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Biomedical subjects

A Volpi

Publications and source records attributed to A Volpi.

At least 91 records · Page 5Linked to original sources

Immune response to cytomegalovirus in patients with acquired-immunodeficiency syndrome related complex (ARC) and AIDS.

This study was undertaken with the aim of elucidating the mechanisms underlying the cell-mediated immunodeficiency seen in the acquired immunodeficiency syndrome (AIDS). An intrinsic functional defect in the in vitro surviving T lymphocytes from patients with AIDS has been described. This defect is reflected by profound reductions in both the cloning efficiency of these cells and in the number of precursor cells for response to lectins. Since many patients affected by AIDS present active cytomegalovirus (CMV) infections and impairment in CMV-specific cellular immunity, we examined the number of CMV-specific precursor cells in patients affected by the AIDS-related complex (ARC), who had serum antibodies to CMV and to the human-T-lymphotropic retrovirus-type III (HTLV-III), recently termed human immunodeficiency virus (HIV). Their responses were compared to those of patients with AIDS and to those of healthy-CMV-seropositive and HTLV-III seronegative controls. We detected a significant reduction of precursors for cell-mediated immune response to CMV in AIDS, in comparison to normal controls and a reduction in ARC, even if not significant. In parallel, we assayed the response to phytohemagglutinin, which was maintained in ARC and depressed in AIDS. Our results show a defect of specific cell-mediated immunity to CMV in ARC and AIDS patients.

AIDS-Related Complex↗

Flecainide distribution in human tissues.

The distribution of antiarrhythmic drugs in human tissues may yield a better understanding of their therapeutic action and side effects. We report tissue distribution of flecainide in a patient who died suddenly while being treated chronically with the drug. Lungs showed the highest concentration of flecainide (143 micrograms g-1 wet tissue); liver, kidney and heart, in decreasing order, have good affinity for the drug. Flecainide was present also in the central nervous system in lower concentrations. The lowest concentration was found in the adipose tissue.

Flecainide↗

Severe reversible cardiac failure associated with methanol intoxication.

Methanol intoxication produces a well recognized clinical picture characterized by gastrointestinal, ocular and nervous system symptoms. The effect of poisoning on the cardiovascular system has not been well documented. We report the case of a 55 year old man whose acute methanol intoxication caused severe reversible cardiac failure. This represents the first description of an association between methanol toxicity and acute cardiac dysfunction in man.

Echocardiography↗

Evidence for an inhibition of thyroid hormone effects during chronic treatment with amiodarone.

The effects of chronic amiodarone treatment on several thyroid and cardiac function parameters were studied in 50 euthyroid patients with refractory ventricular arrhythmias, divided in responders and nonresponders according to their sensitivity to the antiarrhythmic action of the drug. No differences in the severity of cardiac disease and blood amiodarone concentrations were found in the two groups. Amiodarone induced a significant inhibition of peripheral T4 monodeiodination, more pronounced in responders compared to nonresponders. On the contrary, only in responsive patients, elevated basal and TRH-stimulated TSH levels were observed (despite serum T3 levels were not different from those in nonresponders) and the indirect indices of cardiac performance, particularly the systolic time intervals, fell in a range usually observed in the hypothyroid states. These findings suggest that amiodarone, besides the well-known inhibition of T4 to T3 conversion, also induces a partial resistance to the thyroid hormones, which is probably involved in the therapeutical effectiveness of the drug.

Adolescent↗

Cardiac amyloidosis involving the conduction system and the aortocoronary neuroreceptors. Clinicopathologic correlates.

In a patient with cardiac primary amyloidosis with conduction disturbances and dynamic cardiocirculatory disorders, the specialized system of the heart and the hitherto neglected cardiac nerve plexus and annexed aortocoronary glomera were studied histologically. Amyloid deposition in the conduction system and in the nerves and neuroreceptors seemed to correlate with the dysrhythmic manifestations, and, respectively, with some undue responses to vasodilator therapy. The possible hazards deriving from involvement of the aortocoronary glomera in patients with amyloidosis have been pointed out accordingly.

Amyloidosis↗

Idiopathic recurrent sustained ventricular tachycardia responsive to verapamil.

The role of i.v. verapamil in the management of atrioventricular (AV) nodal reentrant tachycardias is well established (Schamroth et al., 1980). Generally however the drug is not very effective in recurrent ventricular tachycardia (VT) (Singh et al., 1983). Verapamil was recently demonstrated to be successful in terminating VT induced by programmed stimulation in only 1 out of 8 patients tested (Wellens et al., 1980). Conversely a few recent cases of verapamil responsive VT, mostly occurring in young people without obvious organic heart disease, have been reported (Belhassen, 1984; Klein, 1984; Delise, 1985; Ward, 1984; Lin 1983; German, 1983; Mason, 1983; Wu, 1981). We describe 3 clinical examples of idiopathic recurrent sustained VT responsive to verapamil. A careful analysis of our cases support the hypothesis of different pathophysiologic mechanism involved in the genesis of this unique arrhythmic entity.

Adolescent↗

Two false-negative responses to the ajmaline test in the Wolff-Parkinson-White syndrome.

Anterograde block in the accessory pathway with a short effective refractory period was observed after intravenous (IV) injection of 1 mg/kg of ajmaline in two patients with the Wolff-Parkinson-White syndrome. The possibility of a false-negative response to this test is discussed. Ajmaline is proposed as an emergency drug in the Wolff-Parkinson-White syndrome in the setting of atrial fibrillation with a very high ventricular rate.

Adult↗