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Biomedical subjects

C Moro

Publications and source records attributed to C Moro.

71 records · Page 4Linked to original sources

Amiodarone and hypokalemia. A dangerous combination.

We describe the appearance of long QT interval and polymorphous ventricular tachycardia in a patient treated with amiodarone who presented with hypokalemia secondary to chronic diuretic therapy. Ventricular pacing was initiated upon admission. The hypokalemia was corrected and amiodarone was discontinued. After three days the patient showed a normal QT interval and was free of ventricular tachyarrhythmias. Although hypokalemia could itself have been the arrhythmogenic factor in this particular patient, the additional toxic effect of amiodarone cannot be ruled out. It seems reasonable to consider the combination of both as dangerous when we take into account that the majority of patients cited as having amiodarone-induced torsade de pointes had also potassium depletion.

Amiodarone↗

Postnatal dependence of plasma copper and zinc levels on gestational age and maturity observed in infants fed a high zinc content formula.

We studied the effect of gestational age and maturity on plasma zinc and copper levels at 10 and 120 days of age. The association of plasma zinc changes and body growth was also investigated. Infants were receiving a controlled intake of zinc and copper solely through a zinc-supplemented formula (4.7 mg/L of zinc and 0.16 mg/L of copper). Twenty-eight low-birthweight infants (less than 2,500 g) having gestational ages ranging from 33 to 40 weeks [17 with an appropriate birthweight for gestational age (AGA) and 11 small for gestational age (SGA)] were enrolled in the present study. Measurements of plasma zinc and copper concentration, weight, length, head circumference, and tricipital and subscapular skinfolds were carried out at 10 and 120 days of age. Proton-induced x-ray fluorescence technique (PIXE) was used to assess copper and zinc concentrations. At 10 days of age a significant correlation between copper concentration and gestational age was found. At 120 days of age the copper concentration was higher than at 10 days and independent of gestational age and maturity (mean +/- SEM = 116 +/- 5 micrograms/dl). At 10 days of age no significant correlation between zinc content and gestational age was found (86 +/- 4 micrograms/dl). The plasma zinc percent change over the period from 10 to 120 days of age was positively correlated with gestational age in the whole sample as well as in AGA and SGA infants separately.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Height↗

Correlation between electrical and echocardiographic data in hypertrophic cardiomyopathy.

We have studied 38 patients with clinical and echocardiographic evidence of hypertrophic cardiomyopathy. We tried to correlate the electrical findings of hypertrophy in electrocardiographic and vectorcardiographic tracings with the anatomical data supplied by M-mode echocardiography of septal and posterior wall thickness and left ventricular diameters.

Cardiomyopathy, Hypertrophic↗

Electrophysiologic study of patients with short P-R interval and normal QRS complex.

In order to elucidate the electrophysiological nature of the short P-R interval we have studied 15 patients with this phenomenon and a normal QRS complex in the electrocardiogram; none of them had a history of arrhythmias. His bundle electrography and atrial stimulation were used to study the conductivity and refractory periods of the atrioventricular (AV) junction. In 13 cases the studies were repeated after the administration of verapamil. Baseline recordings showed a shortened A-H interval in 6 cases, a shortened H-V interval in 6 and in 3 more with a borderline H-V interval. During rapid atrial pacing A-H interval prolongation was abnormal in 10 cases that showed small increases or sudden prolongations at certain atrial rates. The effective nodal refractory period was shorter than normal. A double AV nodal pathway was demonstrated in one patient and another developed junctional reentrant tachycardias at fixed extrasystolic intervals. After verapamil the A-H interval increased in all but one patient. Significant changes were recorded for the AV nodal refractory periods. In the patient with dual AV nodal conduction verapamil prolonged conduction time and refractory periods through both pathways, and in the one with reentrant tachycardias upon atrial stimulation it abolished the tachycardia. In the presence of a normal QRS, a short P-R interval may be due to shortened conduction time through the AV node, and/or the His-Purkinje network. Our observations tend to rule out the presence of a complete bypass of nodal tissue. Despite the absence of a history of arrhythmias these patients may have electrophysiological abnormalities that predispose them to reentrant AV nodal tachycardias.

Atrioventricular Node↗

Jaccoud's arthropathy in patients with chronic rheumatic valvular heart disease.

In a prospective study over a period of 3 yr, involving all patients with rheumatic valvular heart disease seen at our hospital, we found the diagnostic signs of Jaccoud's arthropathy in 17 of 400 cases (4.2%). All 17 patients had a past history of acute arthritis involving the joints and showed deformities at the time of diagnosis. The valvular lesions were mitral and aortic in 11 cases, mitral in 5 cases and aortic in 1 case. The most frequent joint deformities were: ulnar deviation at the metacarpo-phalangeal joints (12 cases), lateral deviation at the metatarso-phalangeal joints (12 cases), and hammer toe deformity (6 cases). The deformities were reducible in all of them. None of the patients had pain or signs of acute inflammation and functional capacity was normal. Other causes of joint deformity were ruled out by means of radiographic and serologic studies. Jaccoud's arthropathy is not a rare entity and its recognition is important for a differential diagnosis with chronic arthritis of other etiologies, also associated with valvular heart lesions.

