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Biomedical subjects

R Rotunno

Publications and source records attributed to R Rotunno.

9 recordsLinked to original sources

["The memory effect" in healthy heart and transplanted heart. "Cor se ipse alit, se ipse movet, se ipse reget"].

The heart's memory, interpreted as information residue between a cardiac cycle and the subsequent one, is a very definite phenomenon (short- term memory) both in healthy subjects and in heart transplanted recipients. This "memory effect", we have observed by the autocorrelation and by the spectrum analysis of the values expressing the heartbeat acceleration variability (tachogram 24 h). The "memory effect" cannot be absolutely put down in heart transplanted recipients to interference or to the activity of the central and/or peripheral nervous system, because the heart transplanted is a denervated heart by definition. Moreover, an immediate regulating effect of hormonic factors in the short-term heartbeat regulation is not completely plausible. As already known, the heart transplanted responds to the emergency situation autonomously and autochthonously in proportion to the signals reaching it directly from the circle (vascular resistance, blood pressure, etc.). This implies the existence of functional memory that is likely to be inborn in the conduction system of the heart. Looking at the results of our research we can conclude: "cor se ipse alit, se ipse movet, se ipse reget" (it autonomously models itself to all the different modifications in the circle, it feeds itself as the organ propelling blood circulation and, if necessary, it carries on its kinetic activity autonomously).

Adult↗

Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion.

OBJECTIVES: To evaluate, in a prospective and randomized fashion, the efficacy of a pretreatment with verapamil (V) in reducing recurrences of atrial fibrillation (AF) after electrical cardioversion (C). BACKGROUND: The increased vulnerability for AF recurrence is probably due to AF-induced changes in the electrophysiologic properties of the atria. This electrical remodeling seems to be due to intracellular calcium overload. METHODS: One hundred seven patients with persistent or chronic AF underwent external and/or internal C. All patients received oral propafenone (P) (900 mg/day) three days before and during the entire period of follow-up (three months). In the first group, patients received only the P. In the second group, in adjunct to P, oral V (240 mg/day) was initiated three days before C and continued during the follow-up. Finally, in the third group, oral V was administered three days before and continued only for three days after electrical C. RESULTS: During the three months of follow-up, 23 patients (23.7%) had AF recurrence. Mantel-Haenszel cumulative chi-square reached a significant level only when comparing AF free survival curves of group I versus group II and group III (chi-square = 5.2 and 4, respectively; p < 0.05). Significantly, 15 (65.2%) AF relapses occurred during the first week after cardioversion with a higher incidence in group I (10/33 patients, 30.3%) than group II (2/34 patients, 5.9%; p = 0.01) and group III (3/30 patients, 10%; p = 0.04). CONCLUSIONS: Six days of oral V administration centered on the C day, combined with P, significantly reduce the incidence of early recurrences of AF compared with P alone.

Aged↗

[The predictive value of junctional beats during the radiofrequency transcatheter ablation of the slow pathway of the nodal reentry circuit].

BACKGROUND: Junctional beats (JB) are often recorded during slow pathway (SP) radiofrequency (RF) ablation in patients with atrioventricular nodal reentrant tachycardia (AVNRT). Neither the correlation between JBs and SP potentials nor the role of mechanically-evoked JBs has been clarified yet. METHODS: Two hundred-eleven consecutive patients, with common AVNRT, underwent RF transcatheter ablation guided by Jackman SP potential searching. If we were unable to record an SP potential or if 4 RF pulses delivered on ideal ablation sites were ineffective, the ablation was carried out on anatomical landmarks. Light pressure was applied with the ablation catheter to each ablation site before RF delivery in order to evaluate the inducibility of JBs. RESULTS: Transcatheter ablation was performed successfully in 209/211 (99%) patients. In 17 (8.1%) patients, no SP potential was recorded. JBs were observed more often delivering RF in the mid-septal region, whereas SP potentials were more often recorded at the base of the Koch triangle. The success rate (successful pulses/overall pulses) was higher in the mid-septal (58.6% in M1, 77.8% in M2) than in the postero-septal region (4% in PSC, 16.8% in P1). JBs showed a higher specificity (73.2 vs 5.3%), positive (55.5 vs 24.6%) and negative predictive value (97.3 vs 63.8%) than SP potential in identifying the successful ablation site. Mechanical JBs were evoked in 23 patients on 29 ablation sites, and 18/29 (62.1%) of them were successful ablation sites. CONCLUSIONS: The recording of JBs during or before RF ablation is a useful parameter to guide SP ablation in patients with AVNRT. Although the underlying mechanism has not been clarified yet, their preferential occurrence in the mid-septal region suggests that they might be due to thermal stimulation of compact atrioventricular node.

