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M Cipriani

Publications and source records attributed to M Cipriani.

34 records · Page 2Linked to original sources

Detection of normotension, borderline and hypertension cutoffs in a population evaluated by non invasive blood pressure monitoring.

The 24-hour blood pressure (BP) average value in normotensive and hypertensive subjects is not defined. In 329 subjects three occasional blood pressure data were measured. The same day a non invasive 24-hour blood pressure monitoring was performed. The average of the occasional blood pressure and the average of the 24-hour blood pressure data were compared. In many cases the occasional blood pressure average was not strictly linked with the 24-hour blood pressure average. A statistical procedure (K-Means Cluster Analysis) was performed separately on occasional blood pressure values and on the hourly blood pressure average of the whole day. By this method three clusters of subjects were selected to evaluate the occasional and the 24-hour blood pressure cluster's cutoffs. The cluster's blood pressure cutoffs evaluated on occasional blood pressure values were not dissimilar from the blood pressure values suggested by literature for normotensive, borderline and hypertensive groups. The K-Means Clusters Analysis seems an interesting statistical method to research the subsets in a population evaluated by 24-hour blood pressure monitoring. We suggest that the 24-hour BP cutoffs evaluated in the three cluster groups may be considered as indicative for a clinical diagnosis of normotensive, borderline and hypertensive state.

Adult↗

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↗

Chlorthalidone does not increase the hypotensive effect of nifedipine in essential hypertensives: a crossover multicentre study.

To determine whether the combination of nifedipine + chlorthalidone exerts an additive antihypertensive effect when compared with single-drug treatment, we studied 66 uncomplicated essential hypertensives, with diastolic blood pressure of greater than 100 and less than 115 mmHg. At the end of a 1-month washout placebo period, using a double-blind crossover design, the patients were randomly allocated to nifedipine (20 mg twice a day), chlorthalidone (25 mg once a day), the two drugs combined at the same doses and the corresponding placebo. Compared with the randomly allocated placebo, the three active treatments significantly reduced blood pressure without changing the heart rate or body weight. Both the absolute and percentage decreases in mean blood pressure induced by nifedipine and the combination compared with placebo were similar and significantly greater than those induced by chlorthalidone. Taken together, these data show that the combination of nifedipine + chlorthalidone does not exert any additive antihypertensive effect compared with nifedipine alone. This finding indicates that the combination of a dihydropyridine calcium antagonist + a thiazide diuretic is probably devoid of any particular clinical significance in the treatment of uncomplicated essential hypertensives.

Adult↗

Fulminant leukemic polyradiculoneuropathy in a case of B-cell prolymphocytic leukemia. A clinicopathologic report.

A 52 year old man with a 10-month history of B-cell prolymphocytic leukemia (PLL) died of an apparent acute fulminant polyradiculoneuropathy, a condition generally attributed to paraneoplastic complication. The pathologic examination disclosed diffuse leukemic infiltrations of the peripheral nervous system. It is suggested that this particularly aggressive form of B-cell chronic prolymphocytic leukemia presented a constellation of features that promoted the invasion of the peripheral nervous system by way of the bloodstream and may explain the unusual clinical presentation.

B-Lymphocytes↗

[Hepatic iron and chronic alcoholic liver disease. Histochemical findings].

Histochemical methods (Perls-Turnbull-Blan) were used to assess the amount of iron present in the liver tissue (needle biopsy) of patients in various stages of chronic alcoholic liver pathology. The highest iron titres were found in the patients at the most advanced stage of the disease and there appeared to be a correlation between the size of the anatomopathological alterations and the quantity of haemosiderinic pigment.

Biopsy↗

[Not Available].

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Epilepsy↗

Transthoracic high-frequency echocardiographic detection of atherosclerotic lesions in the descending portion of the left coronary artery.

To assess the ability of transthoracic high-frequency two-dimensional echocardiography to detect atherosclerotic lesions in the descending portion of the left coronary artery, 30 consecutive patients with suspected coronary artery disease underwent two-dimensional echocardiographic examination 24 to 96 hours before coronary angiography. The descending portion of the left coronary artery was arbitrarily divided into a mid segment (the portion of the coronary vessel embedded in the anterior interventricular sulcus) and an apical segment (the portion turning around the cardiac apex into the posterior interventricular sulcus). The mid segment was imaged in 24 and the apical segment in 25 of the 30 patients for a total of 49 out of 60 segments (82%). Comparison of the echocardiographically visualized segments with the corresponding angiographic segments indicated that a correct echocardiographic diagnosis of significant stenosis was made in 11 out of 12 segments. There were no false positive results. Thus the sensitivity and specificity of high-frequency transthoracic echocardiography in the detection of significant stenosis in the imaged segments were 92% and 100%, respectively. Compared with angiography, additional information concerning the status of the arterial wall, the presence of calcific plaques, and the cross-sectional extent of the obstructive lesions was obtained by echocardiography in eight patients.

Adult↗

[Not Available].

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Diagnosis↗

[Blood rheology].

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Blood Flow Velocity↗

[Indication for transcranial Doppler studies in transient ischemic attack].

UNLABELLED: The diagnostic procedures for the assessment of transient ischemic attacks (TIA) include both brain imaging (computed tomography, nuclear magnetic resonance) and cerebrovascular investigation by means of ultrasound studies and angiography. Transcranial Doppler sonography (TCD) has not yet become a widely used diagnostic tool, although it allows noninvasive investigation of the intracranial cerebral circulation. The aim of this study was to assess the value of TCD investigation in patients who suffered from TIA. Eighty-one consecutive patients admitted to our General Medicine Department with a diagnosis of TIA underwent cranial computed tomography, ultrasound investigation of the extracranial cerebral arteries, and TCD. RESULTS: 39% of the TCD findings were not significant; TCD findings were highly significant in 18% of the patients with TIA, mainly for intracranial arterial stenoses and symptomatic subclavian steal; the other abnormal TCD findings were nonspecific, but in all these cases TCD yielded information on the efficiency of intracranial collateralization and the mechanisms regulating cerebral hemodynamics. These results suggest that TCD is a useful tool for the assessment of TIA.

Adult↗