Evaluation of the Surgical Treatment of Patients over 90 Years Old with Hip Fractures and Their Morbidity and Mortality.

 Hip fractures in older adults have the highest impact on the patient's health. These injuries result in many complications, reducing functional capability, quality of life, and life expectancy. This study aimed to provide more epidemiological data on the outcomes of these fractures in nonagenarians from a large city treated at a tertiary hospital.

What is the impact of local control in Ewing sarcoma: analysis of the first Brazilian collaborative study group - EWING1.

Background: Relapse in localized Ewing sarcoma patients has been a matter of concern regarding poor prognosis. Therefore, we investigated the impact of local control modality (surgery, surgery plus radiotherapy, and radiotherapy) on clinical outcomes such as survival and recurrence in patients with non-metastatic Ewing sarcoma treated on the first Brazilian Collaborative Group Trial of the Ewing Family of Tumors (EWING1).

Methods: Seventy-three patients with localized Ewing sarcoma of bone aged < 30 years were included.

Pindborg tumor in the distal femur.

To describe a case of possible diagnosis of Pindborg tumor on the distal femur. A 32-years-old female patient, a native of Bolivia, resident in Brazil, arrived to this service for tumor research in the right femur. After biopsies and resection of the lesion, the case was referred to analysis and consultancy in the United States.

[Echocardiographic alterations suggestive of pulmonary hypertension in the Italian ultrasonography laboratories. Epidemiological data from the INCIPIT study (INCidence of Pulmonary Hypertension in Italian ulTrasonography laboratories)].

Background: Pulmonary hypertension is characterized by an increase in pulmonary vascular resistance and premature death. Echocardiography is useful in the screening of patients with suspected pulmonary hypertension by estimation of the systolic regurgitant tricuspid flow velocity according to the simplified Bernoulli equation. On this basis, the survey INCIPIT was created aiming at evaluating the frequency of suspected pulmonary hypertension among Italian patients.

[Isolated congenital coronary fistula in adult population: discussion a clinical case and review of current literature].

We describe a case of a 56 year-old man with a history of chest pain. No evidence of myocardial ischemia or arrhytmias was observed. Echocardiographic examination in Emergency Department evidenced aortic root dilatation.

[Prevalence of aneurysm of the interatrial septum in the general population and in patients with a recent episode of cryptogenetic ischemic stroke: a tissue harmonic imaging transthoracic echocardiography study in 5.631 patients].

Cerebral ischemia is among the principal causes of mortality and morbidity in industrialized countries being responsible of 10-12% of all deaths and of an elevated number of permanent disability. The cardio-embolic forms may be responsible of the 30-35% of cerebrovascular acute syndrome, nevertheless in a significant percentage of cases, especially among young people, cerebral ischemic episodes are not induced by these cardio-embolic forms: these cases are defined as cryptogenetic stroke/TIA. In these patients cardiac abnormalities represented by an aneurysm of the interatrial septum (ASA) and by a patent foramen ovale (PFO) have been frequently observed.

[Echocardiography in the diagnostic and prognostic evaluation of thromboembolic pulmonary hypertension].

Pulmonary arterial hypertension frequently develops after a thromboembolic pulmonary event. The difference in degree of pulmonary artery pressure depends mainly on the size and location of the pulmonary embolus and presence of pre-existing cardiopulmonary diseases. Right ventricle (RV) afterloading from an acute obstruction of the pulmonary vasculature causes an increase of RV volume and dysfunction of right heart cavities, the varying levels of severity of which explain the multiple clinical expression of pulmonary embolism (PE).

[Cardiovascular disease in early collagen diseases].

Aim: The purpose of this paper was to verify whether there is any sign of involvement of the cardiovascular system in the early stages of collagen diseases.

Methods: Seventeen patients (10 female and 7 male, average age 41.35 +/- 9.

Importance of troponin T for the risk stratification of normotensive patients with pulmonary embolism. A prospective, cohort study with a three-month follow-up.

To determine the prognostic importance of troponin T in normotensive patients with pulmonary embolism, we investigated the rate of adverse events in patients with normal and elevated troponin values, during the hospital period and at three months of follow-up. We also calculated the proportion of patients with abnormal troponin values and adverse outcomes who could have been treated with more aggressive therapy according to published criteria.

[The diastolic function: an echocardiographic study and its clinical meaning].

Many patients with manifestations and/or symptoms of heart failure show a normal or only slight depressed systolic function of the left ventricle. The origin of these symptoms is attributed to anomalies of the diastolic function and the echocardiography has became an important technique for a non-invasive investigation of such anomalies. The valuation of the diastolic function, mainly in patients with a left ventricle dysfunction, is usually performed by means of the analysis of the transmitral flow with pulsed Doppler, integrating as necessary the basal information with actions of preload variations.

Diagnostic utility of echocardiography in patients with suspected pulmonary embolism.

The aim of this study was to investigate the clinical utility of echocardiography in the diagnosis of pulmonary embolism (PE). For this, we enrolled 162 patients with suspected PE in a prospective study. We evaluated the sensitivity and specificity of right ventricular dilatation, the Doppler evidence of pulmonary hypertension, and their possible associations.

[Combined diagnostic approach to venous thromboembolism with multidetector computed tomography].

Background: Multidetector computed tomography (CT) improves scan length and spatial resolution. The availability of a single test that allows a comprehensive evaluation of the chest and pulmonary arteries, of the deep venous system of the abdomen and legs and the hemodynamic impact of pulmonary emboli on the right heart could be a new and effective strategy for patients with venous thromboembolic disease. We assess a combined study protocol on venous thromboembolic disease by multidetector CT.

