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Biomedical subjects

R Bettini

Publications and source records attributed to R Bettini.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Amyloidosis in monoclonal gammapathies. Observations of the authors' own cases].

We have investigated the presence of amyloid in 25 patients with multiple myeloma and in 12 patients with benign monoclonal gammopathies. Ascari's function resulted valid for the screening of patients with amyloidosis. Fine needle biopsy of subcutaneous fat showed the amyloid in 20% of patients with myeloma and in no patient with benign monoclonal gammopathies. The ratio voltage/mass resulted very useful for the diagnosis of cardiac amyloidosis. Sites involved were heart and kidney.

Adipose Tissue↗
PubMed1990

[Cardiac rhythm in athletes: a Holter study of top level and ex-professional football players].

The study we performed aimed at identifying the arrhythmological pattern in the football player. Between 1984 and 1989, 50 top level football players (group A) from the National Olympic team and from the National A team, average age 24.2 years (min. 19, max. 32), underwent Holter monitoring. The recordings were carried out in different environmental conditions according tot he programmes of the team and the number of recordings depended on how long each football player stayed in the National team. Moreover, 40 trainers (group B) from the Italian football teams, average age 38.4 years (min. 32, max. 57), all of whom had formerly been professional high-level football players practising intensive physical exercise for professional reasons, underwent one 24 h Holter monitoring. RESULTS. Group A: 2621 hours of monitoring were able to be analysed in 48/50 football players. Sinus node pauses greater than or equal to 1750 ms were found in 21/48 (43.7%) with a maximum of 3740 ms on altitude in 1/21, second degree atrioventricular block in 8/48 (16.7%) with a maximum of 5400 ms on altitude in 1/8, supraventricular ectopic beats in 13/48 (27%), ventricular ectopic beats in 26/48 (54.1%) which were complex (cl. Lown greater than or equal to 3) in 7/26. Group B: 882.30 hours of monitoring were able to be analysed in 39/40 former football players. Sinus node pauses greater than or equal to 1750 ms were found in 18/39 (46.1%) with a maximum of 2280 ms in 7/18, second degree atrioventricular block in 1/39 (2.6%) with a maximum of 2400 ms, supraventricular ectopic beats in 32/39 (82%), ventricular ectopic beats in 24/39 (61.5%) which were complex in 5/24.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Stable ventricular tachycardia in arrhythmogenic dysplasia of the right ventricle in sportsmen].

Right ventricular arrhythmogenic dysplasia (RVAD) is a typical asymptomatic arrhythmogenic cardiopathy in athletes, which is occasionally concurrent with normal ventricular function and life-threatening arrhythmias. A total of 32 athletes (28 males and 4 females, mean age, 23 years, mean follow-up, 6.7 years) were examined for severe cardiac arrhythmias with left bundle branch block. The conclusive diagnosis of RVAD was established from clinical, echocardio-, and angiographic evidence. The protocol of the examination involved Holter monitoring, loading tests, electrophysiological study, two-dimensional echocardiography, cardiac angiography of the right and left ventricles, coronary angiography. The most severe arrhythmias were observed in athletes whose mean age was 23.4 years, 20 patients had sustained ventricular tachycardia (it occurred only in 19 who were indulging in sports), 6 presented with transient ventricular tachycardia, and 1 had ventricular fibrillation. They all had been considered fit for sports. The disease proceeded severely in 16 of 32 athletes (in 13 of 16 while indulging in sports), the conditions close to syncope were seen in 9 patients (8 had sustained ventricular tachycardias and 1 had transient ventricular tachycardias), syncopes were observed in 5 patients (sustained ventricular tachycardias).

Adult↗
PubMed1990

[Stage classification of chronic lymphatic leukemia. A retrospective analysis of 263 cases].

We have analyzed 263 consecutive patients with chronic-lymphocytic leukemia. They all have been studied according to five different staging systems respectively proposed by Rai (1975), Binet (1977), Binet again (1981), Baccarini (1982) and Rozman (1984). All these procedures proved to be effective, because they divided our cases in groups with significant differences in survival time. The paper displays features and usefulness of each staging system.

