Both mitral valve closing speed (MVV) and the mean standardized circumferential lengthening of the myocardial fibrocell (MVCL), between which a good correlation exists, may be used as indirect indices of ventricular compliance. These two indices have been compared with those obtained echocardiographically from the movement of the posterior wall of the ventricle in a group of normal subjects and in a group suffering from hypertrophic subaortic stenosis (IHSS). The comparison between MVCL and mean standardized speed of protodiastolic prolapse of the posterior wall (Wpwd) was fairly significant (P=0.01); that between MVCL and mean speed of protodiastolic prolapse of the posterior wall (DEV) was only slightly significant (P=0.05) or was not significant at all; that between MVCL and the maximum speed of protodiastolic release (DEVM) was slightly significant (P=0.05). Although the correlation between MVV and the various indices obtained from the movement of the posterior wall (DEV, DEVM, Vpwd) were quite significant (P=0.01), it is considered that Vpwd is preferable as an indirect index of ventricular compliance. As it is capable of distinguishing subjects with IHSS from normal subjects inthose cases in which the movement of valvular peaks, modified or impeded by inflammatory or fibrotic processes does not a-low MVV to be measured, we think Vpwd can be usefully employed as it can in all those circumstances in which it is impossible to measure MVCL owing to alterations to normal septal synchronism (infarction and fibrosis of the septum, branch blocks, etc.).

Aortic Stenosis, Subvalvular↗

PubMedDate not supplied

[Diagnostic imaging of current pulmonary tuberculosis. Clinical significance of the presentation patterns and particular aspects in HIV-positive and HIV-negative subjects].

PURPOSE: We compared two groups of risk patients to try to identify different radiologic patterns in pulmonary tuberculosis. MATERIALS AND METHODS: 74 subjects, divided into two groups (HIV+:27; HIV-:47) were included since 1993. The patients were examined with chest X-ray (CXR) and CT. RESULTS: In the HIV+ group we observed 40 radiologic alterations, with 6 cases of bilateral lung involvement and 9 of atypical localizations; particularly: 11 consolidations, 8 cavitations, 5 miliary diseases, 9 hilar or mediastinal adenopathies, 3 extrapulmonary localizations and 4 negative CXRs. In the HIV- group we found 53 radiologic alterations, with 6 cases of bilateral lung involvement and 3 of atypical localizations; particularly: 12 consolidations, 25 cavitations, 5 nodular patterns, 1 miliary disease, 5 nodal disease, 4 pleural diseases and 1 negative CRX. DISCUSSION AND CONCLUSIONS: In HIV- patients lung consolidations and tysiogen patterns are significantly prevalent, while miliary diseases, mediastinal diseases and atypical localizations and negative CRXs are more frequent in HIV+ patients. We found miliary diseases, mediastinal diseases and extrapulmonary localizations also in HIV- patients with heavily impaired social, economic and sanitary conditions. This alterations indicate compromised host resistance, independent of the causes and modalities of immunodeficiency. The distinction between primary and secondary tuberculosis is currently not mandatory.

Adult↗