Biomedical subjects
Publications and source records attributed to F Chierici.
Nonsteroidal anti-inflammatory drugs are widely used and relatively safe medications. We report here an uncommon case of fluid retention simulating acute congestive heart failure, secondary to aspirin consumption, promptly reversible after discontinuation of therapy, and triggered again by pharmacological challenge test.
From 1982 to 1994, 54 patients (47 men; mean age 72 years) were referred to the Hospital of Ferrara, Italy for spontaneous rupture of abdominal aortic aneurysm. Sixteen died in the emergency department and 38 underwent urgent surgery. Day and month of onset of acute symptoms leading to urgent surgery were recorded. A seasonal variation with significant peaks in spring and autumn was found. These findings are likely influenced by local environmental, social and epidemiological factors, but may be relevant for the appropriate timing of the follow-up and therapeutic strategies for abdominal aortic aneurysms.
Convincing evidence is now available suggesting that several unfavorable cardiovascular events respect a well-defined diurnal pattern in their occurrence. In particular, ischemic heart disease has been widely investigated, and many data indicate a constellation of underlying risk factors whose temporal coincidence might act as triggering factors in the occurrence of acute events. In this paper, the recent knowledge concerning both epidemiology of ischemic heart disease and potentially favoring factors are reviewed from a chronobiological point of view.
A growing body of evidence has recently accumulated suggesting that several unfavorable cardiovascular events, e.g., myocardial angina and infarction, sudden cardiac death, and stroke, present a specific temporal pattern in their occurrence. This has also been shown to be true for fatal pulmonary thromboembolism, with a high frequence peak in winter and in the morning hours. The authors report the circannual and circadian aspects of pulmonary thromboembolism, analysing both the temporal patterns of the underlying favouring or precipitating factors, and the possible therapeutic implications.
The purpose of this study was to assess prospectively the circadian distribution of spontaneous paroxysmal supraventricular tachycardia (PSVT) in drug-free subjects with no previous history or symptoms and signs of concomitant heart or lung disease. Of 112,424 presumably diurnally active patients admitted to the Emergency Department of a city hospital during a 2-year period (1990-1991), a total of 185 patients were screened with these characteristics. Time of symptom onset was exactly recordable in 177 (75 men and 102 women). Analysis of variance documented a higher incidence in the morning-afternoon hours. Cosinor analysis, although not a perfect method for the time series analysis, verified circadian rhythmicity with afternoon peak times. Our findings suggest that a circadian pattern in intrinsic electrical instability of the heart conduction system exists irrespective of the circadian fluctuations in the pathophysiologic mechanisms of the cardiovascular or lung diseases most frequently associated with PSVT itself.
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