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Biomedical subjects

M Petti

Publications and source records attributed to M Petti.

8 recordsLinked to original sources

Value of echocardiography for diagnosis and prognosis of chronic Chagas disease cardiomyopathy without heart failure.

OBJECTIVES: To establish the usefulness of echocardiography for the clinical classification of patients with Chagas disease and to determine the predictors of mortality and clinical events. METHODS: 849 patients with chronic Chagas disease with a mean follow up of 9.9 years were studied. On admission, ECG, chest radiograph, and two dimensional echocardiogram were obtained from all patients. Clinical events were defined as new ECG abnormalities, change in clinical status resulting in transfer to another group, and death. Morphologically characterised segmental lesions were also seen in 12 patients on a second harmonic echocardiogram with intravenous contrast agent. Univariate and multivariate analysis for clinical events and mortality were performed. SETTING: Community of San Martín, Buenos Aires, Argentina. RESULTS: Change in clinical group (68 of 833 survivors v 15 of 16 who died, p < 0.001), left ventricular systolic dimension (mean (SD) 3.06 (0.72) cm v 4.71 (0.90) cm, p < 0.0001), and ejection fraction (mean (SD) 0.67 (0.11)% v 0.42 (0.17)%, p < 0.0001) were found to be the only predictors of mortality. ECG abnormalities related to the disease (in 220 of 699 patients with no clinical event v 98 of 150 patients with a clinical event, p < 0.0001), left ventricular diastolic dimension (mean (SD) 4.88 (0.54) cm v 5.44 (0.83) cm, p < 0.0001), left ventricular systolic dimension (mean (SD) 2.98 (0.62) cm v 3.64 (1.03) cm, p < 0.0001), and ejection fraction (mean (SD) 0.68 (0.10)% v 0.60 (0.16)%, p < 0.0001) were predictors of clinical events. Segmental lesions were observed in 211 of 849 patients (25%). Segmental lesions were seen in 66 (13%) and systolic dysfunction was seen in four of 505 (0.8%) patients with normal ECG. Significant differences were found between the groups of patients (group 0: reactive serology and normal ECG and chest radiography without cardiac enlargement and no signs of heart failure; group 1: reactive serology and abnormal ECG and chest radiography without cardiac enlargement; group 2: reactive serology and abnormal ECG and chest radiography with cardiac enlargement and no signs of heart failure). CONCLUSION: Echocardiography was useful both to characterise and to determine the prognosis of patients with chronic Chagas disease without heart failure.

Adolescent↗

Adrenal carcinosarcoma.

The clinical and pathologic features of a case of adrenal carcinosarcoma are reported. Although synchronous malignancy of the adrenal gland has been described, no case of an adrenal tumor combining both carcinomatous and sarcomatous elements has been previously documented. This neoplasm is extremely aggressive with distant metastasis arising from the sarcomatous component, and rapid progression despite multimodal therapy.

Adrenal Cortex Neoplasms↗

Fax/modem board communications decrease preceptor communication costs.

BACKGROUND: Mail and the telephone are common communication links between departments of family medicine and their community-based preceptors. The availability of low-cost fax/modem boards offers the potential for new communication methods. This study compares the cost of personal computer-based fax/modem board communications with traditional mail and telephone linkages. METHODS: The department's community preceptor faculty served as the study population. Sixty-eight physicians (54%) had fax machines; these physicians received faxes instead of mailed communications. The remaining 59 physicians (46%) received mailed communications. All preceptors received standard telephone calls. Costs for telephone, mail, and fax/modem board communications were tracked over a 4-month period. RESULTS: Faxes were significantly less expensive and more efficient than either telephone or mail communications. Telephone communications were the most expensive. CONCLUSIONS: The study suggests that fax/modem boards offer a communication linkage with preceptors that is more economical than either mail or telephone.

Cost-Benefit Analysis↗