Determination of S-phenylmercapturic acid in urine as an indicator of exposure to benzene.

S-phenylmercapturic acid (S-PMA) was measured in urine from 145 subjects exposed to low benzene concentrations in the air (C(I), benzene). The 8-h, time-weighted exposure intensity of individual workers was monitored by means of charcoal tubes and subsequent gas-chromatographic analysis after desorption with CS2. S-PMA excretion level in urine was determined by high-performance liquid chromatography with fluorescence detection.

Patient-ventilator interaction and inspiratory effort during pressure support ventilation in patients with different pathologies.

The aim of this study was to evaluate whether pressure support ventilation (PSV) requires different diaphragmatic efforts and patient-ventilator matching, according to the underlying disease. Four groups of patients requiring PSV were studied: Group A, recovering from an episode of acute respiratory failure due to adult respiratory distress syndrome (ARDS); Group B, with postsurgical complications; and two subsets of chronic obstructive pulmonary disease (COPD) patients, with "normal" static compliance of the respiratory system (Cst,rs) (Group C) or elevated Cst,rs (Group D). Ventilatory pattern, transdiaphragmatic pressure (Pdi), the pressure-time product of the diaphragm (PTPdi), static (PEEPi,stat) and dynamic intrinsic positive end-expiratory pressure (PEEPi,dyn), Cst,rs and resistance of the total respiratory system (Rrs) were recorded.

Echo-Doppler evaluation of left ventricular impairment in chronic cor pulmonale.

The effects of acute right ventricular (RV) pressure and volume overloads on left ventricular (LV) filling are well known, while the significance of chronic RV pressure overload on LV function has been less studied. To evaluate the LV impairment, 30 patients with chronic cor pulmonale and pulmonary arterial hypertension secondary to chronic obstructive lung diseases (COLDs) were studied. All patients underwent respiratory tests and arterial blood gas assessment.

[Experience of an intermediate respiratory intensive therapy in the treatment of prolonged weaning from mechanical ventilation].

109 patients who suffered from an episode of acute respiratory failure, necessitated mechanical ventilation (MV) in a general Intensive Care Unit (ICU) and admitted to our Respiratory Intermediate Intensive Unit (RIIU), were retrospectively evaluated for outcome and weaning success. The patients, 69 +/- 9 years old, presented the following diseases: COLD (70%), cardiovascular (15%) and neuromuscular (15%). A relapse of underlying disease (62%), pneumonia (20%), thoraco-muscular pump failure (15%) and pulmonary embolism (3%) were the relapsing causes needing the ICU admission.

Cardiac and pleuropulmonary AL amyloid imaging with technetium-99m labelled aprotinin.

Antiproteases are known to be present in amyloid deposits. We evaluated the possibility of using an anti-serine protease (aprotinin) labelled with technetium-99m (TcA), usually employed as a cortical renal tracer, for the imaging of amyloid deposits. Because of the known high uptake of TcA by the kidneys, we limited our analysis to extra-abdominal amyloid localizations.

Elevated static compliance of the total respiratory system: early predictor of weaning unsuccess in severed COPD patients mechanically ventilated.

Objective: To assess in a group of COPD patients mechanically ventilated for an episode of acute respiratory failure the respiratory mechanics with a simple and non invasive method at the bedside in order to evaluate if these parameters may be predictive of weaning failure or success.

Design: A prospective study.

Setting: Intensive care and intermediate intensive care units.

Sputum induction: a method to assess airway inflammation in asthma.

In recent studies, sputum cell counts have been used to examine the cell and molecular markers of airway inflammation. In this paper, we describe three different technical methods of analysing sputum samples: the first using smears, the second using cytocentrifugation after selection of a mucous plug, and the third using cytocentrifugation to analyse the entire sputum sample. These last two techniques have been used in a pilot study to compare the differential cell counts in sputum and bronchoalveolar lavage (BAL).

[Abdominal propriospinal myoclonus of unknown etiology].

We report the case of a 77-year-old woman with a two-year history of abdominal non rhythmic myoclonus. Neurological examination was normal. Bursts of myoclonic activity were recorded from the rectus abdominis muscle and then from the external oblique muscle after a delay of 40 ms.

[Medium- and long-term effects of various treatment schedules with nasal S-calcitonin spray].

188 patients with high-turnover type post-menopausal osteoporosis were treated for 18 months with 4 different treatment regimens of S-calcitonin nasal spray. For a total of 18 months group 1 was given 100 IU/day, continuously; group 2, 100 IU/day daily for 30 days every other month ("ciclically"); group 3, 200 IU/day continuously, and group 4, 200 IU/day, ciclically. To monitor the effects of treatment, MOC of L2-L4, as well as serum osteocalcin and urinary hydroxyproline: creatinine levels were measured, on initiation of therapy, then at 9, 12 and 18 months, and finally at 6 and 12 months after completion of therapy.

Ventilation techniques: invasive versus noninvasive.

Conventional medical treatment of COPD patients with acute respiratory failure (ARF) was associated with an overall mortality ranging 12-29%. When conservative treatment fails, ARF is usually managed by means of mechanical ventilation (MV) via an endotracheal tube (ET) or tracheostomy. Mortality of COPD patients with ARF treated with invasive MV ranged 21-54%.

Location and architectural structure of IICU.

