Brachial venous pressure measurement for diagnosis of pulmonary embolism.

Background: Imaging methods for diagnosis of pulmonary embolism (PE) are not available at small medical or rural centres as well as during night time. Herein, we evaluated the diagnostic value of brachial venous pressure measurement in the diagnosis of PE in patients with deep vein thrombosis.

Materials And Methods: One-hundred and fifty consecutive patients with deep vein thrombosis and suspected PE were prospectively evaluated by measuring brachial vein pressure by CW Doppler.

Angiomegaly and arterial aneurysms.

Angiomegaly is characterized by an alteration in the elastic component of arterial and venous vessels determining their elongation and tortuousness. This involves an increased risk of thromboembolism and aneurysmal degeneration in affected subjects, even if they have been asymptomatic for a long time. The aim of this study is to demonstrate the correlation between angiomegaly and aneurysmal disease.

eHealth in Antarctica: a model ready to be transferred to every-day life.

Antarctic expeditions are an important testing area for technology and procedures, such as telemedicine, with analogies for space and other extreme, isolated and remote environments. Telemedicine has also implications in reducing risks and costs related to accidents and health-care in general in Antarctica. During the last 14 years, since the very beginning of Italian Antarctic activities, we have tested many different technological solutions, and set up a link between one of the largest Italian hospitals, San Camillo in Rome, and the principal Italian Antarctic Base at Terra Nova Bay.

The role of the renal resistive index ratio in diagnosing obstruction and in the follow-up of children with unilateral hydronephrosis.

Objective: To assess the role of the renal resistive index ratio (RIR) in discriminating equivocal upper urinary tract dilatation in children, and thus in establishing the need for surgery, in comparison with traditional diagnostic tools.

Patients And Methods: The study comprised 40 children with unilateral hydronephrosis unrelated to vesico-ureteric reflux, posterior urethral valves, megaureter or a duplex system. In all patients one or more of the following 'indices of obstruction' were positive; an anteroposterior renal pelvic diameter of >20 mm, a half-time diuretic 'washout' (T/2) of > 20 min, a separate renal function of < 40%, and symptoms of obstruction (pain, sepsis).

Association between Takayasu's arteritis and Crohn's disease in two young women: case reports.

Among 34 patients under observation, two young women, aged 23 and 24, developed Takayasu's disease (Takayasu's arteritis) associated with Crohn's disease. The typical vascular symptoms of Takayasu's arteritis developed late during a quiescent phase of Crohn's disease. We discuss the usefulness of diagnostic methods, particularly the contribution of duplex Doppler.

[Epidemiology and clinical framework of the ischemic pathology of the lower limbs].

The atherosclerotic disease is a very important problem for the health in the advanced countries. The Rose's questionnaire was utilised for diagnosing the intermittent claudication but the current diagnostic method is the ankle-arm blood pressure ratio (Winsor's index). The incidence of intermittent claudication is 0.

Angiomegaly.

The authors report a clinical and ultrastructural study on a group of patients with angiomegaly, a vascular disorder characterized by elongated and distended blood vessels affecting the arterial (arteriomegaly) and/or venous system (venomegaly). The arterial group, drawn from a large arteriographic series, focuses on a comparison between atherosclerotic arteriopathy and arteriomegaly. The venous group, drawn from a large ultrasound series of vein disorders, is made up of patients with venomegaly.

Successful management with interferon alpha-2a after prednisone therapy failure in an infant with a giant cavernous hemangioma.

A giant cavernous hemangioma of the left arm with severe thrombocytopenia and consumptive coagulopathy was observed in a neonate. Initial treatment with prednisone, platelet transfusions, and clotting replacement failed to control the bleedings. The child was then treated with daily subcutaneous infusions of interferon alpha-2a.

[Arteriomegaly in the aorto-iliac-femoral area with or without associated aneurysm].

The authors present a group of 199 patients with arteriomegaly, an affection characterized by elongated and distended blood vessels of the arterial system, with or without accompanying aneurysms. Our study on this group of patients, drawn from a large arteriographic series of peripheral abdominal and lower limb arterial disorders, focuses on a comparison between atherosclerotic arteriopathy and arteriomegaly. Small tissue blocks were taken from the arterial wall of patients operated on for megadolichoarteries.

The syndrome of the "coup de fouet". Is it always a benign disease?

Background: The "coup de fouet" syndrome is an uncommon condition characterized by a spontaneous intramuscular venous hemorrhage of the calf, sometimes accompanied by a deep thrombosis of the leg.

