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Biomedical subjects

L Mauri

Publications and source records attributed to L Mauri.

36 records · Page 2Linked to original sources
PubMed1992

Transoesophageal electrophysiological evaluation of paediatric patients with Wolff-Parkinson-White syndrome.

Forty-one consecutive children with the Wolff-Parkinson-White (1-15 years: mean 8 years), 22 symptomatic [including 20 with supraventricular tachycardia (SVT) and one with ventricular fibrillation (VF) episode--Group A) and 19 asymptomatic (Group B)], underwent transoesophageal electrophysiological examination. The mean anterograde effective refractory period of the anomalous connection (AERPAC) was 249 +/- 34 ms with no significant difference between the two groups. However, values of less than 220 ms were more frequently observed in Group A than in Group B (23% vs 11% Pns). The effective atrial refractory period was significantly shorter in Group A (183 +/- 34 ms) than in Group B (220 +/- 24 ms) (P less than 0.02). The refractory period of the AV node was 205 +/- 41 ms in Group A and 244 +/- 63 ms in Group B. Orthodromic SVT was induced exclusively in 75% of Group A patients. Atrial fibrillation (AF) was induced in a total of 46% of patients (45% of Group A, 47% of Group B) and was considered easily induced in 37%. The minimum RR interval between pre-excited beats was significantly shorter in Group A (221 +/- 23 ms) than in Group B (321 +/- 143 ms) (P less than 0.04). Four of the patients in whom AF was easily inducible had an RR interval less than 250 ms; three were symptomatic (one with VF). While the AERPAC is generally short in children, and atrial vulnerability generally slight, 9% of children with a short AERPAC had high atrial vulnerability, thus placing them at risk for life-threatening arrhythmias.

Adolescent↗
PubMed1992

[The PTCA of venous grafts: the immediate and long-term results].

BACKGROUND AND METHODS: From June 1981 to September 1991, 30 coronary angioplasty procedures were performed in 25 patients with lesions of saphenous vein grafts. The mean time between bypass surgery and PTCA was 63.1 months (range: 2-168 months). The clinical indications for PTCA were: stable angina in 25 cases; unstable angina in 2 and silent ischemia in 3. The treated lesions were localized at the proximal anastomosis site in 12 cases, in the midshaft in 11 and at the distal anastomosis in 10. IMMEDIATE RESULTS: Twenty-five procedures (83.3%) were successful with a mean residual stenosis of 24% +/- 9%; 1 procedure was unsuccessful and 4 were complicated (13.3%) (1 death in the catheterization laboratory; 1 non Q wave acute myocardial infarction, and 2 emergency bypass operations). The only factor predicting the immediate result was the stenosis morphology (p < 0.05). LONG-TERM CLINICAL FOLLOW-UP. The 20 patients with a first successful PTCA were followed up clinically for a mean period of 36.3 months (range: 1-120 months). There were no deaths nor acute myocardial infarctions. Ten patients (50%) remained completely asymptomatic for the follow-up period. Ten subjects (50%) had recurrence of angina, treated medically in 4 (20%) and with a repeat PTCA in 6 (30%) (for restenosis in 5 cases and for disease progression in 1). Three (15%) of these patients with a repeat PTCA had a new recurrence and were sent to surgery. Sixty-five percent of the patients where asymptomatic at the last clinical control after one or repeat PTCA. We did not find any statistically significant predictor of events (angina) at follow-up. CONCLUSIONS: In our experience PTCA for lesions of saphenous vein grafts is a feasible procedure with acceptable initial success and a favourable long-term outcome.

Angioplasty, Balloon, Coronary↗
PubMed1992

[Complications and sequelae of cardiac electrostimulation in children. Our experience with 47 children].

