Biomedical subjects

L Russo

Publications and source records attributed to L Russo.

At least 19 recordsLinked to original sources

PubMed1992

Syntheses, resolution, and structure-activity relationships of potent acetylcholinesterase inhibitors: 8-carbaphysostigmine analogues.

The synthesis of a series of 1,2,3,3a,8,8a-hexahydroindeno[2,1-b]pyrrole 5-alkylcarbamates and their resolution are reported. These compounds are structurally related to physostigmine with substitution of a methylene group in place of the NMe group at position 8 of physostigmine. Many of these 8-carbaphysostigmine analogues are more potent acetylcholinesterase inhibitors in vitro and less toxic in vivo than physostigmine. The (-)-enantiomer (e.g., 1d and 1g) possessing the same absolute configuration at C3a and C8a as that of physostigmine, is about 6 to 12-fold more potent at inhibiting acetylcholinesterase than the corresponding (+)-enantiomer (e.g., 1e and 1h).

Animals↗

PubMed1992

Role of a prehospital medical system in reducing heroin-related deaths.

OBJECTIVE: The mortality rate from heroin overdose in Italy between 1977 and 1987 increased significantly. However, in the same period, a significant increase was not observed in Tuscany, an administrative region in Italy. This study was performed to determine if the prehospital emergency medical system of Florence, the capital of Tuscany (the only one operating in Italy during the study period), affected this lower mortality rate. DESIGN: Retrospective study. SETTING: The Florence system consists of 17 mobile ICUs, each of which is staffed by a physician and three paramedics. These units are able to carry out advanced cardiopulmonary resuscitation with equipment transported to the scene of an emergency. PATIENTS: A total of 126 consecutive patients with heroin overdose, assisted by four mobile ICUs from January 1, 1984 through December 31, 1987. INTERVENTIONS: Common therapeutic protocol in the treatment of heroin overdose and of cardiac arrest. RESULTS: Fifty-two (41.3%) patients were in respiratory arrest, and seven (5.6%) patients were in cardiorespiratory arrest. The prehospital mortality rate was 1.6%, the inhospital mortality rate was 0.8%, and the overall mortality rate was 2.4%. During the period considered, the number of heroin overdose-related interventions increased significantly, as did the number of heroin overdoses complicated by respiratory arrest or by cardiorespiratory arrest, but the mortality rate remained low. CONCLUSION: We suggest that an emergency medical system can play an important role in reducing the mortality rate from heroin overdose.

Adolescent↗

PubMed1992

[Alfentanyl and midazolam in combined anesthesia. Clinical evaluation].

We have evaluated the effectiveness of a technique of blended anaesthesia (epidural-general) in 31 patients undergoing major surgery. Thoracic epidural blockade with lidocaina CO2, adrenalin 1/200000, ensures analgesia while induction and hypnosis maintenance were obtained with midazolam, alfentanil, atracurium and N2O/O2. This technique seems able to protect the patients from endotracheal intubation and surgical stress and also to enable a rapid, quiet awakening. The dose of midazolam necessary to maintain hypnosis was inversely proportional to the patient's age. The reversal of hypnosis was necessary in 4 patients only.

Adult↗

PubMed1991

Feasibility of out-of-hospital treatment of supraventricular tachycardias.

Explore the source record for details and available documents.

Aged↗

PubMed1991

Evaluation of a mobile coronary care unit protocol in patients with acute onset chest pain.

This study was designed to assess the accuracy of a diagnostic protocol of the mobile coronary care unit (MCCU) of Florence for acute chest discomfort. During 1986, 706 patients with chest pain were seen by the MCCU. Of these, 324 of 376 (95.2%) of those hospitalized and 247 of 324 (76.2%) of the nonhospitalized patients were entered in the study. The MCCU diagnosis of acute myocardial infarction (AMI) was confirmed in 120 patients (80.3%). A false positive diagnosis of AMI was made in 27 patients (6.9%), while in 37 patients AMI was not diagnosed at the first MCCU clinical examination (false negative). The sensitivity in the diagnosis of AMI was 80.5%, the specificity 91.8%, and the diagnostic accuracy 89.1%. In the recognition of acute coronary syndromes (AMI + unstable angina), sensitivity and specificity were, respectively, 94.0% and 94.4%. The protocol of the Florence MCCU provides high accuracy in the diagnosis of AMI and acute coronary insufficiency; close adherence to the protocol can decrease the number and the costs of undue hospital admissions while protecting the safety of patients.

Acute Disease↗

PubMed1991

Brain in eclampsia: MR imaging with clinical correlation.

Cranial magnetic resonance (MR) imaging was performed on eight consecutive patients with generalized tonic-clonic seizures caused by eclampsia. Each patient underwent serial neurologic examinations until all symptoms resolved. Six of those eight patients underwent follow-up MR imaging. These patients were compared with those in previous case reports of MR imaging abnormalities of the brain in eclampsia. MR imaging typically demonstrates bilateral hyperintense lesions on T2-weighted images and iso- to hypointense lesions on T1-weighted images. MR imaging abnormalities are most commonly located in the distribution of the posterior cerebral circulation and are associated with visual disturbances. Basal ganglia and deep white matter lesions are less common and are associated with mental status changes. Most lesions seen at MR imaging in patients with eclampsia are reversible.

Adolescent↗

PubMed1991

[Mental stress and ambulatory monitoring of arterial pressure].

