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Biomedical subjects

L Russo

Publications and source records attributed to L Russo.

At least 37 records · Page 2Linked to original sources
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

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↗
PubMed1989

Altered renal tubular function in men with high erythrocyte sodium-lithium countertransport.

The renal fractional excretion of uric acid was determined for both a habitual diet and an NaCl-restricted diet in two groups of untreated subjects with low (117-207 mumol per litre of cells per h) and high (373-598 mumol per litre of cells per h) erythrocyte Na-Li countertransport identified in a population-based survey of middle-aged male workers. The group with high Na-Li countertransport had a higher mean blood pressure (P less than 0.05); this group also had a significantly reduced fractional excretion of uric acid with the NaCl-restricted diet even after adjustment for the difference in blood pressure (P less than 0.03). These findings are compatible with an abnormality in kidney tubular function and possibly in the renal handling of sodium in subjects with elevated erythrocyte Na-Li countertransport.

Biological Transport↗
PubMed1988

Early detection of vascular dysfunction in type I diabetes.

Blood flow and transcutaneous oxygen tension was measured by venous occlusion plethysmography and a transcutaneous oxygen electrode before and after 5 min of arterial occlusion in the forearm of young adult subjects with type I (insulin-dependent) diabetes without overt evidence of angiopathy. In control subjects (n = 21), the forearm blood flow increased by greater than or equal to 2.8-fold at 30 s after ischemia. Diabetic subjects with glycosylated hemoglobin (GHb) less than or equal to 9.5% (n = 15) exhibited a blood flow response that was not statistically different from normal control subjects. Diabetic subjects with GHb greater than or equal to 12.5% (n = 23) did not exhibit an increase in the postischemic blood flow. When blood flow patterns for the first 14 diabetic subjects were examined regardless of GHb value, four patterns of response were noted: 1) normal pattern (n = 3), 2) normal postischemic rise in blood flow with a prolonged elevation (n = 3), 3) no postischemic rise (n = 4), and 4) variable baseline blood flow with a decrease in blood flow postischemia (n = 4). This approach indicated that a comparison of means obscured potentially meaningful abnormal patterns. Abnormalities in the response of the transcutaneous oxygen tension to ischemia were observed in both groups of diabetic patients, but the difference between diabetic patients in good and poor control was less obvious. We have defined an abnormal response of blood flow and transcutaneous oxygen tension to ischemia that may correlate to glycemic control and have identified several patterns of blood flow after ischemia that may be important in defining the etiology and natural history of diabetic angiopathy.

Adolescent↗
PubMed1988

[Prevalence of pulmonary valve insufficiency in healthy children: a Doppler color study].

One hundred patients, institutionalized for mental retardation, aged between 3 and 14 years (mean age 12.2 +/- 3) and free from cardiovascular and pulmonary diseases, were studied using Doppler technique (pulsed wave-continuous wave and color-coded Doppler), to evaluate the prevalence of pulmonary regurgitation. The authors, utilizing a triple method (diastolic turbulence above pulmonary valve detected by pulsed wave Doppler or diastolic flow detected by continuous wave Doppler, presence of regurgitant pulmonary color-jet, from short axis view, toward the right ventricular outflow tract, and presence of the same feature in the color m-multigate) to detect the presence or absence of pulmonary regurgitation found 73% positivity. There were no differences between the two sexes and the size of the pulmonary artery was in the normal range. The characteristics of regurgitation were: No holodiastolic. The regurgitant max velocity jet was not greater than 1.50 m/s. Beat to beat variability. Max length of color-jet was not more than 2 cm. Rapidly decreasing Doppler profile. We can conclude that pulmonary regurgitation is very frequent in children and is not significant if it has the above-named characteristics. This latter fact is further confirmed by other authors.

Adolescent↗
PubMed1987

Controlled trial of long term oral potassium supplements in patients with mild hypertension.

A 15 week randomised double blind placebo controlled trial of oral potassium supplements (48 mmol daily) was conducted in 37 patients who had mildly increased blood pressure and a normal dietary intake of sodium. After a two month run in and a one week baseline period the patients were randomly assigned to receive either potassium supplements (n = 18) or placebo (n = 19). By the third week of treatment blood pressure in the actively treated group had decreased significantly compared with that in the placebo group, though the decrease reached its maximum after 15 weeks. Urinary potassium excretion increased significantly in the group who received potassium supplements, but no significant changes were found in plasma sodium and potassium concentrations or in urinary sodium excretion. In a subgroup of 13 patients who underwent a further nine weeks of treatment with oral potassium supplements at half of the previous dose (24 mmol daily) their blood pressure, at the end of this second study period, was still significantly lower compared with their baseline value but not with that of the placebo group. These results show that moderate oral potassium supplements are associated with a long term reduction in blood pressure in patients who have mild hypertension.

Administration, Oral↗
PubMed1987

Cerebral infarction with a single oral dose of phenylpropanolamine.

Phenylpropanolamine (PPA), a synthetic sympathomimetic that is structurally similar to amphetamine, is available over the counter in anorectics, nasal congestants, and cold preparations. Its prolonged use or overuse has been associated with seizures, intracerebral hemorrhage, neuropsychiatric symptoms, and nonhemorrhagic cerebral infarction. We report the case of a young woman who suffered a cerebral infarction after taking a single oral dose of PPA.

Administration, Oral↗
PubMed1985

Effects of beta-receptor blockade on carbohydrate metabolism.

The effects of beta-blockers on glucose tolerance, insulin secretion and peripheral insulin sensitivity were evaluated by oral glucose tolerance test and euglycaemic insulin technique in six normoglycaemic patients with primary arterial hypertension at the end of 3-week treatments with placebo (one tablet twice daily) and propranolol (80 mg twice daily). Body weight did not change during the study (83 kg at the end of placebo, 83 kg at the end of propranolol), while blood pressure (150 +/- 9/97 +/- 8 mmHg on placebo, 138 +/- 8/89 +/- 8 mmHg on propranolol, P < 0.01) and heart rate (66 +/- 9 beats/min on placebo, 60 +/- 5 beats/min on propranolol, P < 0.05) showed a significant fall on the beta-blocker. No change was observed in glucose tolerance (incremental area for glucose 3462 +/- 1149 mg/dl per min on placebo, 3209 +/- 1695 mg/dl per min on propranolol), insulin secretion (incremental area for serum insulin 7579 +/- 4380 microU/ml per min on placebo, 7934 +/- 4351 microU/ml per min on propranolol) and peripheral insulin sensitivity (metabolic clearance rate 11 +/- 4 ml/kg per min on placebo, 13 +/- 6 ml/kg per min on propranolol). These data support the hypothesis that chronic treatment with adrenergic blocking agents does not induce any significant change in insulin secretion or peripheral insulin sensitivity.

Adrenergic beta-Antagonists↗