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Biomedical subjects

L Lusiani

Publications and source records attributed to L Lusiani.

48 records · Page 3Linked to original sources

Natural history of carotid artery disease on the side contralateral to endarterectomy.

The natural history of the nonoperated carotid artery opposite an endarterectomy was examined in 134 patients by means of ultrasonic duplex scanning over a period extending to 48 months. None of the nine deaths that occurred during follow-up was stroke related. A total of 22 arteries showed progression of disease over this period. By life-table analysis the mean annual rate of progression for all categories of disease was 12.6% and 7.4% for progression to a diameter reduction greater than 50%. Disease progression was more rapid in patients under 65 years of age. Symptoms occurred in 13 patients for an overall incidence of 10% and a mean annual rate estimated at 5%. All symptoms indicated transient ischemic attacks; there were no strokes. There was a strong relationship between the development of symptoms and stenoses greater than 80% either at the initial examination or secondary to progression. No correlation was found between the presence of bruits or their change over time and the progression or appearance of symptoms. Conservative management of nonoperated vessels opposite an endarterectomy appears appropriate until symptoms develop or a lesion greater than 80% is detected.

Adult↗

[M-mode echocardiography of left heart in hypertensive patients (author's transl)].

72 hypertensive patients have been studied by means of M-Mode echocardiography. The results of our study have shown that a consisting number of hypertensives exhibits signs of left atrial enlargement, an increase of the myocardial mass and of the thickness of the posterior wall. The diastolic indices resulted more precociously impaired as compared to the systolic ones. Finally a positive correlation was found between left atrial enlargement, myocardial mass on one hand and mean blood pressure on the other, and between atrial enlargement and myocardial mass.

Adult↗

[Value of cycloergometer and dynamic ECG (Holter ) in the diagnosis of coronary insufficiency (author's transl)].

The purpose of thee present work is to compare th value of two non invasive techniques: cycloergometer and dynamic ECG (Holter) in the diagnosis of ischaemic heart disease in subjects without basal ECG abnormalities and without clearcut clinical signs of coronary insufficiency. Twenty patients underwent both tests while in hospital. The ECG was continuously monitored for 24 hours according to the Holter method. In fifteen out of the twenty cases examined for results obtained with the two different techniques were in agreement; in three cases ischaemic ECG changes were seen only with the ergometer, in one only with the Holter and in one they were clearly present with the Holter, but were doubtful with the ergometric test. In our experience the Holter method should represent the first approach to studying patients suspected to be suffering from angina pectoris in view of its good sensitivity and of the absence of risk and contraindications. Maximal exercise test should be reserved to the patients in whom the Holter method has given negative results. The latter not only has a diagnostic value, but also "quantifies" the degree of ischaemia by recording symptomatic and asymptomatic ST depressions.

Adult↗

Clinical follow-up and progression of carotid atherosclerosis determined by duplex scanning in patients suffering from TIA.

We investigated the clinical outcomes and the progression of the internal carotid arterial lesions of a group of patients presenting with hemispheric TIAs. The cumulative frequency of TIAs during a mean follow-up period of 40 +/- 14 months was 14%, and no relationship was found between new TIAs and the presence of known cardiovascular risk factors or plaque characteristics as determined by duplex scanning. With the exception of one patient who died of stroke, none of the patients developed a permanent neurologic deficit. The cumulative death rate was 6.5%; myocardial infarction was the most common cause (3 out of 7). Anatomic progression of plaques was determined by duplex scanning in 22% of the internal carotid arteries. No relationship between progression of these plaques and the development of new TIAs was evident. We conclude that, in this group of patients, TIAs do not inevitably lead to stroke and that TIAs are not predictable based on risk factors or plaques characteristics.

Aged↗

[Prevalence of clinically silent pulmonary embolism in deep venous thrombosis of the legs].

BACKGROUND: Thromboembolic venous disease is a possible lethal condition which is very often present in clinical practice. The aim of this study was to evaluate the prevalence of clinically occult pulmonary embolism (PE) in a group of patients with recent proximal deep venous thrombosis (DVT), and the relationship between prevalence of PE and DVT extension, echographic features of the thrombi, anticoagulant therapy administered. MATERIALS AND METHODS: The study enrolled 93 patients with DVT of the proximal lower extremities, without clinical symptoms and signs of PE. All patients were submitted to echo color-Doppler and ventilation-perfusion lung scan. The results were analysed by a score system for the echographic scan and by a series of probability criteria, as recommended by the PIOPED investigators, for the lung scan. RESULTS: All patients were recognised to suffer from proximal DVT. High probability lung scans for PE were found in 43 subjects (46.2%), intermediate probability in 14 (15%), low probability in 7 (7.7%), very low-normal in 29 (31.1%). The prevalence of PE failed to show any significant difference with respect to DVT extension, ultrasonographic features of the thrombi and anticoagulant therapy administered. CONCLUSIONS: The results obtained show a high prevalence of asymptomatic PE in patients with DVT, and suggest the need of an extensive use of lung scan in this kind of patients, and the utility of an early detection of DVT, in order to establish an intense antithrombotic therapy, irrespective of the extension of the thrombus with US.

Aged↗