[A health education program for the prevention of heart diseases carried out in a population in Calabria]. / Un programma di educazione sanitaria per la prevenzione delle cardiopatie realizzato in un ambito di popolazione della 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. RESULTS: The analysis of 3675 questionnaires shows that almost all students were between 18 and 20; 16% of males (m) and 7.4% of females (f) were overweight; 1.5% and 0.4% respectively were obese; 88.8% of m and 44% of were doing physical activity; 32.4% of m and 26.8% of f were cigarette smokers. Knowledge about cardiovascular risk factors were poor. Development of the prevention campaign. In the school districts four seminars were organized to discuss about cardiovascular prevention with science teachers of the province, using audiovisual materials. The same teachers devote 4-6 hours to the same matters during school lessons. In the next months conferences destined to the population of the province will be organized. CONCLUSIONS: This program allows to promote health education in the whole population, through the students, with a low cost.

[Ventricular arrhythmias in the acute phase of myocardial infarct and in the postinfarct. A 1-year follow-up]. / Aritmie ventricolari nella fase acuta dell'infarto miocardico e nel post-infarto. Follow-up di un anno.

A total of 90 AMI patients (80 male, 10 female; mean age: 62 years, range: 36-70 yrs) who were admitted to the coronary care unit within six hours of the onset of symptoms were evaluated for the following: the incidence and variability of complex ventricular ectopic beats (classes Lown III-V) in the acute, subacute and chronic phases of myocardial infarction. The diagnostic utility of Holter monitoring and treadmill exercise testing was compared so as to reveal complex ventricular ectopic beats. The relation between complex ventricular ectopic beats and left ventricular dysfunction was determined using the echocardiographic technique (ejection fraction, fractional shortening). The hospital mortality rate was 6.6% (6/9 patients) while the post-hospital mortality rate was 3.5% (3/84 patients). The prevalence rate of complex ventricular ectopic beats detected by Holter monitoring was respectively: 85.5% (77/90 patients) in the acute phase, 8.5% (7/80) at the 72nd hour, 18.5% (15/80) in the pre-discharge phase. At 1, 3, 6 and 12 months the prevalence rate was respectively 35% (27/77 patients), 28.8% (22/77), 24.6 (19/77), 24.6% (19/77). A high variability in arrhythmic groups was found. Each group was composed of new arrhythmic patients and stable arrhythmic patients, in addition to a small number of patients who were arrhythmic in the preceding control but no arrhythmic in the following control. This specific analysis of various groups revealed that the pre-discharge phase is the period with the highest number of "stable arrhythmic" patients (4 Holter positive out of 5) compared to the 1st month (3 Holter positive out of 4) and the 3rd month (2 Holter positive out of 3).(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of diltiazem in supraventricular paroxysmal tachyarrhythmias]. / Effetti del diltiazem nelle tachiaritmie parossistiche sopraventricolari.

Diltiazem (0.3 mg/kg body weight intravenous in 2 minutes) was administered to 40 patients (24 males, 16 females, mean age 51.55 years) with paroxysmal supraventricular tachyarrhythmias: 7 patients with atrial fibrillation, 6 patients with atrial flutter, 25 patients with paroxysmal supraventricular tachycardia, 2 patients with uncommon atrioventricular reciprocating tachycardia. In patients with atrial fibrillation intravenous diltiazem produced a significant decrease of ventricular response (from 160 +/- 11 to 113.57 +/- 10.34--p less than 0.01). In patients with atrial flutter intravenous diltiazem produced variable effects: an increase in atrio-ventricular block (from 2:1 to 3:1 atrio-ventricular conduction (2 patients); conversion to sinus rhythm (1 patient); change to atrial fibrillation (1 patient); no appreciable change of the basic rhythm (2 patients). In paroxysmal supraventricular tachycardia patients conversion to sinus rhythm occurred in 20/22 patients (91%) treated with intravenous diltiazem (mean conversion time 4.69 minutes). In the 2 patients with uncommon atrioventricular nodal reciprocating tachycardia diltiazem increased P'-R and R-P' intervals without appreciable change of the basic rhythm. No serious side effects from drug administration were noted. Intravenous diltiazem appears to be as a highly effective medication in conversion or control of paroxysmal supraventricular tachyarrhythmias.

[Arterial hypertension caused by mediastinal paraganglioma. Description of a case and review of the literature]. / Ipertensione arteriosa da paraganglioma mediastinico. Descrizione di un caso e revisione della letteratura.

