PubMed Health⌕ Search

Biomedical subjects

L Del Corso

Publications and source records attributed to L Del Corso.

35 records · Page 2Linked to original sources

[Congestive heart failure with frequent hospital readmissions in the elderly].

Ten elderly patients with heart failure and frequent hospital readmission within 12 months before the study, were submitted to clinical radiologic, electrocardiographic and echocardiographic evaluation in order to find the causes of readmission. The most frequent factors were found to be non compliance with drug prescriptions and therapy inadequate for the etiology of the heart failure and the kind of cardiac dysfunction.

Aged↗

[Destructive endocarditis caused by Streptococcus sanguis on normal valves after gastroduodenoscopy].

In recent years, epidemiological and clinical patterns in infective endocarditis are changed: mean age of patients, sex, underlying cardiac diseases, source of bacteremia, availability of better diagnostic methods--specially two-dimensional and doppler echocardiography--and surgical options. The Authors report a paradigmatic case of a young man without cardiac disease, who developed a destructive endocarditis complicated by refractory congestive heart failure; the cause was an organism of low pathogenicity, Streptococcus sanguis, that entered the bloodstream after gastroduodenoscopy.

Adult↗

[Effects of a low-fat diet including vegetables on total blood cholesterol levels in the aged].

High total serum cholesterol and low HDL levels are major risk factors for cardiovascular disease before the age of 65. Currently in older populations their role has not yet been defined. In the elderly a low-cholesterol diet is therefore preferable to pharmacological treatment, in view of the absence of collateral effects. In this study 40 elderly patients with hypercholesterolemia were divided at random into two groups. They were respectively fed their usual diet and a legume-supplemented normal caloric diet for 8 weeks. Total serum cholesterol levels significantly decreased in the latter group from the 2nd week onward.

Age Factors↗

[Dilated cardiomyopathy and visceral anomalies in myotonic dystrophy].

In dystrophia myotonica clinical evidence of cardiac involvement usually appears several years after the onset of neuromuscular symptoms. In more than 90% of cases there is damage to the specialized cardiac tissues and in about 7% of cases there are alterations to the myocardium. We report a case characterized by early and spread deterioration of the pump function developing into refractory congestive heart failure. The contemporary involvement of the smooth muscle of gallbladder and colon confirms the hypothesis that dystrophia myotonica is a pan-muscle disease.

Aged↗

[Recurrent lymphoblastic crises sensitive to vincristine in a case of chronic myeloid leukemia].

Approximately one year after the onset of chronic myeloid leukemia, a 66-year-old patient had multiple recurrent blast crises with the morphological, cytochemical, and immunological features of lymphoblasts. The lymphoblastic eruptions proved always highly sensitive to small doses of vincristine only (1.5 mg), which at variable intervals, of at first 3 months and later 20 days, brought about the immediate disappearance of blast cells from the peripheral circulation as well as from bone marrow blood. Some variable clinical aspects of the case during the crises are described; the crises recurred until the patient's sudden death due to cardiac causes.

Aged↗

[Echocardiographic parameters and systolic times in arterial hypertension in the elderly].

In 40 subjects, 15 mean age 70.7 +/- 5.6 with systolic-diastolic hypertension, 15 mean age 75.5 +/- 6.8 years with systolic hypertension and 10 mean age 73.6 +/- 5.1 normotensive control group we have analyzed with M-mode 2D echocardiography and echophonocardiography the following parameters: diastolic--EDD--and systolic diameter--SD--of left ventricle, diastolic thickness of septum--SSD--and posterior wall--SPPD--of left ventricle, left ventricular ejection fraction--EF--(Theicholtr. formula), radius posterior wall thickness--R/SPPD--, left ventricular mass--LVM--(Devereux' formula), and systolic time intervals (Q-A2, LVET, PEP and PEP/LVET). The differences between groups are: systolic-diastolic hypertensive patients have increased EDD, SPPD and LVM, reduction of EF and increased PEP/LVET ratio in comparison with B and C groups; systolic hypertension doesn't increase EDD; SSD and PEP/LVET increase, while the EF remains within normal limits. In the healthy aged subjects SSD, SPPD and LVM are normal.

