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Biomedical subjects

F Basile

Publications and source records attributed to F Basile.

At least 37 records · Page 2Linked to original sources

Thallium-201-dipyridamole imaging: comparison between a standard dose and a high dose of dipyridamole in the detection of coronary artery disease.

UNLABELLED: The purpose of this study was to compare two different doses of dipyridamole as a pharmacologic stress test for 201Tl imaging. METHODS: Twenty-four patients with significant coronary artery disease (15 had undergone a coronary angiogram and 9 had undergone a previous 201Tl study with a significant lesion) were prospectively studied. Within 1 wk, all patients underwent two 201T-dipyridamole myocardial planar studies, one using a standard dose (STD) and the other, a high dose (HIGH) of dipyridamole. The protocol order was randomly assigned. The STD protocol used a dose of 0.14 mg/kg/min for a duration of 4 min (0.56 mg/kg), and the HIGH protocol used a dose of 0.14 mg/kg min for a duration of 6 min (0.84 mg/kg). The 201Tl was injected 3 min after the end of the dipyridamole infusion. Images, obtained 5 min and 4 hr later, were interpreted (divided into five segments each) by three blinded observers. RESULTS: The STD protocol showed normal, ischemia and scar in 252, 91 and 17 segments, respectively. The HIGH protocol detected 232, 118 and 10 segments, respectively. A side-by-side evaluation was done to evaluate the defect extent subjectively, which was greater with HIGH in 14, equal in six and smaller in four patients. One or more side effects were seen in 14 patients with STD and in 19 with HIGH. Increased heart rate (8 bpm for STD and 19 bpm for HIGH, p < 0.001) was the only significant change seen in the hemodynamic parameters. CONCLUSION: This preliminary study indicates that a high dose of dipyridamole seems to be safe and can be helpful to increase the sensitivity of 201Tl imaging.

Coronary Disease↗

A comparison of aspirin with placebo in patients treated with warfarin after heart-valve replacement.

BACKGROUND: Despite the use of warfarin, major systemic embolism remains an important complication in patients with heart-valve replacement. Although the addition of antiplatelet agents has the potential to reduce this complication, their efficacy and safety when given in combination with warfarin are uncertain. METHODS: In a randomized, double-blind, placebo-controlled trial, we assessed the efficacy and safety of adding aspirin (100 mg per day) to warfarin treatment (target international normalized ratio, 3.0 to 4.5) in 370 patients with mechanical heart valves or with tissue valves plus atrial fibrillation or a history of thromboembolism. RESULTS: A total of 186 patients were randomly assigned to aspirin and 184 to placebo, and they were followed for up to 4 years (average, 2.5). Major systemic embolism or death from vascular causes occurred in 6 aspirin-treated patients (1.9 percent per year) and 24 placebo-treated patients (8.5 percent per year) (risk reduction with aspirin, 77 percent; 95 percent confidence interval, 44 to 91 percent; P < 0.001). Major systemic embolism, nonfatal intracranial hemorrhage, or death from hemorrhage or vascular causes occurred in 12 patients assigned to aspirin (3.9 percent per year) and 28 patients assigned to placebo (9.9 percent per year) (risk reduction, 61 per cent; 95 percent confidence interval, 24 to 80 percent; P = 0.005); major systemic embolism or death from any cause occurred in 13 patients (4.2 percent) and 33 patients (11.7 percent), respectively (risk reduction, 65 percent; 95 percent confidence interval, 33 to 82 percent; P < 0.001); and death from all causes occurred in 9 patients (2.8 percent) and 22 patients (7.4 percent), respectively (risk reduction, 63 percent; 95 percent confidence interval, 19 to 83 percent; P = 0.01). Bleeding occurred in 71 patients in the aspirin group (35.0 percent), as compared with 49 patients in the placebo group (22.0 percent) (increase in risk, 55 percent; 95 percent confidence interval, 8 to 124 percent; P = 0.02); major bleeding occurred in 24 and 19 patients, respectively (increase in risk, 27 percent; 95 percent confidence interval, -30 to 132 percent; P = 0.43). CONCLUSIONS: In patients with mechanical heart valves and high-risk patients with prosthetic tissue valves, the addition of aspirin to warfarin therapy reduced mortality, particularly mortality from vascular causes, together with major systemic embolism. Although there was some increase in bleeding, the risk of the combined treatment was more than offset by the considerable benefit.

Adult↗

Fast and sensitive laser-based enzymatic detection of the lactose operon in microorganisms.

This work investigates the ability of laser-based, time-resolved fluorometry to detect the lactose operon genetic marker in microorganisms and to study protein-DNA interactions. In the first study, rapid detection of the Escherichia coli lacZY operon inserted in two strains of Pseudomonas proposed as fungal biological control organisms was achieved. Optimization of incubation time, immobilization apparatus size, and reagent volumes, along with the laser-based instrumentation, yielded an assay capable of detecting 10(4) immobilized lac+ Pseudomonas fluorescens cells within a 30-min incubation time. In the second study, the synthesis of E. coli beta-galactosidase was monitored in "real-time" with observable enzymatic activity beginning 4 to 5 min after induction with isopropylthiogalactoside.

DNA Transposable Elements↗

[Neurofibromatosis and pregnancy. Considerations on a clinical case and review of the literature].