The Authors describe a case of artery hypertension caused by the secretion from the mediastinal paraganglioma and they emphasize the importance of correct diagnostic approach to patients with hypertension. This particular case is extremely rare, in literature, in fact, there are only 25 known cases of paraganglioma arising from the sympathetic trunk in the posterior mediastinum.

[Influence of sleep, wakefulness and some daily activities on ventricular ectopic activity in recent myocardial infarction (author's transl)]. / Influenza del ciclo sonno-veglia e di alcune attivita' giornaliere sull'attivita' ectopica ventricolare nell'infarto miocardico recente.

87 24-hour electrocardiographic monitoring sessions were conducted in 71 ambulatory patients (pts) in the early post-hospital phase after acute myocardial infarction. 29 (41%) had anterior, 42 (59%) inferoposterior myocardial infarction, 44 (62%) had angina or asymptomatic ischemia, 7 (10%) were in cardiac failure (II-III class NYHA). The occurrence of ventricular ectopic activity (VEA) during sleep hours was compared to the awake state; VEA during sexual and other activities of the awake state was studied. Excluding pts free of VEA during 24-hour monitoring the number of ventricular mature beats was lowered in 71% of sessions and augmented in 12% during sleep hours (p less than 0.001). Maximal grade of VEA was observed during wakefulness in 62% of session and in 9% during sleep (p less than 0.001); in 9% there was no difference, in 20% no VEA occurred. Total VEA, bi-tri-quadrigeminism and repetitive extrasystoles were significantly reduced during sleep: p less than 0.001, p less than 0.05 and p less than 0.01 respectively. This pattern was independent from site of infarction, presence of ischemia, cardiac failure (II-III class NYHA). A discrete correlation was observed between total VEA and heart rate; a poor correlation was seen between total VEA, multiform and repetitive extrasystoles. During wakefulness VEA was mainly related to physical exertion and emotional stress. Sleep and relax periods of the day showed VEA similar to sleeping hours of the night. Sexual activity did not significantly elicit more VEA than other activities of the awake state. Repetitive forms, observed in 8% of the population, were probably related to the rapid increase of sympathetic tone. The absence of repetitive VEA, potentially dangerous, during sleep hours (except the first) not due to antiarrhythmic drugs suggests to increase the dosage of these medications during the awake state in the majority of these pts.

[Prognostic and diagnostic value of the exercise test and early coronary anamnesis in patients with myocardial infarct studied in a median term follow-up]. / Valore prognostico e diagnostico della prova da sforzo e dell'anamnesi coronarica precoce in pazienti con infarto miocardico in un follow-up a medio termine.

We performed a maximal or symptom limited exercise stress test (ET) 58 +/- 20 days after acute myocardial infarction (AMI) and looked for the presence of angina (A) 4-5 weeks after AMI in 193 consecutive patients (pts.). The aim of the study was to research from ET and history of early A parameters able to predict further coronary events in the follow-up (FU): new onset of angina, reinfarction or cardiac death. The FU lasted 18.06 months. The drop-out was 7%; so, data was collected on 179 pts.; 95% of our population performed the ET without any therapy. 72 pts. (40%) had an anterior-lateral AMI (I group) and 107 (60%) had an inferior-posterior AMI (II group). Pts. with early A were 35% in the I group (GR) and 52% in the II GR (P less than 0.02). Pts. with a positive ET were 38% in the I Gr and 57% in the II GR (P less than 0.01). The double product (DP) of positive ETs in the I GR was inferior (P less than 0.01) to that of the II GR; the DP of negative ETs in the I GR was inferior (P less than 0.01) to that of II GR. The comparison of the DP of positive and negative ETs showed that the former was inferior either in the I GR (P less than 0.02) or in the II GR (P less than 0.05). The highest value of serum CPK of the acute phase was observed in pts. with ST depression during ET in both groups. In the early phase after AMI, ET and A identified 50% of pits. in the I GR and 74% in the II GR as having further signs of coronary artery disease. These data were confirmed during the FU; the two techniques are then complementary to predict further events in our FU. Incidence rate of early symptoms, ischemic responses to ET, work capacity and DP values obtained during ET differed significantly in the two GRs. Reinfarction rate was 5% in the I GR and 10% in the II GR; mortality rate was similar (4.5%) in both GRs; we dit not identify predictive signs for mortality after 18.06 months from AMI. A negative history of A and a negative ET were predictors of absence of angina, but not of reinfarction nor of coronary death during our FU.