Aged↗

Serum thyroid hormone concentrations and recovery of TSH secretion after excision of autonomously functioning thyroid nodules.

Serum concentrations of TSH, TT4, TT3 and rT3 were monitored for one month after excision of ten autonomous thyroid adenomas which had suppressed TSH secretion. Basal serum TSH levels start to increase between 30 hr and 20 days after surgery reaching normal and steady levels by the 24 day. Serum TT3 concentrations rapidly decrease in the first 20 hr to values near the lower limit of the normal range. Thereafter TT3 levels change little until pituitary TSH secretion recovers. Serum TT4 levels also fall, but much more slowly than TT3. Rising TSH levels stimulate residual extranodular thyroid tissue secretion of both TT3 and TT4. However, serum TT3 levels rise more rapidly than TT4 levels. Preoperative serum concentrations of both TT4 and TT3 are related directly to the time required until the beginning of the postoperative rise in TSH levels, and inversely with the maximal postoperative serum TSH concentration achieved. Throughout the study period, for all patients, serum TSH concentrations were inversely related to serum TT4 concentrations. These data suggest that, although the time required until the onset of recovery of TSH secretion is directly related to preoperative levels of TT4 and TT3, the regulation of postoperative TSH levels is dependent upon serum TT4 levels. Also, the serum TT3 levels constant at the lower limit of the normal range before recovery of TSH secretion, and the preferential rise in serum TT3 concentrations associated with rising TSH secretion, may prevent or abbreviate temporary postoperative hypothyroidism.

Adenoma↗

Triiodothyronine turnover studies in euthyroid patients with autonomous thyroid nodules.

Triiodothyronine (T3) kinetic studies were carried out using 126I-T3 and the single injection technique in eight clinically euthyroid patients with autonomous thyroid nodules and the metabolic results were compared to those obtained in a group of 12 healthy control subjects. Plasma labeled T3 concentration was measured by a chromatographic method based on the extraction of the hormone on Sephadex G-25 columns, followed by its elution with a specific anti-T3 antiserum. The analysis of the experimental plasma disappearance curves of the labeled hormone was performed using the noncompartmental method. The results obtained showed a significantly increased metabolic clearance rate of T3 in the patients with autonomous thyroid nodules, as compared to the control group. On the average, the T3 production rates were increased more significantly than the corresponding circulating levels of the hormone, therefore, suggesting that the significant TSH inhibition observed in the euthyroid patients with autonomous thyroid nodules could be related with an increased peripheral utilization of triiodothyronine.

Adolescent↗

Effect of endogenous thyroid stimulating hormone levels on the secretion of thyroid hormones in man.

The effect of endogenous thyroid stimulating hormone (TSH) on the thyroid secretion of triiodothyronine (T3) and thyroxine (T4) was evaluated by serial determinations of serum T3. T4 and TSH concentrations in the following groups of patients: a) three patients submitted to surgical removal of a solitary, autonomous thyroid nodule which had completely inhibited the extranodular tissue; b) five subjects, with the same disease, in whom functional recovery of the extranodular tissue was induced by increased circulating TSH levels, produced by treatment with methimazole; c) one patient submitted to hemithyroidectomy for multinodular goitre; d) two hyperthyroid patients who had been treated with methimazole. In all these patients serum T3 and T4 levels progressively decreased, with a consequent progressive increase in serum TSH concentrations, leading to stimulation of the thyroid gland. During this TSH-induced stimulation of thyroid tissue, a significant positive correlation was found between the serum TSH concentrations and the corresponding ratio between the serum levels of T3 and T4 (T3/T4), both within each patient group (P less than 0.001) and among all patients (P less than 0.001). The same correlation also governs the relationship between the TSH and the T3/T4 values of 34 euthyroid control subjects and one patient with incipient hypothyroidism. These data strongly suggest that endogenous TSH can induce a preferential secretion of T3 over T4 by the human thyroid.

