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G Rossetti

Publications and source records attributed to G Rossetti.

At least 19 recordsLinked to original sources
PubMed1996

Time domain signal-averaged electrocardiogram in predicting arrhythmic events after myocardial infarction: role of the duration of the filtered QRS complex.

Several studies showed that time domain analysis of the signal-averaged ECG may identify groups of patients with low and high risk for arrhythmic events after myocardial infarction (MI). However, the signal averaging methods were not uniform and the definition of abnormal signal-averaged ECG was empiric. To identify the best quantitative signal-averaged variable in predicting arrhythmic events (sustained ventricular tachycardia, ventricular fibrillation and witnessed, instantaneous death) 262 patients surviving acute MI were prospectively evaluated. Twelve clinical variables, left ventricular ejection fraction (LVEF), complex ventricular arrhythmias (CVA) on Holter monitoring and three conventional signal-averaged variables (either at 25-250 or 40-250 Hz) were entered in a Cox proportional hazards regression model. During a mean follow-up of 20.3 +/- 13.7 months 16 (6.1%) patients had arrhythmic events. All six signal-averaged variables were independent predictors of arrhythmic events and the filtered QRS duration (fQRSD) > or = 120 ms at 40 Hz high pass filtering resulted the most predictive. In a regression analysis, including the best signal-averaged variable, LVEF and CVA, only fQRSD > or = 120 ms at 40 Hz and LVEF independently predicted arrhythmic events. Sensitivity, specificity, positive predictive value and odds ratio for fQRSD > or = 120 ms at 40 Hz were 63, 90, 29 and 11%, respectively, and for the combination of fQRSD > or = 120 ms at 40 Hz and LVEF < 40%, were 73, 95, 47 and 39%, respectively. In conclusion, the fQRSD > or = 120 ms at 40 Hz best predicts arrhythmic events in the post-infarction period. The combination of signal-averaged ECG and LVEF is recommended to stratify patients at risk of arrhythmic events after MI.

Aged↗
PubMed1996

[Ultrasonography in acute diverticulitis of the colon: semiologic features].

To assess the ultrasonographic (US) patterns of acute colonic diverticulitis, we prospectively examined 21 patients. US was performed in all of them, CT in 13/21, contrast enema in 18/21 and endoscopy in 2/21 patients. US follow-up was carried out in 15/17 patients managed with conservative treatment. To analyze the US patterns of simple diverticula, we carried out an in vitro study of two surgical specimens with simple colonic diverticulosis. Wall thickening was seen in 21/21 cases, diverticula in 19/21, changes in pericolic fat in 11/21, local tenderness on gradual compression in 19/21 and changes in peristaltic activity in 21/21 cases. Even though diverticula may appear differently, we found 4 main patterns: round or linear hyperechoic pericolic outpouchings with no definite wall, usually with shadowing or reverberation artifacts (pattern 1), a saccular focus with a well-defined wall and various contents (pattern 2), a tubular structure with no content but with central linear echoes (pattern 3), and a flask-like or arrowhead-like hypoechoic focus (pattern 4). Patterns 1, 2 and 3 were shown in inflamed colic segments and in unaffected adjacent tracts, both in the acute phase and at follow-up, with no relevant morphological changes. In contrast, pattern 4 was observed in 10/19 patients, always in the acute phase and in affected colic tracts. The follow-up showed a decrease in size in 3 cases and a change to patterns 1, 2 or 3 in 7 patients. The authors believe pattern 4 to represent inflamed diverticula, while patterns 1, 2 and 3 indicate simple diverticula. Moreover the detection of diverticula and thickened wall segments does not necessarily indicate diverticulitis: thus, the diagnosis of this condition must rely on the presence of several signs, the most specific of which were, in our series, the flask-like and arrowhead-like patterns, presumptively expressing peridiverticular abscess.

Acute Disease↗
PubMed1995

Survival after AIDS among Italian haemophiliacs with HIV infection. The Italian Group on Congenital Coagulopathies.

