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Biomedical subjects

L Schivazappa

Publications and source records attributed to L Schivazappa.

At least 37 records · Page 2Linked to original sources
PubMed1983

Failure of sulphinpyrazone to affect platelet survival in patients with rheumatic heart valvular disease: a double blind study using 75Se-methionine labeled platelets.

We have investigated platelet survival time in 18 patients suffering from valvular heart disease. Platelet survival was performed using the 75Se-methionine method modified by us. Nine of our eighteen patients underwent surgery for heart valve replacement. Platelet survival time was performed before treatment and six months afterwards with placebo or sulfinpyrazone in a double blind study. Before treatment and surgery, platelet survival time was significantly reduced in patients with a history of embolism (P less than 0.0048). In patients receiving valve replacement, platelet survival time was shortened both in the sulfinpyrazone and placebo groups six months after surgery. Of the nine patients not receiving prostheses and with a thrombotic history, treatment with placebo and sulfinpyrazone resulted in improved platelet survival times.

Adult↗
PubMed1983

[Usefulness of the 12-lead standard electrocardiogram in assessing myocardial infarct size].

The value of the electrocardiogram in assessing infarct size was studied using serial estimates of serum creatine phosphokinase (CPK) in serum and serial 12-lead electrocardiograms in patients admitted to a coronary care unit with acute myocardial infarction. Sum of the ST segment deviations from the isoelectric line (sigma ST12) and sum of the conventional scores of Q waves amplitude (sigma Q12) were obtained from each electrocardiogram, and then the time-course of these parameters was considered. The correlation between maximum sigma Q12 and CPK-peak in anterior infarcts, was highly significant (r = 0.733; P less than 0.001). Maximum sigma ST12, measured upon admission or immediately thereafter in patients hospitalized within 4 hours from the onset of chest pain, was found to correlate significantly with CPK-peak (r = 0.675, P less than 0.001 for the whole group; r = 0.758, P less than 0.01 for patients with inferior infarcts). Time-course of sigma ST12 and CPK showed 4 different patterns. Among them, type 1 ("rapid necrosis") showed the most significant correlations (maximum sigma ST12 within 4 hours from symptoms versus CPK-peak: r = 0.909, P less than 0.001; maximum sigma Q12 versus CPK-peak in anterior infarcts: r = 0.782, P less than 0,05; and maximum sigma ST12 within 4 hours from the onset of pain versus sigma Q12 in patients with anterior infarcts: r = 0.863, P less than 0,05). There was no correlation between sigma ST12 at any other time and CPK-peak: this observation is in accordance with the presence of a rapid decrease in the mean sigma ST12 after the first 3-4 hours from the beginning of symptoms. This study shows that the analysis of ST segment deviations and of Q waves development in the standard electrocardiogram provides useful information on the size of acute myocardial infarction as reflected by the peak value of serum CPK.

Adult↗
PubMed1982

Pregnancy in patients with a porcine valve bioprosthesis.

Seven patients who became pregnant after valve replacement with a Hancock bioprosthesis were followed up during 8 pregnancies. Six had undergone isolated mitral valve replacement, and 1 had mitral and aortic valve replacement. Their age at the time of operation ranged from 14 to 31 years (average 24); delivery occurred 21 to 88 months (average 51.3) after valve replacement. All women were in sinus rhythm at the time of gestation, and administration of oral anticoagulants was avoided in all. No embolic episodes occurred either after operation or during pregnancy, labor, or puerperium. The only major complication during pregnancy was cardiac failure in 1 patient, associated with onset of atrial fibrillation. Four women had vaginal delivery and 3 required cesarean section. All but 1 delivered a normal, healthy baby. One premature infant died soon after birth because of respiratory distress. No maternal or fetal hemorrhagic complications were observed. One patient died 3 months after delivery in severe heart failure caused by diffuse calcification of both mitral and aortic xenografts. Another women underwent successful reoperation soon after the second pregnancy because of calcific stenosis of the mitral porcine valve. It is concluded that (1) bioprosthetic valves can be considered the most suitable devices employed in women of childbearing age because anticoagulants can be avoided, therefore eliminating the risks related to inappropriate administration of oral anticoagulants as well as the hazards associated with the potential teratogenic effect of coumarin drugs; and (2) pregnancy might favor calcification of porcine heterografts, leading to bioprosthetic failure. Until further data are available to support this suspicion, close clinical and echocardiographic follow-up study of these patients is recommended after pregnancy.

Adolescent↗
PubMed1982

Long-term follow-up of acute and chronic non-A, non-B post-transfusion hepatitis: evidence of progression to liver cirrhosis.

The long-term outcome of non-A, non-B post-transfusion hepatitis was evaluated in 21 patients who developed the illness after open-heart surgery and could be followed thereafter up to five years. Histological chronic sequelae were documented in 13 patients, and consisted of chronic persistent hepatitis in one case, chronic lobular hepatitis in two and chronic active hepatitis in 10, five of whom also developed superimposed cirrhosis. Progression to these chronic states was in most cases symptomless, independently of the severity of liver lesions; one patient, however, died of gastrointestinal bleeding due to cirrhosis of the liver. During follow-up the biochemical pattern of chronic non-A, non-B hepatitis was unique, while striking fluctuations of transaminase levels. Liver histology proved essential to identify the severity of chronic liver lesions, as clinical and biochemical features were uniform and not indicative of it. Our results suggest that cirrhosis may develop, often with an asymptomatic course, in a significant number of patients who do not recover after acute post-transfusion non-A, non-B hepatitis.

