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Biomedical subjects

F Mauri

Publications and source records attributed to F Mauri.

At least 73 records · Page 4Linked to original sources
PubMed1987

Thrombolysis and myocardial infarction.

Many studies suggested that the administration of streptokinase (SK) via a coronary catheter or with intravenous treatment is effective in lysing the offending thrombus which is the cause of most acute myocardial infarctions (AMI). The research carried out by the Italian Group for the Study of Streptokinase in Infarct (GISSI) which enrolled a central randomised population of 11,712 patients with AMI, clearly suggests: intravenous infusion of 1.5 million units of SK reduces in-hospital mortality from 13% to 10.7% (P = 0.0002); the decrease in mortality is 47% in patients treated within 1 hour after the onset of pain. The incidence of adverse reaction was low (4.7%). The results of the follow-up (12 months) demonstrate that beneficial effects of SK treatment on mortality were unchanged. Analysis of plasma creatine kinase curves (CK) from 7,632 patients demonstrates that the rate of input and disappearance of CK into the blood was significantly increased in SK patients. In elderly patients (greater than 65 years) the in-hospital mortality was higher (22.4% vs. 7.4%): SK is effective in patients with first AMI (19.1% vs. 22.9%). The incidence of reinfarction in the hospital phase and at the six months follow-up is higher in SK group (7.4% vs. 4.4%). Some questions remain open about the therapeutical approach to the post-thrombolytic phase and about the treatment of residual stenosis.

Age Factors↗
PubMed1987

[The Italian Group for the Study of Streptokinase in Myocardial Infarct: Analysis of intrahospital causes of death].

Aim of the present study was to analyse the causes of death of the patients admitted to the G.I.S.S.I. Study. Clinical records of the 1386 in-hospital deaths were centrally analysed by two independent clinicians, who were not aware of the performed treatment and based their classification criteria upon clinical and anatomic data. Death causes were classified as follows: cardiac failure, electromechanical dissociation, cardiac rupture, sudden death and extracardiac deaths. Cardiac failure was the most frequent cause of mortality, as 725 pts out of the 1386 (52%) died from this complication in the whole group. 392 pts were part of the control group (6.7%), while 333 had received SK (5.6%): the difference was significant. No difference was observed between treated patients and control group for what concerns the remaining causes of death. Mortality from cardiac failure was strikingly reduced in a few groups of patients: females (from 11.4 down to 8.7%); age less than 65 years (from 4.1 down to 3.2%); early treated pts (up to 3 hrs): from 6.3 down to 5.2%; anterior location of AMI (9.2 down to 7.4%); first AMI episode (from 5.9 down to 4.7%). Such a reduction was remarkable for patients who remained alive after the 7th day from onset of symptoms: cardiac failure was the cause of death in 65 out of 5385 treated patients, and in 100 out of 5333 control group patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗
PubMed1986

Indications for surgical treatment in post-infarction angina.

In order to evaluate whether or not criteria for surgical revascularization in patients with early post-infarction angina (EPIA) should be different from those commonly used for patients with angina, the incidence and prognostic implications of EPIA were analysed in 188 AMI patients in Killip's class I or II on admission. Sixty-two patients (33%) complained of EPIA (Group I) and 126 patients were symptom-free (Group II). There were no differences between the two groups in in-hospital and late mortality and reinfarction. On the contrary, severity of angina was significantly associated with the occurrence of in-hospital and late cardiac death, reinfarction and revascularization procedures. EPIA patients underwent revascularization procedures significantly more frequently than group II patients, both during hospitalization (29% versus 1%; P less than 0.001) and follow up (10% versus 1%; P less than 0.01). Coronary artery involvement was significantly more severe in group I than in group II and in the operated patients compared with the non-operated ones. Our data suggest that the severity of angina should be the leading criterion for surgery, as it is able to identify most of the patients with severe coronary artery disease and poor prognosis.

