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Biomedical subjects

L Favaro

Publications and source records attributed to L Favaro.

At least 19 recordsLinked to original sources
PubMed1996

Dactylitis in patients with seronegative spondylarthropathy. Assessment by ultrasonography and magnetic resonance imaging.

OBJECTIVE: To establish by means of ultrasound and magnetic resonance imaging (MRI) the role of tenosynovitis and arthritis in determining the "sausage-like" aspect of finger dactylitis and to compare the results of the 2 examinations. METHODS: Twelve dactylitic fingers and their corresponding normal contralateral fingers belonging to 10 patients who met the Amor criteria for the diagnosis of seronegative spondylarthropathy (SpA) were studied by ultrasonography and MRI. RESULTS: MRI revealed a significant increase in the volar bone-to-skin distance in dactylitic fingers with respect to that of the normal contralateral fingers (P < 0.001). This increase was due to distension of the flexor synovial sheaths (P < 0.00001) by fluid collection. Peritendinous soft tissues were not involved, since these were found to be significantly thicker in the normal fingers (P < 0.05). Of the 36 joints of the 12 dactylitic fingers, only 1 showed capsule distension. Using MRI as the "gold standard," ultrasonography showed a 100% sensitivity and specificity for flexor tenosynovitis, but lacked sensitivity for joint involvement because it failed to reveal joint capsule distension in the only joint involved. Similarly, physical examination showed a 100% sensitivity and specificity for flexor sheath involvement. CONCLUSION: Dactylitis is due to flexor tenosynovitis. Enlargement of the finger joint capsule is not an indispensable condition for the "sausage-like" feature. Physical examination is a sufficient method for the diagnosis of dactylitis.

Fingers↗
PubMed1995

Dactylitis with pitting oedema of the hand in longstanding ankylosing spondylitis.

The case of a patient with seronegative spondyloarthropathy showing oligoarthritis of the hand together with large pitting oedema is reported. Unlike the patients with late onset peripheral spondyloarthropathy described by Dubost and Sauvezie who show minimal involvement of the axial skeleton, the patient has been suffering from AS for about twenty years.

Edema↗
PubMed1995

Late onset undifferentiated seronegative spondyloarthropathy.

OBJECTIVE: To define the clinical spectrum of late onset undifferentiated seronegative spondyloarthropathy (uSpA) based on a large number of patients. METHODS: All consecutive patients older than 45 years at the onset of SpA and not meeting criteria for any of the definite categories of the SpA complex seen in the 1988-1993 period were entered in a special register and were followed prospectively. RESULTS: Twenty-three patients (mean age at onset 56.9, range 46-72; mean age at the last visit 61.7, range 48-79) were studied. Of these, 12 had 3 or more clinical and/or radiological manifestations of SpA, while 7 showed only 2, and 4 only one. Of the 10 patients with peripheral arthritis, only 3 had the large pitting edema of the lower limbs described by Dubost and Sauvezie. Of the 4 patients with only one manifestation, 2 had peripheral enthesitis and 2 acute anterior uveitis. CONCLUSION: The clinical spectrum of late onset uSpA is as wide as in children and young and middle aged adults.

Age of Onset↗
PubMed1994

Cutaneous amputation of the terminal phalanges in syringomyelia.

We describe a 30-year-old woman with syringomyelia, who developed recurrent painless whitlows of the left hand that led to amputation of the terminal phalanx of the 4th finger and considerable shortening of the terminal phalanges of the 1st, 2nd, 3rd and 5th fingers. A roentgenogram of the left hand showed a complete resorption of the terminal phalanges of the 3rd, 4th and 5th fingers and partial resorption of the terminal phalanx of the 2nd finger. Although the defective sensory function undoubtedly contributes to the development of bone resorption by facilitating mechanical repetitive injuries and infections, impaired vasomotor function possibly plays an equally important role.

Adult↗
PubMed1989

Dilated cardiomyopathy with regional myocardial hypoperfusion in Becker's muscular dystrophy.

We describe two cases of Becker's muscular dystrophy, both of which presented with a dilated cardiomyopathy with alterations of myocardial perfusion and hypokinesia in the anteroseptal and apical ventricular walls. To the best of our knowledge, only one case with similar cardiologic characteristics has been reported previously. Myocardial involvement in this disease is comparable to that found in the Duchenne form of dystrophy. The possible mechanisms underscoring its induction are discussed.

Adult↗
PubMed1989

[Syndrome X].

The authors reviewed the literature on X syndrome, finding criteria of inclusion/exclusion so different as to often invalidate the results. The syndrome should be diagnosed only in patients with typical anginal pain on effort relieved by nitroglycerin or rest, with perfectly regular coronary vessels and a normal resting left ventricle, without any evidence of variant angina. Other diseases must be strictly excluded (mostly at the esophageal level) and an ischemic process has to be proved by means of more than one provocative test. Interesting pathophysiological findings are the dynamic limitation of coronary flow reserve and frequent reports of a left ventricle dysfunction during stress. Whether these last findings represent an independent entity, an aspect or stage of the variant angina or the initial appearance of a cardiomyopathy, has yet to be clarified. Frequent reports of a higher prevalence of X syndrome in women have not been substantiated and could be explained by many biases.

