Calcium antagonists in the therapy of acute myocardial infarction.

The theoretical background and experimental evidence of the use of calcium antagonists in the treatment of acute myocardial infarction are summarised. The main clinical trials that have studied the effects of the three different groups of these drugs in patients with myocardial necrosis are then reviewed. Finally, the conclusion is drawn that there is no proof of the efficacy of calcium blockers in the therapy of patients with acute myocardial infarction but that, in some subgroups of these subjects (Q-wave myocardial infarction with good left ventricular function, non Q-wave myocardial infarction), non-dihydropyridinic compounds should be effective, in particular in patients with contraindications to beta-adrenergic blockade.

[The results of large clinical trials comparing primary angioplasty and thrombolysis].

One of the main cardiological debate is about which one, between primary angioplasty (PTCA) and thrombolysis, is to prefer for the therapy of acute myocardial infarction. The data available in the literature do not show that one of these two therapeutical choices is definitely better than the other one. Since the main therapeutical goal in patients with acute myocardial infarction is the early and persisting recovery of the anterograde coronary flow, the best therapy for every patient is the one that can be performed more quickly and safely.

[Intrahepatic cholestasis].

The intrahepatic cholestasis is not an common syndrome, in particular way in people between 50 and 60 years of age. It is often unknown or confused, because of itching, with allergic or dermatologic diseases. The most frequent causes of intrahepatic cholestasis are primary sclerosing cholestasis, primary biliary cirrhosis and hepatic cirrhosis.

[Chronic viral hepatitis: diagnosis and treatment].

HBV and HCV cause most of chronic hepatitis; the HDV is a co-infectious virus and it rend the help of HBV to duplicate; HAV and HEV do not induce chronic hepatitis. Etiology is not the same, without apparent reasons, in all the world and the distinction between persistent chronic hepatitis and active idiopathic chronic hepatitis is meaningless, because one can shift in the other. Diagnosis is possible using serologic tests and by determination of the DNA of the HBV and RNA of the HCV.