Aged↗
PubMed1986

Neuroendocrine structures in normal and diseased human lung.

The increasing amount of histological, immunohistochemical and ultrastructural information on some endocrine secretions in human lung cancers suggest the need to revise the classification of neuroendocrine lesions on surgical material. The aim of the present investigation based on lung specimens removed surgically is to give further support to recent proposal for an updated classification of neuroendocrine lung carcinomas. Our study includes 58 squamous cell carcinomas, 58 adenocarcinomas, 6 large cell carcinomas, 27 neuroendocrine carcinomas, and 30 nontumourous cases. Using histological methods (HE, Alcian PAS, Grimelius silver impregnation), we illustrate the presence of neuroendocrine cells and neuroepithelial bodies with their pathological evolutions, ranging from hyperplasia, to dysplasia, and overt neoplasia. On the basis of our experience we propose the following classification of neuroendocrine carcinomas (NEC): typical carcinoids (NECNID), peripheral carcinoid or well-differentiated NEC (NECWED), NEC of intermediate or poorly differentiated type (NECINT) and NEC of small celled or microcytoma type (NECMIC).

Adenocarcinoma↗
PubMed1986

[Prognostic setting and bloodless hemodynamic evaluation of acute myocardial infarct with equilibrium radioisotopic ventriculography].

Forty-four consecutive patients with acute myocardial infarction were studied with equilibrium radionuclide angiography (RNA) within 24 hours from the onset of symptoms, three days after admission and three days before hospital discharge (14 +/- 3 days). To assess the prognostic value of RNA derived parameters we assessed: the ejection fraction (EF), the left ventricular end-systolic volume index (ESVI), the left ventricular end-diastolic volume index (EDVI), the cardiac index (CI), the stroke volume index (SVI) and the peak systolic pressure/end-systolic volume index ratio (PSP/ESVI); we also determined Peel's prognostic index (PI) on admission and measured systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and cardiac frequency (CF) as the same time as the radioisotopic parameters were taken. Thirty-nine patients were discharged without signs of ventricular failure with and without medical treatment (group A), 5 died during hospitalization (group B). Using EF alone, we obtained a very clear distinction between the two groups (Group A 43 +/- 12%; Group B 22 +/- 3%; p less than 0.005). Stepwise, multivariate analysis showed that, by linking PSP/ESVI to EF, we can even obtain a function that correlate better with hospital survival (F = 0.09832 X EF - 0.32035 X PSP/ESVI - 3.12981; p less than 0.002). There was good exponential correlation between EF and PSP/ESVI (r = 0.781) and this would seem to confirm that PSP/ESVI is a more sensitive contractility index for patients with a not very depressed EF.

Blood Pressure↗
PubMed1985

Neuroretinitis in acquired syphilis.

Syphilitic disease of the retina and/or the optic nerve head, without choroidal involvement, occurred in our 4 cases and in another 19 cases. The condition almost always takes place in the secondary stage, frequently associated with meningitis, and rarely in tertiary meningovascular syphilis. Fluctuating visual loss and floating spots without ocular pain are the presenting symptoms. Retinitis, papillitis, and neuroretinitis are accompanied by an inflammatory reaction in the vitreous and, sometimes, in the aqueous. Paracentral scotomas and blind spot enlargement, related with posterior pole and papillary edema, are the most usual visual field defects. Almost complete visual recovery is the rule in the treated cases, although in some instances cystoid macular edema and retinal ischemia due to endarteritis cause permanent visual loss. Treatment with crystalline penicillin is mandatory in patients with concomitant neurosyphilis, whereas procaine penicillin is seemingly sufficient in those with a normal cerebral spinal fluid examination.

Adult↗
PubMed1985

[In-hospital and long-term prognosis in acute myocardial infarction. Comparative longitudinal study of 2 patient groups].

