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Biomedical subjects

M B Secchi

Publications and source records attributed to M B Secchi.

At least 19 recordsLinked to original sources
PubMed1989

[Severe hypopotassemia and rhabdomyolysis in a normotensive subject after use of a nasal spray containing 9-alpha-fluoroprednisolone].

We report the case of a 16-year-old boy who was admitted to our hospital for acute urinary retention, flaccid paralysis of the legs and arms and rhabdomyolysis due to a nasal spray containing 9-alpha-fluoroprednisolone. In our normotensive subject, rhabdomyolysis occurred after vigorous physical activity performed before the administration. The case emphasizes the need to avoid the use of 9-alpha-fluoroprednisolone considering its intense mineralocorticoid activity.

Administration, Intranasal↗
PubMed1986

Beta-blocker versus diuretic for control of the blood pressure response to stress in hypertensive patients.

To compare the antihypertensive effects of beta-blockers and diuretics on the blood pressure increase to stress, a randomized single-blind crossover study was performed in 27 patients with mild or moderate hypertension. At the initial examination and after two subsequent periods of therapy with 100 mg atenolol or with a combination of 50 mg hydrochlorothiazide and 5 mg amiloride hydrochloride, once a day, blood pressure and heart rate were measured at rest, during mental arithmetic, sustained handgrip and cycloergometric test. Both treatment significantly decreased supine and standing systolic and diastolic pressure at rest, during and immediately after mental stress and isometric exercise, with the reduction of diastolic pressure significantly greater after atenolol. During dynamic exercise, systolic and diastolic pressures were significantly decreased by diuretics at the lowest work-load only, whereas beta-blocker caused significant and greater blood pressure reductions throughout the exercise. The combination of two classes of drug normalized resting blood pressure in 8 of 9 subjects in which the monotherapy had failed to obtain values less than 140/90 mmHg and gave a better control of systolic and diastolic pressures throughout all the stress tests. It is concluded that atenolol is more effective than diuretics during stress, suggesting that beta-blocking drugs are the first choice treatment for mild to moderate hypertension and that when the antihypertensive effect of a single agent is insufficient, a combination of beta-blockers and diuretics is also effective during stress.

Adult↗
PubMed1984

Usefulness of stress testing for the evaluation of hypertensive heart disease in young hypertensive subjects.

To investigate the usefulness of stress testing for the evaluation of hypertensive heart disease, 40 subjects, 28 men and 12 women (mean age 30.8 +/- 6.2 years), with mild or moderate hypertension, without ST segment or T wave abnormalities in their resting ECG, were examined. 13 patients (32.5%) showed exercise-induced ST segment depression. The heart rate at rest was significantly higher in the patients with a positive response; 6 of the 7 subjects with electrocardiographic signs of left ventricular hypertrophy (summed SV1 + maximum R V5/V6 voltage of 45 mm or more) had a positive exercise electrocardiographic test. There were no significant differences between positive and negative cases in age, sex, systolic and diastolic blood pressure, or the double product (heart rate X systolic pressure) at rest or during exercise. After resting blood pressure values had been significantly decreased by giving methyldopa with or without diuretics for at least 6 months, there were a regression of left ventricular hypertrophy in the resting ECG and an impressive reduction in the prevalence of exercise-positive responses (to 17.5%). In the 7 patients with positive exercise electrocardiographic tests even after antihypertensive treatment, no significant reduction in blood pressure values during exercise was obtained.

Adult↗
PubMed1983

Prognostic value of exercise EKG testing in asymptomatic normotensive subjects. A prospective matched study.

We prospectively studied 135 asymptomatic normotensive subjects with exercise-induced ST ischemic depression of 1 mm or more and compared them with 379 controls. At least two controls with negative responses on the exercise electrocardiographic (EKG) test were selected for each case and were matched for age, sex, work, community, and coronary-risk-factors index. The end points considered were the following coronary events: angina pectoris, myocardial infarction, and sudden death. After a median follow-up period of 6.0 years for the cases and 6.4 years for the controls, the relative risk was 5.55 (95 per cent confidence limits, 2.75 to 11.22). Coronary events occurred significantly earlier in the cases than in the controls. Our data also suggest that the exercise EKG response is a particularly good prognostic indicator for myocardial infarction. In addition, our analysis has confirmed the predictive roles of age, smoking, blood pressure, and the coronary-risk-factors index and suggests that the exercise EKG response is an additional independent risk indicator for coronary events.

