a parallel reduction in PEP/LVET. ECHO examination did not reveal any reduction in diameters, an increase in Vcfm and a reduction in Ses. The Ses/Vs and P/V contractility indices increased to some extent. Irrelevant changes were observed in peripheral circulation evaluated with rheography, and cerebral circulation evaluated with CW Doppler. On the basis of these results it can be concluded that ibopamine is in a position to determine an improvement in ventricular performance during heart failure and that, allowing for its sympathergic effects, it is the treatment of choice in bradykinetic decompensation.