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Biomedical subjects

J Lanfranchi

Publications and source records attributed to J Lanfranchi.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Subacute myocarditis as a manifestation of acquired immunodeficiency syndrome].

A case of acquired immunodeficiency syndrome associated with myocarditis is reported. The myocarditis was peculiar in that it heralded the syndrome and followed a subacute course. It was most probably of infectious origin, although no pathogen has positively been identified; it may have been caused by a cytomegalovirus or even by the human immunodeficiency virus itself on a background of genetic predisposition. This case shows that while cardiologists are concerned with cardiac disorders occurring during AIDS, they must also consider the possibility of AIDS when confronted with a myocarditis.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Evaluation by myocardial thallium-201 scintigraphy using dipyridamole of the coronary risk in peripheral vascular surgery].

From October 1983 to January 1985, 46 patients (38 men and 8 women; mean age 60 years, range 37-83) underwent peripheral vascular surgery either of the internal carotid artery or of arteries of the lower limbs. All patients had thorough clinical examination, ECG and thallium dipyridamole myocardial scanning before operation, as a result of which they were divided into 20 with, and 26 without chronic ischemic heart disease. Three major cardiac events were noted during or following a period of one month after surgery: two deaths due to a cardiac ischemic event and one post-operative unstable angina pectoris. The three patients with these complications were classified in the coronary group (NS). When the patients were reclassified according to the presence or absence of thallium redistribution on serial images after dipyridamole, 14 had redistribution and 32 had no redistribution. The three major cardiac events were found to have occurred in the group with redistribution (P less than 0.04). Our study suggests that patients with redistribution have a high incidence of postoperative ischemic events. They should be considered for a particular pre-operative coronary management to avoid post-operative major cardiac events and to improve survival.

Adult↗
PubMed1987

[Antigens A and B of the HLA system in dilated cardiomyopathies related to alcohol].

It has been hypothesized that dilated cardiomyopathy (DCM) is of dysimmune origin. Conventional immunological studies have provided no evidence that a primary disregulation of immune mechanisms is involved. In the present study, the possibility of an individual predisposition to DCM resting on a preferential distribution of HLA system antigens has been investigated. Typing of the HLA system antigens A and B was performed in a group of 38 DCM patients who were heavy drinkers. The results were compared with those obtained in: (a) 57 alcoholic patients without cardiopathy, and (b) a population of 306 healthy subjects. All subjects were caucasians. Compared with alcoholic patients without cardiac disease, DCM patients had a prevalence of B8 allele. The relative risk of developing DCM was 2.83 in the presence of the B8 antigen. This result suggests a genetic predisposition to DCM: the B8 allele, prevalent among our patients, is associated with the phenotype of numerous autoimmune diseases. This study therefore supports the theory that DCM is of dysimmune origin, but this must be confirmed by further investigations conducted on a larger number of cases.

Adult↗
PubMed1987

[Dilated cardiomyopathies and cytomegalovirus].

Apparently primary dilated cardiomyopathy poses a difficult aetiological problem. There is epidemiological, biological and histological evidence that some of them are the long-term results of acute myocarditis especially due to Coksackie virus. In order to establish whether cytomegalovirus infection could also have the same consequences 67 cases of dilated cardiomyopathy were reviewed to look for inflammatory changes and CMV serology. The results indicate a possible link between acute CMV myocarditis and dilated cardiomyopathy (7 p. 100 of cases) but this is difficult to prove in the chronic stage of the disease.

Adult↗
PubMed1987

[Radiation-related atrioventricular block].

Twelve years after mediastinal irradiation for Hodgkin's disease, a 38-years old man developed an infra-hisian atrioventricular block with syncopes. The rarity of this complication of radiotherapy is emphasized. A review of the literature yielded only 6 cases of atrioventricular block associated with cobalt therapy; a pathological examination was performed in two of these patients and an electrophysiological study in two others.

Adult↗
PubMed1987

[Comparative value of 24-hour ECG monitoring and standardized maneuvers in the detection and exploration of cardiac autonomic neuropathy in diabetics].

24-hour continuous electrocardiographic ECG monitoring and standardized tests were performed to detect cardiac autonomic neuropathy in diabetic patients. Thirty-eight patients, with a mean duration of diabetes of 10 years, twenty-five IDDM and thirteen NIDDM, and thirty-two controls, with no illness or treatment which could alter the heart rate (HR), were studied. Five standardized tests were performed. Three tests investigated parasympathetic function: variations of HR during Valsalva manoeuvre, deep breathing and standing. The other two tests investigated sympathetic function: detection of orthostatic hypotension and blood pressure response to sustained handgrip. Parasympathetic HR control was impaired in twenty-nine patients, together with impaired sympathetic cardiovascular control in seven. According to the 6 indices studied, 24-hour ECG monitoring detected abnormalities in only eight patients. Mean minimum 24-hour HR and mean sleeping HR were elevated in the group of patients whose five standardized tests were normal and in the group of patients with impairment of both parasympathetic and sympathetic cardiovascular control, but not in the group of patients with only impaired parasympathetic HR control. This study suggests that 24-hour ECG monitoring is a less sensitive test of cardiac autonomic neuropathy than standardized tests. Moreover, it shows HR abnormalities that are not specific to cardiac autonomic neuropathy.

Adult↗
PubMed1986

[Statistical study of the profitability of recording cardiac electric activity by Holter's technic in diagnostic practice. Apropos of 200 cases].