OBJECTIVES: To estimate survival trends for persons with haemophilia and HIV/AIDS. DESIGN AND METHODS: Survival analysis conducted among the cohort of HIV-positive haemophiliacs with AIDS at the Italian Haemophilia Registry. Kaplan-Meier method was used to estimate survival times, stratifying for demographic and clinical covariates. Cox proportional hazards model was applied in order to identify factors independently associated with survival. RESULTS: Median survival from the first AIDS diagnosis to death was estimated to be 17.0 months for 176 individuals with AIDS. Median survival after AIDS diagnosis increased from 12.0 months in December 1983-December 1988 to 17.0 months in January 1989-May 1990 and to 25.0 months in June 1990-December 1991. Median survival times were significantly (P < 0.001) lower for individuals diagnosed with non-infective AIDS indicator diseases (lymphoma, AIDS-associated neurological disease, Kaposi's sarcoma, wasting syndrome: 4.0 months), in comparison with haemophiliacs diagnosed with Pneumocystis carinii pneumonia (PCP; 18.0 months) or other infections (35.0 months). Antiretroviral treatment after AIDS diagnosis was associated with a longer survival than that estimated for individuals with no treatment after AIDS; the same was true for PCP prophylaxis. Younger age at HIV seroconversion and at AIDS diagnosis were associated with a longer survival. Multivariate analysis showed that factors independently associated with survival were type of AIDS indicator disease and antiretroviral administration after AIDS diagnosis. CONCLUSIONS: This study indicates an increasing survival from AIDS diagnosis to death over time, also as a result of the introduction of antiretroviral therapy. Survival trends are similar to those reported among homosexual men and intravenous drug users with AIDS, suggesting a similar access to the health-care system for individuals with AIDS. Survival studies may improve our understanding of the natural history of HIV infection and may indicate the impact of preventive measures.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Reproducibility of the spectral turbulence analysis of the signal-averaged electrocardiogram.

Spectral turbulence analysis (STA) of the signal-averaged electrocardiogram (SAECG) is a recently proposed technique to identify patients with ventricular tachycardia as well as patients at risk for arrhythmic events after acute myocardial infarction (MI). The short-term reproducibility of this technique has been previously reported; our study evaluates the reproducibility of STA by shifting the reference points. Twenty patients with acute MI were recruited. SAECG was recorded 13 days after onset of the acute MI. Unfiltered data were transferred and analyzed by personal computer software for spectral turbulence analysis according to the standard condition; reference points of the segment of interest were shifted from QRS offset -10 ms and QRS onset -10 ms to QRS offset +10 ms and QRS onset +10 ms, step 2 ms. Thus, 10 analyses were computed. Reproducibility of the results was calculated using the coefficient of variation (CV) and the relative error (RE). The reproducibility of the classification (RC) was defined as the percentage of the identical classification compared with the standard segment. CV of the intersegment correlation standard deviation was statistically higher than the other parameters regardless of the lead considered. RE was not different in each parameter and in each lead. RC was > 90% in all parameters, except in spectral entropy which showed an RC > 80%. Reproducibility of the STA introducing a temporal shift in the analyzed segments was high in all considered parameters.

Analysis of Variance↗
PubMed1993

Plateletpheresis during plasma collection.

New systems for collection of platelet concentrate (PC) and platelet poor plasma (PPP) are presently available. The aim of our work was to test the possibility of preparing PC routinely from normal plasma donors in a minimum amount of time and, at the same time, providing a second product that can be used as source-plasma or fresh-frozen plasma. Over a 3 year period (from 1990 to 1992) we performed 3503 procedures using 2 Haemonetics PCS machines (1236 procedures) and 3 Autopheresis-C (2267 procedures). With the PC produced we were able to satisfy all the requests coming from the hospitals of our region. The platelet yield was 1.95 x 10(11) with PCS and 3.2 x 10(11) with Auto-C in a PC volume of 150 and 200 ml respectively; collection times were quite similar (56 and 63 min). The results show that plasma-plateletpheresis is an efficient and competitive system. Regarding platelet yield, the best results were obtained with the Auto-C.

Humans↗
PubMed1990

[A study of the variations in myocardial perfusion induced by systemic thrombolysis in acute myocardial infarct using sequential scintigraphy with 201-thallium].

