PubMed Health⌕ Search

Biomedical subjects

M Paradiso

Publications and source records attributed to M Paradiso.

53 records · Page 3Linked to original sources
PubMedDate not supplied

Morphologic left ventricular patterns and prevalence of high-grade ventricular arrhythmias in the normotensive and hypertensive elderly.

In the elderly, systemic hypertension is the main risk factor for cardiovascular diseases. Left ventricular hypertrophy, the most common adaptation to chronic pressure overload, has been recognized as an independent risk factor for an increased incidence of sudden death and arrhythmic disturbances. This study compared the prevalence of serious ventricular arrhythmias in elderly individuals with uncomplicated hypertension and in normotensive age-matched controls, using left ventricular mass index (LVMI) to differentiate patterns of anatomic adaptation to systolic, diastolic, or systolic-diastolic hypertension. The study enrolled 378 consecutive untreated elderly subjects (> or = 65 years of age), without clinical evidence of heart failure; 203 were hypertensive and 175 were normotensive. Each participant underwent standard 12-lead electrocardiography, M-mode and B-mode echocardiography, and 24-hour ambulatory electrocardiographic monitoring. Serious, statistically significant arrhythmias (Lown classes > or = 3) were present in 6.8% of normal subjects versus 17.1% of individuals with systolic, 31.5% of those with diastolic, and 20.4% of participants with systolic-diastolic hypertension. Arrhythmias did not differ in terms of left ventricular morphologic patterns or LVMI or between subgroups of hypertensive patients. Our data support the hypothesis that the pathogenesis of arrhythmias is related not to the electrophysiologic derangement of hypertrophied muscle but, rather, to the effects of hypertension on the cardiac structure. Cardiac fibrosis, one of the deleterious events accompanying hypertension, may be the main substrate for ventricular arrhythmias.

Aged↗
PubMedDate not supplied

Natural history of cardiac involvement in myotonic dystrophy (Steinert's disease): a 13-year follow-up study.

Myotonic dystrophy (MD) is associated with a wide spectrum of cardiac abnormalities, but only a few longitudinal studies have investigated the natural course of heart disease in MD. To assess whether neuromuscular involvement significantly predicts cardiac disorders in MD, 83 patients with various grades of disease severity were enrolled in a 13-year follow-up study (mean, 60.6 +/- 37.8 months) that included periodic physical and instrumental cardiac examinations (standard and Holter electrocardiography, echocardiography). During follow-up, muscular disease worsened clinically in 9 patients (11%) whose baseline severity grade changed accordingly; only 3 of them demonstrated parallel worsening of cardiac disturbance, however, compared with a large number of patients who showed additional cardiac abnormalities. These included further worsening of pre-existing pathologic features (19/83) and the appearance de novo of serious arrhythmias and/or conduction defects (23/83). Pacemaker implantation was necessary in 11 of 83 patients (13.2%) who had symptomatic bradyarrhythmias, bifascicular block, and P-R prolongation with a His-to-ventricle interval exceeding 55 ms, as documented by electrophysiologic study. Eight (9.6%) patients died: 2 from noncardiac and 1 from unknown causes, 1 from heart failure, and 4 from sudden death closely related to documented ventricular tachycardia. The incidence and seriousness of arrhythmic and conduction disturbances correlated with the severity of the muscular involvement. Nevertheless, cardiac and muscular disease did not show a linear progression. Cardiac involvement generally worsened more rapidly than did skeletal muscle disease.

Adolescent↗
PubMedDate not supplied

Association between histological diagnosis of Helicobacter pylori and coronary heart disease: results of a retrospective study.

OBJECTIVE: Several epidemiological and clinical reports have investigated the relationship between Helicobacter pylori (H. pylori) infection and ischemic heart disease (IHD). All studies utilized for the diagnosis of H. pylori infection the antibody titre that is unable to distinguish an actual from a previous H. pylori infection. PATIENTS AND METHODS: We report a retrospective analysis on 149 subjects, who underwent an esophago-gastro-duodenoscopy, in whom the search for H. pylori was histologically performed. RESULTS: The prevalence of IHD is not significantly different from that observed in H. pylori free patients (26% vs 21%, p = 0.527). CONCLUSIONS: The mechanism underlying the possible role of H. pylori needs further investigation and prospective studies to further analyze the relationship between "active" H. pylori infection and ischemic heart disease were necessary.

Adult↗
PubMedDate not supplied

[Rationale for the use of renin-angiotensin inhibitors in the treatment of arterial hypertension and correlated organ damage].

The treatment of hypertension has evolved in recent years. Blood pressure lowering per se is no longer a sufficient parameter to evaluate its beneficial effects on end-organ damage. Drugs must be considered on the basis of their effects on cellular level and structural alterations that occur in the vasculature, heart and kidney. Angiotensin converting enzyme inhibitors and angiotensin II receptor blockers, two classes of drugs that inhibit angiotensin II effects, may protect target organs from damage and thereby improve outcomes. The mechanisms of action are different even if both counteract all noxious effects of angiotensin II. Angiotensin II receptor blockers selectively inhibit AT1 receptors whose stimulation mediates the hypertensive and proliferative effects of angiotensin II while do not interfere with AT2 receptors. These last ones have a role not well established but it has been postulated that they have antihypertensive and antiproliferative effects. A review will be made on the cellular mechanisms of angiotensin II activity and the effects of AT receptor antagonists.

Angiotensin-Converting Enzyme Inhibitors↗
PubMedDate not supplied

[Amebic liver abscess: clinical and therapeutic considerations].

The authors report the case of a young adult with an amebic liver abscess. The primary infection localized in the gut occurred during a vacation in Africa. This disorder is fairly uncommon in western countries which is why the authors considered it worthwhile to draw practitioners' attention to it, stressing that it should be taken into account in differential diagnosis of fever of unknown origin in young adults who have travelled to regions where amebiasis is endemic. In addition, the diagnostic procedures used and especially the treatment applied are briefly set out. Medical therapy is almost always successful but if significant improvement is not achieved within a reasonable lapse of time and if complications are suspected, all possible therapeutic measures, including surgery, must be applied.

Adult↗
PubMedDate not supplied

Are low levels of HDL2-cholesterol a risk factor for atherosclerosis of cerebral vascular disease? Case report.

A case of a 45 years old man with an atherosclerotic stenosis of right internal carotid and TIA event is reported. The patient showed an increase of total cholesterol and LDL-cholesterol serum levels and, in particular, a very low familiar HDL2-cholesterol serum value. The possibility that this last condition could represent an important co-factor of the extracranial cerebrovascular disease is discussed. The usefulness of a long-term follow-up of all family members, showing the same lipids pattern, is also suggested.

Carotid Artery Diseases↗
PubMedDate not supplied

[A case of non-Hodgkin T-cell lymphoma with predominantly cutaneous manifestations].

There is a wealth of experiences concerning cancer and leukemia induced in human populations by radiation. The contribution of the nuclear industry to the radiation exposure of the general population is small, but there is the risk of catastrophic accidents causing a large number of deaths. The authors describe the case of a 48 year old black man accidentally exposed to the effects of radiations during the nuclear disaster of Chernobyl in 1986. The patient showed, many years later, a predominantly cutaneous high-grade T cell lymphoma, which was refractory to traditional treatments but sensitive to high doses of a recombinant interferon. Unluckily the patient died, six months later, because of autoinfection overwhelming. The goal of the authors is again to ask to reflect on the risk of the use of nuclear power and to debate the possible choice of the still experimental treatments.

Ethiopia↗