Angina Pectoris↗
PubMed1988

Environmental and social factors in rheumatoid factor epidemiology.

The effect of social and environmental conditions on the epidemiology of Rheumatoid Factor (RF) in healthy population was studied. For this purpose 2 sample of 828 subject was studied using 5 tests for RF. Our sample included: 419 randomized subjects from a quarter at the outskirts of Bologna (high rate immigration, non homogeneous habits and health background; 409 randomized subjects from one rural small town on the Romagna's hills (no immigration, no change in residence or profession for generations, uniform, habits and health background). These tests included: three on slide with binded human (2) and rabbit (1) IgGs and sheep-cells tests-one on slide (Scat) and the other in tube (W.-Rose by Mizuoka). The most frequent positive test was Scat test, in urban population and one human IgG latex-test in the rural population. No urban subject reacted at the same time to 4 or 5 tests. Associated positive results for 2, 3 or 4 tests are usually observed in rural subjects. These results are the expression of the different and more uniform social and biological background acquired by rural people.

Adult↗
PubMed1988

Evolution of the rheumatoid factor over time.

With purpose to verify the epidemiological value of the Rheumatoid Factor's variations over time, we studied: 421 RA at first hospitalization (from 1976 to 1985; Group A); 348 consecutive RA with follow-up at 0, 6, 12, 24, and 48 months (Group B); 750 subjects, chosen at random from a healthy population, before and after 48 months (Group C). Five agglutination tests were used: three latex tests with human (2) and rabbit (1) IgGs; one red cells test on slide, and one in tube. The results were: uneven variations in positive results in all tests (Group A); the maximum confirmation of the basic profile are provide in short-term follow-up; in subsequent follow-ups, with the exclusion of the case of all the negative tests, the remaining profiles have a decreasing confirmation rate (Group B); the positive frequency is different in all the tests; this trend is sustained at follow-up (4 years later) in spite of the overall increase of positive results (Group C). Serum-positive RA, according to all or many tests, tend to reduce the number of positive results; healthy subjects (with few positive tests) tend to increase the number of positive results over time. RA with all the negative tests have a reasonably constant profile.

Agglutination Tests↗
PubMed1988

[Efficacy of verapamil in the prevention of ventricular fibrillation in the acute phase of myocardial infarction].

The effectiveness of verapamil in preventing ventricular fibrillation caused by coronary occlusion or reperfusion has been well demonstrated in animal studies, but these experimental data have not yet been confirmed in man. In this study we evaluated the prevalence of ventricular arrhythmias (fibrillation, sustained tachycardia and frequent extrasystoles) in patients hospitalized for myocardial infarction and treated with or without verapamil. The records of patients admitted to our Coronary Intensive Care unit during a 5-year period were analyzed retrospectively. Strict selection criteria enabled us to divide our patients into two homogeneous groups. The control group (group A) consisted of 106 patients who received only continuous infusions of heparin. The treated group (group B) comprised 89 patients who received exclusively verapamil by intravenous injections followed by continuous infusions. The prevalence of ventricular arrhythmia of all types was significantly lower in group B (22 p. 100) than in group A patients (71 p. 100; p less than 0.001). Episodes of ventricular fibrillation, in particular, were considerably less frequent in group B patients (1 p. 100) than in group A patients (13 p. 100; p less than 0.001). It would appear from these results that verapamil is highly effective in preventing death due to cardiac arrhythmia in the acute phase of myocardial infarction.

Cardiac Complexes, Premature↗
PubMed1987

Impressive lung uptake during exercise thallium imaging with decrease of systolic blood pressure.

A case of very high thallium lung activity during exercise myocardial imaging in a patient with an old myocardial infarction but free from typical angina or heart failure symptoms is reported. The impressively abnormal lung uptake occurred in connection with a stress-induced fall in the systolic blood pressure, pointing out a causal rôle of a transient left ventricular dysfunction and interstitial pulmonary oedema in the genesis of the scintigraphic picture. Three weeks after the test, the patient suddenly died at home.

Blood Pressure↗
PubMed1987

Sex differences in exercise induced left ventricular dysfunction in patients with syndrome X.

