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Biomedical subjects

A Pappalardo

Publications and source records attributed to A Pappalardo.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Relapsing polychondritis. A case report].

The authors describe a case of "relapsing polychondritis" showing that the characteristic manifestation of the disease on nasal and ear cartilage took place at a later stage than in the eye vessels, the inner ear and the trunk and valves of the aorta. The authors therefore consider the term "relapsing polychondritis" to be somewhat restrictive and claim that owing to the systemic diffusion of the disease in all vessels, R.P. should be included among systemic vasculitis diseases.

Adult↗
PubMed1989

Effectiveness of intravenous propafenone for conversion of atrial fibrillation and flutter of recent onset.

The efficacy of intravenous propafenone (2 mg/kg) was assessed in 83 consecutive patients: 68 with atrial fibrillation (AF) and 15 with atrial flutter lasting less than 15 days. Conversion to sinus rhythm occurred in 47 patients (57%), including 42 (62%) of those with AF and 5 (33%) of those with atrial flutter (p less than 0.05). The mean time to conversion was 29 +/- 24 minutes. The success rate was strongly affected by arrhythmia duration. Thus, conversion occurred in 40 patients (71%) among the 56 with arrhythmia lasting less than 48 hours but in 7 patients (26%) among the 27 with a longer lasting arrhythmia (p less than 0.0005). Left atrial size (determined echocardiographically in 56 patients) was significantly larger in nonconverters (49 +/- 12 vs 39 +/- 7 mm, p less than 0.0005). In nonconverters the mean ventricular rate decreased from 141 +/- 26 to 104 +/- 22 beats/min (p less than 0.0005). Except for reversible low output state in 3 patients already hemodynamically compromised, no significant side effects were observed. In conclusion, (1) intravenous propafenone allows a quick restoration of sinus rhythm in the majority of patients with AF of recent onset, whereas it seems less effective in atrial flutter; (2) its efficacy is influenced by the duration of the arrhythmia and by left atrial dimensions; (3) the drug allows control of ventricular rate; and (4) its use seems to be safe except in patients with severe cardiac failure.

Adult↗
PubMed1989

[Telethermographic evaluation of the intra-articular administration of thymopentin in rheumatoid arthritis of the knee].

Fifteen subjects with rheumatoid arthritis defined as "classical" or "definite" according to A.R.A. criteria and classified according to Steinbrocker as stages I to III were submitted to knee joint infiltration (bilateral where both knees were involved) with 50 mg thymopentin in 1 ml, once a week for five weeks. Telethermographic examination was performed in all cases in order to evaluate the thermal inflammatory component before the first and 48 hours after the last infiltration. In none of the patients with the exception of only one case, did the drug lead to a significant change of the thermal index. This evaluation does not take into account any other objective and subjective parameters the study of which was beyond the scope of the above research.

Adjuvants, Immunologic↗
PubMed1988

Sequential rupture of the left ventricular free wall and of the interventricular septum after myocardial infarction. Surgical implications.

Two patients are reported in whom ventricular septal rupture complicated the recovery from surgery for left ventricular free wall rupture. One patient was successfully reoperated upon, but the second died before the diagnosis was obtained. The importance of being aware of the association and of excluding a left ventricular to right ventricular shunt at the time of surgery, or subsequently during clinical deterioration, is discussed.

Aged↗
PubMed1988

[Reoperation in patients with heart valve prostheses. Analysis of risk factors affecting perioperative mortality].

