PubMed Health⌕ Search

Biomedical subjects

A Serradimigni

Publications and source records attributed to A Serradimigni.

At least 19 recordsLinked to original sources
PubMed1992

Simultaneous modelling of mexiletine and hydroxy-methyl-mexiletine data after single- and multiple-dose administration of a sustained-release mexiletine formulation.

The pharmacokinetics of mexiletine and its metabolite hydroxy-methyl-mexiletine have been investigated following single-dose and during multiple-dose administration of a sustained-release form of mexiletine to six post-myocardial infarct patients. Comparison of single-dose and washout pharmacokinetics, after short-term multiple-dose administration, showed significant (p < 0.005), but not systematic, modifications in mexiletine apparent clearance for three patients. Furthermore, for these patients, simulation with both sets of parameters indicated that the steady-state was achieved before washout experiment in two cases. The fraction of mexiletine metabolized to hydroxy-methyl-mexiletine was lower for multiple-dose administration (about 18 per cent) than for the single dose (about 42 per cent). The hydroxy-methyl-mexiletine elimination rate constant was about four times that of mexiletine. Mexiletine clearance could be accounted for by other metabolic pathways. In one patient, hydroxy-methyl-mexiletine was undetectable even during multiple-dose administration, despite a significant increase in mexiletine clearance. However, the observed changes in mexiletine disposition had no therapeutic implications and active plasma levels were achieved by the third day of administration and maintained in the therapeutic range (0.75 to 2 micrograms ml-1) in all patients after a twice daily dosage regimen.

Aged↗
PubMed1979

[Value of continous electrocardiography (Holter monitoring) in mitral valve prolapse].

Twenty three patients with mitral valve prolapse underwent ambulatory 20 to 24 hour electrocardiography to study the incidence and severity of ventricular arrhythmias. These arrhythmias were found in 20 cases (87 p. 100). Ventricular extrasystoles were usually grouped (14 cases) causing doublets in 8 cases and bursts of ventricular tachycardia in the 6 others. The importance of the information obtained by Holter monitoring should not detract from the value of the standard resting electrocardiogramme. In fact, there appears to be a good correlation between the severity of the ventricular arrhythmia and the presence of ST changes over the postero-inferior zones. These abnormalities were never present in patients without ventricular extrasystoles but on the other hand they were observed in 5 of the 6 patients with ventricular tachycardia. From a practical point of view this may represent a simple means of identifying patients at high risk of dangerous arrhythmias.

Adolescent↗
PubMed1979

[Painless ST elevation with syncope. Diagnosis by continuous electrocardiography].

The aetiology of syncope in a 53 year old man was discovered on continuous ambulatory electrocardiography. A ventricular arrhythmia associated with ST elevation was recorded. It proved resistant to medical therapy and a double aorto-coronary bypass graft was performed. Post-operative Holter monitoring showed surgery to have been effective.

Arrhythmias, Cardiac↗
PubMed1978

Treatment of venous thrombosis and pulmonary embolism by streptokinase.

We applied the standard treatment with streptokinase to 52 cases of deep venous thrombosis and 35 cases pulmonary embolism. Angiography demonstrated total lysis of the clot 22 times, partial lysis 42 times, and no lysis 23 times. The absence of lysis was more frequent in venous clots than in pulmonary clots. Early treatment was more effective, achieving complete lysis in 21 of 22 cases. Nevertheless, in deep venous thrombosis, late treatment can result in partial lysis and set an important venous junction free. With the standard treatment, the biologic controls showed good lysis in 75% of the cases, insufficient lysis in 15%, and no lysis in 10%. The extent of the thrombosis is an important point. The clot was totally lysed in 9 of 10 cases of localized deep venous thrombosis. In patients with pulmonary embolism, about 30% of the obstructed surface is cleared. Nevertheless, in such cases we must take into consideration not only the nonperfused pulmonary area, but also the venous starting point of the clot.

Adult↗
PubMed1978

[Criteria of prognosis in apparently primary hypokinetic myocardiopathies (prospective study of 60 cases)].

The fate of 60 cases of apparently primary cardiomyopathy were studied by angiocardiography and coronary arteriography over a 2 to 6 year period, with a mean of 4 years. Correlations were established between the clinical, paraclinical, haemodynamic and angiocardiographic findings on the one hand, and the quality and length of survival on the other. Among the criteria leading to an improved prognosis, the most precise was the left ventricular ejection fraction.

Adolescent↗
PubMed1978

[Effects of intravenous trinitrine on myocardial function in left ventricular insufficiency].

