[Transitory left posterior hemiblock in acute ischemic cardiopathy].
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Biomedical subjects
Publications and source records attributed to L Colonna.
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Report of seven cases of intermittent left posterior hemiblock in subjects with acute ischaemic heart disease. The electrocardiograms of all the patients (together with the coronary arteriography in three cases) have shown the presence of two different areas of ischaemia: the anterior wall and the diaphragmatic wall of the left ventricle. In three patients acute coronary ischaemia was present in both areas; in the other cases one myocardial wall only was involved.
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The use of lithium as an antiaggressive agent independently of its action in bipolar illness is now well documented. It appears particularly effective in the control of aggressive behavior in chronically aggressive prisoners and mentally retarded patients. Approximately 70-75% of these patients are likely to show a positive response to lithium therapy. No convincing features have been identified as being predictive of a good response. The clinical effect of lithium is to reduce the frequency and the severity of both hetero and auto aggressive outbursts. The use of lithium for aggressive behavior remains controversial in epileptic disorders and inconclusive in chronically psychotic patients. Careful monitoring of lithium blood levels is necessary to ensure adequate therapeutic efficacy without toxicity. A caution is needed in patients with brain damage especially when concurrent neuroleptic treatment is used. The antiaggressive effect of lithium seems rather specific and may be associated with a serotoninergic effect.
In a phase IV study with clotiazepam 9 cardiologists were involved to treat 86 patients (52 female, 32 male, mean age 51 years) effected by cardiovascular diseases and anxiety. The dosage was 5-10 mg TID, and the treatment lasted for 3 weeks. Variations of the dosage were requested in 21% of patients and generally at the 2nd week of treatment. The safety of clotiazepam was good: only in the 14% of patients side-effects were observed (especially drowsiness 9.3% and asthenia 2.3%). Clotiazepam was judged to be effective in 75% of patients. The Hamilton psychiatric rating scale for anxiety showed a progressive decrease both of the total score and of the scores of every item; the cardiovascular symptoms particularly improved at both the controls.
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