Adolescent↗

Endocrinological study of the dopaminergic regulation of prolactin release in metastatic breast cancer.

AIMS AND BACKGROUND: Prolactin (PRL) may be a growth factor for breast cancer. Abnormally high levels of PRL have been proven to be associated with a poor prognosis in metastatic breast cancer. However, most studies have been limited to the evaluation of basal levels of PRL rather than its response to the classical endocrine dynamic tests. This study was performed to analyse the dynamic secretion of PRL under stimulatory and inhibitory tests in metastatic breast cancer. METHODS: The study included 10 untreated metastatic breast cancer women, who were evaluated after the classical stimulatory and inhibitory tests for PRL secretion with the antidopaminergic agent Metoclopramide (10 mg iv as a bolus) and with L-dopa, respectively. Serum levels of PRL were measured by RIA before and at subsequent intervals after drug administration. PRL levels were considered to be elevated when they were higher than 25 ng/ml. RESULTS: Abnormally high basal levels of PRL were seen in 6/10 patients. L-dopa was unable to inhibit PRL secretion, whose mean concentrations paradoxically significantly increased in response to L-dopa, with values comparable to those observed after the classical stimulatory test with metoclopramide. CONCLUSIONS: This study confirm the existence of hyperprolactinemia associated with metastatic breast cancer. In addition, by showing a paradoxical rise of PRL in response to L-dopa, which inhibits PRL secretion in physiological conditions, this study would suggest that breast cancer-related hyperprolactinemia may depend at least in part on endogenous disease-related neuroendocrine alterations.

Adult↗

Effect of tamoxifen on GH and IGF-1 serum level in stage I-II breast cancer patients.

OBJECTIVE: Tamoxifen suppresses insulin-like growth factor-1 (IGF-1) plasma levels in early and advanced breast cancer patients. Relationships between tamoxifen (GH) and IGF-1 are complex and not completely described yet. The present investigation was performed to evaluate the effect of acute and chronic tamoxifen administration on GH response to growth hormone-releasing hormone (GHRH), as well as on IGF-1 serum levels. MATERIALS AND METHODS: Evaluation of GH after administration of GHRH was performed (a) at baseline, (b) 3 hours after 20 mg oral administration of tamoxifen and (c) after 12 weeks of 20 mg a day oral tamoxifen treatment, in fifteen postmenopausal stage I-II breast cancer patients. IGF-I was measured at baseline and after chronic tamoxifen administration. RESULTS: The GH response to GHRH was significantly reduced after 12 weeks of tamoxifen 10 mg administered twice a day orally (mean peak 3.2 +/- 0.2 micrograms/l, mean AUC 261.3 +/- 18.2 micrograms/minute p < 0.01 versus basal AUC). A concomitant significant reduction of IGF-1 was observed after 3 months of tamoxifen treatment. Basal pretreatment levels of 113.2 +/- 15.5 micrograms/l were suppressed to 70 +/- 7.9 micrograms/l (p < 0.01). CONCLUSION: Our study confirm the inhibitory effect of tamoxifen on IGF-I and suggested, as shown in previous in vitro data, that its suppression could be directly related to GH reduction in response to GHRH stimulation.

Aged↗

[Retroperitoneal rupture of the duodenum caused by closed abdominal injury].

Preoperative diagnosis of retroperitoneal rupture of the duodenum is very difficult. Radiographical observation of air surrounding the right kidney or psoas muscle is of great assistance in this respect, but may only be expected in 30% of cases. Examination of the first segment of the digestive tract with the aid of "gastropgrafin" is advised. With the abdomen open, the presence of air, haematoma or bile in the transverse mesocolon or mesentery of the small intestine may be noted. In most cases, the breach can be closed with a double layer, leaving a drainage tube in the retroperitoneum. Measures than can be taken when suturing is unfeasable are also described.

Abdominal Injuries↗

[Cardiac fulguration. A healing treatment for intranodal re-entry tachycardias refractory to medication].

Six patients underwent fulguration of the AV junction for typical paroxysmal intranodal reentry tachycardias, refractory to medical treatment. Unipolar cathodic discharges at distal electrode were administered against an external plate. Bipolar His and atrial deflections showed mean values of 0.16 and 0.54 mv, respectively. Mean energy used was 233 J (range 50-750), with a mean number of 1.6 (range 1-3) discharges per patient. Complete AV block was achieved, but conduction reappeared in all, within a mean of 30 minutes. Electrophysiologic evaluation was assessed 3-8 days after ablation. Intranodal reentry tachycardias could not be initiated in any patient. Retrograde conduction was abolished in 3 patients, and in three it was slow and decremental. First degree AV block, with intranodal delay was diagnosed in 4 with a mean AH interval of 237 msec (range 190-300). Mean rate for appearance of Wenckebach AV block was 154 b/m. None of the patients required permanent pacing. Mean follow-up of the patients was 6.8 months. One of the patients required a new ablation for reappearance of intranodal tachycardia and CAVB was achieved in the second ablation. The other five remain asymptomatic. Intranodal reentry tachycardias can be cured by fulguration. Less energy and less discharges should be administered to abolish functional dissociation of the AV node, without complete interruption of anterograde conduction.

Electrocoagulation↗