Adult↗
PubMed1990

[Prognosis in Hodgkin's disease: verification of a new predictive equation].

A retrospective analysis of a series of 114 patients with Hodgkin's disease was carried out. The patient were male, aged greater than or equal to 45 years, histotype mixed cellularity or lymphocytic depletion, advanced stage (III o IV), ESR greater than 45 mm/1h., serum albumin less than or equal to 3.5 gr/dl appeared to be unfavorable parameters at diagnosis. The application of a predictive linear equation recently proposed by Gobbi et al. revealed a agreement between survival and predicted mean survival.

Adolescent↗
PubMed1989

Arrhythmia patterns in athletes with arrhythmogenic right ventricular dysplasia.

Arrhythmogenic right ventricular dysplasia (ARVD) is a typical 'silent' arrhythmogenic cardiomyopathy in athletes, with the possibility of normal ventricular performance and life-threatening arrhythmias. We studied 32 athletes (28 M, 4 F), mean age 23 years, follow-up 6.7 years, all previously declared fit for sports activity. They were studied for significant ventricular arrhythmias with LBBB with a final diagnosis of ARVD based on accepted clinical, echocardiographic and angiographic criteria. The study protocol included Holter monitoring (HM), stress test (ST), electrophysiological endocavitary study (EES), 2D echocardiography, RV and LV cardioangiography and coronarography. The most serious arrhythmia appeared at a mean age of 23.4 years, 20 had clinical sustained ventricular tachycardia (VT) (19/20, 95% during sports activity), six non-sustained VT and one ventricular fibrillation (VF). Severe symptoms occurred in 16/32 athletes (50%) during sports activity in 13/16 (81%): presyncope in nine (non-sustained VT in one, sustained VT in eight); syncope in five (sustained VT); aborted sudden death (SD) in one, SD (follow-up) in one. The reproducibility (HM, ST, EES) of clinically severe arrhythmic manifestations which occurred during sports activity was not high. In fact, during sport many factors are at work which may activate several arrhythmogenic mechanisms not easily reproducible in the laboratory. We conclude that a cardioarrhythmological study is mandatory in suspected right ventricular arrhythmias, including morphological study of the RV, to avoid arrhythmic risk during athletic activity.

Adult↗
PubMed1989

[Prognostic significance of skeletal lesions in multiple myeloma].

Prognostic significance of the skeletal lesions in multiple myeloma. Fifty-two patients with multiple myeloma have been analysed and relations between bone X-ray changes and several clinical biohumoral parameters and survival have been found. Our studies show no correlation between the extent of skeletal lesions and the seriousness of anaemia, or between bone marrow infiltration and renal involvement. The results also show that patients with apparently normal bones may also have serious anaemia, wide bone marrow infiltration and serious renal lesions rapidly leading to a poor prognosis. Comparison of survival curves, according to the grade of bone X-ray changes at presentation, shows no significant difference: the grade of bone lesions at diagnosis does not seem to considerably influence survival.

Aged↗
PubMed1989

[Arrhythmologic study of 50 patients with arrhythmogenic disease of the right ventricle: prognostic implications].