Sixty-two patients with at least one prosthetic heart valve each underwent a total of 70 reoperations. Their cases were analysed with special regard to the risk of perioperative mortality and to the factors affecting that risk. The age of the patients studied was 47 +/- 14.6 years (mean +/- 1 SD), and 4.75 +/- 4 years had elapsed since their previous operation. A total of 85 prostheses were implanted at the time of initial surgery. Forty-nine of those were mitral, 28 were aortic, and 8 were tricuspid prostheses. There were 48 mechanical valves, 24 bioprostheses and 13 Carpentier rings (9 of the latter being mitral and 4 tricuspid). At reoperation (n = 70) 95 valves required treatment. Eighteen patients died following their first reoperation (18/62, 29%), and two more died after a second reoperation (2/8, 25%). Actuarial probability of hospital survivors being alive 8-9 years following reoperation was 47 +/- 15%. It was found by multiple regression analysis that the duration of cardiopulmonary bypass (p less than 0.01), surgical priority (p less than 0.05) and the patient's age (p less than 0.05) were the only independent predictors of hospital death. A review of the literature and our own results suggest that surgical problems encountered with reoperation have unfavourably affected surgical results in the past. Objective risk factors are currently more related to the operative outcome. For these to be neutralised, patients with dysfunctioning prosthetic heart valves should be operated at an early stage before they reach a critical one. Only patients with stable, mild dysfunction unlikely to worsen acutely may probably be followed-up safely.

Actuarial Analysis↗
PubMed1988

[Monoclonal antibody assessment of lymphocyte subpopulations in rheumatoid arthritis in adult patients in relation to stage and treatment].

Twenty patients with various stages of RA were examined. They included: 1) 7 cases in Steinbroker stage 1 (onset); 2) 13 cases in Steinbroker stage 2-3 (chronic). The group was divided into 16 treated and 4 untreated cases. Monoclonal antibodies were used to assay T3, T4, T8 and T4/T8 ratio and the results were compared with those in a control group. The results showed a T8 deficit and a consequent change in the T4/T8 ratio in untreated subjects with "onset" RA. The immune situation of the chronic and treated cases was very similar to that in the control group probably as a result of treatment.

Adult↗
PubMed1988

[Audio-vestibular changes in patients with rheumatoid arthritis].

A functional audio-vestibular investigation based on impedance metric techniques and electronystagmography was carried out in a group of patients with "classical" rheumatoid arthritis (RA) and with treated or untreated "definite" RA in various stages. Data obtained from these patients were compared with those obtained from a control group. Significant hypoacusis of the transmissive type was found in initial stages of RA while sensorineural or mixed type hypoacusis was found in later stages of RA. Significant vestibular alterations of the central type suggesting supratentorial involvement were found in several cases independently of the stage of RA and of the age of the patients.

Acoustic Impedance Tests↗
PubMed1987

[Fibrillation and atrial flutter. Immediate control and conversion to sinus rhythm with intravenous propafenone].

The safety and efficacy of intravenous Propafenone, in the treatment of atrial fibrillation (a.f.) or flutter (A.F.) of recent onset (15 days), were assessed. Propafenone (2 mg/kg) was administered to 36 consecutive patients (mean age 60.8 years), 28 with a.f. and 8 with A.F. Nineteen patients (52.7%) reverted to sinus rhythm within 85 min (mean 27.2 min): 17 of 28 (60.7%) with a.f. and 2 of 8 (25%) with A.F. The efficacy of the drug was significantly influenced by the time elapsed from the onset of the arrhythmia: 14/21 (66.6%) patients with the arrhythmia lasting less then 48 hours and only 5/15 (33.3%) of those with the arrhythmia lasting more than 48 hours or of unknown onset, were converted (p less than 0.05). 18 patients underwent echocardiographic control: mean left atrial dimensions were 41.4 +/- 11.4 mm in converters and 47.4 +/- 11.2 mm in non converters (p = NS). Mean QRS lengthening observed was 16% (from 89 +/- 35.1 to 103.5 +/- 48.8 msec) (p = NS); QTc interval increased from 390 +/- 64.3 to 403 +/- 36.2 msec (p = NS). Arterial blood pressure showed significant changes only in two patients in whom a serious hypotension developed, needing infusion of adrenergic drugs. Non converters showed a reduction of the ventricular rate from 141.8 +/- 29.4/min to 101.8 +/- 18/min (p less than 0.01) meanwhile the shortest RR interval increased from 359.5 +/- 60.8 to 450 +/- 81.5 msec (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

A reappraisal of the factors affecting early patency of aortocoronary saphenous vein bypass grafts. Current experience with extensive revascularization employing sequential grafting techniques.

