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Biomedical subjects

A Finzi

Publications and source records attributed to A Finzi.

At least 19 recordsLinked to original sources
PubMed1992

Family history, smoking habits, alcohol consumption and risk of psoriasis.

We have conducted a multicentre case-control study to assess the epidemiological importance of previously suggested risk factors for psoriasis, including family history of the disease, smoking and alcohol consumption. Newly diagnosed psoriatics, with a history of skin manifestations no longer than 2 years were eligible as cases; as controls we selected subjects with newly diagnosed dermatological conditions other than psoriasis. Interviews were performed by trained medical investigators using a structured questionnaire. Two-hundred and fifteen cases, aged 16-65 years (median age 38), and 267 controls, aged 15-65 years (median age 36), were interviewed and included in the analysis. Family history was a risk factor for psoriasis; the multiple logistic regression (MLR) adjusted-odds ratio was 18.8 (95% confidence interval 6.4-54.8) for a history in parents, and 3.2 (95% confidence interval 1.5-6.6) for a history in siblings. The risk of psoriasis was higher for current smokers than for those who had never smoked. The MLR adjusted odds ratio was 2.1 (95% confidence interval 1.1-4.0) for people smoking 15 cigarettes or more per day. The risk of psoriasis was higher for alcohol drinkers: compared with teetotallers the MLR adjusted-odds ratios were 1.3 (95% confidence interval 0.8-2.3) for subjects drinking one or two drinks/day and 1.6 (95% confidence interval 0.9 to 3.0) for those drinking three or more. However, the trend in risk was not statistically significant. Our study confirms the role of family history in psoriasis and provides some evidence of a dose-response relationship for an association between smoking habits and psoriasis.

Adolescent↗
PubMed1991

A double-blind crossover comparison of flecainide and slow-release mexiletine in the treatment of stable premature ventricular complexes.

In 24 patients with stable premature ventricular contractions (PVCs) greater than or equal to 100/h, Lown class greater than or equal to 2 the relative anti-arrhythmic efficacy of flecainide 150 mg twice daily and slow-release mexiletine 360 mg twice daily was evaluated in a double-blind placebo-controlled randomized crossover study. All the patients had normal ventricular function. Criteria of efficacy were: reduction greater than or equal to 70% of PVCs or reduction greater than or equal to 50% with abolition of Lown class greater than 2 arrhythmias or suppression of non-sustained ventricular tachycardias (nSVT). Twenty-two patients completed the study protocol. The placebo phases showed comparable results and no carry over effect. The criteria of efficacy were fulfilled in 20 of the 22 patients (91%) on flecainide and in 12 of the 22 (55%) on mexiletine. The absolute reductions of PVCs, couplets and nSVT obtained on flecainide and mexiletine, in comparison to the placebo, were statistically significant (p less than 0.01 for flecainide, p less than 0.05 for mexiletine). Flecainide was superior to mexiletine in overall PVC reduction (p less than 0.05). In the 17 patients with couplets the reduction obtained with flecainide was superior to mexiletine (p less than 0.05). Both drugs were highly effective on nSVT. At steady state, the mean plasma levels of both drugs were within the range of clinical efficacy. The drugs were well tolerated and no patient withdrew because of side-effects. It was concluded that at the dosages employed flecainide was superior to mexiletine in reducing premature ventricular contractions and in abolishing couplets. The efficacy of both drugs for non-sustained ventricular tachycardias was comparable. Both drugs were highly effective by comparison with the placebo.

Cardiac Complexes, Premature↗
PubMed1991

[Therapy and prevention of atrial fibrillation].

In the last decade, broader insights into the mechanisms and clinico-prognostic significance of atrial fibrillation have prompted a dramatic shift in the clinician's decision making process in terms of treatment and prevention of this common rhythm disturbance. In fact, evidence of short- or long-term untoward effects on cardiac function and the risk of cerebrovascular accidents, together with a much wider therapeutic armamentarium, form the rationale for the present far more aggressive attitude, aiming at restoring sinus rhythm in all patients in whom an even weak chance exists. The newer class IC (flecainide, propafenone) and class III (amiodarone, sotalol) antiarrhythmic agents are widely and successfully utilized to restore and to maintain sinus rhythm, with significant advantages in comparison with classic quinidine derivatives in terms of efficacy and patient compliance, as demonstrated in clinical controlled trials. Moreover, calcium channels blocking agents as verapamil and diltiazem have been demonstrated more effective than digitalis in the limitation of ventricular rate in patients with chronic atrial fibrillation. Although the advantages of long-term anticoagulation and/or antiaggregation in patients with atrial fibrillation are still being widely investigated at the present time, data obtained in the last years favoured a wider use of this treatment. Many non-pharmacologic interventions have been shown as dramatically effective in particular aspects of atrial fibrillation. Permanent atrial or atrioventricular pacing, alone or in association with antiarrhythmic drugs, has come out as first choice option in patients with bradycardia-tachycardia syndrome. Transcatheter ablation and antiarrhythmic surgical techniques are more and more widely utilized with increasing success in cases refractory to conventional approaches.

