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Biomedical subjects

S Forconi

Publications and source records attributed to S Forconi.

106 records · Page 6Linked to original sources
PubMedDate not supplied

Pulmonary embolism in the elderly: clinical, instrumental and laboratory aspects.

OBJECTIVE: To focus on diagnostic and therapeutic problems of pulmonary embolism in the elderly. METHODS: Retrospective analysis of 5 years of clinical, instrumental, and laboratory data (collected at the time of hospital admission) for patients 65 years and older with pulmonary embolism proven by a high-probability scintigraphic lung scan or necropsy. Sixty-eight patients, 46 females and 22 males, 78.61 +/- (SD) 7.71 years old, were enrolled in the study. RESULTS: Dyspnea, chest pain, tachycardia, and tachypnea were the most common symptoms and signs; they were present alone or in combination in all patients. Bed rest over 4 days was found in 65% of the patients and deep vein thrombosis in the leg in 35%. Only 7 patients were on anticoagulant therapy which was likely to reduce the incidence of pulmonary embolism. The mortality was 29.5%. Major bleeding due to anticoagulant therapy was observed in 4.4% of the patients; 1 case was fatal. Sinus tachycardia, ST segment and T wave abnormalities in anterior leads, and incomplete bundle branch block were the most frequent electrocardiographic findings. Chest X-ray was normal in 19.5% of the patients and compatible with pulmonary embolism in 10%. A transthoracic two-dimensional echocardiogram was abnormal in 74% of the cases, with involvement of the right ventricle in the majority of them. Many patients had laboratory parameters within the normal range. The value of the latex agglutination D-dimer assay was less than the cutoff value of 500 microg/l in 16% of the patients. Hypoxemia and a high alveolar-arterial oxygen gradient were the most frequent aspects of the arterial blood gas analysis. Respiratory alkalosis was observed in only one third of the patients. CONCLUSIONS: Pulmonary embolism is often underdiagnosed in the elderly. Clinical, instrumental, and laboratory findings are nonspecific. Only acute suspicion can increase the number of diagnoses, reduce the time to diagnosis, and improve the prognosis.

Aged↗
PubMedDate not supplied

Fibrinolytic activity of oral cyclandelate in patients with generalized atherosclerotic vasculopathy: a double-blind study.

In a double-blind study, a single dose of 1600 mg cyclandelate or placebo was administered to 10 patients with cerebrovascular and/or peripheral vascular disease, and fibrinolytic activity was evaluated before and 1, 2, 4 and 6 h after treatment. Cyclandelate induced a reduction in euglobulin lysis time, an increase in tissue plasminogen activator concentration and a reduction in plasminogen activator inhibitor, alpha 2-antiplasmin and immunological fibrinogen concentrations, but no changes in antithrombin III and plasminogen concentrations were observed. After placebo administration no significant changes were observed. After treating two patients with 800 mg cyclandelate twice daily for 14 days, 1600 mg cyclandelate stimulated fibrinolysis for 8 h. It is concluded that the fibrinolytic activity of cyclandelate has implications for the treatment of cardiovascular complications of atherosclerosis.

Aged↗
PubMedDate not supplied

Determination of plasma concentrations of cyclandelate and mandelic acid in patients with generalized atherosclerotic vasculopathy treated with oral cyclandelate.

Cyclandelate, a vasoactive substance consisting of the mandelic acid ester of 3,3,5-trimethylcyclohexanol, was administered to 10 patients with cerebrovascular and/or peripheral vascular disease. Blood specimens were collected at 1-6 h after oral administration of 1600 mg cyclandelate, and the ester and acid were extracted from plasma in acid medium using n-hexane/isopropyl alcohol. The concentrations were determined by a high-performance liquid chromatography isocratic system. The highest plasma cyclandelate concentrations were detected at the third hour, whereas plasma mandelic acid concentrations were still increasing 6 h after administration.