Clinical, electrocardiographic, and scintigraphic data were reviewed from 32 patients (18 men and 14 women) who had syndrome X (chest pain, evidence of ischaemia, and normal coronary arteries without coronary vasospasm). The mean (SD) resting left ventricular ejection fraction, determined by first pass radionuclide angiography was 62.6 (9.2)% and was greater than 50% in all subjects. There was no significant difference between men and women. On exercise, left ventricular ejection fraction decreased significantly to 57.4 (13.0)%. In 17 of 32 subjects there was a fall in left ventricular ejection fraction of greater than 5%, and regional wall motion abnormalities developed in 12 subjects. The fall in left ventricular ejection fraction on exercise was significant in women (from 61.9 (8.5)% at rest to 54.0 (9.8)% on exercise) but not in men (from 63.2 (9.8)% at rest to 60.0 (14.8)% on exercise). Exercise left ventricular ejection fraction fell by greater than 5% in 10 (71%) of 14 women and in seven (39%) of 18 men. Dyskinetic segments developed in eight (57%) of 14 women and only four (22%) of men. Exercise duration in women was significantly shorter than in men (4.1 (1.5) vs 6.6 (2.1) minutes) and was the only one of several clinical and scintigraphic variables that correlated with the change in left ventricular ejection fraction on exercise. In this selected group of subjects with chest pain and angiographically normal coronary arteries, exercise induced left ventricular dysfunction, as shown by a fall in ejection fraction or the development of regional abnormalities, is a common finding. These are more likely to occur in women than men and are associated with a lower exercise capacity. The data suggest that the sex of the patient is important in the interpretation of the non-invasive evaluation of subjects suspected of having syndrome X.

Adult↗
PubMed1987

[Rheumatoid serology: insufficient using a single test].

The rheumatoid factor research restricted to only a test finds evident limitation not only in clinical field, but also on epidemiological investigations. The problem may find a solution by contemporary employment of a tests pool both in epidemiology and in the different physiopathological conditions present in rheumatology. Such kind of proposal has been verified on rheumatic diseases (rheumatoid arthritis classic or probable, polyarthritic syndrome, polyarthritis, spondylitis, psoriatic arthritis) and not rheumatic ones and in control group population (2901 subjects controlled). The results obtained emphasize the eventual presence of rheumatoid factor in the control group population, usually documented by the isolate positivity of three or more tests is preponderant for the same occurrence. By the statistical analysis applied to the conditions with equivalent number in the positive tests, is resulted that the possibility to discriminate the population, apparently health from the sick one is realized in a significative way of the positive tests, and starting from the positivity of two or more tests at least. It can be concluded confirming the already historical datum that the rheumatoid factor research with a test only has a limited orientation power to the diagnosis purpose.

Adult↗
PubMed1987

[Anomalous origin of the left coronary from the trunk of the pulmonary artery. Description of a clinical case].

The case of a 32 year old woman with anomalous origin of the left coronary artery from the pulmonary trunk is reported, in whom, for technical difficulties, the surgical correction has been limited to artery ligation. After surgery, there was a complete clinical improvement and normalization of the stress electrocardiogram. Nevertheless, radioisotopic studies--exercise Thallium 201 scintigraphy and radionuclide ventriculography--disclosed a poor left ventricular function. It is possible to suppose that the prolonged perfusion deficit resulted in an extensive area of myocardial fibrosis.

Adult↗
PubMed1983

[The campaign against arterial hypertension].

The Authors synthetize the up to date knowledge about arterial hypertension as a community disease. They consider benefits and disadvantages of long term drug treatment for millions of people and the usefulness of hygienic and nutritional action, centered on behavioral risk factors that can be modified by means of personal and social changes in the way of life. In the Authors' opinion, the traditional person to person approach--often only pharmacological--must be coupled with a community approach, centered on reducing the risk factors. Health Education is an essential and effective tool in the struggle against arterial hypertension, that is a part of the broadest fight against the chronic degenerative diseases.

Adult↗
PubMed1982

[Electrophysiological effects of lidocaine on the QRS and ST segment during acute myocardial infarct. Evaluation with thoracic electromaps].

We have evaluated the effects of lidocaine on the main haemodynamic parameters, the QTc interval, the ST segment elevation (sigma ST) and the R wave sum (Max sigma pos), studied by automatic recording of thoracic maps, in 9 patients with acute anterior myocardial infarction, admitted to the CCU within 6 hours from pain onset. Lidocaine has been given at the dosage of 2 mg/kg as an i.v. bolus, followed by continuous infusion at 2 mg/min. Haemodynamic parameters, QTc interval and ECG maps have been recorded before and after 5, 15 and 30 min from the beginning of the therapy. Heart rate, systolic and diastolic arterial pressure and cardiac output have not been significantly affected by Lidocaine. The QTc interval has showed a significant reduction of the control ECG from 0.364 +/- 0.059 sec to 0.352 +/- 0.051 at 5 min, 0.353 +/- 0.053 at 15 min and 0.0355 +/- 0.058 sec and 30 min (P less than 0.05). The sigma ST segment decreased significantly after Lidocaine at 5 and 15 min. (from 126 +/- 26 mV to 109 +/- 23 mV and to 112 +/- 23 mV; P less than 0.01 and, respectively, P less than 0.025), whereas at 30 min. sigma ST was not different from control value. There were no significant changes of max sigma pos. Lidocaine did not significantly modify the main haemodynamic determinants of oxygen consumption. We therefore believe that the observed reduction of ST segment elevation was not caused by a decrease of the ischemic damage but was probably due to a primary electrophysiological effect. This drugs, which affects in a different way the action potentials of normal and ischemic cells, could abolish their differences, thus reducing the systolic current of injury.

Aged↗