Acute Disease↗
PubMed1982

[Evaluation of left ventricular enlargement in isolated aortic insufficiency. Importance of the total cardiac volume calculated on the standard chest film].

A radiographic and hemodynamic investigation has been performed in 53 patients with pure isolated aortic regurgitation, in order to evaluate the most reliable method to detect left ventricular enlargement in this condition. Twelve plain chest film measurements have been compared to the end diastolic volume of the left ventricle calculated by left ventricular angiography. The most sensitive detector of left ventricular enlargement was the plain film total heart volume ( r = 0.754); the cardiothoracic ratio, the cardiac perimeter and the frontal area were less sensitive measurements, but still statistically significant (p less than 0.001). The results of our investigation support the conclusion that plain film total heart volume is the most reliable single measurement for evaluating the left ventricular enlargement in patients with isolated pure aortic incompetence.

Adolescent↗
PubMed1982

Pregnancy in a patient after mitral valve replacement with a porcine bioprosthesis.

The course of two pregnancies in a woman, who had previously undergone mitral valve replacement with a porcine bioprosthesis, is reported. The present case suggests that porcine heterografts are to be considered as the most suitable cardiac valve substitutes in females of childbearing age, since anticoagulants are not needed, avoiding therefore the risks related to both an incorrect anticoagulation and to the recognized teratogenic effect of coumarin drugs.

Adult↗
PubMed1982

[Fetal malformations caused by oral anticoagulants during pregnancy. Report of a case].

The case of a newborn infant girl with a partial agenesis of the corpus callosum and hypoplasia of the nasal bones is reported. She was the product of a full-term pregnancy of a woman who had previously undergone mitral valve replacement with a Björk-Shiley prosthesis and had been maintained on oral anticoagulants (sodium warfarin) until the 38th week of gestation. This case underlines: 1) The need for maintaining an adequate anticoagulation in pregnant women with a mechanical prosthesis. 2) The potential risks of fetal malformations when the oral anticoagulants are given during the first trimester of pregnancy and of fetal hemorrhagic complications when these drugs are administered during the last two trimesters of gestation. 3) The lack of effective pharmacological alternatives to coumarin drugs, which can allow an adequate anticoagulation in the mother with minimal hazards for the fetus.

Abnormalities, Drug-Induced↗
PubMed1981

[Idiopathic orthostatic hypotension (Shy-Drager syndrome). Clinical and hemodynamic studies of a case].

A case of idiopathic orthostatic hypotension (Shy-Drager syndrome) in a 50-year-old man is reported. The diagnosis was made after other possible causes of orthostatic hypotension had been excluded. The Authors emphasize the need for a correct diagnosis in order to adopt an adequate symptomatic therapy, and to avoid useless and often harmful treatments.

Autonomic Nervous System Diseases↗
PubMed1981

Aortic valve replacement in rheumatoid aortic incompetence.

Cardiac valvular involvement in patients with rheumatoid arthritis is rare and seldom so severe as to require surgery. The present report is concerned with a case of rheumatoid aortic incompetence successfully treated by prosthetic valve replacement. As suggested by previous similar reports, surgery is the most effective therapy for clinically significant rheumatoid endocarditis.

Aortic Valve Insufficiency↗
PubMed1981

Hemorrhagic follicular cyst of the left ovary. An unusual complication of anticoagulant treatment.

A 34-year-old female, six months after surgery for implanting a mitral valve bioprosthesis (Hancock), was admitted to hospital because of acute abdomen. The patient had been on coumarin medication since the operation. On the 15th day of her menstrual cycle the patient presented gingival bleeding, epistaxis, and pain in the left lower abdominal quadrant. The prothrombin time was overdepressed (10% of normal), and coumarin drugs were stopped. Bleeding from the left ovary at time of ovulation was suspected and the patient was treated with vitamin K and then submitted to an exploratory laparotomy. A hemorrhagic cyst of the left ovary was found, and the histologic examination showed the cyst to be follicular in type.

Adult↗
PubMed1981

Evidence for the need of long-term antithrombotic therapy in patients with porcine heterograft heart valve.

The plasma levels of two platelet specific proteins, namely beta-thromboglobulin (beta TG) and platelet factor 4 (PT4), were investigated in 86 patients with different types of artificial valves, biological and disc, at different times after valve insertion. Significant differences were demonstrated for both proteins with increased age of the disc valve. On the other hand, no significant change in the high average levels was shown for patients with porcine heterograft (Hancock). The general view of anticoagulate or antiaggregate lasting only a few months after bioprosthesis insertion has to be carefully evaluated again.

Animals↗
PubMed1981

[Ostium secundum atrial septal defect: report of a case with atypical auscultatory findings (author's transl)].

The wide and persistent splitting of S2 is commonly considered the auscultatory hallmark of uncomplicated ostium secundum atrial septal defect (ASD). We have recently observed a 31-year-old female with a variable splitting of S2 and a 2/6 systolic murmur at the second left intercostal space, who showed incomplete right bundle branch block on the ECG and normal heart shadow with increased pulmonary vascular markings on the chest film. Cardiac catheterization revealed an isolated ostium secundum atrial septal defect with significant left-to-right shunt, normal pulmonary pressures and normal ventricular function. Subsequently the patient underwent closure with patch of the ASD without complications. We feel our case is of interest since it demonstrates that the absence of a wide and persistent splitting of S2 in adults does not exclude the diagnosis of uncomplicated "ostium secundum" ASD, when ECG and x-ray findings suggest the disease.

Adult↗