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Biomedical subjects

A Mazzoleni

Publications and source records attributed to A Mazzoleni.

At least 19 recordsLinked to original sources

[Antiestrogen therapy in the treatment of breast neoplasms].

During recent years the development of hormone therapy for the treatment breast neoplasms has seen, in addition to classic aspecific antiestrogens (AE) like tamoxifen (TAM) and to a lesser extent toremifen, a major development of new molecules divided into two groups: the first is the so-called selective estrogen receptor modulators (SERMs), the most important of which is Raloxifen, which mediate estrogen-agonist effects in some tissues and estrogen-antagonist effects in others; the second group includes the aromatase inhibitors (AI), important enzymes for peripheral estrogen conversion. Some studies compare or associate classic AE with the new SERMs and AI, both in adjuvant therapy and in treatment for advanced forms. Other trials assess the anti-osteoporotic activity of some SERMs which present concomitant inhibitory activity on the breast and endometrium.

Adult↗

Blood flow velocity waveforms from fetal peripheral pulmonary arteries in pregnancies with preterm premature rupture of the membranes: relationship with pulmonary hypoplasia.

OBJECTIVES: To measure fetal peripheral pulmonary artery velocity waveforms by Doppler ultrasonography in pregnancies complicated by premature rupture of membranes under 24 weeks' gestation and to relate the Doppler indices to the development of fetal pulmonary hypoplasia. DESIGN: A prospective longitudinal study of fetal peripheral pulmonary artery velocity waveforms from premature rupture of membranes to delivery. SUBJECTS: Twenty pregnancies complicated by premature rupture of membranes before 24 weeks of gestation and delivering after 26 weeks. METHODS: Peripheral pulmonary artery velocity waveforms were recorded by Doppler technique at weekly intervals until delivery and Pulsatility Index (PI) calculated. Pregnancies were managed conservatively according to an institutional management protocol. Pulmonary hypoplasia was defined at autopsy by lung/body weight ratios and radial alveolar counts. Pulsatility Indices of fetuses developing pulmonary hypoplasia were compared with those with a normal lung development. RESULTS: After premature rupture of membranes PI values were higher than normal reference limits for gestation, but no differences were found between the six fetuses which developed pulmonary hypoplasia and the remaining 14 fetuses with normal lung development. In this latter group PI values progressively decreased with advancing gestation (ANOVA for repeated measurements F = 11.61; P < or = 0.001), while they increased in fetuses developing pulmonary hypoplasia (F = 8.44; P < or = 0.001). As a consequence of these opposite trends significant differences in PI values were present between the two groups of fetuses from 2 weeks after the premature rupture of membranes. Two weeks after the premature rupture of membranes a PI value from the peripheral pulmonary arteries above the 95th centile had a sensitivity of 62.5%, specificity of 94.6%, positive predictive value of 83.3%, negative predictive value of 78.5% and relative risk of 3.88 (95th confidence interval 1.34-11.28) for the prediction of pulmonary hypoplasia. CONCLUSION: The measurement of peripheral pulmonary velocity waveforms may help to establish the risk of developing pulmonary hypoplasia in pregnancies complicated by premature rupture of membranes.

Adult↗

Sex related differences in glomerular ultrafiltration and proteinuria in Munich-Wistar rats.

Munich-Wistar rats (MWF/Ztm), originally selected for high number of superficial glomeruli, were used to correlate abnormal urinary protein excretion with glomerular hemodynamics and glomerular morphology. Two animal groups were used, one of male and one of female rats. They were kept periodically in metabolic cages to determine urinary protein excretion. All animals were fed standard rat chow. In male animals protein excretion, evaluated at seven weeks of age, was already significantly higher than in females (17 +/- 11 vs. 8 +/- 3 mg/24 hr), and then progressively increased averaging 291 +/- 51 mg/24 hr at week 21. In females urinary protein excretion was within the normal range up to week 18 and averaged 25 +/- 13 mg/24 hr at week 21. Body and kidney weight at the end of the experimental period were significantly higher in males than in females. Whole kidney inulin clearance (CIn) and single nephron glomerular filtration rate (SNGFR) were significantly higher in male than in female rats, while mean glomerular capillary hydraulic pressure (PGC) and transcapillary hydraulic pressure difference (delta P) were comparable. Single nephron glomerular plasma flow (QA) and afferent and efferent arteriolar resistance were comparable in male and female rats. The calculated glomerular ultrafiltration coefficient (Kf) was significantly higher in male than in female MWF/Ztm rats. No significant differences were detected between the two groups in the total number of glomeruli, and in glomerular size. These findings indicate that male MWF/Ztm rats develop spontaneous proteinuria, which progressively increases with the age.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Assessment of left ventricular diastolic function: comparison of Doppler echocardiography and gated blood pool scintigraphy.

Although left ventricular diastolic filling patterns can be examined by both Doppler velocity recordings and gated blood pool scintigraphy, few data exist regarding a comparison of these techniques. Therefore, Doppler echocardiography and scintigraphy were compared in 25 patients. Pulsed Doppler echocardiography was performed using an apical four chamber view with the sample volume at the level of the mitral anulus. Doppler measurements included peak velocity of the early diastolic filling wave, time to peak early diastolic velocity from both end-systole and end-diastole, diastolic time period and diastolic integrated velocity (early, atrial and total). The cross-sectional area of the mitral anulus and the left ventricular end-diastolic volume were estimated from measurements made on the apical four chamber view. Scintigraphic measurements included normalized peak filling rate, time to normalized filling rate from both end-diastole and end-systole, diastolic time period and relative diastolic filling during early and atrial filling. Doppler echocardiography and scintigraphy compared favorably in assessment of fractional filling during early diastole (r = 0.84) and atrial systole (r = 0.85), ratio of early to atrial filling (r = 0.83), diastolic filling period (r = 0.94) and interval from end-diastole to peak early diastolic flow (r = 0.88). Normalized peak filling rate and time to normalized peak filling rate from end-systole did not correlate closely by these two techniques. The differences in normalized peak filling rate may be explained by difficulties in estimating mitral anulus cross-sectional area and left ventricular end-diastolic volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Mitral valve prolapse in patients with anorexia nervosa and bulimia.

