Does ergometric stress test induce a procoagulative condition in patients with previous myocardial infarction?

A regularly scheduled physical training program seems to have antithrombotic effects. Moreover, the hemostatic changes occurring in patients with coronary artery disease during acute exercise have not been clearly elucidated. Since stress testing is routinely performed in clinical cardiology, it would be helpful to assess whether patients with coronary artery disease are exposed to acute coronary thrombosis during or soon after sustained physical exercise. This study was designed to evaluate the effect of acute physical exercise (stress test by bicycle ergometer) on blood coagulation in a group of patients with previous myocardial infarction, and to determine whether the antithrombotic therapy commonly administered favorably influences hemostatic equilibrium. Our results suggest that exercise testing is not harmful to patients with previous myocardial infarction in regard to hemostasis and fibrinolysis and that antithrombotic therapy reduces postexercise increase in platelets.

New indices in the evaluation of clonidine transdermal therapy of hypertension.

Since high blood pressure might be more harmful the higher it is and the more it remains above a determined critical value (140/90 mm Hg - 18.7/12.0 k Pa - in the present study), the hyperbaric impact, a measure of the total load exerted on the arterial walls and the total time during the day when blood pressure is elevated above the critical value, have been evaluated. Ten patients with essential hypertension underwent non-invasive automatic 24-h blood pressure monitoring three times (baseline and after three and seven days from the application on the upper chest of a transdermal self-adhesive patch delivering clonidine). The recorder was programmed to measure blood pressure every 30 min during the day and every 60 min during the night. Significantly lower values of blood pressure, hyperbaric impact and duration of elevated blood pressure have been demonstrated from the third day after the beginning of transdermal therapy.

[Light chain deposition disease]. / La malattia da deposito di catene leggere.

We report the case of a rather rare form of K-light chain deposition disease (LCDD) in a 61-year-old man with hypertension and rapidly progressing nephropathy. Laboratory findings prompted suspicion of the diagnosis which was confirmed by light-microscopic and immunofluorescent studies of samples taken by percutaneous renal and liver biopsy. Hepatic and urinary K-light chains were present; no circulating light chains were detected. Bone marrow examination evidenced mild infiltration of lymphoid cells, all positive for K-light chain staining. Plasma cells were within normal ranges. LCDD appeared as nodular glomerulosclerosis with rare crescents and extensive tubular involvement with K-light chain deposits. There was no evidence of altered liver function, nor was amyloid found in the bone marrow, kidney or liver. After one year of continuous therapy with melphalan and prednisone, the patient's renal function has not worsened. We conclude with a review of the clinical and physiopathological features of the light chain subgroup of monoclonal immunoglobulin deposition diseases (MIDD).

A chronobiological study on the relation between heart rate and QT interval duration in newborn infants.

The relation between heart rate and QT interval is the result of the autonomic nervous system control on cardiac function in healthy adults; accordingly, chronobiological studies have shown that adult subjects have circadian rhythms of heart rate (expressed as R-R interval) and QT interval in phase. We have employed chronobiological methods to study heart rate and QT interval relation in 10 newborn infants, who are known to have an immature cardiac control. Findings from this study indicate that not all the newborns show circadian rhythms of heart rate and QT interval and that when both rhythms are present they do not correlate like in the adults. Likely, this lack of relationship between heart rate and QT interval in newborns is due to different maturational stages of the newborns studied. As a practical implication, in newborn infants, mathematical correction of QT interval by heart rate is not a reliable method.