Anti-Arrhythmia Agents↗
PubMed1990

[His bundle block 2:1 during paroxysmal supraventricular tachycardia involving an occult accessory atrio-His pathway].

A high degree AV block during paroxysmal supraventricular tachycardia is an uncommon and short-lasting finding in patients with intranodal re-entry circuits. The AV block is the result of temporary inadequacy of the infranodal conduction system--which is not part of the circuit--to cope with the sudden increase in heart rate in terms of refractory periods and conduction velocity. In a patient with paroxysmal reciprocating tachycardia at a very high rate (230-250 bpm), 2:1 intra-hisian AV block was constantly observed after arrhythmia initiation by atrial extrastimuli. This persisted for 1-4 minutes and then progressively subsided passing through a period of 3:2 intra- infra-hisian AV block until it reached 1:1 conduction with transient left bundle branch block. The latter occasionally disappeared as result of retrograde activation of the area of functional anterograde block and of subsequent noncompensatory pause, following a premature ventricular depolarization. Tachycardia-dependent AV block was abolished by verapamil and flecainide, because of lengthening of the tachycardia cycle length. Functional and electropharmacological features of retrograde conduction were consistent with an extranodal concealed atrio-hisian accessory pathway acting as the retrograde limb of the re-entry circuit. Moreover, His bundle electrogram was prolonged and polyphasic even in sinus rhythm. Therefore, tachycardia-dependent advanced AV block can occur not only in truly intranodal re-entry but also in very fast atrio-hisian re-entry tachycardias with evidence of transient impairment of intra-hisian conduction, distal to the insertion of the accessory pathway. Localized morphofunctional pathological changes in the His bundle are probably involved in the mechanism of this uncommon pattern.

Bundle of His↗
PubMed1990

[Clinical framework of psoriatic arthropathy. Proposal of an evaluation protocol].

Psoriatic arthropathy is an inflammatory seronegative arthritis characterized by an involvement of peripheral or axial joints in association with psoriasis. In this study the clinical features of both skin and joints have been observed simultaneously by a rheumatologist and a dermatologist. We have finally proposed a clinical protocol based on PASI to evaluate psoriasis and on a simple subset classification to estimate joint involvement.

Adolescent↗
PubMed1990

Evaluation of skin irritation and contact sensitizing potential of fenticonazole.

A double blind, randomized clinical trial was performed on twelve healthy volunteers to evaluate the irritation potential of fenticonazole 2% cream (Lomexin) and spray versus micomazole 2% cream and econazole 1% spray. The contact-sensitizing potential of the two fenticonazole preparations was also investigated. There was no evidence of irritation after the treatments with fenticonazole cream, its excipients, miconazole cream and fenticonazole spray excipients, whereas signs of irritation were observed in four cases after treatment with the spray formulations (two after fenticonazole, two after econazole). The contact-sensitizing test was performed only with fenticonazole 2% cream and spray. Neither spray nor cream formulation of fenticonazole showed evidence of sensitization in any of the twelve subjects.

Adult↗
PubMed1988

Plasma melatonin levels in psoriasis.

Melatonin is synthesized and secreted by the pineal gland. A daily rhythm of melatonin secretion, with high plasma values during the dark period, has been found in all vertebrates studied so far. In psoriatics, several hormones, including GH and prolactin, have altered chronobiology, and some studies in humans suggest that melatonin affects the levels of GH and prolactin. We investigated circadian melatonin rhythm in 13 male psoriatics and 13 healthy males with an RIA specific for measuring the hormone in plasma. Samples were taken at 6 a.m., 8 a.m., 12.00, 4 p.m., 8 p.m. and 2 a.m. Differences in (mean +/- SD) plasma melatonin levels were analysed by Student's t-test. Our results show that psoriatic patients had lost the nocturnal peak and usual circadian rhythm of melatonin secretion. Levels of melatonin were significantly lower than in controls at 2 a.m., and higher at 6 and 8 a.m. and at 12 noon. Further investigations of this disorder of melatonin secretion in psoriasis are needed to understand its significance.

