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Biomedical subjects

A Coppola

Publications and source records attributed to A Coppola.

At least 19 recordsLinked to original sources

Comparison of rest-redistribution thallium-201 imaging and reinjection after stress-redistribution for the assessment of myocardial viability in patients with left ventricular dysfunction secondary to coronary artery disease.

Thallium (Tl)-201 reinjection after stress-redistribution (RI) imaging has been proven to accurately identify ischemic and viable myocardium. Quantitative Tl-201 analysis after stress has also shown viable myocardium in most mild to moderate (51% to 85% of normal uptake) irreversible Tl-201 defects. However, if the main clinical question is whether a region is viable, and not whether there is inducible ischemia, a resting protocol may be more appropriate. The aim of this study was to determine whether rest-redistribution (RD) quantitative Tl-201 single-photon emission tomographic imaging provides the same information on viable myocardium as Tl-201 RI. Thus, 15 patients (mean age 58 +/- 9 years) with chronic coronary artery disease and left ventricular dysfunction (ejection fraction 35 +/- 8%) were studied by both RI and RD Tl-201 single-photon emission tomography. Regional Tl-201 uptake was assessed quantitatively using a 16-segment model. When Tl-201 images were classified as normal/reversible (viable) or irreversible (nonviable), RI showed viable myocardium in 145 of 240 myocardial regions (60%), whereas RD showed it in 103 of 240 myocardial regions (43%). The 2 imaging protocols provided concordant information in 176 of 240 myocardial regions (73%). Among the 64 (27%) discordant regions, 53 (22%) were viable by RI and nonviable by RD, whereas 11 (5%) were viable by RD and nonviable by RI (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[The peak of creatine phosphokinase level in the acute phase of myocardial infarction in patients with and without ischemic precedents].

Two hundred and one patients admitted to Coronary Care Unit with documented acute myocardial infarction, whose chest pain had occurred within 12 hours of hospital admission non thrombolised, were studied. The peak of creatine kinase (CK) was examined and compared between patients without previous manifestations of myocardial ischemia (group A, 106 patients) and patients with/history angina pector or healed myocardial infarction (group B, 95 patients). The mean peak creatine kinase level in the negative history group was higher (2261 +/- 226 U/L vs 1779 +/- 97 U/L p < 0.001), especially in patients aged less than 65. No significant difference was observed in patients aged more than 64 of the two groups. Patients with a positive history presented more frequently ischemic complications (p < 0.05) while the frequency of hemodynamic disturbances and arrhythmias was not significantly different. Total mortality was similar in the two groups (22.6% vs 21%) and more frequently occurred in older patients with congestive heart failure. The authors form the hypothesis that the higher mean peak creatine level in patients without previous myocardial ischemia is the result of absence of coronary collateral circulation. The presence of collateral vessels permits less extensive myocardial infarction but it does not change the prognosis.

Aged

Pre-Cushing's syndrome: a case report.

A 67-year-old man affected by prostate cancer was incidentally found to have a nodular enlargement of the left adrenal gland without apparent changes in hormonal status. The adrenal mass was found to be scintigraphically active, the radiolabelled compound being concentrated in its context with a consensual suppression of the contralateral uptake. The patient underwent a resection of the adrenal tumor. Histologically and biochemically, the adrenal mass was found to be a non-functioning adenoma. The radioisotopic uptake along with the non-hormonal activity prompted us to call this tumor "Pre-Cushing's syndrome" of the adrenal cortex.

Adrenal Cortex Neoplasms

Perinatal mortality in southern Italy.

Perinatal deaths occurring in the Campania region of southern Italy in 1982 were analysed. The perinatal mortality rate was 17.6 per thousand (stillbirth rate 8.3, early neonatal mortality rate 9.3). Compared with Swedish data, our deaths excess does not seem attributable to an unfavourable birthweight distribution, but to high birthweight mortality rates in every birthweight category and particularly in the normal birthweight group (greater than 2500 g). This group of newborns, representing about 94% of the births, contributes 45.4% of perinatal deaths; this situation is not common in developed countries, where the normal birthweight newborns form a much smaller proportion of perinatal deaths. The analysis of the causes of perinatal mortality, even though autopsies are rarely executed in Campania, shows a high prevalence of events which should be prevented by good antenatal and perinatal care.

Cause of Death

Antenatal and perinatal care in southern Italy. I. The mothers' reports.

A population-based cross-sectional study of antenatal and perinatal care was performed in Campania, a region of southern Italy. One thousand three hundred women who had given birth in 1982 were interviewed. The number of antenatal visits was very low, less than 1% of the mothers having attended more than three times during pregnancy. The women at high obstetric risk did not attend more than those at low risk and certain aspects of their antenatal care were unsatisfactory. The place of birth was similar for high risk and low risk mothers, with 40% delivering in small private facilities (with few neonatal resuscitation facilities and often with inadequate infant transport services). The labour was induced or accelerated in 60% of the mothers. The organisation of perinatal care did not take into account many of the needs of the mothers such as presence of a relative at delivery, ambulation during labour, early relationship with the newborn, rooming-in, or encouragement to breastfeed.

Cross-Sectional Studies

Antenatal and perinatal care in southern Italy. II. The clinicians' reactions.