We studied 43 consecutive individuals with eating disorders (anorexia nervosa and/or bulimia) for the presence of mitral valve prolapse and/or cardiac arrhythmias by physical examination, M-mode and two-dimensional echocardiography, and 24-hour continuous ambulatory electrocardiographic monitoring. Ten of the 43 had findings of mitral valve prolapse on resting cardiac auscultation. Echocardiographic evaluation confirmed the diagnosis of mitral valve prolapse in these ten as well as in six other individuals, giving an overall incidence of 37% (16/43). Similar echocardiographic findings were present in only 4% (1/23) of control individuals. Cardiac arrhythmias other than benign isolated premature extrasystoles were noted in five patients with eating disorder; all five also had echocardiographic findings of mitral valve prolapse. The incidence of mitral valve prolapse appears to be increased in patients with eating disorders. In addition, the arrhythmogenic effects of mitral valve prolapse may present an additional risk factor in these patients.

Adolescent↗

Accuracy of various techniques in the measurement of the duration of the Q wave: a possible source of error in diagnosing myocardial infarction by electrocardiography.

The method of measuring the width of the Q wave on electrocardiogram is one of the variables contributing to conflicting findings regarding the accuracy of the ECG in the diagnosis of myocardial infarction. This study assesses the accuracy of a variety of methods of measuring the width of the Q wave recorded by direct-writing electrocardiographic instruments. The assessment was made by comparing the width of the Q wave as inscribed by thermal direct-writing electrocardiographs to the width of the Q wave as measured from an oscilloscopic display, the latter representing the "true" width of the Q wave. The measurement of the width as obtained from the upper edge of the tracing obtained with direct-writing electrocardiographs underestimated the true width of the Q wave, while the opposite was the case by measuring the width along the lower edge of the tracing. The most reliable ways to obtain the true width of the Q wave are: (1) to average the measurements as obtained along the upper and lower edge, (2) to measure the width along an ideal line in the middle of the tracing, or (3) to measure the width along the trailing edge of the deflection.

Diagnostic Errors↗

On the relationship between Q waves in leads II and VF and inferior-posterior wall motion abnormalities.

Twelve electrocardiographic criteria, based on various combinations of Q wave morphology in leads II and aVF, were tested in 235 cases for their diagnostic value in detecting inferoposterior wall motion abnormality (presumably reflecting infarction in the area) as demonstrated on left ventriculogram. The most reliable indicator of inferoposterior wall motion abnormality was found to to a QR complex with a Q wave width greater than or equal to .03 or greater than or equal to .04 sec associated with a Q/R ratio greater than .25. Using as criterion a QR complex with a Q wave width greater than or equal to .04 sec and a Q/R ratio greater than .25, the sensitivity was 41.9% in the cases with akinetic-dyskinetic wall motion and 3.7% in the cases with hypokinesis with an associated specificity of 100%. By lowering the Q wave duration to greater than or equal to .03 sec, the sensitivity increased to 51.6% and 9.3%, respectively, while retaining a very high specificity (96%). The exclusion of cases with a Q and R of less than 5 mm markedly lowered the sensitivity with a negligible increase in specificity. QS complexes in leads II or aVF were not found to be reliable indicators of inferoposterior wall motion abnormality.

Electrocardiography↗

Two-dimensional echocardiography in predicting left ventricular wall motion abnormalities and left ventricular function.

In an attempt to formulate a reliable noninvasive method of detecting segmental wall motion disturbances, we examined 25 patients with coronary artery disease by two-dimensional echocardiography (2-DE), standard 12-lead electrocardiography (ECG), and biplane left ventriculography. The 2-DE technic predicted qualitative wall motion abnormalities as defined by ventriculography with a sensitivity of 88% and a specificity of 86%. The ECG (Q waves) predicted segmental wall motion disturbances with only 50% and 51% sensitivity and specificity, respectively. Extrapolating the advantages of 2-DE to the assessment of global myocardial function, left ventricular wall motion index (LVWMI) and E-point septal separation (EPSS) by 2-DE were correlated with left ventriculographic ejection fractions; r values were high (.73 and -.76, respectively) in both instances. Thus, 2-DE provides a reliable noninvasive technic by which both regional and global myocardial wall motion disturbances can be assessed. Unlike previous noninvasive methods, the 2-DE results compared very favorably with those of biplane left ventriculography.

Cineangiography↗

Clinical correlates in hypertensive patients with left ventricular hypertrophy diagnosed with echocardiography.

Seventy-three hypertensive patients were evaluated with M mode and two dimensional echocardiography. Left ventricular hypertrophy was found in 37 patients (51 percent); 29 had concentric hypertrophy and the remaining 8 had disproportionate septal thickening. Factors that did not influence the distribution of patients in the group with left ventricular hypertrophy and normal subjects included (1) duration of hypertension, (2) level of blood pressure, (3) age, (4) body surface area, and (5) race. More of the patients who had a normal left ventricular mass (32 or 89 percent) than of those who had hypertrophy (22 or 59 percent) were receiving two or more antihypertensive drugs. Electrocardiography was very insensitive in identifying left ventricular hypertrophy in these patients. The presence of increased left ventricular mass was associated with a greater incidence of other target organ disease.

Adrenergic beta-Antagonists↗

[Alcoholism].

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Alcoholism↗