Permanent cardiac pacing is now easily feasible in children and even in small infants, but the long-term results of this procedure are not well known. We analyzed our experience to determine the morbidity of pacing in children. Over the past 10 years, 47 pediatric patients (pts) required pacemaker implantation in our institution. The mean age was 8.3 +/- 4 years (1 day-17 years) and mean body weight was 23 +/- 14 Kg (2.2-60 Kg). 25 pts had heart disease. 40 children had an A-V block (congenital in 22 cases, post-operative in 17 pts, and secondary to a systemic disease in 1 case); 7 pts had a sick sinus syndrome, primitive in 4 and postoperative in 3 cases. The first pacemaker implantation was epicardial in 17 and transvenous in 30 pts. The pacing was single-chamber in 45 pts (VVI 32, VVIr 7, AAI 5, AAIr 1) and dual-chamber in 2 pts (DDD 1, VDD 1). Two newborns, both with a congenital A-V block and severe heart failure, died in the first hours after epicardial pacing. Two other children, both with congenital heart disease, died during follow-up, but the death was not pacemaker-related. Finally, two children were lost to follow-up. The mean follow-up of the 41 remaining pts was 5.2 +/- 3.5 years (4 months-10 years). Twelve children (29%) required 19 implant revisions and the causes were: lead fracture (26%), rising stimulation threshold (26%), growth problems (21%), erosion and/or pocket infection (21%). Revisions were more common in epicardial (52%) than in endocardial (22%) implantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Affective disorders in subcortical ischemic cerebrovascular pathology. Prospective clinical study of 43 patients].

To evaluate the prevalence and clinical features of affective disorders (AD) associated with subcortical ischemic cerebrovascular disease (mainly localized in the deep areas depending from the anterior, middle and posterior cerebral arteries), a prospective clinical study was carried out in 43 patients with lacunar infarctions (LI). It was found that AD were uncommon in these patients (25%) (1/43). The prevalences of depression in the major lacunar syndromes of the series were the following, from more to less common: pure motor hemiparesis (35%) (7/20); dysarthria-clumsy hand (25%) (1/4); pure sensorial syndrome (16.5%) (2/12), and atypical syndromes (no patient). The capsular topography was associated with AD in 32% (7/22); this association was more uncommon in thalamic (15%) (2/13) or pontine (25%) (1/4) areas. AD had a significant predominance (p = 0.027) in the lesions involving the dominant cerebral hemisphere (63.5%), mainly when these resulted in clinically mild or moderate/severe disability. Past history of AD was also significantly associated with depression (p = 0.0018). Our results show that affective disorders in lacunar infarctions are usually associated with: 1) the type of clinical syndrome; 2) the topography of the lesion; 3) the involved cerebral hemisphere; 4) the associate neurological focality, and 5) the previous occurrence of affective disorders.

Adult↗
PubMed1990

[Affective disorders in the chronic phase of ischemic cerebrovascular disease].

Thirty-nine percent (33/83) of patients in this study present affective disorders in the chronic phase of ischemic cerebral vascular disease (ICV). The incidence of depression reaches its maximum in atherothrombotic infarcts (52%, 15/29) and in infarcts of cardiac embolic origin (71%, 5/7), and its minimum in lacunar infarcts (25%, 11/43). Affective disorders are more common (27%) in patients with previous history of depression (p = 0.005) and they are more common when the infarcts are extensive (87%, 7/8), they are located in the carotid territory (42%, 25/59), in the dominant cerebral hemisphere (60%, 20/33) and they are more frequent at cortical level (55%, 15/27) (p = 0.03), mainly when they produce a clinical situation with moderate (50%, 10/20) or severe (87%, 7/8) (p = 0.006) limitation. Our results demonstrate that affective disorders are frequent in the chronic phase of ischemic cerebral vascular disease and it is mandatory its correct diagnosis in order to perform an adequate treatment and to improve the clinical symptoms of these patients.

Brain Ischemia↗
PubMed1989

Echocardiographic assessment of cardiac allograft rejection.

Twenty-one patients surviving orthotopic cardiac transplantation were studied by serial M-Mode and cross-sectional echocardiography on the same day as endomyocardial biopsy (EBS) (n = 205) during a mean follow-up period of 7.7 +/- 6 months. Results of EBS and the corresponding echocardiograms were divided into three groups: (1) no rejection (62 patients); (2) onset of mild rejection (11 patients); (3) onset of moderate rejection (17 patients). Groups 1 and 3 differed significantly in interventricular septum plus posterior wall thickness (IVS + PWth) (P less than 0.001), LV mass (P less than 0.001), LV ejection fraction (LVEF) (P less than 0.001), increased myocardial echogenicity (ME) (P less than 0.01), impaired RV wall motion (P less than 0.001). Groups 1 and 2 differed significantly only in increased ME (P less than 0.01). Groups 2 and 3 differed significantly in IVS + PWth (P less than 0.05), LV mass (P less than 0.01), LVEF (P less than 0.01), and impaired RV wall motion (P less than 0.01). With acute rejection we observed (1) increase of greater than 4 mm in IVS + PWth (55%), (2) increase of greater than 30% in LV mass (34%), (3) reduction of greater than 10 points in LVEF (27%), (4) RV dilatation and wall motion impairment (31%), (5) appearance or marked increase of pericardial effusion (34%), (6) increased ME (58%). Specificity of the individual criteria ranged from 95.6% to 100%.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMed1988

