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Biomedical subjects

G Arosio

Publications and source records attributed to G Arosio.

At least 19 recordsLinked to original sources
PubMed1997

[Anesthesia in Apert syndrome].

The anaesthetic technique chosen for a laparohysterectomy in a woman affected by Apert's acrocephalosyndactilia is described. Difficulties in performing tracheal intubation were overcome by mean of loco-regional anesthesia (LRA). In order to minimize the anaesthetic risk, a standardised preoperative evaluation and assessment integrating the usual investigations and the possibility of employing intubation techniques as alternative to direct laryngoscopy are suggested.

Acrocephalosyndactylia↗
PubMed1992

Assessment of myocardial perfusion with thallium-201 scintigraphy in exercise-induced left bundle branch block: diagnostic value and clinical significance.

Myocardial perfusion scintigraphy with thallium-201 was performed in 33 subjects (mean age 45 years, range 28-61) with exercise-induced, rate-dependent left bundle branch block (LBBB) in order to assess both the value of Thallium-201 myocardial imaging for the diagnosis of coronary artery disease (CAD) and the pathogenesis (ischaemic or not) of the conduction defect. Of the 33 patients evaluated, 16 had chest pain suggestive of CAD and 17 were asymptomatic. None had a history of prior myocardial infarction or clinical and echocardiographic signs of heart disease. LBBB appeared at a heart rate ranging from 70 to 160 b.min-1. Eighteen patients showed repolarization abnormalities (ST segment depression with deep inverted T waves) compatible with ischaemia, after QRS normalization. Thallium-201 myocardial uptake was normal in 12 subjects; in the remaining 21, reversible Thallium-201 defects were demonstrated in the septum (18 patients), septum and apex (2), and septum and infero-apical wall (1). No patient had irreversible defects and all had normal coronary angiography, with negative ergonovine tests for coronary artery spasm. The patients were followed up for a mean of 43 months (range 16-80). One patient died from sudden death, but no cardiac event occurred in the other patients. In conclusion, exercise Thallium-201 myocardial scintigraphy showed a high prevalence (64%) of reversible perfusion defects in a group of patients with exercise-induced LBBB without any evidence of CAD at angiography or coronary spasm at ergonovine test. Moreover, follow-up showed a relatively low rate of major cardiac events.

Adult↗
PubMed1988

Coxsackie virus heart disease: 15 years after.

From 1969 to 1973, 68 patients were admitted to the 4th Division of Medicine of the Brescia Civil Hospital with the diagnosis of viral myocarditis. The patients were divided into two groups according to the results of the Coxsackie virus complement fixing antibodies test: Group 1 (42 patients) with a fourfold or greater rising antibody titre; Group 2 (26 patients) with a negative serum test. Both groups were examined after a follow-up period of 15 years. Ten patients from Group 1 died. The diagnoses were chronic myocarditis (three cases); chronic cardiomyopathy-pulmonary embolism (one case); chronic cardiomyopathy-liver cirrhosis (one case); dilated cardiomyopathy-sudden death (two cases); congestive cardiomyopathy (three cases). No Group 2 patients died. The 15-year mortality rate of Group 1 was significantly higher than that of Group 2 (Fisher Test: p less than 0.005). In conclusion, the natural history of Coxsackie virus heart disease is characterized by two possibilities: a complete recovery from a clinical point of view, in some cases with only minor T wave abnormalities, or evolution into a chronic disease (dilated cardiomyopathy) having a high mortality rate within 10 years of the onset of the acute disease.

Cardiomyopathy, Dilated↗
PubMed1987

Diagnostic accuracy of rest-exercise first pass ventriculography with a fast single crystal gamma camera in detecting coronary artery disease. Study of a group of male subjects without previous myocardial infarction.