Administration, Oral↗
PubMedDate not supplied

[Action of dopamine on blood flow of the limbs and on blood viscosity (author's transl)].

The observation of several cases of gangrene in the lower limbs of subjects treated with an infusion of dopamine has encouraged the authors to study the action of the drug, in a dose capable of increasing the arterial pressure, on the blood flow in the lower limbs and on the viscosity of the blood in a group of normal middle aged subjects. A significant reduction in the values of the blood flow with a simultaneous increase in the blood viscosity was observed. There results confirm the ischemic action of the drug with the doses used at the muscular and cutaneous level in the lower limbs.

Blood Circulation↗
PubMedDate not supplied

Effect of contralateral internal carotid stenosis on the accuracy of continuous wave Doppler spectral analysis results.

In order to determine the effect of a hemodynamically significant contralateral stenosis on the results of a carotid Doppler study, 333 continuous wave Doppler spectral analysis studies were compared to angiography. For most grades of stenoses, both the peak frequency and the spectral broadening index were increased in the group of patients with contralateral carotid arterial stenoses greater than 50% by comparison with the group with less severe stenoses. Using receiver operating characteristic curves, the diagnostic accuracy was found to be slightly reduced by the presence of significant contralateral disease. Hence, when interpreting the results of carotid Doppler examinations, the presence or absence of a hemodynamically significant contralateral stenosis should be considered in determining the likelihood that an ipsilateral stenosis is present and in evaluating its severity.

Carotid Artery Diseases↗
PubMedDate not supplied

Arterial and venous blood viscosity in ischemic lower limbs in patients affected by peripheral obliterative arterial disease.

Blood, plasma and serum viscosity, packed red cell volume, and plasma fibrinogen concentration was measured in a group of 13 subjects, suffering from peripheral obliterative arterial disease of the lower limbs (stage III or IV), awaiting surgery, and in 9 control subjects, none of whom showed signs of circulatory disease of the lower limbs either by clinical examination or by instrumental measurements. The blood samples were taken from the: (a) antecubital vein; (b) femoral vein; (c) femoral artery. In the patients venous blood viscosity was significantly higher than arterial blood viscosity. No significant differences have been found between the femoral and the antecubital vein, but in the femoral vein blood viscosity was slightly higher. Packed red cell volume and plasma viscosity were slightly but significantly higher in venous blood, while no difference was seen in serum viscosity and in plasma fibrinogen concentration. In the control subjects blood viscosity values were decidedly lower than in patients and no statistically significant differences were to be found between artery and vein, even if viscosity values were lower in artery. These results support the hypothesis that an interrelation exists between hyperivscosity syndrome and vascular ischaemia-inducing diseases.

Adult↗
PubMedDate not supplied

Variations of erythrocyte morphology in different pathologies.

In our study we evaluated erythrocytic morphology in different pathologies which can modify flowing red cells. We followed the methodology proposed by Zipursky which allows a three-dimensional evaluation of the red cell and a classification according to the shapes observed through the optical microscope. We studied 150 subjects: 20 normal subjects, 58 patients suffering from vascular diseases, 40 affected by diabetes (type II) (10 without and 30 with vascular diseases), 22 patients with liver disease, 5 patients with monoclonal gammopathies and 5 dehydrated patients. Results show that in normal subjects bowls, which is the shape of the most deformable red cells, are more (55%) than discocytes (44%); the altered forms are only 1%. In vascular patients we noted a statistically significant increase of discocytes (60%). There are no significant differences between subjects affected by diabetes without vascular disease and normal subjects. In diabetics with vascular diseases there are more discocytes (57%) and some altered forms (3%). In patients suffering from chronic hepatitis a great increase (13%) in echinocytes and knizocytes was noticed, which suggests an alteration in the fluidity of the membrane. Our observations testify the importance of this simple methodology in focusing the morphological alterations which can be accounted for both by pathologies of the red cells and by changes in their metabolism.

Adult↗