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Biomedical subjects

L Croce

Publications and source records attributed to L Croce.

At least 19 recordsLinked to original sources
PubMed1994

["Unknown" ectopic ureteral opening. Experience with 8 clinical cases].

The authors after studying eight different cases of ectopic ureters, try to illustrate the most important points of the diagnostic course in this pathology. In fact, in this field of studies, it is not easy, every time, to define diagnosis by the usual ways of investigation, so the authors describe just those cases which were missed by past clinical evaluations. They want to demonstrate by their experience of work, that it is possible to avoid a wrong diagnosis by an accurate evaluation of the clinical phenomenology, but most of all by a good research and right interpretation of the clinical and radiologic signs, direct and not, of this pathology.

Adult↗
PubMed1989

Prognostic significance and evolution of late ventricular potentials in the first year after myocardial infarction: a prospective study.

We performed a prospective study of the high-frequency components of the terminal portion of the QRS complex in 220 patients who survived acute myocardial infarction. Signal-averaged electrocardiograms (SA-ECGs) were performed before hospital discharge (16 +/- 6 days) and then serially at regular intervals over the following year. SA-ECGs were processed using a 40 Hz high-pass bidirectional filter. Duration of "filtered" QRS (D-normal value less than 120 ms), duration of the low-amplitude signals (D40 - n.v. less than 39 ms) and last 40 ms voltage of the QRS complex (V40 - n.v. greater than 20 microV) were measured. Late potentials (LPs) were defined as the presence of two or more abnormal values. In addition, 24-hour Holter monitoring was performed in 208 patients and left ventricular ejection fraction (LVEF) was determined by scintigraphy in 111. Sixty-two patients (group 1) had LPs, 158 had normal SA-ECGs (group 2). Spontaneous normalization of SA-ECGs occurred in 20% of patients after 6 months, although the mean values of D, D40 and V40 did not change significantly and the reproducibility was very good for all the indexes during all the follow-up controls. Three patients had sudden death and three presented again with spontaneous, sustained ventricular tachycardia. Five of 62 (8%) group 1 patients had an arrhythmic event compared with one of 158 patients (0.6%) in group 2. The sensitivity of SA-ECGs as a predictor of arrhythmic events was 83% with a specificity of 73%. Patients with subsequent arrhythmic events had longer filtered QRS (133 +/- 19 vs 104 +/- 16 ms; P less than 0.001), longer duration of the low-amplitude signals (54 +/- 15 vs 33 +/- 14 ms; P less than 0.01), and lower voltages in the last 40 ms of the filtered QRS (11 +/- 3 vs 36 +/- 25 microV; P less than 0.02) and, moreover, higher peak CK values and lower LVEF than those without such events. In conclusion, SA-ECGs provide important prognostic information in identifying patients at risk of arrhythmic events after myocardial infarction although dynamic changes of LPs are observed during the first year after myocardial infarction.

Arrhythmias, Cardiac↗
PubMed1988

[Flecainide and anti-arrhythmia therapy].

Flecainide is a benzenacetamide synthesised about a decade ago and only recently introduced into the treatment of arrhythmias. Its electrophysiological properties place it in Class IC of the anti-arrhythmia drugs. Flecainide has proved useful in the treatment of supraventricular arrhythmias, atrial fibrillation (especially in patients with Wolff-Parkinson-White disease), in reciprocating supraventricular tachycardias and in focal atrial tachycardias. The drug is also extremely effective in ventricular ectopias with a success rate of over 90%. Flecainide is therefore destined to be widely used in the treatment of arrhythmias and is indicated for both supraventricular and ventricular forms, particularly those resistant to other treatment. In addition the biological availability and long half life of Flecainide make it suitable for even very prolonged treatment.

Arrhythmias, Cardiac↗
PubMed1988

Ventricular and supraventricular arrhythmias in clinically silent right ventricular infarction.

To study the relationship between clinically silent right ventricular infarction and the incidence of a-v block, atrial and ventricular arrhythmias, 100 patients with inferior wall myocardial infarction underwent equilibrium gated radioisotopic angiocardiography. Fifty-four of them had radioisotopic evidence of right ventricular involvement and 43 (80%) of them had a-v block and/or supraventricular arrhythmias during the acute phase of the infarct, while only 10 (22%) of the 46 patients without right ventricular involvement did. As regards the incidence of ventricular tachyarrhythmias, 14 (26%) patients with right ventricular involvement had ventricular tachycardia and/or fibrillation, while only one patient without right ventricular involvement had ventricular tachycardia, and no patients had ventricular fibrillation. Moreover, V4R-precordial lead showed a sensitivity in predicting the risk of developing a-v block/supraventricular arrhythmias and ventricular tachyarrhythmias of 0.84 and 0.79, respectively. Therefore, right ventricular involvement should be suspected when atrial arrhythmias, a-v block and ventricular tachyarrhythmias are found in early acute inferior wall myocardial infarction. On the other hand, when right precordial lead V4R in early acute inferior infarction shows ST-elevation and/or a QS pattern, the sudden occurrence of these arrhythmias should be suspected, and possibly prevented.

