Biomedical subjects

N Rigon

Publications and source records attributed to N Rigon.

5 recordsLinked to original sources

PubMed1999

Acute cardiovascular diseases and respiratory sleep disorders.

Respiratory sleep disorders are a risk factor, sometimes independent, for acute cardiovascular diseases which are the most frequent cause of death among populations of industrialized countries. Snoring and obstructive sleep apnea (OSA) are generally involved, while the pathogenetic role of acute exacerbation of COPD seems less evident. The most important acute cardiovascular events related to sleep respiratory disorders are angina pectoris, acute myocardial infarction, cardiac arrhythmias (in some instances as paroxysmal attacks), systemic hypertension with hypertensive crisis, ischemic stroke. A respiratory sleep disorder should be suspected in all obese, cigarette smokers, alcoholics, hypertensives, who present symptoms of obstructive sleep apnea, where snoring may be a marker, and in patients with COPD. The diagnosis is readily established by performing polysomnography and, when needed, by 24-hour Holter monitoring and blood pressure ambulatory recording. Therapy aims at correcting risk factors with particular attention to weight reduction in obese patients. Furthermore, upper airway anatomic abnormalities should be eliminated. In obstructive sleep apnea, nasal continuous positive airway pressure during sleep is to be used, when necessary, while tracheostomy must be performed only in more severe cases.

Acute Disease↗

PubMed1998

[Application of chronotherapy to cardiovascular diseases].

Among cardiovascular diseases, hypertension, angina pectoris, acute myocardial infarction and ischemic stroke present a circadian pattern with a greater incidence of unfavourable events between awakening and noon. Chronotherapy aims to use drugs that release their active principles at different times during the day, according to biological needs. In chronotherapy of cardiovascular diseases, a particular attention has been paid to slow-release drugs that assure a 24 hours therapeutic effect with once a day administration. In primary hypertension well controlled by monotherapy (dipper hypertensives), the morning administration of long-acting beta-blockers and calcium antagonists has shown to control blood pressure over 24 hours, whereas ACE-inhibitors have proved more effective when administered at evening. In secondary hypertension (non dipper hypertensives) the administration of calcium antagonists is more effective at evening. Patients with severe hypertension need polytherapy. In that case, at least one of the antihypertensive drugs should be given at evening to lower night blood pressure values, which are particularly elevated also during sleep, and so to prevent an excessive blood pressure rise on awakening. In chronic monotherapy of ischemic heart disease, long-acting beta-blockers and calcium antagonists have shown to be equally effective when they are administered at morning, whereas slow-release nitrates, which need a nitrate-free interval, are to be administered either at morning or at evening, according to the expected time of onset of anginal pain. ASA seems to reduce the morning incidence of acute myocardial infarction, while tissue-type plasminogen activator presents a circadian variation of its thrombolytic activity with a higher efficacy between noon and midnight.

Cardiovascular Agents↗

PubMed1997

[Evaluation of hyperkinetic cardiac arrhythmia in chronic obstructive bronchopneumopathy].

Patients with chronic obstructive pulmonary disease (COPD), especially during acute exacerbations of their disease, show a greater incidence of cardiac arrhythmias than healthy subjects of the same age. The type of arrhythmias found may be supraventricular (premature atrial beats, paroxysmal supraventricular tachycardia, multifocal atrial tachycardia, atrial flutter, atrial fibrillation) or ventricular (premature ventricular beats, sustained ventricular tachycardia, torsades de pointes, ventricular fibrillation) that may lead to sudden cardiac death. The pathogenesis of arrhythmias is complex and many factors may be involved such as hypoxemia, hypercapnia, respiratory acidosis, metabolic and respiratory alchalosis, hypokalemia, concomitant ischemic heart disease, chronic cor pulmonale, left ventricular diastolic dysfunction. Remarkable attention has been drawn to the possible arrhythmogenic effect of drugs such as theophylline, beta-adrenergic stimulants and digitalis which are commonly used in the therapy of COPD. Both of the main classes of bronchodilators (methylxanthynes and beta-adrenergic agonists), even when used together, apparently do not increase the incidence of dangerous cardiac arrhythmias. However, these drugs should be used with caution in the elderly, in patients with preexisting cardiac arrhythmias, with heart disease or with reduced hepatic function. In these cases Holter monitoring, repeated measurements of plasma drugs concentration and prompt hospitalization of high risk patients in Intensive Care Unit may be needed.

Adrenergic beta-Agonists↗

PubMed1988

[Prevention of thromboembolism in patients operated on for hip prosthesis].

The latest research into the prevention of peri- and postoperative thromboembolic disease has found orthopaedic surgery patients to be most at risk. As the genesis of deep venous thrombosis (DVT) is due to haemodynamic, hemorheologic and parietal factors, various prophylactic measures have been considered in the past, measures which have not proved able to provide satisfactory protection in orthopaedics. The results obtained with Defibrotide in a random and controlled clinical study versus calcium heparin involving 211 patients of both sexes candidates to receive total hip arthroplasty and presenting at least one major thromboembolic risk factor are reported. The patients were assigned at random to one of the following treatments: 1) Defibrotide at a dose of 400 mg b.i.d. i.v. in 50 ml phleboclysis in 5 minutes (n = 108); 2) calcium heparin at a dose of 5000 IU t.i.d. subcutaneously (n = 103). The treatment began the day before operation and continued on average up to the eighth day for the Defibrotide group. With the control group it continued until discharge (usually on the 15th day) and at home for about three weeks until the completion of the physiotherapy cycle. In the 108 patients treated with Defibrotide only one case of DVT was reported and in none of these patients were symptoms or signs of pulmonary embolism encountered. In the group treated with calcium heparin 2 cases of clinically and radiologically diagnosed pulmonary embolism and 4 cases of DVT were observed. Although the differences were not statistically significant, the tendency favours Defibrotide. Statistically significant (p less than 0.01) was the difference in postoperative bleeding evaluated with particular attention in patients of advanced age. Further, in the Defibrotide group, scarring was considered excellent in 96% of cases while in the heparin group scarring was excellent in 85% (p less than 0.05). To conclude, the sure clinical effectiveness, tolerance, handiness and lack of interference with clotting functions make Defibrotide a really useful drug for the prevention of thromboembolic episodes in patients undergoing major orthopaedic surgery.

Adult↗

PubMedDate not supplied

[Serious risks that workers might not be able to identify].

Two cases of occupational accident in confined spaces, recently occurred in the harbour of Venice, are reported in this article. The authors point out that preventive measures have always to be adopted to prevent appropriately occupational risks in confined spaces. They also remark that, in the workplaces where these risks have to be faced, adequate information should be well evident and written in proper language and they believe that proper labelling is a crucial element. Finally, they suggest that a briefing and a periodic training must be given to the workers professionally exposed.

Accidents, Occupational↗