Markers of acute coronary syndrome in emergency room.

Acute coronary syndromes (ACS) encompasses a spectrum of coronary heart diseases, ranging in severity from unstable angina to ST-elevation myocardial infarction (STEMI). Early diagnosis and risk stratification are needed in order to address correctly hospitalization and treatment. Although the diagnosis of STEMI in the presence of typical electrocardiogram (ECG) changes and symptoms is easy and does not require the use of biomarkers, cardiac biomarkers are particularly important in the Emergency Department (ED), where about 25% of patients admitted are affected by ACS but clinical presentation is often atypical and ECG alterations may be absent. The ideal marker in the ED should have rapid release, high sensitivity and specificity and risk stratifying properties. Classic cardiac biomarkers, like myoglobin, cardiac troponin T or I and creatine kinase-MB, have a poor sensitivity, dependent on the time past from the onset of symptoms to presentation, the duration of ischemia and the amount of myocardial tissue involved. Although the serial testing of these cardiac biomarkers can improve the detection of myocardial necrosis, there is still a need for the development of early markers that can reliably rule out ACS from the ED at presentation and also detect myocardial ischemia in the absence of irreversible myocyte injury. There are several markers which represent the different features of ACS pathogenesis and that can be divided into three major groups: markers of cardiac ischemia and necrosis, markers of inflammation and coronary plaque instability and marker of cardiac function.

[Leiomyosarcoma of the spermatic cord. Apropos of 2 cases]. / Leiomiosarcoma del funicolo spermatico. A proposito di due casi.

Two cases of leiomyosarcoma of the spermatic cord are reported. Prognostic factors and therapy of this kind of tumors are discussed.

[Epidemiological utilization of hospital data. Incidence of tumors of the bladder in the Province of Vercelli in the decade 1972-1981]. / Utilizzo in senso epidemiologico di dati ospedalieri. Incidenza dei tumori della vescica nella Provincia di Vercelli nel decennio 1972-1981.

A descriptive epidemiology study carried out with the purpose of assessing the incidence of malignant bladder cancer in the province of Vercelli is reported. 833 hospitalised cases were observed in the period 1972-1981. Incidence rates were calculated on the resident population at the date of the last two national censuses. Sex, patient age and distribution in the three areas into which the province is subdivided are illustrated and discussed and trend in incidence rates in the two five-year periods 1972-1976 and 1977-1981 reported. The standardised rates are compared with those of the provinces of Turin and Varese.

[Aspecific granulomatous prostatitis. Our experience]. / La prostatite granulomatosa aspecifica. Nostra esperienza.

The clinical and anatomopathological features of 7 personally observed cases of granulomatous prostatitis are described. The possibility of confusion between this pathology and cancer of the prostate is pointed out. This is particularly the case when the entire gland is inflammed and only bioptic examination will confirm the diagnosis. The symptoms mostly related to the cervicourethral obstruction, the diagnostic procedure and the treatment, prevalently medical, adopted in each are described.

[Prognostic value of the detection of ABO surface antigens by indirect immunofluorescence technic in transitional tumors of the bladder]. / Valore prognostico della ricerca degli antigeni superficiali ABO con la tecnica di immunofluorescenza indiretta nei tumori transizionali della vescica.

Experience is described in the use of indirect immunofluorescence to reveal ABO surface antigens in transitional tumours of the bladder on histological preparations from 50 patients given endoscopic resection or demolitive surgery. After an adequate period of follow-up (mean 13.7 months) of the same patients it is concluded that the prognostic validity of the survey still fails to offer sufficient specificity for guaranteed support of therapeutic decisions.

[Scintigraphy in the study of varicocele]. / L'indagine scintigrafica nello studio del varicocele.

Varicocele which is relatively common after puberty may cause even severe alterations to fertility. Sequential Isotopic Scrotal Angiography (SISA) was used for the diagnosis of this condition in both the recognition and confirmation phase. This dynamic and static survey based on the use of 99mTc-pyrophosphate proved able to discriminate between the various degrees of varicocele. No statement can as yet be made on the specificity and sensitivity of the examination since so few cases have so far been checked with other techniques (Doppler-Telethermography-Phlebography) and an insufficient number of postsurgical controls came to our observation.

The usefulness of sequential isotopic angiography of the scrotum for study of the varicocele.

132 patients were examined by Sequential Isotopic Scrotal Angiography (SISA) to determine whether or not they had primary varicoceles. The results with SISA were more reliable than those of clinical examination and scrotal telethermography. It is a rapid, simple and essentially harmless procedure that also provides pictures that can clearly present the situation to the patient. The principal indications for the examination are to confirm the presence of small varicoceles and to look for clinically non-detectable (subclinical) varicoceles.