Cardiac Pacing, Artificial↗

[Ablation of paroxysmal tachycardia in Wolff-Parkinson-White syndrome].

Surgical or catheter ablation of accessory pathways by means of high energy shock has been substantial associated with morbidity and mortality. On the contrary radiofrequency current, an alternative energy source for ablation, has a low incidence of complications and a very high success rate. Aim of this study was to relate about the results using catheter ablation of accessory pathways by radiofrequency current in our Electrophysiologic laboratory. Radiofrequency current (20-40 W) was delivered between a large-tip catheter electrode positioned against the mitral or tricuspid anulus and a standard adhesive electrosurgical dispersive pad applied to the left chest wall. When possible radiofrequency delivery was guided by catheter recordings of accessory pathway activation. Ablation was attempted in 181 patients with 191 accessory pathways. We obtained successful ablation of 187/191 accessory pathways and accessory pathway conduction was eliminated in 177/181 patients. During a mean follow-up of 14 +/- 10 months preexcitation returned in 7 patients (3.9%). All underwent a second successful ablation. In 1 patient, during the procedure, we observed a transient ischemic attack, with no complications. In accordance to other reports we conclude that radiofrequency ablation is highly effective in ablating accessory pathways, with low morbidity and no mortality.

Adolescent↗

[The psychodynamic basis of diver training].

The techniques employed in teaching diving and especially diving safety, were studied. Since it was felt that most accidents are not merely fortuitous but also derive from unconscious urges towards risk-taking, an attempt was made to understand the psychodynamics of the question. The study also investigated the effectiveness of the teaching method as a means not only of transmitting intrinsically useful skills and knowledge, but also as a psychotherapeutic technique aiding the diver to control any self-destructive aggressive urges.

Diving↗

[Psychodynamic aspects of sports diving].

Individual and group discussions with divers and instructors were used to discover the psychodynamic bases of the diver's psychology. The clearly narcisistic compensation mechanisms, based essentially on so-called "cross-identification" appear to explain the apparently contradictory personality traits revealed by both psychodiagnostic techniques and phenomenological analysis. The recognition of cross identification as the basis of the narcisism-masochism collusion appears to be a useful addition to the field of accident prevention.

Adult↗

Relation between voice-onset time and vowel duration.

As part of an investigation of the temporal implementation rules of English, measurements were made of voice-onset time for initial English stops and the duration of the following voiced vowel in monosyllabic words for New York City speakers. It was found that the VOT of a word-initial consonant was longer before a voiceless final cluster than before a single nasal, and longer before tense vowels than lax vowels. The vowels were also longer in environments where VOT was longer, but VOT did not maintain a constant ratio with the vowel duration, even for a single place of articulation. VOT was changed by a smaller proportion than the following voiced vowel in both cases. VOT changes associated with the vowel were consistent across place of articulation of the stop. In the final experiment, when vowel tensity and final consonant effects were combined, it was found that the proportion of vowel duration change that carried over to the preceding VOT is different for the two phonetic changes. These results imply that temporal implementation rules simultaneously influence several acoustic intervals including both VOT and the "inherent" interval corresponding to a segment, either by independent control of the relevant articulatory variables or by some unknown common mechanism.

Humans↗

[Atmospheric pollution and chronic respiratory diseases in the blast-furnace areas of iron-works].

An epidemiologic research together with a study on the environmental pollution were carried out in order to evaluate the risk of chronic respiratory diseases of blast furnace workers. The environment study was performed mainly using personal samplers given to workers with different jobs. Observations on 222 work shifts have shown that the total dust concentration to which cast workmen, maintenance men and blast furnace service men were exposed, marginally exceed the TLV values. Furthermore the level of respirable dusts for blast furnace service men was found slightly excessive. The average SO2 concentration was largely below the TLV values. However this gas could be found in excess for very short periods during the work. The epidemiologic study, conducted on a cohort of blast furnace area workers against a control group cohort, indicated a moderate prevalence of pneumoconiosis and chronic bronchitis amongst blast furnaces workers. The clinic and radiological pictures do not seem to go beyond the initial stages.

Bronchitis↗

[Environmental lead pollution. An epidemiologic study in road gasoline station workers (author's transl)].

Erythrocyte ALA-D and urinary coproporphyrins were investigated in 29 road gasoline station workers in order to detect a possible abnormal lead absorption. The ALA-D test represents the most sensitive laboratory device to detect both abnormal lead absorption and possible initial lesions due to lead poisoning. Using the above mentioned laboratory tests evidence of abnormal lead absorption was found in five of the examined subjects. Some remarks on prevention of possible lead intoxication are done.

Adult↗