PubMed Health⌕ Search

Biomedical subjects

L De Simone

Publications and source records attributed to L De Simone.

15 recordsLinked to original sources
PubMed1992

[The usefulness of Doppler echocardiography in the diagnosis of neonatal Marfan's syndrome. A clinical case report].

Marfan syndrome is very rarely diagnosed in the neonate, and specific pathological and clinical findings are described in this age; cardiac involvement occurs very often, carrying severe prognosis in most patients. In the presented case the diagnosis was suspected according to clinical findings; bidimensional echocardiography showed that the most important lesion was tricuspid dysplasia and prolapse; Doppler echocardiography has contributed to explain the clinical severity, showing regurgitation of all cardiac valves and a pattern of functional tricuspid atresia. Autoptic examination has later confirmed all these findings.

Echocardiography↗
PubMed1991

[Use of integrated echocardiography in the evaluation of neonatal asphyxia].

Perinatal asphyxia provides a dramatic example of vulnerability of the cardiovascular system during adaptation to the extrauterine life. The clinical picture is variable, depending upon the severity of perinatal stress and the individual response of pulmonary vascular bed and myocardium. Doppler Echocardiography is a reliable and noninvasive method which allows both the ruling out of congenital heart disease and the making of an early diagnosis in these neonates.

Asphyxia Neonatorum↗
PubMed1991

[Usefulness of pulsed doppler echocardiography in the diagnosis and medical therapy of patent ductus arteriosus in the newborn with respiratory distress].

In preterm infants patent ductus arteriosus (PDA) may worsen the clinical course of Respiratory Distress Syndrome (RDS). Indomethacin is usually effective in producing duct closure in the first days of life, but clinical diagnosis is often difficult to perform in these patients. In recent years Pulsed Doppler Cross-Sectional Echocardiography (PD-CSE) has made it possible to identify the duct and to assess noninvasively the characteristics of blood flow within it. The aim of this study was to verify the utility of PD-CSE in the early diagnosis of PDA and to provide the basis for a more effective drug therapy. Among 51 patients with RDS, a significant PDA was evidenced in 20 with PD-CSE and in only 8/20 with physical and E-TM examination (p less than 0.01). Indomethacin administration produced duct closure in 19/20 patients (95%). In this study PD-CSE has been more sensitive than the other noninvasive procedures in the diagnosis of PDA; moreover, the success with drug therapy demonstrates the utility of this procedure in providing the basis of a more effective treatment of the duct.

Ductus Arteriosus, Patent↗
PubMed1990

[Methodologic and therapeutic approach to patients in shock].

The authors extensively review pathophysiology and clinical aspects of the several forms of shock. Then they report a statistical evaluation of the incidence of the different shocks in the Campania area and an analysis of the therapeutic protocols used in several medical centers. From January 1983 to May 1986, 212 patients in shock have been followed: 90 patients with hypovolemic shock; 81 patients with cardiac shock; 24 patients with shock caused by abnormal peripheral distribution; 17 patients with obstructive shock; Furthermore, from January to May 1986, in a multicenter cooperative study (69 medical centers evenly distributed all over Italy) operational factors that could be considered prognostic factors have been investigated utilizing a questionnaire. Finally the authors extensively discuss the therapeutic management of shock proposing new therapeutic protocols based on recent knowledge concerning the pathophysiology of the several clinical features investigated.

Anaphylaxis↗
PubMed1990

[Familial pulmonary stenosis: considerations on genetic aspects].

A family with 4 cases of pulmonary valvular stenosis with under-developed or normal right ventricle, is reported. The father and his three daughters were affected. In two of the girls, who were twins, a prenatal diagnosis was made using 2D-echo. The importance of genetic counseling and prenatal diagnosis in the families at risk are underlined.

Adult↗
PubMed1989

Prognostic significance of early clinical manifestations in postanoxic coma: a retrospective study of 58 patients resuscitated after prehospital cardiac arrest.

The neurologic progress for 58 patients resuscitated after prehospital cardiac arrest was analyzed in order to evaluate their prognostic significance. Twenty-four patients were conscious on admission; their inhospital mortality rate was 4%. Thirty-four patients showed alterations of their state of consciousness; their inhospital mortality rate was 53%. On admission, only the absence of spontaneous breathing was significantly predictive of an unfavorable outcome. The failure of response to painful stimulation and pupillary light reflex became significantly predictive of an unfavorable outcome only in the late inhospital course. The time delay before onset of CPR was significantly longer in unconscious patients, but in this group no difference was observed between survivors and nonsurvivors. At discharge, no patient was in a comatose or vegetative state; three patients showed severe neurologic impairment. These data indicate that, in patients with postanoxic coma, early clinical evidence of severe neurologic dysfunction is predictive of neither inhospital death nor neurologic sequelae.