Adult↗
PubMed1987

[The electrocardiogram in hypothermia].

Hypothermia is reflected in the electrocardiogram in the form of alterations that permit early recognition of the condition. In fact the electrocardiogram is a more sensitive indicator of temperature than the standard measurements of body temperature used in clinical practice. The various aetiological aspects of hypothermia are described as are its electrocardiographic features.

Atrial Fibrillation↗
PubMed1986

[Intra-sinus echo: demonstration using direct intracavitary recording of the sinus potential].

The authors searched for intra-sinusal echos during electrophysiological investigation of 53 patients (41 men, 12 women, average age: 61 +/- 12 years). Cycles of sinus echos were recorded in 8 patients (15 per cent). The period during which sinus echos could be recorded was 125 ms (average 40.6 +/- 34 ms). Indirect assessment of sinus node function in patients with sinus echos was normal (corrected sinus node recovery time, estimated atrio-sino atrial conduction times using Narula's technique). A valid and reproducible direct recording of the sinus node potential was only possible in one patient. In this case the echo cycles were provoked by stimulation periods of between 440 and 320 ms (echo zone of 120 ms). All the echos obtained were preceded by a sinus node potential with a different duration and morphology to that observed during basal sinus cycles (respective sino-atrial conduction times 105 and 115 ms). In this patient we were also able to induce sinus echos after a single extrastimulus during the spontaneous rhythm. the echo zone was 130 ms and with a shorter coupling interval (310 ms) two successive sinus echos were recorded. The demonstration of intrasinusal echos by direct recording of the sinus node potential supports the experimental data of Allessie and Bonke on isolated right atrial tissues of the rabbit. Improvements in the technique of endocavitary direct recording of the sinus node potential in man should complete this data by showing the possibility of sinoatrial tachycardias due to reentry.

Action Potentials↗
PubMed1985

Mexiletine action on the specialized tissues of the human heart.

Electrophysiological properties of mexiletine (3 mg/kg i.v.) were studied in fifteen patients with various degrees of abnormalities in the specialized conduction system. Sinus cycle length was decreased in all patients; sinus node recovery time was increased in all patients, but the increment was not statistically significant. Atrial and atrioventricular (AV) nodal refractoriness were not modified. The relative refractory period of the His-Purkinje system was reduced in patients with normal intraventricular conduction on the surface electrocardiogram; no changes were noted in five patients with intraventricular conduction delay. In two patients, in whom AV nodal refractory period curves showed antegrade dual AV nodal pathways, mexiletine increased refractoriness of the fast pathway. This report points out that the drug is effective against arrhythmias sustained by a reentry mechanism, not only in the ventricles, but also in the AV node.

Aged↗
PubMed1985

[Sinus node electric activity in prolonged atrial pauses in subjects with the sick sinus syndrome].

Sinus node electrogram (SNE) was recorded in 15 patients with sick sinus syndrome (SSS) in which prolonged atrial pauses were observed. The aim of this study was clarify the physiopathological mechanisms underlying atrial pauses as well as to evaluate the sensitivity of sinoatrial conduction time (SACT) directly measured on SNE and of SACT estimated with the indirect Strauss method with respect to the detection of SSS. The following results were obtained: Sinus electrical activity was recorded during atrial pauses (greater than or equal to 2 basic sinus cycle length) in all the 9 patients in which the pauses spontaneously occurred and in the 2 patients in whom the pauses of 2860 and 3190 msec were induced by atrial pacing. In one of these latter two patients, moreover, a complete electrical desynchronization was observed. In the remaining 4 patients in whom, pauses (greater than or equal to 3 sec) were induced by carotid sinus massage of in 3 no sinus electrical activity was detected on SNE while in 1 advanced sinus node desynchronization was observed. Direct sinoatrial conduction time was abnormally prolonged in 6 patients with SSS and indirect sinoatrial conduction time in 9 patients.

Adult↗
PubMed1984

[The sinus node electrogram in the evaluation of atrial pauses].

The aim of this study was to establish the electrophysiological mechanism of atrial pauses, defined as a sudden lengthening of atrial cycle greater than or equal to 10% of its basal value. The sinus node electrogram (SNE) was recorded during electrophysiological study in 20 subjects. Satisfactory recordings of 64 pauses were obtained, 25 of which were spontaneous, 16 were induced by short periods of atrial pacing (AP) in normal subjects, whereas 23 atrial pauses were induced with the premature stimulation method. The basal sinus cycle and the one during the spontaneous pauses were measured from the upstroke slope on the SNE. The electrically induced pauses of the sinus cycle were measured from the artifact of the stimulus to the upstroke slope of the SNE of the first post-pacing beat. We have found that: 1-spontaneous atrial pauses correspond to a moderate slowing of the sinus cycle and to a depression of the sinoatrial conduction occasionally up to a second degree sinoatrial block. Only in subjects with sick sinus disease, the atrial pauses are induced by depression of the sinus automatism; 2-in normal subjects the AP results in a sinoatrial conduction delay; 3-the single extrastimulus regularly produces a moderate increase of the sinoatrial conduction time with variable but minimal effects on the sinus node automatism.

