Biomedical subjects

G Fragasso

Publications and source records attributed to G Fragasso.

58 records · Page 4Linked to original sources

PubMed1988

Prevalence of parathyroid insufficiency after thyroidectomy: study of 1037 cases.

In 1037 patients undergoing total (827 cases) or partial thyroidectomy (52 cases of subtotal thyroidectomy, 108 of hemithyroidectomy, 50 of enucleation and resection) for each study group the incidence of hypoparathyroidism, its possible causes and technical factors favouring the onset, were examined. In this series postoperative prevalence of hypoparathyroidism was 16.6%. It seems to be directly proportional to the extent of surgery thus confirming the necessity to locate and preserve the parathyroid glands during surgery. This should be as conservative as possible according to the prognosis of the thyroid disease.

Cross-Sectional Studies↗

PubMed1987

Relative roles of preload increase and coronary constriction in ergonovine-induced myocardial ischemia in stable angina pectoris.

To assess the relative role of increased ventricular preload and critical coronary lesions in ergonovine-induced myocardial ischemia, 9 normal subjects (group A), 7 patients with stable angina (group B) and 5 with variant angina (group C) were studied. In all patients, the 12-lead electrocardiogram, blood pressure and left ventricular (LV) volume (technetium-99m blood pool) were continuously recorded before and during administration of incremental doses of ergonovine given at 5-minute intervals. In all subjects, an initial LV dilatation developed; in group B and C patients, this was followed by a decrease in stroke volume and ejection fraction with subsequent onset of electrocardiographic changes and angina. The interval between these events was significantly shorter in group C and in 3 group B patients; in these patients, signs of ischemia appeared with smaller ergonovine doses and at minimal preload increase, coronary constriction being the likely mechanism of ischemia. In the remaining 4 group B patients, the onset of stroke volume, ejection fraction, electrocardiographic changes and angina was significantly delayed, occurring after administration of larger ergonovine doses when LV volume was already considerably increased. This finding suggests that the loading effect of ergonovine on LV volume, rather than on coronary constriction, could be the prevailing mechanism of ergonovine-induced ischemia in these patients.

Angina Pectoris↗

PubMed1987

Usefulness of Holter monitoring to improve the sensitivity of exercise testing in determining the degree of myocardial revascularization after coronary artery bypass grafting for stable angina pectoris.

To assess whether Holter monitoring improves the sensitivity of exercise testing in identifying incomplete myocardial revascularization, both tests were performed in 45 patients from 3 to 5 months after elective coronary artery bypass grafting (CABG) for stable angina pectoris. Coronary angiography revealed incomplete revascularization in 26 patients. Six of these 26 had 52 episodes of ST-segment depression during Holter monitoring and myocardial ischemia during exercise testing. Their exercise capacity was significantly lower than that of 10 other patients in whom the results of exercise testing only were positive (heart rate at 0.1 mV ST-segment depression 112 +/- 9 vs 123 +/- 15 beats/min, p less than 0.001). In the other 10 patients with incomplete myocardial revascularization the results of both investigations were negative. The graft patency rate was lower in patients with a positive response to exercise testing than in those with a negative response (52% vs 71%, p less than 0.005). Myocardial revascularization was angiographically complete in 19 patients. In 18 of these 19 patients the findings of both investigations were negative; in 1 patient Holter monitoring revealed episodes of ST-segment elevation suggestive of variant angina. Thus, after CABG for stable angina pectoris the results of Holter monitoring do not improve the sensitivity of exercise testing in identifying patients with angiographically incomplete myocardial revascularization because findings are positive only in patients with low exercise capacity. Both tests fail to show evidence of myocardial ischemia in most patients with angiographically complete myocardial revascularization.

Aged↗

PubMed1986

Complementary role of whole body scan and serum thyroglobulin determination in the follow-up of differentiated thyroid carcinoma.

In 233 patients with differentiated thyroid carcinoma previously treated by total thyroidectomy supplemented, when necessary, with a therapeutic dose of 131I, serum thyroglobulin determinations and whole body scans were simultaneously performed. 82 of the 233 showed local or distant metastases: they were detected by both tests only in 36 cases. In 43 patients thyroglobulin was positive but without pathological concentrations of 131I at whole body scan were observed. The remaining 3 cases were detected on the basis of the positive whole body scan only, without increase in the circulating thyroglobulin. These results suggest that caution should be taken when considering thyroglobulin determination as possible substitutive test of whole body scan in the follow-up of differentiated thyroid carcinoma. However, for optimal sensitivity and reliability the complementary role of the two tests is stressed.

Adenocarcinoma↗