The aim of this study was to validate the use of arithmetical mental stress testing as an indicator of an abnormal subject's response to stress in general. For this purpose 82 males (mean age 31 +/- 7 years, mean body surface area--BSA--1.76 m2), free from cardiovascular disease, underwent mental stress testing. In the sample examined we found 13 so-called reactive subjects, (mean age 32 +/- 7 years, mean BSA 1.8 +/- 0.1 m2), who during the test showed increases in mean blood pressure (greater than 20%) greater than mean values of the whole sample (17.8%). In any case blood pressure was higher than 150/100 mmHg. These data were compared with those of 15 subjects (mean age 32 +/- 4 years, mean BSA 1.77 +/- 0.1 m2) randomly selected among those, whose mean pressure increases were not higher than 17.8% (mean increase within sample). The 2 groups underwent blood pressure ambulatory monitoring and submaximal bicycle test. In reactive subjects, values of systolic (PAS) and diastolic pressure (PAD) were significantly higher than in controls (p less than 0.001) during blood pressure ambulatory monitoring, with a greater variability of such values as can be seen from the higher standard deviation (PAS 121 +/- 19 mmHg vs PAS 113 +/- 13 mmHg; PAD 82 +/- 11 mmHg vs PAD 75 +/- 10 mmHg). During ergometric testing, blood pressure trend was similar in the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

[The mobile coronary unit of Florence: an evaluation of 10 years of prehospital cardiac care].

In order to reduce the high mortality from ischemic heart disease, a mobile coronary care unit manned by a cardiologist has been operating in Florence since 1979. From 1980 to 1989 there were 13,029 interventions, 8,718 (66.9%) of which were cardiac emergencies. 1,718 (19.7%) patients showed acute myocardial infarction while in 2,274 angina was diagnosed (26.1%). Acute pulmonary edema and paroxysmal supraventricular tachyarrhythmias accounted, respectively, for 6.2% and 18.3% of total cardiac emergencies; moreover there were 753 (5.8%) attempted resuscitations in sudden cardiorespiratory arrest from cardiac causes. In acute myocardial infarction, the median time between the onset of symptoms and mobile coronary care unit arrival was 85 minutes, and 69.9% of patients were reached within 3 hours from the onset of symptoms. Ventricular fibrillation, ventricular tachycardia and asystole were observed respectively in 80 (4.6%), 42 (2.4%) and 50 (2.9%) patients. Success rate of emergency treatment was 81.3% for ventricular fibrillation, 88.1% for ventricular tachycardia and 18% for asystole. Prehospital mortality was 4.06%. The ECG picture of the 753 patients found in cardiac arrest showed sustained ventricular tachycardia in 12 (1.6%), ventricular fibrillation in 198 (26.3%), bradyarrhythmia in 28 (3.7%), and asystole in 431 (57.2%). Cardiopulmonary resuscitation was successfully performed in 230 patients (30.5%). Finally, more than 50% of the patients with angina, 20% of the patients with acute pulmonary edema, and 70% of the patients with paroxysmal supraventricular tachyarrhythmia were adequately treated at home and needed no hospitalization. The ten years experience of Florence Mobile Coronary Care Unit suggests that a community wide emergency cardiac care system can significantly reduce the pre-hospital mortality and the time delays preceding thrombolysis and intensive care in acute myocardial infarction. Moreover, the cardiac "sudden death" can often be successfully treated. Most other cardiac emergencies may be adequately treated at home and unnecessary hospitalizations can be avoided.

Arrhythmias, Cardiac↗

PubMed1990

[Cardiovascular aspects of Martin-Bell syndrome].

Cardiovascular anomalies have been studied in 13 subjects (8 males and 5 females, average age 15 +/- 7 years) affected from fragile X syndrome. This group has been examined by standard-ECG, Holter-ECG, echocardiography (M-mode, B-mode, Doppler and color-Doppler). The results have been compared with a control group of 39 subjects (20 males and 19 females, average age 15 +/- 5 years), with non genetic mental retardation. Clinical examination, ECG and Holter did not show any significant pathological alteration compared with the results of the control group. In the study group echocardiography showed the following results: 10 subjects (77%) had mitral valve prolapse of the anterior leaflet (arching); 4 of which (31%) with associated posterior leaflet prolapse; 2 subjects (15%) with posterior aortic leaflet prolapse; 2 subjects (15%) with tricuspid septal leaflet prolapse; 3 subjects (23%) had mild pulmonary artery dilatation; 1 subject (8%) had a mild aortic regurgitation; in 9 subjects (69%), 3 of whom with pulmonary artery dilatation, has been found pulmonary valve regurgitation; 10 subjects (77%) had tricuspid valve regurgitation. In all subjects cardiac dimensions were within the normal range. The most important result, in accordance with literature, is the high prevalence of mitral valve prolapse. The prolapse is asymptomatic and silent. We have never found aortic root dilatation that was described by other Authors. The described anomalies could be ascribed at the dysfunction of the connective tissue. This theory has been confirmed by necropsy studies. Therefore, we suppose that these alterations, particularly the anterior mitral leaflet prolapse, are non casually associated with the fragile X syndrome.

Adolescent↗

PubMed1979

[The action of cyclic somatostatin on hypoglycemia due to prolonged fasting in normal animals].

The authors have examined the action of cyclic Somatostatin on blood glucose levels in normal rats and in rats starved for 36 and 50 hours. The infusion of 0,235 gamma/min. of Somatostatin for thirty minutes in the normals induced a slight increase in blood glucose levels that was statistically non significative. Under the same condition, the cyclic Somatostatin increased, in a statistically significant way, the levels of plasma glucose in both starved groups of rats.

Animals↗

PubMed1979

[Paper chromatography of the urinary carbohydrates in normal subjects: the aldoses].

The authors describe a method that utilizes paper chromatography for the separation and identification of urinary carbohydrates, especially the Aldoses. Using 5 ml. of urinary extract, it is possible to separate Lactose, Maltose, Galactose, Glucose, Fructose, Mannose + Arabinose, Xilose + Ribose, Glucuronolactone and other unidentified compounds.

Aldehydes↗

PubMed1979