Iodide mumps: sonographic appearance.

Swelling of the salivary glands occurring after injection of iodine-based contrast agent is a rare late adverse reaction. Only a few cases in the literature illustrate such ultrasound findings.

Ex vivo evaluation of pidotimod activity in patients with chronic obstructive pulmonary disease.

The aim of this study was to evaluate the activity of pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl)carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6) on 52 patients affected with chronic obstructive pulmonary disease (COPD). The study was carried out in a randomized, parallel, double-blind trial, followed by incomplete blocks design. Pidotimod 800 mg was administered orally twice a day for 30 days. The follow-up period was 5 weeks. Our results show that in patients with COPD pidotimod potentiates T-cell activity. The effects on T-cells appear after 15 days of treatment and last for 5 weeks after the end of therapy. Since other studies demonstrated that pidotimod displays an immunopotentiating activity also on macrophages and granulocytes, the drug is useful to increase the immune defense during infections. The drug has a good compliance and is well tolerated also during long-term treatment.

[Surgical risk in patients with heart valve disease in non-cardiac surgery]. / Rischio operatorio nel valvulopatico per gli interventi di chirurgia non cardiaca.

Our purpose was to retrospectively evaluate major risk of non cardiac surgery in patients with valvular heart disease. We studied retrospectively 136 patients, 44 affected by aortic, 81 by mitral and 11 by mitroaortic valve disease. NYHA class was I-II in 130 and III in 6 patients. Sixty four patients underwent orthopedic surgery, 57 patients occulistic surgery and 5 patients urological surgery. There were no hospital deaths. Fifteen patients developed major perioperative complication: 7 serious ventricular arrhythmias, 6 hypotension, 2 "hypertensive attacks". We conclude that non cardiac surgery is safe in patients with valvular heart disease.

Cerebral metastases from perineal leiomyosarcoma.

A case of cerebral metastases from perineal cutaneous leiomyosarcoma is described and documented by the histological and CT findings.

Effects of combined alpha- and beta-blockade by labetalol in patients with coronary artery disease.

1 The effect of labetalol 100 mg orally twice daily on exercise tolerance has been compared with placebo in 19 normotensive subjects with angiographic evidence of coronary artery disease. 2 Labetalol, at the same work load as during placebo exercise, significantly reduced systolic and diastolic blood pressures, as well as heart rate and rate-pressure product. 3 Similarly, ST segment depression was reduced by labetalol from 2.0 +/- 0.4 to 1.36 +/- 0.6 mm (P less than 0.001), thus enabling an increase in exercise tolerance from a control value of 83.7 +/- 18 to 95.3 +/- 19 W (P less than 0.005). 4 In seven other patients, also with coronary artery disease, the haemodynamic effects of a single 0.6 mg/kg intravenous dose of the drug was evaluated during exercise. 5 Compared with conditions during control exercise, labetalol induced a significant reduction in rate-pressure product from 17228 +/- 2375 to 13445 +/- 2404 mmHg/min (P less than 0.005) and in peripheral vascular resistance from 612.0 +/- 61.2 to 512.7 +/- 36.2 dyn cm-5 m-2 (P less than 0.0025). These events were not accompanied by any change in cardiac index and in dP/dT left ventricular end-diastolic pressure (LVEDP) ratio. 6 These data suggest that labetalol may induce reduction in myocardial oxygen consumption, thereby increasing exercise tolerance in patients with coronary artery disease, without impairment of left ventricular performance.

[Protective effect of lithium carbonate in neutropenia induced by antiblastic agents and evaluation of its long-term efficacy]. / Effetto protettivo de litio carbonato nella neutropenia da antiblastici e valutazione della sua efficacia a distanza.

The association of lithium carbonate and antiblastic drugs has been studied in 22 patients suffering from tumours to see whether it was able to prevent or attenuate the neutropenising effect and establish whether its protection action on leucocytaemia was not just transitory but was maintained for prolonged treatment also. Patients were submitted to four oncolytic treatment cycles during which administration with LiCO3 was associated with the first and third cycles (LNLN sequence) in 14 patients and with the second and fourth (NLNL sequence) in the other 8. Statistical analysis of the results obtained confirmed that lithium carbonate performs a protective action with respect to antiblastic-induced neutropenia and that the action is long term. The drop in monocytes also seems to diminish after administration of lithium carbonate.

Protective effects of propranolol on the exercise-induced reduction of blood flow in arteriopathic patients.

The vascular steal phenomenow, that is, the shunting of blood from ischemic to normally perfused areas, is commonly observed during exercise in the affected limbs of patients with peripheral arterial insufficiency. Propranolol was administered to 18 arteriopathic patients before the exercise to ascertain whether the reverse situation can be induced. The results indicate that before propranolol administration, Jantsch's index (used to quantify the plethysmographic waves) decreased from 0.53 +/- 0.05 to 0.33 +/- 0.04 (P less than 0.001) at 1 minute, and to 0.38 +/- 0.04 (P less than 0.001) at 5 minutes after the end of the exercise. When the exercise was repeated after propranolol, Jantsch's index did not change. These findings indicate that propranolol can inhibit exercise-induced vascular steal.

Effects of propranolol in a case of orthostatic hypotension.

In a hypertensive patient with orthostatic hypotension, the changes in several haemodynamic indices with respect to posture were evaluated. In the upright position, systemic blood pressure was reduced as compared with the supine position, and peripheral vasodilation was present, as shown by an increase in Jantsch's index of the impedance plethysmographic tracings. Systolic time intervals remained unchanged with changes in posture. Propranolol 10 mg intravenously brought the response to normal. In fact, after beta-blockade in the standing position the blood pressure remained unchanged and normal peripheral vasoconstriction was observed. Similar results were seen during atrial pacing at a constant heart rate of 130 beats/minute. In this patient, propranolol appears to normalise the response to the posture change, by restoring normal vasoconstriction in the upright position.

Reduction of blood flow following ischemia in arteriopathic patients: reversion of the phenomenon induced by propranolol.

In most arteriopathic patients, the release of a transitory ischemia in the affected limb reduces blood flow, instead of increasing it as in normal subjects. In this study the effects of propranolol administration on this paradoxical response have been investigated. After rheographic tracings were recorded in 14 arteriopathic patients in the basal condition and in the postischemic period, 10 mg of propranolol was administered IV and the protocol was then repeated. The blood flow in the affected area, measured as Jantsch's index of the rheographic tracings, was 0.63 +/- 0.04 in the basal condition and was reduced to 0.51 +/- 0.05 (P less than 0.001) in the postischemic period. When the ischemia was repeated after propranolol administration, Jantsch's index rose from 0.57 +/- 0.04 to 0.85 +/- 0.09 (P less than 0.01). The reversion of the paradoxical response to the ischemia induced by propranolol administration suggests that the beta-adrenergic blockade can increase blood flow to the ischemic area, probably through a constrictive action on arterovenous connections.