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Biomedical subjects

A Rimondini

Publications and source records attributed to A Rimondini.

27 records · Page 2Linked to original sources
PubMed1987

Increased cardiac electrical instability concomitant with pacing induced repolarisation abnormalities.

The relation between the occurrence of repolarisation abnormalities after right ventricular pacing and spontaneous arrhythmias was investigated in 16 patients in whom the sick sinus syndrome was suspected. All patients had normal QRS complexes and T waves in the electrocardiogram before pacing and required atrial stimulation and His bundle recording for diagnostic purposes. Patients were randomised into a study group or a control group. In the eight patients in the study group right ventricular pacing was performed for 12 hours, and was followed by inversion of the T wave in surface leads II, III, aVF, and V2-V5 and lengthening of the QTc interval. The frequency and complexity of ventricular arrhythmias increased after pacing in six patients who had ventricular extrasystoles in the baseline Holter recording. As the configuration of the T wave became normal the frequency of ventricular extrasystoles returned to baseline values. In the control group of eight patients ventricular pacing was not performed after the electrophysiological study and no changes were seen in T wave configuration and in the frequency of spontaneous arrhythmias. These results suggest that the post-pacing repolarisation abnormalities reflect abnormal electrical properties of the ventricle and that in some cases they lead to increased electrical instability.

Adult↗
PubMed1987

Analgesic and hemodynamic effects of buprenorphine in acute infarction of the heart.

The analgesic, hemodynamic and respiratory effects of buprenorphine (0.3 mg i.v.) were monitored in 15 coronary care unit-admitted patients presenting with myocardial infarction who were in functional class I according to the Killip classification. At the time of the study, 8 of them had unequivocal precordial pain (group 1); the remaining 7 were painfree (group 2). The agent showed a prompt and potent analgesic action. It also induced a slight decrease in mean aortic pressure associated with a reduction in systemic vascular resistance and an increase in cardiac index, a rise in the pulmonary arterial pressure and arteriolar resistance and right atrial pressure, a reduction in arterial pO2 and pH and an increase in pCO2. Tension-time-indices of the left and right ventricles varied in parallel with variations in aortic and pulmonary artery pressure, respectively. These responses were probably unrelated to analgesia since they were similar in groups 1 and 2. Changes in systemic circulation were such as to possibly decrease the contractile effort and the oxygen need of the left ventricle and the size of infarction. On the contrary, the rise in pulmonary arterial pressure imposes a hemodynamic burden on the right ventricle that, depending on the patient's condition, may assume clinical importance. It is felt that the use of buprenorphine in myocardial infarction should be restricted to uncomplicated and selected cases.

Buprenorphine↗
PubMedDate not supplied

Radiologic evaluation in planning surgery of renal tumors.

The evolution in diagnostic imaging modalities, mainly in computed tomography (CT) and magnetic resonance imaging (MRI), have made it possible to extend the applications of these techniques from diagnosis to staging and surgical planning. Nowadays, the possibility to present images on different planes with an intrinsic resolution close to that of the original axial sections allows presentation of the kidney on sagittal, coronal, and oblique planes. Three-dimensional reconstructions can be obtained with different methods and have attained excellent image quality. Multidetector spiral CT presently is the best technique for planning surgery, but MRI also enables high-quality images to be obtained if state-of-the-art equipment is available. This update reviews the current status and possibilities of diagnostic imaging modalities in planning surgery of renal tumors.

Diagnostic Imaging↗
PubMedDate not supplied

Severe hypertension in childhood due to prolonged skin application of a mineralocorticoid ointment.

We report the case of a 9-year-old boy suffering from exzematous dermatitis who was treated for 6 years with a daily dose of 100 mg of a dermatological ointment containing 9 alpha-fluoroprednisolone-21-acetate. At examination the patient's blood pressure was persistently 230/160 mm Hg and was considered essential in origin after secondary forms of arterial hypertension had been excluded. Treatment with nifedipine and labetalol lowered the blood pressure to 150/100 mm Hg. When we became aware of the dermatological treatment, we advised its discontinuance. In the subsequent 7 days, the blood pressure fell to hypotensive levels (75/40 mm Hg) and then became normal a few days after discontinuance of the antihypertensive therapy. This case suggests that prolonged use of topical steroids, commonly prescribed for skin diseases, may cause hypertension, especially in childhood.