One hundred obstetricians and 50 paediatricians engaged in public antenatal and perinatal care in southern Italy were interviewed about the provision of care in their facilities: 93% of the obstetricians judged the coverage of the target population to be insufficient and 53% of them considered the use of the risk approach to be unsatisfactory in public clinics. For example, no initiative was taken by 60% of public clinics when a woman at high risk failed to attend a booked antenatal visit. Bed rest during labour was prescribed by 72% of the obstetricians, a supporting relative was admitted to only 18% of the births and routine episiotomy was performed in 77% of primigravidae. Only 56% of the paediatricians interviewed allowed early contact between mother and baby. In public hospitals, 80% of paediatricians were present in the delivery room for the births. Screening for congenital hypothyroidism and phenylketonuria was executed in only 37% of the public hospitals. Newborn transport system adequate to national standards was available in only 33% of the hospitals. Antenatal and perinatal care need to be rapidly improved to meet population needs in southern Italy.

Attitude of Health Personnel

In vitro inhibition by defibrotide of monocyte superoxide anion generation: a possible mechanism for the antithrombotic effect of a polydeoxyribonucleotide-derived drug.

In an attempt to elucidate the antithrombotic potential of defibrotide (D) we have evaluated several functions of monocytes from 7 healthy subjects before and after in vitro incubation of the cells with increasing concentrations of this drug. At concentrations as high as 40 micrograms/ml, D hardly affected the expression of both the procoagulant activity of monocytes and the formation of superoxide anion in response to 1 mg/ml zymosan (STZ). In contrast, at concentrations that may be achieved in vivo following the administration of the drug (5-20 micrograms/ml), D impaired in a dose-dependent manner (p less than 0.05) the generation of O-2 in response to N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP, 1 microM) or calcium ionophore A23187 (10 microM). Regardless of the agonist employed, at concentrations between 1 and 5 mM, extracellular Ca2+ had little effect on the impairment of superoxide anion generation by D. In contrast, the inhibitory effect was time-dependent, the maximum impairment (greater than 30%) being observed when the cells were preincubated with the drug for 20 h. These data support the concept that the antithrombotic potential of D involves the ability of the drug to affect the generation of free radicals by leukocytes and suggest that future in vivo studies for the evaluation of the activity of D should take into account the role of monocytes in hemostasis and thrombosis.

Adult

Snorting benzodiazepines.

Two cases of intranasal benzodiazepine use are presented. The methods of preparation and administration of the powder and accounts of the pharmacological effects of the drugs used are described. The pattern of development and progress of the habit and its associated features are delineated. Snorting benzodiazepines appears to be more common than is currently appreciated, and the clinical complications and implications of this habit are discussed.

Administration, Intranasal

[24-hour blood pressure: effects of sports in aged subjects].

The present study deals with the blood pressure (BP) and heart rate (HR) 24-h pattern in aged people of both sexes ranging in age from 66 to 75 years. 20 subjects were active in agonistic sports (running and swimming), 20 others had sedentary habits. BP and HR were studied by non-invasive monitoring along with chronobiometric analysis. The BP and HR 24-h pattern was seen to preserve its circadian rhythm in both aged athletes and sedentary elderly. The analysis reveals that the aged athletes show a higher mesor for systolic BP and a lower mesor for diastolic BP and HR. The daily pressure load, as the integral of the BP 24-h values multiplied by the HR mesor, is lower in aged people practising sport as compared to age-matched individuals with sedentary habits. The spectral analysis reveals that physical exercise acts to change the time structure of BP and HR 24-h patterns. The conclusion is drawn that active sport plays beneficial effects in aged people because of a lower pressure load.

Aged

[Bidimensional echocardiographic images of extracardiac tumors. Detection of mediastinal masses by the bidimensional echocardiographic Doppler technique].

A mediastinal tumor might mimic tricuspid stenosis, pulmonary stenosis, constrictive pericarditis, producing symptoms and signs of a cardiologic illness. We report 2 cases of mediastinal masses (1 lymphoma and 1 pulmonary cancer) localized in the anterior mediastinum and compressing the cardiac silhouette. Bidimensional echocardiography and Doppler were used to differentiate masses of cardiac origin from extracardiac origin and to study the hemodynamic alterations; moreover these techniques allow to evaluate the efficacy of therapy.

Adult

[Pituitary-testicular evaluation in patients with chronic renal insufficiency in hemodialysis treatment].

Hormone assays were performed in 10 nephropathic men on haemodialysis who revealed reduced libido and importance. In particular, testosterone, 17-beta-estradiol, prolactin, FSH and LH plasma levels were assayed in 8 patients before dialysis and at last, after both long and short interdialytic periods. Below normal testosterone, elevated 17-beta-estradiol, FSH at the upper limits of the range and markedly increased LH levels were noticed; prolactin levels were almost normal. No substantial difference was observed between pre- and post-dialytic hormone levels, after either interdialytic periods. Testosterone, 17 beta-estradiol, prolactin, FSH and LH plasma levels were again assayed in 8 patients (six of the former group + two more) and afterwards a test with HCG was performed. Basal hormone levels agreed with the previous ones; prolactin levels were quite normal. An almost complete absence of response of testosterone and 17-beta-estradiol to HCG was noticed. These results demonstrate a primary hypogonadism responsible for reduced libido and impotence in the patients on haemodialysis investigated.

Adolescent

[Pathogenetic endocrine aspects of primary osteoporosis].

The pathogenetic endocrine aspects of primary osteoporosis are reviewed on the basis of some physiological remarks. Specifically, postmenopausal and senile osteoporosis represent 2 distinct clinical entities. For both, the last event in the pathogenetic chain is in any case the negative skeletal balance, but the starting point and the development of processes present differently.

Aged