Rest and exercise radionuclide ventriculograms were performed in 61 non infarcted, male, patients who underwent cardiac catheterization for chest pain and in 16 normal control subjects. Studies were performed using the first pass method with a fast single crystal gamma camera, which allowed a count rate of 140 +/- 19 Kcounts/sec to be reached during left ventricular filling; the count integral on left ventricular area was 10.8 +/- 1.6 Kcounts and the maximum count/pixel 155 +/- 16. We analyzed sensitivity, specificity, positive and negative predictive value of global ejection fraction (EF) and of the regional wall motion in identifying ventricular function abnormalities due to obstructive coronary artery disease. The regional wall motion was evaluated with four functional images: regional ejection fraction (REF), amplitude (A) and phase (PH) from Fourier analysis and systolic transit times (TT). Sensitivity was near 90% for EF, REF, A and TT, while PH was less sensitive (80%); all functional images were more specific (nearly 90%) than EF (80%). Both sensitivity and specificity were lower for the exercise EKG (59% and 63%, respectively) in this patient group. Significant differences between single vessel and multiple vessel disease were also observed either for the EF increase/decrease (-1.34 +/- 7.4 and -7.82 +/- 9.96; P less than 0.05) or for the number of segments which developed wall motion abnormalities during exercise (1.22 +/- 0.73 and 2.15 +/- 1.04; P less than 0.02). In conclusion, with our method, a fast single crystal gamma camera is suitable for obtaining optimal first pass radionuclide ventriculograms with a count density sufficient either for global or regional left ventricular function evaluation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Study of myocardial perfusion by means of scintigraphy with thallium-210 in left bundle branch block induced by exertion].

Myocardial perfusion scintigraphy with 201-TL was performed in a group of subjects affected by exercise-induced, rate-dependent left bundle branch block (LBBB). The aim of the study was: to define the significance of the exercise-induced conduction abnormality: "primitive" or "ischemic". 14 patients, aging 28-58 years (x = 42), 8 with chest pain (4 typical angina, 4 atypical angina) and 6 without any symptoms were studied. None had history of prior myocardial infarction or clinical and echocardiographic signs of heart disease. LBBB appeared at a heart rate ranging from 70 to 160 beats/min. 6 patients showed repolarization abnormalities (ST changes, deep and negative T wave) suggestive for ischemia, during successive QRS normalization. 201-TL-uptake was normal in 5 subjects; in the remaining 9 ones reversible TL defects were demonstrated in the septum (6), in the septum and apex (2), in the septum and inferior-apical wall (1). No patients had irreversible impaired perfusion. All the patients had normal coronary angiography, with negative ergonovine test for coronary artery spasm. In conclusion, in the majority of our subjects (64%) with exercise-induced LBBB, a reversible TL-uptake defect, usually located in the septum without diagnostic value of obstructive CAD, has been observed. Further studies will establish if the TL-defect is only an "apparent phenomenon" due to contraction abnormality secondary to LBBB, or, on the contrary, an expression of myocardial ischemia with normal coronary vessels as a consequence of the LBBB.

Adult↗
PubMed1987

[Acute and chronic effects of verapamil on indices of systolic and diastolic function of the left ventricle in patients with hypertrophic cardiomyopathy].

The aim of this study has been the analysis of acute and chronic effects of Verapamil on resting left ventricular (LV) systolic and diastolic function indices derived from ECG gated radionuclide Angiocardiography (GRA) in patients (pts) affected by Hypertrophic Cardiomyopathy (HCM). 18 pts with HCM were imaged in basal conditions (twice in two different days) and after i.v. infusion of Verapamil 0.1 mg/kg (1st acute test); than chronic oral treatment of Verapamil (240 mg/die) was started. Three months later 14 pts were studied again, during oral chronic therapy and after a second administration of Verapamil i.v. 0.1 mg/kg (2nd acute test). After acute infusion we observed a significant increase of the peak filling rate (PFR) (from 3.3 +/- 0.9 to 3.51 +/- 0.71 EDV/sec, P less than 0.01) and a shortening of the time to PFR (from 188.1 +/- 24.9 to 165 +/- 30 msec, P less than 0.005). No significant variations of the contribution of atrial systole to the ventricular filling (AS) (from 17.03 +/- 5.96 to 18.15 +/- 6.91%), of the heart rate (from 70 +/- 12 to 69 +/- 12 bat/min), and of systolic function indices, ejection fraction (EF) (from 74.4 +/- 9.7 to 74.30 +/- 10.02), peak ejection rate (ER) (from 4.17 +/- 0.92 to 4.10 +/- 0.9), ejection time (ET) (from 307.4 +/- 46.4 to 322.22 +/- 48.6) were noticed. After chronic oral therapy we observed a significant shortening of the time to PFR (from 197.5 +/- 16.7 to 182.8 +/- 13.7 msec, P 0.01), while the remaining indices of diastolic function we analyzed (PFR from 3.2 +/- 0.6 to 3.3 +/- 0.8 EDV/sec; AS from 17.1 +/- 4.9 to 17.1 +/- 6.6%), the systolic function indices (EF from 74.4 +/- 10.5 to 75.4 +/- 9.4%; ER from 4.2 +/- 0.8 to 4.2 +/- 0.6 EDV/sec; ET from 309.6 +/- 48.5 to 308.9 +/- 40.5 msec) and the heart rate (from 67.7 +/- 8 to 66 +/- 8) were not modified. If a 30 msec time to PFR variation was considered significative (confidence limit of 95% between absolute changes measured on two basal studies) the 1st acute test was predictive of chronic efficacy in 10/14 (71%) pts. Four of five pts in which a shortening of TTPFR was observed during the 2nd acute test, showed the same effect with a higher chronic dose of Verapamil (360 mg/die). Our results suggest that Verapamil after acute or chronic treatment improves diastolic filling of LV, without worsening systolic indices.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1985