In this paper, starting from a case of neurofibromatosis adversely affecting pregnancy, the authors consider several interactions between pregnancy and Von Recklinhausen's diseases. The review of the literature emphasizes either an exacerbation of the maternal disease because of pregnancy, or the onset appearance of serious complications such as sarcomatous degeneration of neurofibromas, activation of a silent pheochromocytoma, rupture of an aneurysm. Moreover, the effects of neurofibromatosis on the pregnancy cause an elevated risk of IUGR, pregnancy hypertension, abortion and stillbirth and oligohydramnios. The pregnancy of a patient affected with neurofibromatosis needs careful evaluation of the maternal clinical conditions and of the foetus-placenta unity.

Adult↗

Comparison between technetium-99m-teboroxime and thallium-201 dipyridamole planar myocardial perfusion imaging in detection of coronary artery disease.

Technetium-99m (TC-99m)-teboroxime is a new myocardial perfusion imaging agent. The purpose of this prospective study was to compare Tc-99m-teboroxime with thallium-201 imaging after the administration of dipyridamole. Thirty patients referred for the evaluation of chest pain were studied with both thallium-201 and Tc-99m-teboroxime dipyridamole scans (mean interval 2 days). Dipyridamole was administered at 0.142 mg/kg/min for 4 minutes. Planar imaging (3 standard views) was obtained at 5 and 240 minutes after the injection of 2.2 mCi of thallium-201. Tc-99m-teboroxime (18 to 25 mCi) was injected after dipyridamole infusion. A second injection, at rest, was repeated 4 hours later. Planar imaging (3 standard views of 1 minute/view for the first 2 views, and 90 seconds for the last view) was obtained 2 minutes after Tc-99m-teboroxime injection. Blinded reading was performed by 3 observers. Thallium-201 showed perfusion defects in 182 myocardial segments corresponding to 33 of 45 (73%) significantly stenosed coronary arteries (greater than or equal to 70% reduction in endoluminal diameter), and Tc-99m-teboroxime detected 160 abnormal segments corresponding to 29 of 45 (64%) stenosed arteries. Thallium-201 and Tc-99m-teboroxime studies were normal in 3 patients. In conclusion, this study shows that there is a good correlation in the imaging results found with thallium-201 and Tc-99m-teboroxime using dipyridamole infusion on both a segmental and a diagnostic comparison.

Adult↗

[Recurrent hernia of the Douglas pouch. Surgical reconstruction by the vaginal route using a mersylene net].

The paper reports an interesting case of Douglas' hernia in a patient who had previously undergone gynecological surgery using a vaginal and abdominal route. The paper is illustrated by radiographic image. The importance of the clinical, anatomical and morphological conditions of the patient is underlined in the evolution of the hernial pathology. Reconstructive surgery was performed by creating a support barrier of mersylene net in order to avoid further recurrences.

Douglas' Pouch↗

Heart valve replacement with the Björk-Shiley Monostrut valve: early results of a multicenter clinical investigation.

To evaluate the clinical performance of the Björk-Shiley Monostrut prosthesis, five centers combined their early experience. Between May, 1982, and June, 1985, 537 prostheses were implanted in 486 patients at these centers: 246 patients had aortic valve replacement (AVR), 163 underwent mitral valve replacement (MVR), and 47 had double-valve replacement (DVR). Thirty patients underwent other, more complex procedures. Concomitant cardiac procedures were performed in altogether 25%. Overall hospital (30 days) mortality was 5.1% (3.6% for AVR, 4.3% for MVR, 8.3% for DVR, and 16.6% for other procedures). The patients were followed up at 6- to 9-month intervals from 6 to 48 months (mean follow-up, 33 months). Follow-up was 99.6% complete. Late mortality was 7.2%. The three-year survival rate was 91.0% for AVR, 92.3% for MVR, and 76.2% for DVR. There was no structural failure of the prosthesis. No instances of valve thrombosis and fatal thromboembolism occurred in anticoagulated patients. The three-year incidence of freedom from thromboembolic events (including TIA) was 89.8% for AVR, 94.9% for MVR, and 90.2% for DVR. Preoperative and postoperative data for the assessment of mechanical hemolysis was available in 60% of the patients. The degree of mechanical hemolysis was low and did not change with time. Although the follow-up is still short, the Björk-Shiley Monostrut prosthesis appears to represent an improvement over previous Björk-Shiley models, particularly with regard to durability.

Actuarial Analysis↗

Long term results of high selective vagotomy: a 12-year experience.

The long term results (6 to 12 years) of high selective vagotomy are reported. The study includes 470 patients operated electively for uncomplicated duodenal ulcer. The indications for surgery were: persistence of ulcer after medical treatment; recurrent ulcer after repeated treatments with antacids and/or H2 blockers; noncompliance of the patients with the medical treatment for various reasons. The procedure was performed following the technique described by Goligher with minor modifications. Subsequently, a personal technique of intraoperative transesophageal gastric pHmetry was applied for the control of the completeness of vagotomy. The clinical results were classified according to Visick grading. It is concluded that the absence of mortality, the negligible postoperative morbidity, the clinical and functional results make high selective vagotomy the best treatment for uncomplicated duodenal ulcer.

Duodenal Ulcer↗