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P Azzolini

Publications and source records attributed to P Azzolini.

12 recordsLinked to original sources

[The prognostic value of the ejection fraction at rest and under stress assessed by nuclear angiography in myocardial infarct patients].

BACKGROUND: The aim of this study was to assess the utility of ejection fraction at rest (rEF) and its change during stress (delta EF) as a predictor of cardiac events during the follow-up of patients (pts) with myocardial infarction. METHODS: 74 pts (44 treated with thrombolytic therapy (TR), and 30 not (noTR)), were studied with 99mTcPYP angiography within 2 +/- 1 months, after AMI. By 20 +/- 10 months, 41 pts had no events (Group A) while 33 pts experienced cardiac events (3 deaths, 16 angina, 12 CABG, and 2 PTCA). RESULTS: rEF was similar in both Groups A and B (A 47 +/- 8 vs B 45 +/- 10 p. ns), 44 +/- 15 vs B-noTR 46 +/- 12 p. ns). delta EF was different between Groups A and B. Group A showed a positive delta EF (3.2 +/- 6), and this result was more evident in thrombolyzed AMI (A-TR 4.4 +/- 4.5 vs A-noTR 1.16 +/- 3.9 p. < 0.01). Group B showed a negative delta EF (-4.4 +/- 5.3), and this result was more evident in non thrombolyzed AMI (B-TR -2 +/- 6.4 vs B-noTR -5.8 +/- 8 p. < 0.01). CONCLUSIONS: A decrease in EF during exercise radionuclide angiography is useful in identifying pts with high risk of cardiac events after AMI. Thrombolytic therapy improves stress EF in both Groups A and B.

Adult

Ventricular cross stimulation in a dual chamber pacing system: phenomenon analysis.

Seven cases of ventricular cross stimulation from a group of 23 patients implanted with DDD devices are presented. In two patients the phenomenon was observed at the moment of DDD programming at nominal values, and in five other patients it was reproduced by increasing the atrial output voltage up to ten volts. In all 23 patients cross stimulation disappeared permanently within 24 hours after implantation. From the onset of cross stimulation to its end, atrial and ventricular threshold voltages were unchanged, while the atrial and ventricular impedances significantly decreased. These results suggest that an important role in the phenomenon occurs by impedance variation at the interface between the pulse generator and body tissue.

Aged

[Extension of necrosis and left ventricular function in recent myocardial infarct. Correlation between a QRS scoring system and various echocardiographic indexes].

The purpose of this study was to evaluate the extension of myocardial necrosis and the impairment of left ventricular function in patients with recent myocardial infarction by means of the standard 12-lead ECG. Then, we tried to correlate the QRS scoring system proposed by Wagner and coll. with some indexes obtained from a M-Mode and Two-Dimensional echocardiographic examination (echo-score, number of compromised areas, E-septum separation and left ventricular ejection fraction) in a group of 105 pts. (mean age 61.54 +/- 9.66 SD years). Patients were divided into three groups: 47 with anterior infarction, 45 with inferior infarction and 13 with anterior and inferior infarction. A statistically significant correlation was found between the QRS scoring system and (a) the infarct size (r between ECG-score and echo-score = 0.40, p less than 0.001; r between ECG-score and compromised areas = 0.47, p less than 0.001) and (b) left ventricular ejection fraction (r = -0.48, p less than 0.001), measured echocardiographically, particularly in pts. with anterior infarction. No correlation was found with the E-septum separation. In conclusion, the correlation between QRS scoring system and echo indexes appeared statistically significant, even if minimally applicable to single cases.

Arrhythmias, Cardiac

[Sickle cell anemia in surgical patients. Significance and problems].

Drepanocytosis, a disease notoriously widespread among blacks, is surprisingly frequent in certain Italian islands. Surgical aspects of the disease are discussed: erythrocyte sequestration attacks, pigmentary cholelithiasis, priapism, malleolar ulcers and vaso-occlusive attacks. A knowledge of such aspects is considered fundamental for the purposes of a reasoned differential diagnosis in the field of paediatric pathologies requiring surgery.

Anemia, Sickle Cell

[New prospects offered by echography in the diagnosis of carcinoma of the gallbladder].

Experience in diagnosing several cases of primary carcinoma of the cholecyst echographically in reported. The most important ultrasonic characteristics in relation to staging of the lesion are reviewed. It is seen that echographic features always correlate with surgical findings, confirming the diagnostic accuracy of the method which permits morphofunctional as well as structural evaluation. At this time echography seems to be the most rational tool for efficient diagnosis, a step forward in ensuring timely surgery and the improvement of long term prospects for the condition.

Adenocarcinoma

[Experimental intrauterine surgery. Morphological study of lung development in the sheep fetus with congenital diaphragmatic hernia].