[Evaluation of the interventricular septum in left bundle branch block using basal echocardiography (M-mode) and myocardial stress scintigraphy (thallium-201)].

In thirty-six consecutive subjects, with left bundle branch block (LBBB) of the interventricular septum (IS), septal perfusion and/or viability was verified by M-mode echocardiography and by stress redistribution 201 TI-scintigraphy. After the early systolic "dip", a characteristic pattern of interventricular septum in left bundle branch block, we observed: a) an anterior paradoxical movement (A-type) during the ejection phase in 5 subjects; b) hypokinetic posterior movement (B-type) in 10 subjects and c) a normal motion (C-type) in 21 subjects. All the subjects with an A-type paradoxical anterior motion of the interventricular septum, showed a persistent defect of T1 uptake both during exercise and after redistribution. Of 31 patients with posterior interventricular septum motion (B and C types), 21 showed normal septal TI uptake and 10 reversible, exercise-induced perfusion defect, with complete redistribution on scintigrams at rest. In conclusion the analysis of our data demonstrates that in patients with left bundle branch block 1) the motion of the interventricular septum is not merely due to the anomalous electrical activation, but to other different factors, such as the anatomical and functional changes underlying the conduction pathology, 2) an A-type motion by M-mode echocardiography is highly predictive of interventricular septum damage.

Adult↗
PubMed1981

[Particles in infusion fluids. Preventive effectiveness of terminal filters. Comparative study].

The main particles present in solutions for parenteral use are potentially harmful. Current industrial technologies are not yet capable of supplying products that are entirely free of corpusculated substances. In addition, the latter increase in direct proportion to the number of handlings that are carried out by hospital staff in the preparation of infusion treatments. Filters capable of cutting down the number of infused particles are suggested for application to defluxion devices. Three such filters currently available on the Italian market are examined. The filter with 0.45 mu diameter holes proved capable of minimising the amount for particles without provoking an appreciable interference with the defluxion times of the solutions used in the experiments.

Antigen-Antibody Reactions↗
PubMed1980

[Tube feeding: an old technique with a new method].

The total parenteral nutrition (T.P.N.) in now largely adopted, often in no strictly cogent indications. The Authors outline the wellknown advantages of enteral nutrition. To overcome the frequent episodes of intolerance in tube feeding, they list the rules followed in preparing diets, strictly balanced from the caloric point of view, using lyophilized natural elements of wellknown composition. Their results seem to confirm the value of the technique.

Diet↗
PubMed1980

[Post-traumatic tricuspid insufficiency. Hemodynamic and echocardiographic study of one case (author's transl)].

The case of a patient, aged 63, with isolated post-traumatic tricuspid insufficiency is described. In this patient the correct diagnosis was made immediately after a non penetrating chest trauma. Physical examination, electrocardiogram, phonocardiogram, chest roentgenogram, hemodynamic and angiocardiographic investigations are reported. The usefulness of echocardiographic examination is emphasized and a comparison with the fail valve syndrome of the mitral valve is made. According to previous reports no immediate surgery was considered and the patient is still under follow up.

Angiocardiography↗