UNLABELLED: Arrhythmogenic right ventricular disease is a syndrome which involves a wide spectrum of anatomo-clinical features. It is characterised by different levels of right ventricle anomaly, and by life-threatening "right" hyperkinetic ventricular arrhythmias. Fifty consecutive pts were retrospectively examined at the Arrhythmological Centre in Trento between 1977 and 1988. The results of rigorous arrhythmological, echocardiographic and angiographic criteria showed that all pts were affected by arrhythmogenic right ventricular disease. CASE STUDY: 39/50 (78%) males, 11/50 (22%) females; age 30.6 years (11-78) at the time of the first study. METHODS: clinical history in 50/50 pts, electrocardiogram in 50/50 pts, Holter monitoring in 50/50 pts, ergometric test in 49/50 pts, non-invasive analysis using signal-averaging QRS in 17/50 pts, 2D echocardiogram in 50/50 pts, angiography in 38/50 pts, electrophysiological endocavitary study in 35/50 pts. RESULTS: familial 2/50 (4%); 1/50 (2%) was in class II NYHA; first arrhythmia at 24.6 years (8-60); most severe arrhythmia at 27.7 years (9-74). Forty-three out of fifty patients (86%) were symptomatic for arrhythmias: 28/50 (56%) as a result of stress; 20/50 (40%) had life-threatening symptoms; 6/50 (12%) had aborted sudden death. Arrhythmogenic right ventricular disease was "localized" in 42/50 (84%) and "diffused" in 8/50 (16%) and was associated with anomalies of the left ventricle in 30/50 (60%). Electrocardiogram showed: right bundle branch block in 10/50 (20%), negative T wave on the right precordial leads in 19/50 (38%), delayed ventricular potentials in 4/17 (23.5%). Using the electrocardiogram, Holter monitoring and electrophysiological endocavitary study the following were documented: a) clinical ventricular tachycardia in 40/50 (80%): non-sustained ventricular tachycardia in 10/50 (20%), sustained ventricular tachycardia in 30/50 (60%); b) electrically induced ventricular tachycardia in 26/35 (74.2%): non-sustained ventricular tachycardia in 8/35 (22.8%), sustained ventricular tachycardia in 18/35 (51.4%) (clinical sustained ventricular tachycardia in 18/18); c) multiform ventricular tachycardia in 12/50 (24%) (diffused arrhythmogenic right ventricular disease in 3/12 and associated anomalies of the left ventricle in 11/12); d) pleomorphic sustained ventricular tachycardia in 9/30 (30%) (diffused arrhythmogenic right ventricular disease in 2/9, and associated anomalies of the left ventricle in 8/9). Forty-two out of fifty patients (84%) underwent antiarrhythmic treatment. When the study was carried out 6.6 years (1 month-22 years) had passed since the first symptom; follow-up was 2.1 years (1 month-11 years) while the interval between the first symptom and the last check-up was 8.4 years (1-30 years); 2/50 dropped out and 2/50 died suddenly.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1988

Induction of supraventricular tachyarrhythmia at rest and during exercise with transoesophageal atrial pacing in the electrophysiological evaluation of asymptomatic athletes with Wolff-Parkinson-White syndrome.

Even today there is controversy as regards the best approach to asymptomatic or slightly symptomatic athletes with the WPW syndrome as regards fitness for sports activity, especially in some countries where the doctor is responsible for certifying sports fitness. This study concerns 84 asymptomatic or slightly symptomatic athletes (66 males, 18 females, mean age 21.7 years, range 12-44 years) who underwent a stimulation protocol the end-point of which was the induction of atrial fibrillation (or, if not possible, atrial tachyarrhythmia) in the basal state and during bicycle stress test with transesophageal atrial pacing. The 81 athletes in whom the end-point was reached were divided into two groups: Group I includes the 32 athletes with the shortest R-R interval between pre-excited beats less than or equal to 240 ms in the basal state and/or less than or equal to 210 ms during bicycle ergometer test, Group II includes the other 49 patients. The evaluation during exercise was not carried out in four athletes because of serious haemodynamic compromise due to the arrhythmia induced in the basal state. Only 21/32 athletes would have been included in Group I if only evaluated in the basal state. In 30/81 athletes (37%), there was discrepancy between the result of stimulation and the result of the usual non-invasive evaluation (Holter monitoring, ergometric stress test, ajmaline test). On average, 40 min are required for the performance of the study protocol except when the induced arrhythmia lasts more than 5 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Flecainide and encainide.