A number of factors potentially influencing the patency rates of aortocoronary bypass grafts were investigated in a consecutive series of 50 patients by control angiography at 28 +/- 26 days and by univariate and multivariate analysis of a selected set of clinical, surgical and angiographic predictors. There were 234 anastomoses in this series, a mean of 4.7 per patient (range 1 to 9), 215 of which were connected to sequential vein grafts. After surgery, 40 patients were treated with anticoagulants and/or platelet inhibitors. Of the 234 coronary anastomoses studied, 219 were patent (93.6%). Coronary artery diameter, patient's age and previous myocardial infarction were shown to be independent predictors of increased risk of anastomotic occlusion. Arteries less than 1.5 mm in diameter had a patency rate of 84.9%, versus 96.1% for vessels 1.5 mm or larger (p = 0.009). The use of side-to-side anastomoses with sequential grafts seemed to counterbalance the unfavourable effect of small arterial size. Patients aged 65 or older had a lower probability of having all their grafts patent than younger patients did (50 vs 89%, p = 0.01). Patients with previous myocardial infarction similarly had a lower probability of having all their grafts patent compared to patients without previous infarction (68 vs 95%, p less than 0.05); this correlation was explained by a more frequent occlusion rate of grafts directed to fibrotic left ventricular areas. The effect of anticoagulants and of platelet-inhibitors was favourable, but did not reach statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

[Coronary spasm as a mechanism of ischemia or myocardial necrosis immediately after coronary surgery. Considerations on 5 cases and review of the literature].

Several recent reports suggest that coronary artery spasm may represent a major complication of coronary artery bypass surgery, and that it may have gone unrecognized in the past. During a three-year interval ending July 1983 we have encountered 5 cases in whom reversible S-T changes, angina, arterial hypotension, major arrythmias and/or angiography prompted the diagnosis of coronary arterial spasm early after aorto-coronary bypass surgery. Our experience and the review of 15 previously reported cases reveals that in most cases the clinical presentation was that of an acute, severe, ischemic cardiac event that occurred few hours after termination of cardiopulmonary bypass. A more benign course took place in a minority of cases, although some of them showed evidence of myocardial necrosis on ECG and/or left ventriculography. The mortality rate in the collective series was 20%, and the rate of perioperative non fatal myocardial infarction was 25%. Glyceryl trinitrate administration into the ascending aorta or into the spastic coronary artery appeared to be the most effective way of treating this condition, while the same drug was seemingly uneffective when administered intravenously. The use of calcium antagonists was associated with a favourable outcome in some patients, but on the whole the results were unpredictable. Prompt consideration of the possibility of coronary artery spasm and aggressive treatment are required in order to minimize its impact on perioperative mortality and morbidity rates.

Adult↗
PubMed1979

[Value and significance of the immunologic determination of various serum sialoglycoproteins in rheumatic diseases of inflammatory nature].

A statistical method was used in the evaluation of alpha-1-antitrypsin, acid alpha-1-glycoprotein, and haptoglobin in patients with rheumatic fever, rheumatoid arthritis, gout, periarthritis, arthrosis with inflammation, and primary arthrosis. A highly significant increase was noted in rheumatic fever and rheumatoid arthritis, less so in arthrosis with inflammation and acute gout, while increases were poorly significant for periarthritis and not significant for primary arthrosis. It can be concluded that the determination of these serum sialoglycoproteins serves to distinguish inflammatory and degenerative rheumatism. Haptoglobin proved the most sensitive of the three. Moreover, there was a distinct correlation between ESR and the three indices. It is felt that sialoglycoproteins act as an indirect pointer to acute inflammation, since their degree of increase is related to the formation of inflammatory proteases.

Adolescent↗
PubMed1975

[Studies of cardiovascular damage in subjects with altered purine metabolism].

The percentage of arteriosclerotic changes with or without dyslipaemic humoral deviation was studied in a sample of subjects with altered purine metabolism of various corresponding clinical expression and the percentage of hyperuricaemia in a homologous sample of arteriosclerotics. It is concluded that a definite dependent relationship between arteriosclerotic lesions and abnormality of purine metabolism remains a hypothesis and that between the two metabolic alterations there is a more or less indirect associative, chronological and dysmetabolic involvement relationship.

Adult↗