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Biomedical subjects

T Moccetti

Publications and source records attributed to T Moccetti.

At least 19 recordsLinked to original sources
PubMed1990

[Gonococcal endocarditis: an infection as rare as it dangerous. Apropos of a case: the importance of suspicion in diagnosis and of immediate treatment].

Gonococcal endocarditis, although extremely rare, is increasing in frequency, particularly among young exposed patients. It has a distinct predilection for aortic and mitral valve involvement and tends to cause rapid valvular destruction and acute heart failure. Blood cultures are often negative during the first (3 to 31) days. Echocardiography with Doppler is helpful in detecting valvular vegetations, regurgitation and signs of hemodynamic deterioration. Early antibiotic treatment may stabilize the hemodynamic situation only in mitral but not in aortic valve involvement, which necessitates prompt valvular replacement in the event of perforation and/or annulus abscess. Gonococcal endocarditis should be the first item to be excluded in cases of fever with systemic symptoms in young people with a history of sex-transmitted disease. We present a typical case.

Adult↗
PubMed1988

[Initial experiences with thrombolysis in Swiss hospitals. Synopsis of a round-table discussion].

Thrombolytic therapy of acute myocardial infarction (AMI) has resulted in significant reduction of mortality, limitation of infarct size and preservation of left ventricular function. Among the panelists there was consensus with respect to the following recommendations for efficient thrombolytic therapy of AMI: the prehospital phase should be considerably shortened, especially by reducing patient delay. This can be achieved by rendering patients aware of symptoms of AMI and the need for immediate hospitalization on their occurrence. After contraindications have been ruled out, intravenous thrombolysis should be started in every case where the time elapsed since the onset of pain is not greater than 3 hours. In patients with large infarctions intravenous thrombolysis is indicated up to 6 hours after onset of pain. Accompanying medication should include heparinization and administration of aspirin. When reperfusion is achieved the patient should be monitored for recurrence of ischemia. Regardless of symptoms recurrence of ischemia requires immediate coronary arteriography with a view to revascularization by PTCA or bypass surgery. Patients without recurrence of spontaneous ischemia should undergo ergometric stress testing before leaving the hospital. Exercise-induced angina or ST segment depression are strong indications for coronary arteriography.

Acute Disease↗
PubMed1988

[Systemic thrombolysis using streptokinase. Experiences at the Civic Hospital of Lugano in the framework of the ISIS-2 study].

With a small group of Swiss hospitals we had an opportunity of participating in ISIS-2, the major study on thrombolysis in acute myocardial infarction. Experience with our microcosm (Ospedale Civico Lugano) was compared with the macrocosm of the results of ISIS-2 in 17,187 randomized patients (in brackets). Mortality was 5.1% (7.8%) in our streptokinase group and 15.8% (12.8%) in our placebo group. In the ISIS-2 study the combination of thrombolytic therapy with streptokinase, and of antiplatelet therapy with aspirin, showed a reduction of approximately one third in acute mortality of myocardial infarction, stroke and reinfarction. Our experience confirms the reduced incidence of allergic side effects (3.5%), major bleeding (0.3%) and minor bleeding (2.9%) during or after thrombolytic therapy.

Administration, Oral↗
PubMed1979

[Iatrogenic chromodermatoses].

Generalized hyperpigmentation may be caused by internal diseases, by occasional or occupational intoxications, and by a group of drugs. Seven cases occurring after treatment with amiodarone (Cordarone) are reported, together with one case of argyria and one of mercury poisoning. Several of these cases were initially mistaken for cyanotic heart disease. Silver intoxication may occur after indiscriminate use of currently available silver-containing drugs. It may become even more frequent as a result of antismoking preparations.

Aged↗
PubMed1979

[Predictability of electrocardiographic and vectorcardiographic criteria in pulmonary arterial hypertension caused by chronic bronchopneumopathies].

