[Secondary amyloidosis of the heart. Diagnostic value of 2-dimensional echocardiography. Description of a case].
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Biomedical subjects
Publications and source records attributed to G Lolli.
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Two patients with acute myocardial infarction and hypertensive crises were found to have a pheochromocytoma. We advise that patients with an acute myocardial infarction and hypertensive crises be evaluated with a computerized axial tomography, lest the presence of a pheochromocytoma be overlooked.
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The hydrocortisone test has been performed on 20 patients with lymphoproliferative disease (MH, LNH, CLL, MM, BMG) and 12 patients with solid neoplasm to study the "recirculating" lymphocytic population (mainly T lymphocytes with "helper" function). Therefore, as proposed by Fauci and Dale, we counted the basal venous blood lymphocytes in the morning after fasting and then 4 h after the administration of hydrocortisone 400 mg. While the test did not appear to be statistically modified in patients with solid neoplasms as compared to normal controls, it appears particularly compromised in lymphoproliferative diseases, but with different values in each disease. The results are discussed on the basis of lymphocytic kinetic data.
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The present work reviews current literature and the authors' experience of carotid sinus syndrome (CSS), which is considered to be the most common cause of neurally mediated acute disorders of consciousness in the elderly. Although no definitive consensus about its nosology has yet been reached, most groups agree that three features fulfill the diagnosis: anamnestic presence of syncope or its minor equivalents, and their reproduction by carotid sinus massage associated with defined values of cardioinhibition or vasodepression or both. The technique for performing carotid sinus massage used by the authors is described; this manoeuvre seems very safe and reproducible as long as simple rules are followed, and it allows the classification of CSS types. The treatment of CSS is varied, according to several factors. No pharmacological therapy has yet been demonstrated to be effective. While severe cardioinhibitory forms require an appropriate pacing, vasodepressive ones and types with only minor symptoms show a more favourable natural history. Pacing is advised in mixed CSS with either frequent and invalidating relapses, or 'high risk' attacks (severe, abrupt, with major traumas, etc.). Finally, the protocol for choosing the adequate mode of pacing is illustrated. In most cases VVI is sufficient, but the decision requires a careful individual examination.
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In recent years pancreatic cancer has shown an increasing incidence. Preoperative staging represents a main problem for its surgical management. Recent behaviour in the treatment of the disease led to considerably more encouraging results. The Authors describe the cases treated at the Dept. of Surgery of the University of Perugia and review the most important international reports on preoperative staging of pancreatic cancer.