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Biomedical subjects

A R Todini

Publications and source records attributed to A R Todini.

13 recordsLinked to original sources
PubMed1995

The syndrome of the "coup de fouet". Is it always a benign disease?

BACKGROUND: The "coup de fouet" syndrome is an uncommon condition characterized by a spontaneous intramuscular venous hemorrhage of the calf, sometimes accompanied by a deep thrombosis of the leg. OBJECTIVE: The purpose of this work is to verify the real incidence of the thrombotic complications, making use of the most recent noninvasive diagnostic instruments, such as the duplex scanner and color Doppler. METHODS: From January 1992 to December 1993, we examined 24 subjects (average age, 38.5 years) suffering from the so-called "coup de fouet" syndrome, which had appeared during physical activity: walking (nine cases), running (six cases), and sudden changes of position (nine cases). In all cases we performed a clinical and instrumental examination (analogical and tensive arterial and venous Doppler, arterial and venous duplex scanner, and color Doppler). RESULTS: Clinically we found, in 17 subjects, a hematoma in the posterior calf with increased thickness and, in 10 cases, with spontaneous sharp pain. In the other seven cases we found a modest hematoma without subjective or other objective symptoms. The arterial Doppler and scanner findings were normal. In the first group of 17 cases, the average clinostatic Doppler venous pressure, measured using a method developed by us and already described, was 32 +/- 4 mm Hg (normal value, 15 +/- 7 mm Hg); in the other seven cases the value was 19 +/- 4 mm Hg. CONCLUSION: The duplex scanner and color Doppler examination confirmed in all subjects the presence of an intrafascial hematoma in the gemellar zone; in 10 cases (41.7%), with more painful symptomatology, in a zone contiguous to the hemorrhage, we found a gemellar (six cases) or popliteal (four cases) phlebothrombosis. Lastly, we must point out that the syndrome is not always benign and that, therefore, a correct and more vigilant diagnostic and therapeutic approach is necessary.

Adult↗
PubMed1990

[Hemorheologic changes in patients with obliterative arteriopathy of the leg before and after muscle exercise tests].

Blood and plasma viscosity, erythrocyte filtrability and blood gas analysis were determined in 25 subjects with arteriosclerosis obliterans of the lower limbs before and after a muscle exercise test. Thirty-six shear rates between 0 and 230 s1 were studied to obtain viscosity curves, and regression analysis was performed for each curve. Mean viscosity curves for pathologic and control populations were plotted. The purpose of the study was to determine whether viscosity curves for blood and plasma before and after exercise, based on a high number of measurements, can provide information on rheological changes during intermittent claudication. Practically all viscosity curves in pathologic and control subjects could be described using a hyperbolic equation. Plasma as well as blood viscosity increased in pathologic subjects after exercise. However, erythrocyte filtrability and blood gas analysis in pathologic and control subjects, and blood and plasma viscosity in control subjects, showed no statistically significant changes after exercise. It is suggested that muscle exercise in reduced blood flow conditions can alter the aggregation of macromolecular complexes of plasma proteins, which could have an influence on cell components by modifying blood rheological behavior during claudication.

Arteriosclerosis↗
PubMed1990

[Arteriectasis: a forgotten chapter].

In 1942, Leriche described the first "dolichomégaartères" (or "arteriomegaly" according to the definition subsequently proposed by Anglo-Saxon researchers). We detected 199 cases of arteriomegaly (16.29% of cases examined) during a review of 1,221 translumbar arteriographies of the lower limbs performed from 1980 to 1985 in the vascular radiology department of our hospital. The percentage of associated aneurysms was 33.16%. The possible dysplastic pathogenesis of the affection and the differential diagnosis with atherosclerosis and other vascular affections found in connective tissue diseases is noted. Histopathology showed dystrophic lesions of the media and especially of the elastic fibers as well as occasional associated venous lesions and a familial basis. The peripheral symptomatology was acute, pseudoembolic and severe as revealed by ischemia and cyanosis. There was no collateral circulation. Medical treatment consisted especially in anti-coagulant and hypervolemic hemorrheologic therapy during ischemia. Ultrasonography enabled us to monitor the regular, systematic course of arteriomegaly, to make the diagnosis initially, to measure the exact size of the arteries, to observe the morphology of the wall and, moreover, to determine the presence or not of megaveins capable of reinforcing the dysplastic genesis of arteriomegaly.

Dilatation, Pathologic↗
PubMed1987

[Buerger's disease: etiologic role of the rickettsiae?].