[Evolution and the median- and long-term prognosis of reentry supraventricular tachycardias in children].

UNLABELLED: We have evaluated 37 children with reentrant supraventricular tachycardia and followed them up for 3.9 +/- 2.7 years. Our 37 patients ranged in age from 1 day to 15 years (mean 4.6 +/- 4 years). When supraventricular tachycardia (SVT) began, 14 patients were less than 1 year old (Group A), and 23 were more than 1 year old (Group B). Cardiac heart disease occurred in 6 children, and Wolff-Parkinson-White syndrome was present in 7 children. After the initial episodes of SVT had been converted, chronic therapy was begun in 87% of cases (A 100%, B 78%) and continued for at least 12 months. During follow-up, therapy was discontinued with good results in 51% of patients (A 79%, B 39%). Recurrences were observed in 19% of cases (A 14%, B 22%), and WPW syndrome was a predisposing factor. Among those patients who were treated, none of the drug regimens used, proved significantly better in preventing recurrence. IN CONCLUSION: the long-term prognosis of SVT is better in Group A than in B. In Group A it is possible to discontinue therapy in most cases; on the contrary in Group B chronic treatment is often necessary. In this group it is important to evaluate if and how the side effects of the drugs can change the long-term prognosis of these patients.

Adolescent↗
PubMed1987

Arrhythmias in sport.

The presence of arrhythmias in athletes is not infrequent. Bradyarrhythmias are more frequent in sportsmen than in the general population. This fact is often due to a 'relative vagal hypertony', owing to a training effect. Tachyarrhythmias are also present in sportsmen in almost the same percentage as in sedentary people. Any of several types of tachyarrhythmia can be seen. Abnormal heart conditions can be demonstrated in many athletes with symptomatic tachyarrhythmias. These arrhythmias frequently occur during exercise and in the early phase of recovery. An organic disorder was present in 26 of 32 athletes who were investigated with an exercise test, Holter monitoring and an electrophysiological test because of the presence of tachyarrhythmias. In six cases we were not able to find any cardiac disease. In 75% of these cases the arrhythmias had a strong relation with exercise. During follow-up (1-5 years; mean 2.88 years) some arrhythmias recurred in spite of medical treatment, in 12 of the 32 subjects, while the other 20 were free of symptoms and arrhythmias. In our opinion it is not possible to ascribe to sport, per se, the direct responsibility for these arrhythmias.

Adolescent↗
PubMed1984

Evaluation of endocrine ophthalmopathy with saccadic eye movements.

Horizontal saccades were examined in 25 patients with hyperthyroidism and/or endocrine ophthalmopathy (EOP) using the infrared reflection method. With one exception none had restriction of horizontal eye movements. Conventional saccadic parameters were usually normal. A standardized test for muscle fatigue, however, gave pathological results in all but one of the patients with EOP, and also in three of seven patients with hyperthyroidism but no clinical EOP. In one of the latter the oculographic abnormality disappeared with treatment, while another developed clinical EOP. Performing a saccadic fatigue test seems to be useful for detecting early EOP and especially for monitoring its course.

Adult↗
PubMed1982

Age-related frequency of viral lesions and their association with uterine cervical intraepithelial neoplasia.

Data collection forms of 50,165 routine smears were examined, and of these 47,577 were considered for this study. Viral cytological lesions (VL) were observed in 101 cases: of these, 19 were associated with cervical intraepithelial neoplasia. The total frequency of VL was 0.21%, with the peak in the teenager group (0.49%). The frequency of CIN among VL showed an overall frequency of 18.8%: this was null under 21 years of age and highest (50%) between 51 and 60 years of age. The frequency of VL in relation to clinical provenance of patients and the season of the year did not attain significance.

