[Transient hyperglycemia in acute myocardial infarct: the short- and long-term risk factor for mortality]. / Iperglicemia transitoria nell'infarto miocardico acuto: fattore di rischio per la mortalità a breve e lungo termine.

To evaluate the prevalence and prognostic significance of hyperglycemia in acute myocardial infarction, we studied 700 patients (mean age 63.3 +/- 10.97) subsequently admitted to the UCIC of Tradate Hospital during the period January 1976 to December 1987. Patients were followed up for a median period of four years. On the basis of fasting blood glycaemia values in the first five days of hospitalization, excluding the admission day, patients were divided into groups: 401 patients (57.0%) with constantly normal glycaemia; 84 patients (12.0%) with glycaemia equal or superior to 120 mg/100 ml, and with subsequent normalization; and 215 patients (31.0%) with diabetes mellitus diagnosed before hospitalization and/or with persistent hyperglycaemia. The overall mortality was 284 (40.5%) and cardiovascular deaths were 90.8%. Within the first month of myocardial infarction 98 patients died. The mortality rate was 9.4% in normoglycaemic patients and 20.2% in transient hyperglycaemic patients, similar to the value observed in diabetic patients (20.0%). During the follow-up 186 patients died. Late mortality after the first month is higher in diabetic patients (40%) and patients with transient hyperglycaemia (37%) compared to normoglycaemic patients (25.3%). Multivariate analysis shows that independent predictive variables are: for mortality in the first month, Killip class only; and after the first month, Killip class, metabolic classification, sex and supraventricular arrhythmias. The present study shows that transient hyperglycaemia has a low prevalence in the first days of acute myocardial infarction. Transient hyperglycaemia could be attributed not only to increased sympathetic tone elicited by acute myocardial infarction, but is probably a pathologic condition with an adverse outcome to which multiple factors contribute.

[Dilated cardiomyopathy in infants. Report of a clinical case with particularly favorable outcome]. / Cardiomiopatia dilatativa nel lattante. Descrizione di un caso clinico ad evoluzione particolarmente favorevole.

Dilated cardiomyopathy has a poor prognosis in infants and children. We report the favourable long term outcome of a case of dilated cardiomyopathy discovered at age seven months. The knowledge of natural history of these patients is very important to develop predictive indexes to select patients who might respond to medical management and those who might be suitable candidates for cardiac transplantation.

[M-mode echocardiography: determination of morphological parameters in the normal newborn infant]. / Ecocardiografia M-mode: determinazione dei parametri morfologici nel neonato normale.

The purpose of this study is to establish normal echocardiographic values of 25 parameters in the newborn infants. The study group is composed of 100 normal, healty neonates (of 72 to 96 hours of age), from whom echocardiograms and measurements were obtained in a standardized manner. Criteria have been established for a complete echocardiographic profile in the full-term newborn. In addition, attempts have been made to correlate the most relevant measurements with body surface area. No significant correlation was found to exist in the small range we have studied (BSA = 0,16 - 0,26 m2).