Considerations on pulsoplethysmographic changes in fingers due to iontophoresis with methacholine in subjects with Raynaud's phenomenon.

This paper presents a study of plethysmographic changes induced by methacholine (a derivative of acetylcholine) administered via iontophoresis in a population of 41 young women with apparently primary Raynaud's disease. All patients presented with a very clear statistically significant sphygmic increment, obviously connected with the vasodilatation caused by methacholine. Moreover, in nearly half of the 23 cases whose reaction to passive postural variations was successively examined by plethysmography, the district circulatory response was characterised by persistent neurogenous vasoconstriction due to methacholine or by inadequate vasomotor EDRF mediated modulation.

[Occupational vascular acrosyndromes. Considerations on plethysmographic changes in the fingers resulting from postural variations of the arms: do they have diagnostic relevance or just physiopathologic significance?].

334 subjects all with anamnesis indicating a vascular acrosyndrome (mostly due to their working conditions) were studied using the pulsoplethysmographic method to evaluate whether a relationship exists between the absence of increases to physiological acral posture and the presence of Raynaud's disease successively induced by Cold Test. The results obtained showed marked correlation (which for some of the subgroups examined was also statistically significant) between the lack of postural regolation and abnormal or frankly phatological plethysmographic findings following the Cold Test. The results appeared to be of some relevance in the physiopathologic interpretation of vascular acrosyndromes.

[Occupational exposure to vibration: Raynaud's phenomenon and the vascular response to methacholine iontophoresis].

A homogeneous group of 34 subjects exposed to occupational vibratory stress were studied to determine their vasodilatory response to methacoline. The methacoline was administered by iontophoresis. Methacoline is an acetylcholine derivate with the same pharmacological properties of acetylcholine.

[Aberrant papillary muscle causes wall motion alterations: diagnostic implications].

We report a case of 77 year old man who never complained cardiac symptoms, with progress septal myocardial infarction diagnosed by electrocardiographic signs and akinesia of the septum-apical segment, detected by echocardiography. He underwent a new echocardiographic examination that pointed out an aberrant papillary muscle in the left ventricle which base (19 mm) was situated on the middle of the anterior-septum and apex connected with the apical portion of the lateral wall, inducing a dissinergic movement of the septum-apical segment as for the adjacent wall segments and with a reduced sistolic thickening. An exercise myocardial perfusion scintigraphy (Tl 201) detected no reversible or irreversible uptake defects, continuous ecg monitoring and an exercise test did not show any ischemic event.

[Echocardiographic assessment of alcohol consumers in different clinical stages].

In relation to the importance of cardiac damage in alcohol drinkers this study aims to check the modifications of some cardiac sonographic parameters in drinkers examined at different stages of alcohol intoxication. Seventy-seven male subjects (43 +/- 9 years old) were divided into 3 groups in relation to the biohumoral alterations used for the diagnosis of chronic alcoholism (increase of GGT and MGV). EF, interventricular septum hypertrophy, LVEdD and the presence of left ventricular diastolic failure were considered.

[The diagnosis of occupational hand-arm syndromes. 2. The quantification of the plethysmographic changes due to the cold test].

The diagnostic utility of digital volumetric pulse plethysmography with the cold test in well known for the study of subjects vibrations exposed and symptomatic for acrosyndrome. In this study the authors show how to perform this test and how to analyse the results quantitatively (in particular the time-course of the vascular modifications during cold test) to improve the clinical interpretation and to allow a comparison during the years. The parameters studied are: the morphologic pattern of each wave; the entity, duration and the regression pattern of the modifications after cold test; the existence of hemorrheologic predisposing conditions to vasospasm.

[The diagnosis of occupational hand-arm syndromes. 1. The state of the art].

Alterations of the microcirculation are, at our latitudes, the most common distal manifestations of the hand-arm syndrome, and of a number of other work-related diseases. Diagnostic investigations aimed at providing documentary evidence for microvascular damage or disfunction are, therefore, of particular importance. This paper discusses the currently available diagnostic approaches for professional acrosyndromes.

[Early ECG changes after experimental focal cerebral ischemia. A pathogenetic hypothesis of the brain-heart syndrome].

Primary CVT alterations and arrhythmias, occurring one hour after embolization were detected in several experiments about focal cerebral ischaemia in rabbits. 62 animals were fed on a standard diet and 15 on an atherogenic diet. Primary CVT alterations and arrhythmias occurred in 4 rabbits fed on a standard diet and in 6 rabbits fed on an atherogenic diet.

Blood hypercoagulability secondary to experimental cerebral ischemia in the rabbit: influence of a hyperdyslipemia induced by an atherogenic diet.

Within the framework of a research carried out at the Neurological Institute of Pavia on experimental cerebral ischemia some biohumoral determinations were done on two groups of rabbits: one kept on a standard diet and the other on an atherogenic diet to induce dyslipemia. The aim was to find out whether induced ischemia produces an activation of the hemocoagulation processes and whether hyperdyslipemia constitutes an aggravating factor. In the animals on a standard diet there was a statistically significant increase in factor X A and a nonsignificant increase in parameter (r + k) on TEG (thromboelastogram) and of factor VIII C after embolization.

The brain-heart syndrome: remarks on early ecgraphic changes following focal cerebral ischemia in healthy and in experimentally hyperdyslipidemic rabbits.

Early cardiac effects of focal cerebral ischemia in two groups of rabbit, one of which made hyperdyslipidemic with an atherogenic diet, were detected in several experiments. In the group of 62 animals fed on a standard diet, primary CVT alterations and arrhythmias occurred in 4 rabbits (6.4%), in the group of 15 animals fed on an atherogenic diet the same cardiac alterations occurred in 6 rabbits (40%).

EEG changes and platelet aggregation in experimental cerebral focal ischemia in rabbits.

