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Biomedical subjects

V Paolillo

Publications and source records attributed to V Paolillo.

At least 37 records · Page 2Linked to original sources

[Influence of sleep, wakefulness and some daily activities on ventricular ectopic activity in recent myocardial infarction (author's transl)].

87 24-hour electrocardiographic monitoring sessions were conducted in 71 ambulatory patients (pts) in the early post-hospital phase after acute myocardial infarction. 29 (41%) had anterior, 42 (59%) inferoposterior myocardial infarction, 44 (62%) had angina or asymptomatic ischemia, 7 (10%) were in cardiac failure (II-III class NYHA). The occurrence of ventricular ectopic activity (VEA) during sleep hours was compared to the awake state; VEA during sexual and other activities of the awake state was studied. Excluding pts free of VEA during 24-hour monitoring the number of ventricular mature beats was lowered in 71% of sessions and augmented in 12% during sleep hours (p less than 0.001). Maximal grade of VEA was observed during wakefulness in 62% of session and in 9% during sleep (p less than 0.001); in 9% there was no difference, in 20% no VEA occurred. Total VEA, bi-tri-quadrigeminism and repetitive extrasystoles were significantly reduced during sleep: p less than 0.001, p less than 0.05 and p less than 0.01 respectively. This pattern was independent from site of infarction, presence of ischemia, cardiac failure (II-III class NYHA). A discrete correlation was observed between total VEA and heart rate; a poor correlation was seen between total VEA, multiform and repetitive extrasystoles. During wakefulness VEA was mainly related to physical exertion and emotional stress. Sleep and relax periods of the day showed VEA similar to sleeping hours of the night. Sexual activity did not significantly elicit more VEA than other activities of the awake state. Repetitive forms, observed in 8% of the population, were probably related to the rapid increase of sympathetic tone. The absence of repetitive VEA, potentially dangerous, during sleep hours (except the first) not due to antiarrhythmic drugs suggests to increase the dosage of these medications during the awake state in the majority of these pts.

Adult↗

Sodium nitroprusside in the treatment of Prinzmetal's variant angina.

A patient had attacks of Prinzmetal's angina, resistant to sublingual nitrates in high doses and to a calcium antagonist. All the crises wee resolved by sodium nitroprusside therapy. This report suggests that nitroprusside merits further evaluation in the treatment of Prinzmetal's angina, particularly in cases resistant to usual therapy in which the evolution towards myocardial infarction is very likely.

Aged↗

[Prognostic and diagnostic value of the exercise test and early coronary anamnesis in patients with myocardial infarct studied in a median term follow-up].

We performed a maximal or symptom limited exercise stress test (ET) 58 +/- 20 days after acute myocardial infarction (AMI) and looked for the presence of angina (A) 4-5 weeks after AMI in 193 consecutive patients (pts.). The aim of the study was to research from ET and history of early A parameters able to predict further coronary events in the follow-up (FU): new onset of angina, reinfarction or cardiac death. The FU lasted 18.06 months. The drop-out was 7%; so, data was collected on 179 pts.; 95% of our population performed the ET without any therapy. 72 pts. (40%) had an anterior-lateral AMI (I group) and 107 (60%) had an inferior-posterior AMI (II group). Pts. with early A were 35% in the I group (GR) and 52% in the II GR (P less than 0.02). Pts. with a positive ET were 38% in the I Gr and 57% in the II GR (P less than 0.01). The double product (DP) of positive ETs in the I GR was inferior (P less than 0.01) to that of the II GR; the DP of negative ETs in the I GR was inferior (P less than 0.01) to that of II GR. The comparison of the DP of positive and negative ETs showed that the former was inferior either in the I GR (P less than 0.02) or in the II GR (P less than 0.05). The highest value of serum CPK of the acute phase was observed in pts. with ST depression during ET in both groups. In the early phase after AMI, ET and A identified 50% of pits. in the I GR and 74% in the II GR as having further signs of coronary artery disease. These data were confirmed during the FU; the two techniques are then complementary to predict further events in our FU. Incidence rate of early symptoms, ischemic responses to ET, work capacity and DP values obtained during ET differed significantly in the two GRs. Reinfarction rate was 5% in the I GR and 10% in the II GR; mortality rate was similar (4.5%) in both GRs; we dit not identify predictive signs for mortality after 18.06 months from AMI. A negative history of A and a negative ET were predictors of absence of angina, but not of reinfarction nor of coronary death during our FU.

Adult↗

[Neurological complications during therapy with 17 MDCAA (author's transl)].

A case of a 39 years old woman on therapy with Monodicloroacetilajmaline for repetitive crises of Ventricular Tachycardia is shown. We have observed neurological symptoms by central compromission of 3rd, 4th, 6th pair of cranial nerves, cutaneous symptoms and a neurodisletic crisis. We particularly analyse the dosage of the drug in relation to the progression of symptoms and also the possible pathogenesis. Symptoms disappeared completely about 20 days after withdrawal of the drug.

Adult↗