Evaluation of extracranial carotid system with duplex scanner HR in hemiplegic patients.

The aim of this work is to study extracranial carotid lesions and their relation to some risk factors for atherosclerosis, in a large group of hemiplegic patients during rehabilitation treatment. The results indicate that in patients with stabilized ischemic stroke there is a high percentage of positive Duplex Scanner examination. However, the presence of negative patients with hemiplegia leads us, in this case, to look for a carotid lesion placed higher up. The high presence of bilateral atherosclerotic lesions also shows that atherosclerosis is not only a local process. The clinical event may be caused by the type of carotid lesion (as demonstrated by thrombosis or carotid lesions with superficial ulceration contralateral to the hemiplegia).

[Reproducibility of ergometric parameters at the ischemic threshold: study of 160 patients with effort coronary insufficiency]. / Riproducibilità dei parametri ergometrici rilevati alla soglia ischemica: studio su 160 pazienti con insufficienza coronarica da sforzo.

To assess the reproducibility of ergometric parameters at the ischemic threshold, 160 patients, with coronary artery disease and exercise-induced S-T segment depression (102 with previous AMI), were evaluated by means of two control exercise tests performed, in pharmacological wash-out, on different days within 48 hours. The mean values of work load (WL), heart rate (HR) and double product (DP) did not show any statistical difference between the two exercise tests at 0.1 mV S-T depression (ischemic threshold), recorded by a computer assisted electrocardiograph system (Marquette CASE); on the contrary blood pressure (BP) slightly, but significantly (p less than 0.05) decreased at the second test (173.9 +/- 27.2 vs 179.8 +/- 25.8). The variability of the DP values in each subject at 0.1 mV S-T depression, expressed as numerical (delta) and percentage (delta %) differences, exhibited normal distributions. The delta DP showed a mean +/- 1 SD of -157.5 +/- 3271.5 beats x mmHg/min and the delta % DP a mean of +/- 1 SD of 1.46 +/- 16.4%. The values within a standard deviation from the mean (from +3114 to -3429 when numerical differences and from +17.8 to -14.9 when percentage differences) were used for defining the reproducibility of the ischemic threshold. No correlation was found between the delta % DP and the percentage differences in work load at the ischemic threshold. So, DP being more strictly related to MVO2, appears more apt in defining the ischemic threshold reproducibility. A good correlation (r = 0.821) was found between delta DP and delta % DP.(ABSTRACT TRUNCATED AT 250 WORDS)