Objective: The purpose of this work is to verify the real incidence of the thrombotic complications, making use of the most recent noninvasive diagnostic instruments, such as the duplex scanner and color Doppler.

Methods: From January 1992 to December 1993, we examined 24 subjects (average age, 38.

[Deep venous thrombosis and the prevention of a pulmonary embolism with temporary caval filters: the experience in 2 pediatric cases].

Deep venous thrombosis with pulmonary embolism is considered rare in pediatric population, but a literature review points out this disease more frequent than would be expected in children. The low incidence and the poor consideration of this occurrence in pediatric age group, cause the thromboembolic disease with pulmonary involvement an often missed diagnosis. The illness is usually related to intravenous catheters, surgery, trauma, sepsis, prolonged immobilization, neoplasia, drugs, some congenital or acquired diseases.

A contribution to the morphology of tortuosity of arteries, aneurysms and arteriomegaly.

Using the electron microscope, the authors examined the structure of the wall in a case of arteriomegaly of the inferior mesenteric artery in man. Structural changes concerned the elastic material showing signs of degeneration. Based on a comparison with literary findings, the authors conclude that tortuosity of the arteries, aneurysms and arteriomegaly are caused by congenital, age-dependent and pathological changes in the elastic material in the vessel wall.

Venous wall ultrastructure in generalized venomegaly.

The ultrastructure of the v. colica sinistra in a case of generalized vasomegaly in man was examined. Elastic material was found in three forms: as a lightly osmiophil amorphous material bordering on myocytes, as a highly osmiophil elastic membrane, and as highly osmiophil slim elastic fibres of different orientation in the tunica media and adventitia.

[Arteriectasis: a forgotten chapter].

In 1942, Leriche described the first "dolichomégaartères" (or "arteriomegaly" according to the definition subsequently proposed by Anglo-Saxon researchers). We detected 199 cases of arteriomegaly (16.29% of cases examined) during a review of 1,221 translumbar arteriographies of the lower limbs performed from 1980 to 1985 in the vascular radiology department of our hospital.

[Hemorheologic changes in patients with obliterative arteriopathy of the leg before and after muscle exercise tests].

Blood and plasma viscosity, erythrocyte filtrability and blood gas analysis were determined in 25 subjects with arteriosclerosis obliterans of the lower limbs before and after a muscle exercise test. Thirty-six shear rates between 0 and 230 s1 were studied to obtain viscosity curves, and regression analysis was performed for each curve. Mean viscosity curves for pathologic and control populations were plotted.

Results of clinical, laboratory and haemorheological investigations of the use of pentoxifylline in high doses.

A study was carried out in 127 patients (94 males and 33 females) presenting with arteriosclerosis (88 patients) or diabetic vasculopathy (39 patients) in different stages of severity (Fontaine) to assess the effectiveness and tolerance of treatment with high doses of pentoxifylline. Patients received a daily dosage of 2200 mg, given as 800 mg orally and 300 mg by intravenous infusion in saline twice daily, for a mean period of 15.8 days.

[Buerger's disease: etiologic role of the rickettsiae?].

Specific seroagglutination tests were performed in 70 patients with Buerger's disease to detect possible antibodies to rickettsia, the test being repeated in 8 cases after activation by doxycycline administration over 10 days. In 21 patients a Weil-Felix test was also carried out. Tests were assessed as positive in 44 cases (62.

Doppler ultrasonic diagnosis of dissecting aneurysms of the aortic and great vessels.

The reliability of the method and the simplicity of the execution of the Doppler examination allowed us to use it as a diagnostic help in the dissecting aneurysms of the aorta and in the hiatrogenetic dissections of the great vessels. The findings carried out are peculiar from the point of view "acoustic" and from the point of view "morphologic" and in part they depend on the type of the vascular dissection.

Instrumental evaluation of the venous circulation in the arteriopathic subjects.

In peripheric arteriopathies, alterations occur to the venous system with a particular swelling of the veins of the foot-top, in the subjects (sclerotic or diabetic) at the 2nd and 3rd Fontaine stage, which gradually decreases until the collapse in the most advanced levels of the arterious affection (4th stage). In order to verify all that, we examined 40 artheriopathic subjects at the different Fontaine stages through a c.w.

[Measuring venous pressure with the Doppler technic: standardization of the method].

Using the Doppler, we have studied the venous pressure, with the patients standing, of 6,172 legs. In a normal subject, the index of average pressure is 59 mmHg in the posterior tibial vein, and 58 mmHg in the long saphenous vein. Where there are varicose veins, the average pressure is 90 and 96 mmHg in the deep veins and in the superficial veins.