Cardiac Pacing, Artificial↗
PubMed1983

Changes of beta-endorphin and Met-enkephalin content in the hypothalamus-pituitary axis induced by aging.

The amounts of beta-endorphin- and Met-enkephalin-immunoreactive material are higher in the pituitary of aged rats. However, the aging process decreases the content of beta-endorphin-, but does not affect that of Met-enkephalin-immunoreactive material, in hypothalamus. Thus, it seems that the regulatory mechanisms in the two areas are differentially affected by increasing age. On the other hand, the pituitary increase of these peptides is in line with the assumption that in the elderly the hormonal response to stress is impaired.

Adrenocorticotropic Hormone↗
PubMed1982

[Direct measurement of sinoatrial conduction time in man. Correlation with sinus cycle length].

Recent reports have shown that it is possible to record sinus node potential (SNP) using a transvenous electrode catheter technique in animals and in man. We applied similar techniques to record sinoatrial activity in 24 normal subjects and in 6 patients with sick sinus syndrome. We used bipolar recordings, with one interelectrode distance of 1 cm, low-pass filters of 0.1-50 Hz and high-amplification (up to 100 microV/cm). Validation of the source of the sinus node electrograms (SNE) was obtained by using ad hoc criteria. Like SNE recorded in animals, human SNE shows a smooth, low-frequency upstroke slope that begins before and merges into atrial activation. Sinus node potential is separated from preceding T wave by an isoelectric plateau. In 24 subjects with normal sinus node function, the directly recorded sinoatrial conduction time (D-SACT) was 82.9 +/- 17.9 msec. Correlation with the SACT estimated by Narula's method was excellent (r = 0,84). In 12 patients with sinus arrhythmia on SNE, SACTs were directly measured as were the associated P-P intervals. When SACT at each sinus cycle length (SCL) was plotted against SCL for all subjects grouped together, the average change of SAT per 100 msec change of SCL was 15 msec. In 6 patients with sick sinus syndrome, D-SACT was 150.4 +/- 67.4 msec. When SACT at each SCL was plotted against SCL, the average change of SACT per 100 msec change of SCL was 39 msec. In the same patients the SACT estimated by Narula's method was 129 +/- 17 msec.

Electrocardiography↗
PubMed1981

[Activity of a new long-acting anti-arrhythmic drug on ventricular extrasystole. Study with Holter continuous electrocardiographic monitoring].

Therapeutic effectiveness of a new long-acting antiarrhythmic preparation was evaluated in 31 patients with sustained premature ventricular beats. After an observation period, a 24 hours Holter monitoring was performed. A group (21 patients) was treated with dihydrochinidine 250 mg twice a day; another group (11 patients) was treated with 500 mg twice a day. In the latter group was determined basal chinidinemia on the first and third day. A 24 hours Holter monitoring was repeated on the fourth day. In the first group we reached a 77.4% reduction of the arrhythmia: not enough, however, to agree with established statements. We reached a larger reduction (84.7%) with higher doses (1000 mg daily). This drug was well tolerated in both groups.

Adult↗
PubMed1972

[Heart tumors].

Explore the source record for details and available documents.

Adult↗
PubMedDate not supplied

[The pattern of patients admitted to psychiatric rehabilitation services: defining homogeneous groups. Multivariate analysis of a sample. A working group].

OBJECTIVE: To provide a multidimensional description about the pattern of patients recovered in some Psychiatric Rehabilitation Services, as emerging from identification of similar groups regarded the total severity. DESIGN AND SETTING: A cross-sectional survey has been conducted on patients recovered in 4 Northern-Italy Psychiatric Rehabilitation Services. A statistical bottom-up analysis (Principal Components and Cluster Analysis) has been performed. MAIN OUTCOME MEASURES: Any patient has been evaluated using a questionnaire with well-known rating scales (BPRS-psychiatric rating, Katx index and IADL index, IDS index of comorbidity) together with informations on sex, age, social and economic state, psychiatric history, therapeutic devices and staff involvement. RESULTS: We analyzed 455 patients. 267 (58.7%) male and the mean age is 58.517.9. After statistical analysis, 4 clusters of patients has been found: the first group (106 patients) is younger, described as not seriously compromised, mostly with psychotic problems; the second (96 patients, most of them woman with diagnosis of dementia) is much older, with serious problems of independency and comorbidity. The third (82 patients) and fourth (171 patients) group show intermediate patterns. The level of care requested by these groups has been provided. CONCLUSIONS: Our results show the usefulness of sophisticated statistical methods to describe patients recovered in psychiatric rehabilitation services. Moreover, our findings could be useful as good proposal to the people involved in this field, planning an active intervention in this area.

Adult↗