When an Intermediate Intensive Care Unit (IICU) is planned, three groups of professionals are usually involved: the managers of the hospital, the architects and the staff. Although several aspects and problems related with the building of IICUs are considered in the specialized literature, lack of communication and discussion of the appropriate issues at the appropriate time is the origin of several errors during the planning and building of IICUs. Standards of IICU for respiratory departments have been proposed by the Working Group "Rehabilitation and Intensive Care" of the Italian Hospital Pneumologist Society.

Electromotive administration of guanethidine for treatment of reflex sympathetic dystrophy: a pilot study in eight patients.

Persistent neuropathic pain is associated with diagnostic and therapeutic challenges that may be very difficult to resolve. This report describes eight patients with incapacitating, posttraumatic neuropathic pain characteristic of reflex sympathetic dystrophy (RSD) who were treated by electromotive administration of guanethidine into affected areas of skin. Following 1-5 treatments, six patients experienced complete resolution of all superficial symptoms of hyperalgesia, pain, pallor, coolness, and sweating of the affected areas.

Non-invasive mechanical ventilation in the treatment of acute respiratory failure in chronic obstructive pulmonary disease.

Acute respiratory failure is usually managed by means of mechanical ventilation via an endotracheal tube or tracheostomy, when conservative treatment fails. Invasive mechanical ventilation is associated with several complications. The recent development of non-invasive methods of ventilation, has led to an attempt to avoid the complications of invasive mechanical ventilation during episodes of acute respiratory failure, ensuring at the same time a similar degree of efficacy.

Activation of the neck muscles from the ipsi- or contralateral hemisphere during voluntary head movements in humans. A reaction-time study.

Reaction times (RTs) of EMG onset of agonist right and left sternocleidomastoid (SCM) and splenius (SPL) muscles in response to acoustic (AC) or unilateral somatosensory (SS) stimulation were measured in normal subjects, during head rotation (to the right or to the left) and flexion. No significant difference was present in the AC-RT of SCM muscles of the two sides between rotations or flexion. The same was true for the SPL.

Physiologic evaluation of pressure support ventilation by nasal mask in patients with stable COPD.

We evaluated the physiologic effects of pressure support ventilation by nasal route (NPSV) in eight patients with severe stable COPD and chronic hypercapnia who were randomly submitted to 2-h sessions of NPSV both with a portable ventilator (Respironics BIPAP device) and with a standard ventilator (Bird 6400ST device) at an inspiratory airway pressure of 22 cm H2O. Two sessions with each ventilator were performed using an FIO2 of 0.21 in each patient on two consecutive days.

[Evaluation of several neuropsychological parameters in subjects occupationally exposed to anesthetics].

51 workers, occupationally exposed to anaesthetic gases and vapours (nitrous oxide, halothane, and isoflurane), were studied monitoring their environmental and biological exposure. Moreover, they were tested for visual reaction times and neurobehavioural batteries. There was no evidence of important neurotoxic effects nor of neurobehavioural problems with low concentrations of anaesthetics.

[Reflex sympathetic dystrophy following electric shock: description of a clinical case].

The acute effects of electrical injuries are well known. However, the occurrence and the mechanisms of the delayed sequelae are still unclear. The effects on peripheral nerves and the sympathetic system in particular are poorly documented.

Acute and chronic effects of nicardipine on rest and exercise haemodynamics in post-myocardial infarction patients with latent cardiac failure.

The acute and chronic haemodynamic effects of nicardipine were studied, at rest and during exercise, in 10 post-myocardial infarction patients with latent cardiac failure and no signs of residual myocardial ischaemia. Intravenous administration of nicardipine (5 mg over 10 min) was associated with a significant increase in cardiac index and significant reductions in mean pulmonary artery pressure, mean pulmonary wedge pressure, total pulmonary resistance and systemic vascular resistance under conditions of rest and peak exercise. After 3 weeks of oral treatment (20 mg three times daily) cardiac index did not change, but the improvements in mean pulmonary artery pressure, mean pulmonary wedge pressure and total pulmonary resistance were sustained at rest and during exercise, at the same workload attained prior to medication.

Silent ischaemia in post-myocardial infarction patients submitted to physical training.

Recently, more attention has been focused on the detection and treatment of silent myocardial ischaemia. Electrocardiographic signs of exercise-induced asymptomatic myocardial ischaemia are very common findings among survivors of acute myocardial infarction. From data of our population we found that silent exercise-induced ischaemia is present in 15-20% of all patients, and that about half of the patients with exercise-induced ST-segment depression were free of symptoms.

Toxicology and health impact of environmental exposure to boron. A review.

The presence of high concentrations of boron in community water supplies has been reported as a localized problem in certain areas of United States, USSR and Italy. In this paper, current information on sources, occurrence, pollution potential and toxicity of environmental boron is reviewed. In animals, chronic low-level boron exposure has been shown to cause reduced growth, cutaneous disorders and suppression of male reproductive system function.

Exercise tolerance in patients with and without ventricular aneurysm.

To assess the role of a left ventricular aneurysm (VA) in affecting cardiac pump function, 36 patients with an echo-proved postmyocardial infarction (MI) VA underwent maximal symptom limited exercise testing. A control group was formed of 36 patients with a previous MI without VA. The two groups were matched for age, sex, and site of MI.