Administration, Topical↗
PubMedDate not supplied

[Current role of color Doppler ultrasound in acute renal failure].

Acute Renal Failure (ARF) is characterized by a rapid decline of the glomerular filtration rate, due to hypotension (prerenal ARF), obstruction of the urinary tract (post-renal ARF) or renal parenchymal disease (renal ARF). The differential diagnosis among different causes of ARF is based on anamnesis, clinical symptoms and laboratory data. Usually ultrasound (US) is the only imaging examination performed in these patients, because it is safe and readily available. In patients with ARF gray scale US is usually performed to rule out obstruction since it is highly sensitive to recognize hydronephrosis. Patients with renal ARF have no specific changes in renal morphology. The size of the kidneys is usually normal or increased, with smooth margins. Detection of small kidneys suggests underlying chronic renal pathology and worse prognosis. Echogenicity and parenchymal thickness are usually normal, but in some cases there are hyperechogenic kidneys, increased parenchymal thickness and increased cortico-medullary differentiation. Evaluation of renal vasculature with pulsed Doppler US is useful in the differential diagnosis between prerenal ARF and acute tubular necrosis (ATN), and in the diagnosis of renal obstruction. Latest generation US apparatus allow color Doppler and power Doppler evaluation of renal vasculature up to the interlobular vessels. A significant, but non specific, reduction in renal perfusion is usually appreciable in the patients with ARF. There are renal pathologic conditions presenting with ARF in which color Doppler US provides more specific morphologic and functional information. In particular, color Doppler US often provides direct or indirect signs which can lead to the right diagnosis in old patients with chronic renal insufficiency complicated with ARF, in patients with acute pyelonephritis, hepatic disease, vasculitis, thrombotic microangiopathies, and in patients with acute thrombosis of the renal artery and vein. Contrast enhanced US is another useful diagnostic tool in patients with ARF which has been recently introduced in clinical practice. Microbubble administration may reduce technical failure in the evaluation of the renal artery. Moreover, perfusion defects due to stenosis or thrombosis of the renal segmentary vessels are better recognized. New diagnostic possibilities of enhanced US include evaluation of both cortical and medullar vessels, and functional evaluation of renal perfusion. Measuring the transit time of the microbubbles is useful for the diagnosis of renal artery stenosis and, in transplanted kidneys, for differential diagnosis between ATN and acute rejection.

Acute Kidney Injury↗
PubMedDate not supplied

New automatic software for virtual colonoscopy: technical aspects.

PURPOSE: To evaluate a new virtual endoscopy software package capable of automatically plotting the path along which to perform endoscopic exploration. MATERIALS AND METHODS: We reviewed the examinations of 50 patients with colonic neoplasms studied by CT colonoscopy by using a single-detector CT scanner (Philips Tomoscan AVE1). The technical parameters used were: slice thickness 3 mm, pitch 1.4, reconstruction interval 2-2.5, 120 kV, 150-200 mA. The images were processed on a separate workstation (Philips Easy Vision 5.1) running an experimental virtual endoscopy software package capable of automatically drawing a line along which to move the virtual endoscope to explore the colon. Reconstruction of the endoscopic images along the path obtained was set at an interval of 15-20 mm between one endoscopic view and the next, to a total of 70 to 120 images. The endoscopic animated image sequence was then saved and evaluated by comparing the starting axial images and the three-dimensional images obtained. RESULTS: The programme plotted the endoscopic path correctly in a single pass in 40 of the 50 cases studied. The overall time spent by the radiologist on image-processing did not exceed 5 minutes. DISCUSSION: The need to reduce the time spent by audiologists on post-processing has led to a gradual improvement in image-processing hardware and software. In the context of virtual endoscopy, one of the main goals is to obtain the path for endoscopic exploration in as short a time as possible. The programme we evaluated successfully fulfils this requirement as, once the image-processing technical parameters have been defined, it plots a path along the entire colon and performs the reconstruction procedures automatically. The time spent by the operator on post-processing does not exceed 5 minutes. CONCLUSIONS: The new programme evaluated in this study facilitates the processing of endoscopic images, reduces radiologist time and may contribute to the widespread use of virtual colonoscopy.

Colonic Neoplasms↗