An unusual false-positive scan in a patient with pericardial effusion.

Uptake of I-131 in the pericardial area is described in an asymptomatic patient who underwent total body scan for recurrent papillary thyroid cancer. Ultrasonography demonstrated a small pericardial effusion that persisted after I-thyroxine therapy was reinstituted. Two I-131 therapeutic doses were given, and follow-up total body scans were performed during the next 6 years. Although tracer accumulation in the neck was eliminated and the serum thyroglobulin level was not elevated, I-131 uptake persisted in pericardial effusion. Despite diligent study, no neoplastic, infectious, or autoimmune etiology could be demonstrated, and we thus classified it as idiopathic pericardial effusion. This phenomenon should be considered when interpreting I-131 scans that show I-131 uptake in the region of the heart.

[Usefulness of ambulatory ECG in the follow-up of patients with pacemakers]. / Utilità dell'ECG dinamico nella gestione del portatore di pacemaker.

In order to evaluate the diagnostic efficacy of Holter monitoring in the follow-up of pacemaker patients, the recordings of 122 patients were reviewed. Indications for monitoring were: evaluation of pacemaker function in 23.6% of the cases; sporadic appearance of arrhythmias in 26.7%; total or partial unconsciousness in 9.7%; a variety of symptoms such as palpitation (12.7), dizzy-spells (9.7%) and irregular pulse (4.2%). Prolonged monitoring of cardiac activity allowed us to exclude pacemaker malfunction in 87.5% of cases of syncope and 88.6% of cases of palpitation, dizzy-spells and irregular pulse; while it disclosed defects of electrostimulation in 11.4% of cases in loss of consciousness in 12.5% of patients with various symptoms and none in cases of arrhythmias. It allowed us to evaluate the therapeutic efficacy of used drugs in 18.2% of cases. Given the variety of clinical and instrumental problems of pacemaker patients, Holter monitoring proved to be a very essential diagnostic means in the follow-up of such patients.

[Usefulness of multicenter evaluation of the reliability of a program for automatic analysis in clinical electrocardiography]. / Utilità della valutazione policentrica dell'affidabilità di un programma per l'analisi automatica in elettrocardiografia clinica.

The HP-5 program for computer analysis of the ECG has been evaluated as far as sensibility and specificity in a multicenter study. A consistent number of tracings were sampled according to a statistical formula and all measurements and statements given by the computer were checked in a standardized manner. The collected data were classified and computerized. The HP-5 program has shown a very high specificity for tracings classified as normal (0.7% of false negatives) and for those classified abnormal (no false positive), while the level of agreement between manual and computer readings of the tracings classified atypical or borderline, was fair (75%). It is concluded that the new program represents a significant step forward in the practical use of computerized ECG.

[Multicenter study and clinical use of HP-5 program (author's transl)]. / Valutazione policentrica e impiego clinico di un programma per l'analisi automatica dell'ECG (HP-5].

The HP-5 program for computer analysis of the ECG has been evaluated as far as sensibility and specificity in a multicenter study. A consistent number of tracings (850) were sampled according to a statistical formula and all measurements and statements given by the computer were checked in a standardized manner. The collected data were classified and computerized. The HP-5 program has shown a very high specificity for tracings classified as normal (0.7% of false negatives) and for those classified abnormal (no false positive), while the level of agreement between manual and computer readings of the tracings classified atypical or borderline, was practical of computerized ECG.

[The Italian experience in permanent pacing. A casuistry for more of 10 years: a policentric study (author's transl)]. / L'esperienza italiana con l'elettrostimolazione permanente a lungo termine. Casistica in trattamento da oltre 10 anni: studio policentrico.

According to a recent national survey, 387 patients were treated by permanent pacing in 10 Italian centers, between 1961 and 1966. Of these patients 205 have died; 131 (77 males and 54 females) are still alive and no informations could be obtained for the remaining 51 (13%). The overall survival of patients treated during this period of time is therefore not less than 34% which is comparable to that of general population of the same age group. The 131 patients still alive have totaled 1,486 years of pacing and have used up to 784 pacers. Comparing the incidence of the most common causes for replacement during the periods 1961-66 and 1973-77, electrode failures dropped from 21 to 0.9%; circuitry malfunctions occurred in 10.5 and 7.8%; battery depletion rose from 36.8 to 69% of the cases. According to their clinical conditions, the 131 patients on long-term follow-up can be grouped as follows: 62% are in class 1 or 2 of NYHA; 26.7% are in class 3, and 3.8% in class 4. Moreover, 53.4% of patients are living an active life, having some sort of occupation and 29% are holding a driving license.