To assess scintigraphic changes induced by intravenous streptokinase therapy, serial rest redistribution thallium-201 perfusion imaging was performed in 62 patients with acute myocardial infarction lasting less than 6 hours. Twenty-seven patients randomized to treatment with intravenous streptokinase (group A) and 35 to conventional therapy (group B) underwent thallium-201 scintigraphy as soon as possible after admission to the coronary care unit (early study). Regional myocardial perfusion was assessed using thallium-201 scintigraphy 7-9 days later in each patient (late study). The size of the perfusion defect was evaluated using a semi-quantitative score. The size of the perfusion defect decreased in serial scans in both group A (preintervention score: 12.1 +/- 6.8; redistribution score: 11.4 +/- 6.8; late study: 8.8 +/- 7.0) and group B (12.8 +/- 6.5; 12.3 +/- 6.7; 10.6 +/- 7.5, respectively). No statistical difference in myocardial perfusion was found between the two groups, on late study. Peak serum creatine kinase MB (CKMB) was earlier in group A than in group B (1030.8 +/- 326.6 vs 1361.0 +/- 271.1: p less than 0.001). The fast CKMB release group (onset of symptoms-peak of CKBM less than or equal to 900 minutes) exhibited higher thallium-201 uptake when compared to the slow CKMB release group, at the time of late study (perfusion defect score: 6.1 +/- 5.7 vs 10.7 +/- 7.3: p = 0.03). Reversibility was observed in 21/62 patients (34%). Reversibility corresponded to unchanged or improved perfusion defect score on late study in 18/21 patients (86%). Nevertheless 20/41 (49%) patients not showing redistribution of thallium-201 within pre-treatment defect had an improvement in regional perfusion on late study. Reversibility was observed in 9/14 (64%) patients with fast CKMB release and in 12/47 (26%) patients with slow CKMB release. We conclude that the early peak of CKMB is associated with a higher uptake of thallium-201 on late study. Furthermore, the reversibility of perfusion defect on redistribution imaging forecasts evolution of scintigraphic perfusion, but, when this is not present, it doesn't rule out late improvement of thallium-201 myocardial uptake. The low sensitivity and specificity of redistribution imaging and the procedure related delay in instituting therapy make thallium-201 scintigraphy unreliable in the evaluation of myocardial reperfusion following thrombolysis.

Adult↗
PubMed1990

[Odontogenic sinusitis. An evaluation and the radiologic checkup protocol after a Caldwell-Luc intervention].

A homogeneous group of 30 patients who were operated over a 5-year period for odontogenic sinusitis using a buccosinusal communication following Caldwell-Luc's technique were studied. A marked discrepancy between the conventional X-ray picture and the clinical picture emerged from these 30 case studies. So as to find an explanation for this discrepancy, all patients underwent CAT tests. On the basis of a critical evaluation of the results obtained it is suggested that patients be followed using a postoperative instrumental control protocol.

Focal Infection, Dental↗
PubMed1984

B cells in chronic lymphocytic leukaemia. Comparative analysis of blood and bone marrow.

A study was performed on cell suspension from peripheral blood and bone marrow aspirates and on cryostat sections from bone marrow biopsies in order to investigate the membrane phenotype of neoplastic B cells in chronic lymphocytic leukaemia (B-CLL). The immunological analyses, performed on 43 patients, included rosetting ability with sheep and mouse erythrocytes, evaluation of surface immunoglobulins and reactivity with anti-HLA-DR, UCHT 1 (OKT-3 like) and RFA-1 (OKT-1 like) monoclonal antibodies. The results demonstrate that neoplastic B lymphocytes in B-CLL display an identical phenotype in peripheral blood and bone marrow. Possible interpretations on the origin of proliferating cells in B-CLL are discussed.

Adult↗
PubMed1984

[Contribution of computerized radioisotope angiocardiography to the diagnosis of arrhythmogenic dysplasia of the right ventricle].

Radionuclide angiography phase analysis was performed in two patients presenting with recurrent right-sided ventricular tachycardia without angiographic evidence of valvular or ischemic heart disease. A dilated, poorly contracting (EF = 20%) right ventricle with localized dyskinetic areas was found in contrast with normal left ventricular function. The suggested diagnosis of Arrhythmogenic Right Ventricular Dysplasia was confirmed by right ventricular angiography performed in one patient. The diagnostic interest of radionuclide angiography phase analysis in patients with Arrhythmogenic Right Ventricular Dysplasia is stressed.

Adult↗