The in-hospital mortality, the causes of death, the actuarial survival curves were compared in two subsequent groups of patients admitted to our CCU for acute myocardial infarction: the first (group A) includes 791 pts, admitted from september '67 to december '72, the second (group B) includes 542 pts admitted from january '78 to june '80. The in-hospital mortality was significantly reduced in group B (A: 186/791, 23.5%; B: 72/542, 13,3%, p less than 0.01). This could be due to a reduction of the number of deaths for cardiogenic shock (A: 71/791, 9%; B: 30/542, 5.6%; p less than 0.01) and to reduction in the mortality rate for pulmonary oedema (from 6% to 1.5%, p less than 0.01), although the frequency of pulmonary oedema was the same during the two periods (A: 205 pts, 26%; B/156 pts 29%). We did not observe any significant difference in the long-term prognosis (54 months: A 79.3%, B 71.5%). The actuarial survival curves overlapped after the 1st semester after discharge. The most frequent cause of death during follow-up was a new myocardial infarction. None in the group A and only 3% in the group B were referred to the surgeon for coronary artery bypass grafting. We conclude that, in spite of a significant reduction of the in-hospital mortality, possibly related to the evolution in diagnosis and management of the disease, the long-term survival was not improved in a non-surgically treated population with myocardial infarction.

Adult↗
PubMed1981

[Comparison between the hemodynamic effects of nitroglycerine ointment and oral isosorbide dinitrate in the treatment of left ventricular failure (author's transl)].

The hemodynamic effects of standard dose of Nitroglycerin (NTG) ointment (23 +/- 4 mg) and oral Isosorbide Dinitrate (ISDN) 10 mg were compared in the treatment of left ventricular failure. Ten patients, 8 males and 2 females (mean age 59 +/- 9 years), affected by acute myocardial infarction (7 cases). Ischemic cardiomyopathy (2 cases) and hypertensive cardiomyopathy (1 case) were submitted to right heart catheterization by triple lumen Swan-Ganz catheter. Heart Rate (HR), mean Arterial Pressure (AP), Right Atrial Pressure (RAP), mean Pulmonary Artery Pressure (PAP), Pulmonary Wedge Pressure (PWP), Stroke volume (SV), Cardiac Index (CI), Stroke Work Index (SWI), Systemic Vascular Resistances (SVR), Pulmonary Total Resistances (PTR) were controlled every 30 minutes until the disappearance of the hemodynamic effects. ISDN did not produce any statistically significant changes; on the contrary NTG ointment caused significant changes in: (formula: see text). Decrease of RAP, PAP, PWP, PTR and increase of SV, CI, SWI were statistically significant from 30 until 180 minutes after NTG ointment administration. These changes were statistically different from those produced by ISDN (p less than 0,05). Thus NTG ointment, at this dose, improved cardiac performance, while oral ISDN 10 mg did not. It is concluded that the hemodynamic effects of NTG ointment are prompt and sustained.

Administration, Oral↗
PubMed1979

Comparative effects of nifedipine, verapamil, isosorbide dinitrate and propranolol on exercise-induced angina pectoris.

According to the experimental model of a 5 X 5 Latin square, 5 treatments were studied single blind in 5 patients, affected by stable-effort angina, by means of exercise tests. In the period of maximal supposed effect the following treatments were investigated: placebo (P), 1 tablet, orally; isosorbide dinitrate (ISDN), 5 mg, sublingually; propranolol (Pr), 40 mg, orally; nifedipine (N), 10 mg, orally; verapamil (V), 160 mg, orally. Placebo, compared with its own control tests, did not change any of the examined parameters. Comparison of the 'active' treatments with P showed the following results. All the treatments increased the duration of work before ECG positivity appearances. An increase in duration of work and total work performed before angina was seen after administration of ISIDN, N and V; the improvement observed after treatment with Pr was not significant. Comparison of treatments showed that work performance before angina was the same after administration of ISDN, N and V; these treatments were more effective than that with 40 mg Pr. Duration of work before ECG positivity was significantly longer after ISDN and N than after Pr. The changes in heart rate, maximal arterial pressure, ejection time index and triple product confirmed the activity of the administered doses. According to the observed effects on exercise tolerance, in comparison with P the same level of work was performed with the same triple product after Pr, and with lower triple products after ISDN, N and V.