Goiter↗

[Hyponatremia, cause of reversible dementia in the elderly].

There are several states of reversible dementias. Among these, electrolyte imbalance--especially hyponatremia--can determine transitory modification of cognitive functions. The purpose of this study is the evaluation of the relationship between cognitive disorders and serum sodium concentrations in the elderly. In a sample of 70 elderly people, the Authors reported a prevalence of hyponatremia in 28 patients (40%); only 4 (5.7% of total population) had impaired cognitive functions or mood disturbances. In the symptomatic patients hyponatremia was severe and had a fast onset; the symptoms disappeared by means a proper and ready treatment. This observation stresses out the importance of routine serum sodium determination in the elderly in coincidence with the sudden onset of a pattern of dementia.

Aged↗

[Clinical evaluation of anemia in the aged].

Of 533 patients over 65 years old (153 males and 380 females), admitted to geriatric units for various medical diseases, 111 (20.8%) were anemic. Among males the prevalence of anemia was 30.1%, among females 17.1%. Three principal causes of anemia were revealed. The most frequent (42.3%) was microcytic, hypochromic anemia, with low levels of serum iron concentrations, related to gastrointestinal diseases (with chronic occult blood loss). 38.7% of anemic elderly people was affected by chronic diseases. In 19.0% a folate (16 case) and iron (5 cases) deficiency was revealed. These results suggest that anemia in the elderly is always pathological; hemoglobin values lower than 12 g/dl should be considered abnormal and investigated.

Age Factors↗

[Venous thrombosis of the lower limbs and pulmonary embolism after desmopressin: a coincidence or a pathogenetic role?].

The authors describe a case of venous thrombosis of the legs, complicated by pulmonary embolism, in a 71 year-old man, following desmopressin therapy for hypothalamic diabetes insipidus. They suggest a role of desmopressin in stimulating the release of Von Willebrand's factor (VWF) from endothelial cells. VWF facilitates platelet adhesion by forming a bridge between platelet membrane and vascular subendothelium, followed by development of a large thrombus.

Aged↗

[Cardiac myxoma in the elderly. Clinical study].

Cardiac mixoma in the elderly. A clinical study. The clinical features of 13 cardiac myxomas surgically resected are presented. The mean age at presentation was 68 years. Ten were in the left atrium, 5 near the fossa ovalis, 3 at the base of the atrial septum, 1 at the inferior wall and 1 on the anterior leaflet of mitral valve, 3 were in the right atrium, 1 of these was accompanied with a myxoma at the apex of left ventricle. The ECG and the chest X-ray were normal in 9 and in 8 patients, respectively. In 3 patients, the diagnosis was occasionally made by routine 2-dimensional echocardiography. 5 patients presented with fever of unknown origin, arthralgias, weakness, weight loss. None had intracardiac or extracardiac recurrence in the 73 months follow-up. The presentation with constitutional symptoms only like fever of UO, may mimic collagen and neoplastic diseases, vasculitis, lymphomas: the 2-dimensional echocardiography is mandatory to esclude a cardiac myxoma in the elderly.

Aged↗

[Fever of unknown origin in the elderly of the 90's].

MATERIALS AND METHODS: Eighteen elderly patients (mean age 76.3 +/- 6.9 years) with fever of unknown origin (FUO) are studied sequentially and prospectively from January 1994 to December 1996. The classic Petersdori's criteria of FUO are no more valid for the elderly. The fever of more than 3-4 weeks duration is the only criterion to be considered, the fever is frequently under 38.5 degrees C and the elderly patient is often studied for more than 1 week outside the hospital. RESULTS: The most frequent underlying conditions were: malignancies in particular haematological diseases, followed by multisystem diseases and infections, tuberculosis "in primis". CONCLUSIONS: Selected investigations directed to the most frequent underlying conditions of FUO in the aged individuals overcome the financial cost and the patient discomfort of the tests since an identified curable disease can improve the life expectancy and quality.

Aged↗