Experimental comparison of the lungs of 7 sheep foetuses with surgically induced CDH and 7 controls permitted an assessment to be made of the changes that take place in lung growth, generally described as hypoplasia, through a study of their morphology and histology, and the lung: lamb weight ratio. Changes increased in gravity in function of the duration of hernia. They included: reduced alveolar expansion, fewer generations of bronchi and alveoli, and septal thickening. An increase in the smooth muscle component of 5th-6th generation arteries (i.e. resistance) may offer an explanation of the hypertension characteristic of CDH, and the non-reactivity of these vessels in response to vasodilators. It is also suggested that damage to the mesenchyma can be regarded as the sole cause of the changes in lung growth observed in CDH. Early treatment before these changes become irreversible is thus advisable.

Animals

[Morphologic and functional aspects of left ventricular hypertrophy evaluated by computerized echocardiography].

We have investigated the possible echocardiographic progression of left ventricular (LV) hypertrophy, in different stages of primary hypertension. Both morphological (LV mass and ratio of interventricular septal thickness to posterior wall thickness-IVST/PWT-, in M-mode) and functional data (parietal stress, duration, degree and velocity of filling in the four phases of diastole, obtained through computerised interpretation of M-mode tracings), were examined. We also tried to assess the morphofunctional differences between LV hypertrophy secondary to primary hypertension and LV hypertrophy secondary to renovascular hypertension, hypertrophic obstructive cardiomyopathy and physical training. Patients with primary hypertension were further subdivided in three groups: A) 14 patients with hypertension of less than one year's duration, B) 28 patients with long-lasting hypertension, and C) 5 patients with cardiomegaly. There was a progressive increase from controls to Group C patients of left ventricular mass (controls 171 +/- 25; Group A 168 +/- 72; Group B 253 +/- 83; Group C 439 +/- 117) and septal hypertrophy (controls IVST/PVT 1 +/- 0.1; Group A 1.2 +/- 0.2; Group B 1.4 +/- 0.3; Group C 1.5 +/- 0.1). The isovolumic relaxation period was prolonged only in Group C (controls 8.6 +/- 3.5 per cent of the diastole; Group C 15 +/- 3.5%) LV dimensions during slow filling and atrial contraction as well as filling velocity during this latter phase of the cardiac cycle were increased in Group A (7.8 +/- 2.3 and 7.3 +/- 2%; 1.2 +/- 0.6 cm/cm X sec respectively) and B (10 +/- 6 and 10.8 +/- 4%; 1.2 +/- 0.6 cm/cm X sec) compared to the controls (5 +/- 2.8 and 3.7 +/- 2%; 0.7 +/- 0.2 cm/cm X sec). The Vcf max was not significantly different in the three groups. The patients with renovascular hypertension (N = 14) could be differentiated from those with primary hypertension of Group B for a greater increase in LV mass, with concentric hypertrophy (IVST/PWT = 1.2 +/- 0.2), for a greater prolongation of IRP (16 +/- 0.6% of diastole), with increased diameter changes in this phase (displacement ratio = 3.3 +/- 2.3%, in Group B; 4.7 +/- 3.8%, in renovascular hypertension), for a normal displacement and velocity of slow and atrial filling, despite the impairment of rapid filling found in this group, too (% displacement and velocity, respectively: 19 +/- 5% and 1.8 +/- 0.6 cm/cm X sec).

Cardiomyopathy, Hypertrophic

[Experimental intrauterine surgery: the creation of a congenital diaphragmatic hernia in a sheep fetus].

Up to 50% of the neonates operated during the first hours of life for a congenital diaphragmatic hernia die. The presence of a severe lung hypoplasia, which is at the origin of hypoxia, acidosis, increased pulmonary vascular resistance and right to left shunt, explains the poor clinical results, in spite of surgical success and intensive therapy. A modern approach to the problem includes treatment with pulmonary vasodilator drugs, whose effects are still discussed. Perhaps the prenatal recognition of the defect could improve prognosis. Lots of experience are needed to know more on the subject. This could be obtained with an experimental approach on newborn animals with a CDH. The article relates authors experience in the creation of a CDH in a foetus of sheep, by means of a surgical intervention during its intrauterine life.

Acidosis

[Hirschsprung's disease in adolescents and adults].

Megacolon must be considered as a diagnosis in any case of intractable constipation also in the adult. Besides the Hirschsprung's disease and the idiopathic megacolon, which have no apparent organic cause, many other pathologic conditions may produce a marked dilatation of the large bowel. The differential diagnosis depends, after a valuation of the clinical and radiologic features, also from enzymatic, histologic and functional tests. The Hirschsprung's disease can be observed after the infancy in: 1) Patients in whom diagnosis is made only in adult age; 2) Patients with a diagnosis made in infancy or childhood, with moderate symptoms, treated with a conservative methods, who are getting worse; 3) Adult relapsers after a previous inadequate operation. Group II also includes the patients who need an emergency operation, because of a perforation or a volvolus of a dilatated loop. We report three cases of adult Hirschsprung's disease and two adult "idiopathic megacolon". The patients with aganglionic megacolon were admitted to our Hospital respectively for an abdominal palpable mass, a volvolus and incontinence. The two patients with idiopathic megacolon showed the same clinical picture of those with Hirschsprung's disease. We choose a surgical therapy in all five patients, with good long-term results.

Adolescent