Angina Pectoris↗
PubMed1978

[Effects of the association of Ca-antagonists with nitroderivatives or betablocking drugs in effort angina pectoris (author's transl)].

The effects of the association of calcium antagonists (CAI) with a nitroderivate and a betablocker were studied by means of exercise tests in 8 patients with stable effort angina pectoris. According the statistical model of a latin square 4 x 4, the first 4 patients were tested with the following treatments: placebo, oral; nifedipine (N) 10 mg, oral; N + isosorbide dinitrate (ISDN) 10 mg oral; N + propranolol (Pr) 40 mg, oral. In the second square verapamil 80 mg oral represented the CAI treatment. Compared to placebo, all the treatments produced a significant increase of exercise duration and total work performed before angina. In both the squares the improvement observed after CAI + ISDN was significantly higher than after administration of CAI alone. In both the squares the association of CAI + Pr determined a little, non significant improvement of exercise duration in respect to CAI alone. EKG positivity was delayed by Pr more than angina appearance: hpwever, also this effect was not significant when compared with administration of CAI alone. By the analysis of the changes of heart rate, maximal arterial pressure, ejection time and triple product at the same level of work, a relevant inhibition of myocardial contractility with the adopted doses of CAI can be excluded; the effect of these drugs seems to be due mainly to a decrease of arterial pressure, and, when associated to ISDN, to decreases of arterial pressure and ejection time.

Adult↗
PubMed1977

[Effectiveness of nifedipine on exercise tolerance in patients with angina pectoris. Comparison with a nitroderivative and a beta-blocking agent].

The effect of nifedipine on effort angina was investigated by means of exercise tests with bycicle ergometer and compared, in the same patients, with the effects of a nitroderivative and a betablocking agent. Five patients with stable effort angina entered the study, after an hemodynamic and contrasto-graphic control. According to the protocol of a latin square 5 X 5, all the patients received in a random sequence the following treatments: placebo, 1 c. orally; isosorbide dinitrate, 5 mg sublingually; propranolol, 40 mg orally; nifedipine, 10 mg sublingually; nifedipine, 10 mg orally. No significant change of any of the considered parameters was observed after the placebo. Isosorbide dinitrate and nifedipine produced significant increases of the duration of work before appearance of pain and EKG positivity, and of total work performed before anginal pain. Only the duration of work before EKG positivity was improved by propranolol. The comparisons between treatments showed no significant difference of the effects of the administered doses of isosorbide dinitrate and nifedipine. The improvements observed after propranolol were significantly lower than that observed after isosorbide dinitrate and oral nifedipine. On the basis of the observed changes of cardiac rate, maximal arterial pressure, ejection time index and triple product, the authors evaluate the possible mechanism of action of nifedipine.

Adolescent↗
PubMed1976

Lipid patterns in haemodialysed and transplanted patients.

The plasma lipid pattern was investigated in 103 dialysis patients and 66 renal transplant patients. Only 32 percent of dialysed patients and 30 percent of transplanted patients had a normal lipid pattern. In other patients the most frequent disorder with hypertriglyceridaemia, and less frequently combined or isolated hypercholesterolaemia. Since these lipid abnormalities are known to predispose to an accelerated atherosclerosis, a dietetic therapeutic approach was tried. Fifteen transplanted patients with severe hypertriglyceridaemia were submitted to a hypocaloric (1700 kcal) and low carbohydrate (130 g) diet. During dieting the plasma lipid pattern was normalised and maintained in a normal range for the period of observation (3-12 months).

Adolescent↗