Adult↗
PubMed1982

[Evaluation of systolic intervals in Duchenne cardiomyopathy].

Patients with progressive muscular dystrophy rarely survive beyond the second or third decades: the commonest causes of death are respiratory failure and cardiac failure. An easily repeatable method for early recognition of cardiac dysfunction and its follow-up would therefore be valuable. We performed a polycardiographic study of systolic time intervals in 11 patients with dystrophy (each subject representing an age from 7 to 17 years) in a group comprising 10 of their mothers and in control groups matched for age and sex. The mean values of QS2, PEP and QS1 were significantly higher in patients compared to controls (QS2 : 543 +/- 26 msec compared to 519 +/- 19 msec; PEP : 142 +/- 21 msec compared to 123 +/- 18 msec, and QS1 : 105 +/- 22 msec compared to 75 +/- 12 msec) whilst mean ICT was shorter (36 +/- 11 msec, compared to 49 +/- 5 msec). Mean LVET was comparable in patients and control. These results indicate a reduction in compliance and an increase in end diastolic left ventricular tension. When the systolic time intervals were analysed in each child, an increase in PEP and reduction in LVET were characteristic of the more serious phases of the disease with cardiac failure. It is emphasized that early stages of the disease are characterised by restrictive changes resulting in a reduction in ICT whilst terminal stages with reduced cardiac output cause a reduction in LVET and an increase in PEP. No significant changes were found in the mothers of patients compared to the control group. These results indicate that systolic time intervals may be useful in following up patients with Duchenne's cardiomyopathy.

Adolescent↗
PubMed1982

[Electro-vectorcardiographic study in Duchenne de Boulogne progressive muscular dystrophy].

Electrocardiographic changes are well known in Duchenne's muscular dystrophy (DMD). Their cause is still controversial. The aim of this study was: to verify the genetic theory of these changes to improve our understanding of their pathogenesis, by studying the distribution and characteristics of the mother carriers; to determine whether electro-vectocardiography could be of value in detecting carriers of the disease. Fourteen patients aged from 7 to 17 years old with DMD underwent ECG and VCG. ECG changes were recorded in 13 of the 14 cases: increased amplitude of the R wave in the right precordial leads or deep Q waves (amplitude greater than or equal to 2 mm, duration less than 0,04 msec) in the peripheral or left precordial leads. The algebraic sum of R--S in V1 was greater than normal in 6 carriers. VCG criteria of posterior myocardial infarction were fulfilled in 11 patients. "Bites" were recorded in 4 patients and 8 carriers. Electrical changes were therefore found in both patients and carriers with equal significance: in the first group the main appearances were of pseudo-infarction, principally involving the posterior wall; in the second group, less specific changes, best recorded on VCG, suggesting foci of myocardial fibrosis were observed. We think that the "bites" recorded in 66 p. 100 of mothers, could be a useful parameter for detecting carrier subjects.

Adolescent↗
PubMed1979

[P wave analysis for the electrocardiographic diagnosis of left ventricular hypertrophy. A study of a population with arterial hypertension (author's transl)].

The electrocardiogram of 100 normal subjects and 216 patients with arterial hypertension in different stages have been analysed. P wave especially has been taken into consideration: it is often abnormal in the presence of left ventricular hypertrophy (LVI). The point-score system elaborated by Romhilt and Estes allows, if only QRS-T is considered, to diagnose LVI in 32 of the hypertensive patients (15%) and in 41 cases (19%) if the increase of P wave terminal forces is emphasized. Nevertheless this P wave characteristic does not appear more useful than others (axis less than or equal to 40 degrees; duration greater than or equal to 0.12 sec; presence of notch). The best results are achieved by considering the coexistence of two or more abnormalities of the P wave. Thus LVI is diagnosed in 52 (24%) of our cases, without false positive.

Adult↗