The Authors have verified in a group of 38 patients with chronic obstructive pulmonary disease (COPD) and suspected pulmonary arterial hypertension (PAH) of precapillary origin the possibility to forsee the pressure within the lesser circulation starting from some electrocardiographic and vectorcardiograhic criteria. The vectorcardiographic analysis has not been shown to be more reliable than the traditional ECG as far as the identification of an eventual PAH is concerned. The matching of both scalar and vectorial criteria has significantly increased the efficiency of the estimate, i.e. the possibility to foresee the right ventricular systolic pressure (RVSP) and the mean pulmonary arterial pressure (PAP), but the same efficiency has remained at unsatisfactory level (S = +/- 10,30 Torr as far as the PAP is concerned. With regard to the value of the various scalar and vectorial criteria or parameters, among the electrocardiographic criteria the most reliable has been the inversion of the T wave in the right precordial leads. This sign, however, did not often appear in the present series (18% of the cases). As to the VCG the analysis made by the Authors stresses as the most reliable criterion the direction of QRS loop rotation on the horizontal plane and the magnitude of the maximum rightward spatial vector. These two elements, among other things, escape detection on the traditional electrocardiographic investigation. The above mentioned conclusions, obviously, only apply to the PAH secondary to COPD, in which particular noncardiac (lung hyperinflation, lowering of the diaphgram, etc.) and cardiac (associated left ventricular hypertrophy) factors contribute to limit the diagnostic value of both the ECG and the VCG.

Adult↗
PubMed1977

[Clinical experiences with the serum digitalis concentration. 1006 radioimmunological determinations].

Serum digitalis concentration was measured radioimmunologically on 1006 patients in the period from 1974-1976. The serum levels were correlated with the clinical signs of digitalis toxicity and the indications for determination of the serum digoxin concentration were established. Clinical signs of toxicity appear at a serum level of digoxin above 2.5 ng/ml. Therapeutic limits (range) are most influenced by individual factors. Serum digoxin determination is especially necessary in patients with renal failure and in undisciplined patients with erratic digitalis intake. It is a useful aid in controlling the course of digitalis intoxication, in "low dosage" digitalization and in the case of possible drug interactions.

Arrhythmias, Cardiac↗
PubMed1977

[Ventricular tachycardia "with reversal of points" and electrolyte disorders].

Ventricular tachycardia "with reversal of points" is described and its occurrence in electrolyte disorders (hypokalemia, hypomagnesemia), particularly in combination with antiarrhythmic drugs, is discussed. This ventricular tachykardia occurs in cases of disturbed and prolonged repolarization and is typified by periodically changing amplitude in the ECG ("reversal of points"). From the therapeutic point of view acceleration of heart rate by use of either sympathicomimetic drugs or pacemaker has proved successful. This distinguishes the treatment from that of other ventricular arrhythmias.

Aged↗
PubMed1976

[Progression of coronary sclerosis demonstrated by repeated coronarography. Experience with 80 cases].

Coronary and left ventricular angiography repeated after an interval of 19 months in 84 patients showed progression of coronary sclerosis in 42 and of ventricular lesions in 7. No relation between the morphology and seriousness of the initial coronary lesions and their progression was noted. No significant differences were observed between patients with and without progression as far as the clinical data and risk factors (angina pectoris, prior myocardial infarct, cholesterol, arterial hypertension, and diabetes) were concerned, though there was a significantly higher percentage in obese subjects.

Adult↗
PubMed1976

["Impending infarct". Clinical, ergometric and angiographic pre- and postoperative results in 12 emergency operated patients. Preliminary report].

Pre- and postoperative results are presented in 12 patients who underwent emergency aortocoronary bypass. Operative mortality was zero. 1 patient died 8 months after surgery. Postoperative follow-up averaged 12.5 months (2-37 months). Postoperatively, 7 patients were totally angina-free, 1 was considerably improved and 3 were unchanged.

Coronary Artery Bypass↗
PubMed1975

[Proceedings: Clinical value of serum digoxin and digitoxin determination in renal insufficiency].

Plasma digoxin and digitoxin determination has proven to have an important bearing, particularly in patients with renal failure. It permits early detection of digitalis intoxication in the absence of marked clinical and ECG evidence, and adjustment of dosage accordingly. Also, in patent intoxication it makes it possible to select the right moment for resumption of therapy. To illustrate the importance of the method some cases are cited involving plasma digoxin and digitoxin determination.

Acute Kidney Injury↗