Aged↗
PubMed1989

[Echocardiographic study of heart rhabdomyoma in tuberous sclerosis].

In order to study the prevalence of cardiac rhabdomyoma in tuberous sclerosis using non invasive methods, 11 consecutive patients affected by tuberous sclerosis (age: 3 months-22 years, mean 6 years) were examined between January 1984 and April 1987. In each patient clinical examination, 12 lead electrocardiogram, M-mode and two-dimensional echocardiogram were performed: on 7 of them a 24-hour ambulatory electrocardiogram was also performed. Clinical examination revealed a systolic murmur (grade 3/6) in two cases. In one of them it was associated with cyanosis and cardiac failure. None of other patients showed signs or symptoms related to the heart during clinical examination. ECG was abnormal in 3 cases (ventricular pre-excitation in 2 cases and left ventricular strain in 1). Two-dimensional echocardiogram showed single or multiple intracardiac masses suggestive of cardiac rhabdomyoma in 8 cases; in 3 of them masses were isolated, intramural, and in the interventricular septum, from 5 to 16 mm in diameter; in the other 5 cases they were multiple, intramural and endoluminal, in the interventricular septum, in the right or left ventricle, from 7 to 20 mm in diameter. Ambulatory electrocardiogram revealed only isolated ectopic supraventricular and ventricular beats in 2/7 cases. Each patient was clinically controlled every six months using ECG standard and two-dimensional echocardiogram. The mean follow-up period was 32 months (range 9-53). This study confirms the usefulness of the two-dimensional echocardiography to visualize intramural or intracavitary masses due to cardiac rhabdomyoma in patients with tuberous sclerosis, especially when they appear clinically asymptomatic. Two-dimensional echocardiography is probably the ideal method to use in order to evaluate potential increase in cardiac rhabdomyoma, when prolonged follow-up studies are performed.

Adult↗
PubMed1988

[Significance of QT interval as a premonitory sign of severe ventricular arrhythmia in the early phase of myocardial infarct].

In order to evaluate the relationship between the length of the corrected QT interval (QTc), calculated according to Bazett's formula, and the incidence of ventricular fibrillation (V.F.) in the early phase of acute myocardial infarction (A.M.I.), the QTc interval was measured in 494 patients (mean age 66.42 +/- 11 years; 357 males and 137 females) assisted by the Mobile Coronary Care Unit of Florence. A.M.I. was anterior in 269 patients, inferior in 177 and non-Q in 34. The QTc interval measured on E.C.G. was recorded within the first hour after the onset of pain in 203 patients and between the first and sixth hour in 291 patients. The QTc interval was also measured in a control group consisting of 96 non A.M.I. patients with no history of coronary artery disease. 43 patients with A.M.I. (8.6%) developed V.F. in the first 24 hours. It was observed that: 1) The QTc interval of patients with A.M.I. was longer than that in patients without A.M.I. (432 +/- 34.18 msec. versus 425.37 +/- 25, p less than 0.02). 2) The QTc interval of patients with A.M.I. who developed V.F. was the same as that of patients with A.M.I. but without V.F., (432.6 +/- 34.18 msec. versus 438.11 +/- 34.13, N.S.). 3) 60.46% of patients with V.F. had a value of QTc less than 440 msec.; the incidence of QTc greater than 440 msec. showed no difference in the groups with or without V.F. (41.86% versus 41.11%). 4) The QTc interval length was greater in anterior than in inferior A.M.I. (435.12 +/- 30.81 msec. versus 429.05 +/- 34.5, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

[Cardiac sudden death. Testing of an extra-hospital emergency system].

From December 1979 to April 1984, 266 victims of cardiac arrest outside the hospital in the metropolitan area of Florence received advanced cardiopulmonary resuscitation by a system for medical emergencies. 69 patients (25.9%) were successfully resuscitated and 42 (15.7%) were discharged alive from hospital without any neurological damage. The time delay between the onset of the cardiac arrest and the cardio-pulmonary resuscitation, the cardiac rhythm present on arrival of rescue squad, the degree of congestive heart failure immediately before the cardiac arrest and the neurological deficit after resuscitation significatively influenced immediate and late outcome.

Ambulances↗