Adolescent↗
PubMedDate not supplied

Association of Src-family protein tyrosine kinases with sphingolipids in rat cerebellar granule cells differentiated in culture.

Src family kinases play a relevant role in the development and differentiation of neuronal cells. They are abundant in sphingolipid-enriched membrane domains of many cell types, and these domains are hypothesized to function in bringing together molecules important to signal transduction. We studied the association of Src family tyrosine kinases and their negative regulatory kinase, Csk, with sphingolipids in sphingolipid-enriched domains of rat cerebellar granule cells differentiated in culture. We find that c-Src, Lyn and Csk are enriched in the sphingolipid-enriched fraction prepared from these cells. Coimmunoprecipitation experiments show that these and sphingolipids are part of the same domain. Cross-linking experiments with a photoactivable, radioactive GD1b derivative show that c-Src and Lyn, which are anchored to the membrane via a myristoyl chain, associate directly with GD1b. Csk, which is not inserted in the hydrophobic core of the membrane, is not photolabeled by this ganglioside. These results suggest that lipid-lipid, lipid-protein, and protein-protein interactions cooperate to maintain domain structure. We hypothesize that such interactions might play a role in the process of neuronal differentiation.

Animals↗
PubMedDate not supplied

[Non-rachitic hypophosphatemic osteopathy].

We have identified a patient with a condition called Hypophosphatemic Bone Disease (HBD). This disorder of phosphate metabolism is unrecorded by Dent in his final classification of metabolic bone diseases and has been described by Scriver C.R. and coll. Although the condition is in same ways analogous to X-Linked Hyophosphatemia (XLH), there are important differences between the two diseases. For example, there is selective impairment in the tubular reabsorption of phosphate in HBD but the defect is less severe and it is clearly different from that described in XLH. Clinical manifestations of HBD appear in infancy, but the dwarfism and the bone changes are less severe than in XLH at comparable concentrations of plasmatic phosphorus in the two diseases. While in both conditions there is osteomalacia of endostal trabecular bone, only in XLH is florid rickets present, affecting the epiphyses and compromising linear growth. The phosphaturic response to PTH infusion is abnormal in qualitative aspects, but it is present in HBD, and this differs considerably from that described in XLH. The treatment with oral load of phosphates and 1,25(OH)2D3 in every patient with HBD, and so in our patient, is accompanied by increase in serum phosphorus, with improved tubular reabsorption of phosphate anion and a fall of hydrossiprolinuria with bone healing; this combination of responses is not present in XLH.

Bone Diseases, Metabolic↗
PubMedDate not supplied

Connective tissue regeneration after laser-CO2 therapy.

The ultrastructural pattern of fibroblasts involved in the healing process of laser-treated tissues has been investigated. This study has been performed on the uterine cervix, the epithelial abnormalities of which are frequently treated by laser. Observations carried out immediately and two and seven days after treatment, have demonstrated that: fibroblasts show an active and almost uniform pattern; myofibroblasts are not present; and macrophages are limited in number. This healing process is interpreted as a proliferative pattern of the connective tissue which differs from that of some benign tumors and of healing wounds.

Cervix Uteri↗
PubMedDate not supplied

[Immediate and late arrhythmia in patients operated on for tetralogy of Fallot].

UNLABELLED: Arrhythmias are a frequent complication after repair of tetralogy of Fallot (TOF). We present our experience with 97 patients with special consideration for early and late hyperkynetic arrhythmias. The most frequent, 4% of the patients, was in junctional tachycardia. Late arrhythmias can be atrial or ventricular. The incidence of ventricular arrhythmias in the literature range from 42 to 82%. In the Authors experience multiforme ventricular ectopy was present in 80% of the patients, 20 years after surgery. We suggest an exercise test and averaging ECG in all the patients. Thirty six percent of patients with supraventricular tachycardia were symptomatic. CONCLUSION: as the incidence of arrhythmias after correction of TOF is high, it is very important to periodically reassess these patients. Antiarrhythmic treatment is indicated in all symptomatic patients, especially in those with major arrhythmias (SVT, AF and VT).

Arrhythmias, Cardiac↗