Flecainide and encainide (class IC) are presently under clinical evaluation in Italy. They prolong the duration of the QRS but not the period of ventricular repolarisation: the prolongation of QT is due solely to the prolongation of the Q-J. Flecainide and encainide are extremely powerful and are suitable for the treatment of reciprocating supraventricular paroxysmal tachycardia and of persistent reciprocating tachycardia, the prophylaxis of WPW atrial fibrillation including cases with a short anterograde refractory period of the anomalous pathway and the treatment of ventricular ectopic beats and ventricular tachycardia. Both drugs are probably effective for the treatment of atrial fibrillation. However, in the case of atrial flutter they are of little effect of sinus rhythm cardioversion; on the other hand they significantly prolong the duration of the A-A interval, with variable results on ventricular rate. Flecainide and encainide have 'parodoxical' arrhythmogenic effects, related to administration dosages, severity of the arrhythmia and seriousness of cardiopathy. Encainide shows peculiar pharmacokinetics due to hepatic oxidating metabolisation and to production of metabolites; among these the O-demethylencainide and the 3-methoxy-O-demethylencainide have an antiarrhythmic activity, which is probably more important than the encainide parent and is longer-lasting. There are 'extensive', 'poor' and 'non-metaboliser' subjects. This results in wide pharmacokinetic inter- and intraindividual variability which must be taken into account during clinical treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Anilides↗
PubMed1987

[The Italian Group for the Study of Streptokinase in Myocardial Infarct: Study of arrhythmias].

The purpose of the trial "Arrhythmias" was to evaluate all the arrhythmic events in the control and treated patients by considering, in the latter, the chronological relation to the infusion of Streptokinase (SK). This was done in order to determine if the presence of arrhythmias was significantly greater in the treated patients, and if these arrhythmias could be considered as possible markers of reperfusion. 10 Centres participated by recording and evaluating all the hyperkinetic and hypokinetic arrhythmic events in the treated and control patients for an observation period of 2 hours including infusion of SK. The recording method used was computerised UCIC or Holter recording. The centre for data handling carried out storage and statistical elaboration of the data. The Lown and the Italian Modified Lown classifications were used. When appropriate, the statistical significance of observed differences was assessed with chi-square and t tests. 433 patients, 227 treated and 206 controls, were randomised. No statistically significant differences were observed between the two groups as regards the quantity and quality of the hyperkinetic or hypokinetic arrhythmias. On the contrary, on dividing the patients into two groups in accordance with the incidence of Hyperkinetic Ventricular Arrhythmias (HVA), more serious HVA were observed in the controls both in absolute value and in relation to those with better functional class, younger patients (less than 65 yrs.) and with multiple site infarct. The results of the search for arrhythmias which can be markers of reperfusion, show that the Slow Ventricular Tachycardia is the only arrhythmia which can be used as such.

Arrhythmias, Cardiac↗
PubMed1986

Diclofenac sodium versus acetylsalicylic acid: a randomized study in febrile patients.

One hundred and twenty adult patients with high temperatures (greater than or equal to 38 degrees C) brought about by influenza viruses or other conditions were randomly treated with two different antipyretics: a) a 25 mg sodium diclofenac tablet (Novapirina) every 12 hours for 2 consecutive days; b) a 500 mg tablet of acetylsalicylic acid (Aspirin) every 8 hours for 2 consecutive days. Antipyretic action (assessed at 6 hours following the first administration) was found to be equally rapid and consistent in both cases but significantly longer-lasting in the Novapirina-treated group than the Aspirin-treated group (p less than 0.01). Mean temperature changes over the 48 hours of observation and the over-all judgement on the antipyretic effect expressed at the end of each day of treatment were similar for both groups and good in all cases. The antiphlogistic-painkilling properties of both drugs were found to be effective in improving the symptomatology accompanying the high temperature during the course of the bout of influenza. The effectiveness/tolerability ratio was found to be satisfactory for both groups: only one case of gastric intolerance to Novapirina was recorded and five cases of gastric intolerance to Aspirin.

Adult↗