[Prevalence of structural abnormalities of the atrial septum and their association with recent ischemic stroke or transient ischemic attack: echocardiographic evaluation in 18631 patients].

Background: Ischemic stroke is one of the most frequent causes of morbidity and mortality in industrialized countries. In more than 40% of cases the cause of the ischemic event is not recognized, especially in young patients in whom, moreover, the presence of a structural abnormality of atrial septal aneurysm (ASA) and patent foramen ovale (PFO) is more frequently reported. The prevalence of this two minor atrial septal defects is strongly related to the study population (unselected patients and patients with recent ischemic stroke/transient ischemic attack-TIA) and to the diagnostic tool employed (transthoracic echocardiography--TTE or transesophageal echocardiography--TEE).

[Diagnosis of heart failure in general medicine: role of cerebral natriuretic peptide. Results of a pilot study of a population sample from Calabria].

Background: The aim of this study was to evaluate the usefulness of brain natriuretic peptide (BNP) in diagnosing congestive heart failure (CHF), in an unselected population.

Methods: Eighty-three patients (47 men, 36 women, mean age 70 +/- 10 years) were referred to our hospital ambulatory from their general practitioners, with a diagnosis of CHF.

Results: Clinical-instrumental evaluation confirmed diagnosis in 45 patients (54%) (group A), and excluded it in the remaining 38 (46%) (group B).

[Thrombolytic therapy during cardiopulmonary resuscitation for acute massive pulmonary embolism. A case report].

Massive pulmonary embolism associated with cardiac arrest has an extremely high mortality in spite of cardiopulmonary resuscitation maneuvers. An early diagnosis of pulmonary embolism as cause of cardiac arrest and a rapid specific therapy able to obtain a restoration of pulmonary flow can improve the prognosis. The authors report a case of cardiac arrest for massive pulmonary embolism promptly diagnosed by echocardiography and treated by thrombolytic therapy with an initial favourable outcome.

[The usefulness of the association of clinical probability, rapid plasma measurement of D-dimer, compression echography of the lower limbs and echocardiography in the diagnosis of acute pulmonary embolism].

Background: The aim of this study was to investigate the diagnostic utility of clinical probability, rapid plasma D-dimer assay, compression ultrasonography (CUS) and transthoracic echocardiography (TTE) in patients with suspected pulmonary embolism.

Methods: One hundred forty consecutive outpatients with suspected pulmonary embolism were enrolled in a prospective trial. We evaluated sensitivity, specificity, positive and negative predictive value of a combination of clinical probability, D-dimer, CUS and TTE using perfusion lung scan and pulmonary angiography as a combined gold standard for determining the presence or absence of pulmonary embolism.

[A health education program for the prevention of heart diseases carried out in a population in Calabria].

Background: To evaluate the behaviour and knowledge of students on cardiovascular risk factors and to programme a campaign for the prevention of cardiovascular diseases.

Methods: All students attending the last year of the secondary school of this province answered a questionnaire. An educational campaign followed the analysis of the questionnaire.

Successful treatment of right heart thromboemboli with IV recombinant tissue-type plasminogen activator during continuous echocardiographic monitoring: a case series report.

Background And Study Objective: Echocardiographic detection of right heart thromboemboli (RHTE) during pulmonary embolism (PE) shows an uncommon but life-threatening event. The treatment of this condition is not well established. The aim of our study is to evaluate the efficacy and safety of recombinant tissue-type plasminogen activator (rt-PA) in treating RHTE.

[Results of a survey on knowledge and habits among hospital doctors concerning primary prevention of venous thromboembolism].

Background: The purpose of this study was to analyse the attitudes towards and knowledge of primary prevention of venous thromboembolism (VTE) among hospital doctors in Calabria.

Methods: The survey was based on theoretical knowledge and practical management of hortopedics, surgeons, gynecologists and internists working in 14 hospitals.

Results: Out of a total of 340 physicians contacted, 154 (45%) agreed to take part in the survey.

[The prevalence and clinical characteristics of heart failure in a population sample of Calabria].

Two-hundred and fourteen patients with congestive heart failure were identified over a six-month period in the general practice of 29 GPs covering an adult population of 29,959 subjects residing in the region of Calabria, in southern Italy, with an overall prevalence of 7 per 1000. Males represented 52% of the cases and females 48%, with a median age of 75 years. On average, the condition was first diagnosed 41 months before the present examination.

[Acute disfunction from thrombosis of a prosthetic mitral valve: thrombolysis with rt-PA in the clinical emergency phase].

Prosthetic valve thrombosis can determine different degrees of valvular insufficiency or obstruction, with a potentially fatal course. The current literature has not established whether the best treatment is thrombolysis or surgery (thrombectomy or valvular replacement). However, both treatments expose the patient to the risk of serious sequelae or death.

[Long-term captopril therapy in asymptomatic patients with severe chronic aortic insufficiency].

Background: Clinical history of patients with severe chronic aortic regurgitation is characterized by a long period without any symptom, although the left ventricle enlarges progressively. The administration of oral vasodilators could reduce ventricular enlargement or its progression, delaying the development of myocardial dysfunction and/or the need for valvular surgery.

Objectives: To verify the efficacy of long-term captopril therapy to reduce left ventricular mass and dimensions in patients with severe chronic aortic regurgitation.

[The role of 2D-doppler electrocardiography in the early diagnosis of massive acute pulmonary embolism and therapeutic monitoring].

Early diagnosis is important for the prognosis of patients affected with pulmonary embolisms. The mortality rate ranges from 30% in untreated cases to 10% in cases getting early treatment. In this context, it is essential to obtain a correct diagnosis in order to start the best treatment for each patient.