The effects of intravenous trinitrin on myocardial function have been studied in 40 patients with heart failure (26 cases of coronary artery disease and 14 of apparently primary cardiomyopathy). Each patient had measurements made of left ventricular pressure, of cardiac output by the dye dilution method, of volume, of the left ventricular ejection fraction, and of the segmental parietal kinetics by means of left side ventriculography both before and after trinitrin. The following results were obtained after injection of trinitrin:--no change in rhythm and cardiac index;--an almost constant decrease in left ventricular end diastolic pressure (38 cases out of 40);--a decrease in arterial pressure and ventricular volume in about two thirds of cases;--improvement of the ejection fraction (25 cases out of 40), and of segmental parietal kinetics (26 cases out of 40) in the left ventricle. These findings were equally true in the patients with coronary artery disease and in the cardiomyopathies. In the light of these results, it appears that when used in left ventricular failure, trinitrin almost always decreases the load, but improves ventricular kinetics only in two thirds of cases, while it has no influence on cardiac output. In addition, given the difficulties in establishing a standard dose of trinitrin, the authors discuss the methods of establishing the optimal dose.

Blood Pressure↗
PubMed1978

[Streptokinase in the treatment of deep venous thrombosis and pulmonary embolism].

Fifty-two deep venous thromboses and 35 pulmonary emboli were treated by Streptokinase administered in accordance with a standard protocol. Radiological examinations revealed total lysis of clots in 22 cases, partial lysis in 42 and failure in 23. The latter more commonly involved venous clots than pulmonary emboli. Early treatment was more effective (21 total lyses out of 22) than late treatment. However, in venous thrombosis, late treatment may give partial lysis and free important venous junctions. With standard treatment, lysis was biologically correct in 70 p. 100 of cases. It was inadequate in 20 p 100 of cases and nil in 10 p. 100 of cases. The results could thus have been improved by treatment established and adjusted in the light of laboratory results. The extent of the thrombosis played an important role. Total lysis was obtained in 9 out of 10 cases of localised deep venous thrombosis. In pulmonary embolism there was an average gain of approximately 30 p. 100 in obstructed surface area. However, in these latter cases, it is important to take into account not only the pulmonary surface area obstructed but also the origin of the clots.

Adult↗
PubMed1977

[Alcoholic cardiomyopathies (author's transl)].

In 108 patients suffering from congestive type cardiomyopathy, there were 42 alcoholics and 66 non-alcoholics. Comparisons between the two groups were made on the basis of clinical data, paraclinical investigations and prognosis. It was possible to distinguish an alcoholic cardiomyopathy which differs from primary cardiomyopathies by the greater severity of the clinical picture and a gloomier prognosis.

Adolescent↗
PubMed1976

[Venous signs at the acute stage of pulmonary embolism].

The authors have carried out phlebograms on 50 patients with recent pulmonary emboli. In the majority of cases (44 out of 50) they found thrombosis in the veins of the lower limbs: in 35 cases, these were situated proximally, ending in the femoro-ilio-caval segment; in 9 cases they were confined to the suropopliteal veins. These facts have led us to modify our treatment plan for pulmonary embolism. Thrombolytic treatment seems to be justified in cases where the prebitis is high up, even if the pulmonary embolus is benign. Heparin is reserved for those cases of benign pulmonary emboli which are secondary to suro-popliteal phlebitis. The question of interrupting the inferior vena cava must bed ecided in the light of the phlebograms.

Acute Disease↗
PubMed1976

[Development of pulmonary embolism].

The authors have made a study of the fate of 118 patients with pulmonary embolism. The mortality (21.8%) is related not only to the embolus itself (especially to the recurrent types) but also to the condition of the affected area. Recurrence is common (34%), serious (9 deaths out of 25), and early (during the first three months.). No treatment or inadequate treatment are the main causes. Treatment works effectively on the pulmonary circulation, which becomes reestablished in the majority of cases, but it carries the risk of a high incidence of haemorrhage (29%) which is severe (2 deaths and 10 tranfusions of more than one litre of blood). In the long term, the prognosis is linked to the developments in the lower limbs, in which there is a progressive failure of venous drainage (46 cases out of 57), even in cases in which there was no local sign of phlebitis at the time of the original embolus.

Adult↗
PubMed1975

[Respective value of labelled fibrinogen and rheography in the detection of phlebitis].

The authors have studied in 212 patients the diagnostic value of radio-active fibrinogen and rheography in deep venous thrombosis of the leg by comparing the results from these two methods with phlebography. Radio-active fibrinogen seems the better means of diagnosis in early distal phlebitis. However, the method is expansive, the radio-active substance can only be manipulated in certain specialized centers, and is useless in the presence of hematoma. Rheography is less expansive, more easily manipulated, yet less sensitive as only proximal phlebitis can be detected-especially when completely occlusive. In addition, active patient cooperation is necessary. The time needed to realize the two methods is a major obstacle; however, they can be fruitful if integrated into a specialized department for the diagnosis and treatment of thrombo embolic disease.

Collateral Circulation↗