Specific seroagglutination tests were performed in 70 patients with Buerger's disease to detect possible antibodies to rickettsia, the test being repeated in 8 cases after activation by doxycycline administration over 10 days. In 21 patients a Weil-Felix test was also carried out. Tests were assessed as positive in 44 cases (62.8%): 18 times for Rickettsia Q. 18, 14 times for Rickettsia Mooseri, 13 times for Rickettsia Burnetii, 5 times for Rickettsia Conorii and 3 times for Rickettsia Prowazekii. After activation by doxycycline the antibody titre was increased 5 times, unchanged 3 times and reduced once. The Weil-Felix gave positive results in 3 of the 21 cases (14.28%), the reaction being positive to Rickettsia Prowazekii. These findings provide supplementary arguments for a possible pathogenic role of rickettsial infection in Buerger's disease.

Adult↗
PubMed1987

Results of clinical, laboratory and haemorheological investigations of the use of pentoxifylline in high doses.

A study was carried out in 127 patients (94 males and 33 females) presenting with arteriosclerosis (88 patients) or diabetic vasculopathy (39 patients) in different stages of severity (Fontaine) to assess the effectiveness and tolerance of treatment with high doses of pentoxifylline. Patients received a daily dosage of 2200 mg, given as 800 mg orally and 300 mg by intravenous infusion in saline twice daily, for a mean period of 15.8 days. Relevant clinical parameters were assessed and measurements made of biological and laboratory indices before and after treatment. The results showed that intermittent claudication was improved in 52.4% of the arteriosclerotic and 50% of the diabetic patients Stage II disease, pain at rest disappeared in 64% and 78% of patients in Stage III, respectively, and trophic lesions in Stage IV patients were reduced or became less clearly marked in 47% and 44%, respectively. Arterial blood pressure, recorded on the tibial arteries using Doppler ultrasound, showed a mean increase of 18%, but no significant changes in blood flow were evident from rheographic examination. Whole blood erythrocyte filtration time was reduced by a mean of 8%. The main changes in the biological indices after treatment were decreases in haematocrit, mean corpuscular volume and blood fibrinogen values, but these were not statistically significant. The other variables showed little if any change. Side-effects initially reported by the patients consisted of headache, nausea, sweating, pruritus and general malaise, and were mainly associated with the infusion time and regressed in most cases when this was extended.

Aged↗
PubMed1985

Instrumental evaluation of the venous circulation in the arteriopathic subjects.

In peripheric arteriopathies, alterations occur to the venous system with a particular swelling of the veins of the foot-top, in the subjects (sclerotic or diabetic) at the 2nd and 3rd Fontaine stage, which gradually decreases until the collapse in the most advanced levels of the arterious affection (4th stage). In order to verify all that, we examined 40 artheriopathic subjects at the different Fontaine stages through a c.w. doppler apparatus and an impedence plethysmograph. Together with the modification of the arterious doppler velocitogram and the reduction of the Winsor index, we noticed that the velocity of the venous flow increases together with a venous hypertension that reaching the highest values at the 3rd stage, while at the 4th stage they are reduced because of the progress of the sclerosis. The impedence plethysmogram shows a reduction of the systodiastolic sphygmic excursion with a variation of the basic line, depending on the respiration, proportional at the clinic stage. In diabetic subjects the progress of the disease is more precocious because of the quicker implication of the microcirculation.

Aged↗
PubMed1985

Doppler ultrasonic diagnosis of dissecting aneurysms of the aortic and great vessels.

The reliability of the method and the simplicity of the execution of the Doppler examination allowed us to use it as a diagnostic help in the dissecting aneurysms of the aorta and in the hiatrogenetic dissections of the great vessels. The findings carried out are peculiar from the point of view "acoustic" and from the point of view "morphologic" and in part they depend on the type of the vascular dissection.

Adult↗
PubMedDate not supplied

[Measuring venous pressure with the Doppler technic: standardization of the method].

Using the Doppler, we have studied the venous pressure, with the patients standing, of 6,172 legs. In a normal subject, the index of average pressure is 59 mmHg in the posterior tibial vein, and 58 mmHg in the long saphenous vein. Where there are varicose veins, the average pressure is 90 and 96 mmHg in the deep veins and in the superficial veins. In the case of post-phlebitic syndrome, the average index is 101 and 102 mmHg in the deep and superficial veins. In this work, the credibility of the method is discussed, and in particular, in comparison with the surgical methods, and its usefulness in current phlebological practice is defined.

Humans↗
PubMedDate not supplied

[Deep venous thrombosis and the prevention of a pulmonary embolism with temporary caval filters: the experience in 2 pediatric cases].

Deep venous thrombosis with pulmonary embolism is considered rare in pediatric population, but a literature review points out this disease more frequent than would be expected in children. The low incidence and the poor consideration of this occurrence in pediatric age group, cause the thromboembolic disease with pulmonary involvement an often missed diagnosis. The illness is usually related to intravenous catheters, surgery, trauma, sepsis, prolonged immobilization, neoplasia, drugs, some congenital or acquired diseases. The Authors report their experience with two pediatric cases of inferior vena cava thrombosis and pulmonary embolism treated with anticoagulant therapy, temporary vena cava filters and locoregional fibrinolysis.

Adolescent↗