Nine white New Zealand rabbits were submitted to internal carotid embolization with microspheres which caused a histologically verified focal cerebral ischemia. Six animals were sham-operated. EEG, QEEG, ECG, blood pressure, rectal temperature and platelet aggregation were monitored in basal conditions and one hour after ischemia.

[Occupational syndromes of the extremities. The role of endothelin in the cold-test vasospasm: a pathogenetic hypothesis].

Unlabelled: In 34 subjects (29 subjects vibrations exposed and 5 controls), the variations of seric levels of endothelin (Et) after Cold Test were investigated, while vasomotor modifications were monitored and recorded by forefinger volumetric pulsoplethismography. Blood sampling for Et dosage (from dorsal vein of the hand) was done in 17 subjects after 2' Cold Test and in 17 subjects after 5' Cold Test.

Results: 1) Et levels are always increased after Cold Test but level increase is statistically significant only after 5' Cold Test.

[Angiopathy caused by vibrating tools: cold test and prostaglandin balance].

A study was made on a group of workers occupationally exposed to tools producing medium-to-low frequency vibrations, and on a comparable control group. The subjects underwent a plethysmographic examination with the cold test, which revealed a greater number of sphygmic alterations in the exposed group; at the same time spontaneous platelet aggregation, blood levels of 6-K-PGF-1 alpha and TXB2 and urinary levels of BTGU were determined in basal conditions and after the cold test. Except for the slight, and not statistically significant, increase in TXB2, the results did not reveal any alterations in the constituents of the prostaglandin balance after the cold test.

[Multicenter study of the effectiveness and tolerance of clotiazepam in cardiology].

In a phase IV study with clotiazepam 9 cardiologists were involved to treat 86 patients (52 female, 32 male, mean age 51 years) effected by cardiovascular diseases and anxiety. The dosage was 5-10 mg TID, and the treatment lasted for 3 weeks. Variations of the dosage were requested in 21% of patients and generally at the 2nd week of treatment.

[Type A behavior and cardiovascular reactivity. Preliminary findings].

In view of reports of a connection between ischaemic cardiopathies and "A" type behaviour, the response of certain cardiocirculatory parameters to given physical stimuli was investigated in a group of people doing high stress work. The data did in fact reveal a tendency to more pronounced cardiovascular reactivity in the A group, a difference that was statistically significant in the cold pressor and cold tests. The possible links between enhanced vasomotor response and increased risk of coronary heart disease are pointed out with emphasis on recent hypotheses about the possible pathogenic role of enhanced 5-OH-tryptamine release and particular alterations in the alpha/beta adrenergic receptor balance.

[Spontaneous platelet aggregation after experimental focal ischemia in the rabbit. "Sensitivity", "specificity" and value of the test used].

Within the framework of an investigation at present under way at the Neurological Clinic of Pavia on experimental focal ischaemia, the peculiarities of platelet aggregation observed, have led to a more accurate assessment of both the phenomenon itself and the validity of the method used. In a group of 30 rabbits (17 of them submitted to embolization by means of microspheres introduced into the carotid and 13 used as controls), biohumoral electrical and histological parameters were examined. The spontaneous platelet aggregation test proved significantly related to the extent of changes taking place, as measured by PDS levels and QEEG "delta" activity (respectively, P less than 0.

[Vibration-induced angiopathy: significance of urinary beta-thromboglobulin increase after cold test].

Twenty subjects working with tools generating 100-400 Hz vibrations were submitted to volumetric pulse-plethysmography with cold Test (C.T.) and to the measurement of BTGU, a thromboxane urinary catabolite.

Quantified EEG, somatosensory evoked potentials and cerebral blood flow in monitoring experimental brain ischemia.

Cerebral ischemic lesions were induced in rabbits through internal carotid artery embolization by means of microspheres. Different models of stroke ranging from single focal cortical lesion to massive bilateral brain edema were reproduced and monitored up to the 24th hour by electroencephalogram (EEG and QEEG), somatosensory evoked potentials (SEPs), cerebral blood flow (CBF), platelet aggregation. The site and extent of the lesions were verified by histological examinations.

[Cardiocirculatory findings in a group of workers exposed to nitro derivatives. A pathogenetic hypothesis of withdrawal hazard].

After briefly recalling the professional pathology characteristics of workers exposed to nitro derivatives and the perplexities surrounding the actual pathogenetic mechanism of the "Withdrawal hazard", the AA report the results of an investigation carried out among the workers of a dynamite producing plant. In the study, the NG and EGDN environmental levels were checked and the workers were submitted to ECG tracings, ECG D according to Holter, and monitoring of postural pressure changes both during exposure to the substances and during time-outs. The results obtained showed that the concentrations found in the plant were practically within the recommended TLV values, with no pathological modifications of the parameters examined.

[Changes in spontaneous platelet aggregation induced by the ambient temperature].

The diagnostic meaning of the functional platelets modifications (particularly those of spontaneous platelet aggregation = P.A.) in cardiovascular pathology has been recalled.

[Platelet hyperaggregation premonitory of myocardial infarct? A clinical case report].

In a patient, treated with antiplatelet drugs because of two previous TIA episodes, an occasional control in apparent welfare, just 4 hours before the onset an IMA, showed a sudden considerable increase of spontaneous aggregation. Two weeks after the infarction all haematological findings, including aggregation, were back to normal. Platelet adhesiveness, evaluated for the first time, was nevertheless considerably increased.

[Platelet changes and occupational carbon disulfide poisoning. I. Variations of platelet adhesiveness].

Platelet adhesiveness was studied in 83 workers exposed to CS2 and 47 controls. Results show an increase of platelet adhesiveness statistically significant in workers in comparison with controls and in workers with high exposure vs. workers with mild exposure.