Adult↗
PubMed1987

Antibodies to cardiac Purkinje cells: further characterization in autoimmune diseases and atrioventricular heart block.

We confirmed the occurrence of IgG antibodies reacting with ox cardiac conducting tissue in the serum of some human subjects. These antibodies failed to react with all ox cardiac conducting tissue cells; they reacted only with the cells defined as Purkinje cells. Having checked 352 sera, we found that the prevalence of antibodies to Purkinje cells was 11% in normal subjects (no correlation with sex and age), 14% in systemic lupus erythematosus, 21% in rheumatoid arthritis, 18% in progressive systemic sclerosis, and 23% in Sjögren syndrome. In 50 patients with permanent pacemakers for chronic non-postinfarction atrioventricular (AV) block the prevalence was 30% (P = 0.008). In a selected set of 29 patients with clinically idiopathic AV block located at or below the level of the His bundle the prevalence was 34.5% (P = 0.006). The possible role of anti-Purkinje cell antibodies in autoimmune damage of cardiac conduction tissue is discussed.

Adolescent↗
PubMed1987

Permanent form of junctional reciprocating tachycardia involving an atrio-hisian accessory pathway: electrophysiologic and histologic correlations.

We present clinical, electrophysiologic and morphologic correlations of a patient with a permanent form of junctional reciprocating tachycardia, who died from a lung tumor. At electrophysiologic study, the tachycardia circuit was suspected to involve an atrio-Hisian accessory pathway antegradely and the AV node retrogradely; a ventriculo-atrial accessory pathway was excluded. Pathologic examination revealed a right-sided atrio-Hisian accessory pathway and an area of abnormal dispersion in the distal His bundle fibers. This case is consistently different from another previously reported case in which a concealed, serpiginous, septal atrioventricular accessory pathway was demonstrated by anatomic examination. Thus, different substrates seem to be responsible for the permanent form of junctional reciprocating tachycardia.

Aged↗
PubMed1986

Long-term prognostic significance and electrophysiological evolution of intraventricular conduction disturbances complicating acute myocardial infarction.

Fifty-nine patients with post-infarctional, isolated intraventricular conduction disturbances (IVCD) who survived the acute stage of myocardial infarction were followed up after hospital discharge for a mean period of 11.4 +/- 4.8 months. Fourteen patients (24%) had HV interval prolongation (greater than 55 ms) during AMI (group A), and 45 patients had normal HV intervals (76%, group B). His bundle recordings were repeated during follow-up in 48 survivors after a mean period of 7.2 +/- 0.7 months. Infranodal conduction delay in the acute stage of infarction was correlated with a higher incidence of heart failure during AMI (78% of patients in group A vs 22% in group B, p less than 0.001), and with higher rate of cardiac mortality during follow-up (50% in group A vs 13% in group B, p less than 0.01). Survivors of group A showed a higher functional NYHA class, a higher incidence of CHF, and a higher prevalence of complex ventricular arrhythmias at Holter monitoring. No statistically significant difference in late sudden death was evident between the two groups of patients, and the global incidence of late AV block was 2%. At repeat His bundle recording no significant change (greater than 5 ms) in HV interval could be demonstrated in comparison to the acute phase recording, neither in patients with prolonged nor in patients with normal HV time. We conclude that HV prolongation in patients with isolated, post-infarctional IVCD is correlated with a worse prognosis, both during acute infarction and during the follow-up period, which presumably reflects wider anatomic damage in comparison to patients with normal HV time. The low incidence of late AV block and the electrophysiological demonstration of the stability of infranodal conduction several months after AMI indicate that these patients do not require permanent prophylactic pacing after acute myocardial infarction.

Adult↗
PubMed1985

Role of the polymorphonuclear neutrophils in the phototoxic reaction in porphyria cutanea tarda.

We have compared the superoxide production of polymorphonuclear cells (PMNLs) from healthy donors, when incubated with either control or porphyria cutanea tarda (PCT) sera at 4, 24 and 48 hours after exposure in vivo to UVA light. Serum from UVA-irradiated (1-5 J/cm2) PCT patients generated significantly greater amounts of superoxides from PMNLs than serum from UVA-irradiated (8-12 J/cm2) normal controls. This indicates that serum factors activated by porphyrin plus UVA stimulate neutrophilic granulocytes to liberate superoxides, triggering a series of events that cause tissue damage. The vascular lesions in patients with PCT could be, at least in part, due to this cytotoxic effect.

Adult↗