The ambulant recording of the electrocardiogram by the Holter technique has become one of the non invasive examinations widely used in two indications: paroxysmal arrhythmias and coronary disease. However, the technical limitations of the method and the occasionally improper extension of the indications of Holter recording lead to disappointing results. The aim of this work is an estimation of the usefulness of Holter as a function of the desired information by a statistical study. Of 646 consecutive recordings, 200 were taken at random; 169 usable ones were classed in 7 categories according to the clinical requirement; the overall usefulness amounts to 27.5 percent of the cases in which Holter permits a diagnosis. As far as paroxysmal disturbances of rhythm are concerned, Holter is more efficacious than the standard electrocardiogram. However, the efficiency of the method is low: 17.4 percent of cases when it was required to find a cardiac arrhythmia causing a cerebral vascular accident, and even lower, 5.1 percent, when a malaise was concerned. In 20 percent of the cases was a useful tool in diagnosing thoracic pain. In 9.5 percent of the cases the tracings were not interpretable owing to their poor quality. These findings urge more rigor in the choice of indications and a better control of technical problems if the efficacy of the method is to be improved.

Aged↗
PubMed1986

[Blood hypereosinophilia syndrome with cardiac involvement and extramembranous glomerulopathy].

The case of a 71 year old woman with an idiopathic hypereosinophilic syndrome is reported. Bidimensional ultrasonography was in favor of endomyocardial involvement. This case was original as nephrotic syndrome developed, due to membranous glomerulopathy which was complicated with renal vein thrombosis. Both eosinophilia and nephrotic syndrome greatly improved with corticosteroid treatment. Nonetheless, the patient died suddenly after 2 years, and this demise is in keeping with the overall poor prognosis of idiopathic eosinophilic syndrome.

Aged↗
PubMed1986

[Absence of ultra-structural histological lesions of the myocardium in cardiac insufficiency of hyperthyroidism].

Myocardial failure may complicate hyperthyroidism. Some authors consider that preexisting myocardial lesions are necessary for its development. We studied a case of myocardial failure, presenting as a dilated cardiomyopathy, complicating hyperthyroidism in a 57 year old woman. She had a bio-clinical evaluation and a haemodynamic study with endomyocardial biopsy of the left ventricule. No valvular or coronary disease were noted. The light and ultra-microscopic aspects of the myocardium were within normal limits. We conclude that preexisting myocardial lesions are not essential to the development of myocardial failure complicating hyperthyroidism.

Female↗
PubMed1985

[Peripheral T-lymphocyte subpopulations in primary and alcoholic dilated cardiomyopathy].

In order to test the hypothesis of the role of a suppressor/cytotoxic T lymphocyte deficit in the pathogenesis of dilated cardiomyopathies (DCM), 20 patients (11 alcoholic-A; 9 primary-P) were compared with 24 normal controls (N) and 10 patients with chronic cardiac failure (CCF). The percentage of OKT 3, a global assessment of the T lymphocytes, did not differ significantly between the groups. The percentage of OKT 4 (helper T lymphocytes) was significantly lower in DCM (43 +/- 8.1 p. 100) compared to N (51.92 +/- 8.1 p. 100), p less than 0.001. The percentage of OKT 4 was also lower in CCF (45.3 +/- 3.91 p. 100) compared to N (p less than 0.05). There was a very significant decrease in the percentage of OKT 8 (suppressor/cytotoxic T lymphocytes) in DCM (17.23 +/- 4.78 p. 100) compared to N (26.42 +/- 5.72 p. 100) (p less than 10(-8)). A reduction of OKT 8 was also observed in CCF compared to N (p less than 0.05). The ratio of OKT 4/OKT 8 was significantly higher in DCM (2.7 +/- 0.97) compared to N (2.08 +/- 0.6) (p less than 0.05). This difference was not observed in CCF (2.19 +/- 0.48). There were no differences between DCM A and P. These results indicate that chronic cardiac failure is associated with an equal reduction in the percentage of OKT 4 and OKT 8 lymphocytes. Dilated cardiomyopathy is associated with a large reduction in the OKT 4 and especially in the of OKT 8 with a statistically significant increase in the OKT 4/OKT 8 ratio. Although chronic cardiac failure seems to affect lymphocytes, these results are compatible with a deficit of suppressor/cytotoxic T lymphocytes in dilated cardiomyopathies.

Adult↗
PubMed1985

[Abnormalities of 24 hour (Holter) ECG monitoring in diabetics: involvement of cardiac autonomic neuropathy and/or insulin therapy].

In order to detect evidence of cardiac autonomic neuropathy, 24-hour continuous electrocardiographic monitoring was carried out on fifty-one diabetic patients (thirty-one IDD, twenty NIDD) and twenty-two healthy controls taking no treatment which could alter the heart rate. In the diabetic patients the minimum 24-hour heart-rate and the mean sleeping heart rate were significantly higher, and the maximum 24-hour heart rate and the ratio [(maximum-minimum heart rates)/minimum heart rate] were significantly lower. Evidence in one diabetic of cardiac autonomic neuropathy was found only as the difference (maximum-minimum heart rates). This index was found to be below 38/min (mean-2 SD of the controls) in seven diabetics, but only one of the nine diabetics with signs of autonomic neuropathy had this abnormal index. The mean values for the minimum and the mean sleeping heart rates were high in the IDD with or without signs of peripheral neuropathy and without signs of autonomic neuropathy but were not high in IDD with signs of autonomic neuropathy. These findings suggest the presence of cardiac autonomic neuropathy in diabetics. However, the possibility of insulin-induced tachycardia should be considered this tachycardia is probably related to stimulation of the sympathetic nervous system, which would explain the absence of abnormalities in IDD with autonomic neuropathy.

Adult↗
PubMed1983

[Multicentric reticulohistiocytosis. A new case].

Multicentric reticulohistiocytosis is a rare disorder of the skin and joints that possesses distinctive histologic findings. A case is reported with typical features, and ulceration, an unusual outcome of "skin" lesions.

Aged↗