[Prevalence of viral hepatitis B markers in a sample of students at the School of Medicine and Surgery, University of Brescia]. / Prevalenza dei markers dell'epatite virale B in un campione di studenti della Facoltà di Medicina e Chirurgia dell'Università di Brescia.

Seroepidemiologic study on hepatitis B virus markers in a group of students in Medicine at the University of Brescia. The prevalence of hepatitis B virus (HBV) markers was studied in a group of 633 students in Medicine at the University of Brescia. HBsAg was detected in 16 (2.5%) students; anti-HBs and anti-HBc in 73 (11.5%); anti-HBs alone in 4 (0.6%); anti-HBc alone in 9 (1.4%). On the whole 102 (16.1%) students were reactive for one HBV marker at least. Significant differences in frequency of HBV markers were found according to age and to personal and familiar history of viral hepatitis; the prevalence of the markers was not associated with sex, year in school, hospital clinical training, blood transfusions and presence of health-care workers in the family. In this seroepidemiologic study the risk of contracting hepatitis B appears not higher in medical students than in other university students and in general population of the same age, sex and residence area. The results of the investigation suggest that medical students are appropriate candidates for hepatitis B vaccine at the beginning of their post-graduate medical profession.

Left ventricular dysfunction versus paravalvular leak in patients with mitral disc prostheses.

UNLABELLED: Left ventricular dysfunction and prosthesis malfunction are the main causes of hemodynamic deterioration following prosthetic mitral valve replacement. The aim of this study is to reassess the usefulness of a combined echo-phonocardiographic technique to differentiate these different situations in order to select medical or surgical treatment in patients with a mitral disc prosthesis. Two patient groups were studied. The first group consists of five patients with paravalvular leak (PL), surgically or pathologically verified. Second group: nine patients with left ventricular failure (LVF) and normal functioning prosthesis. The diastolic diameter of the left ventricle (LV) was significantly increased in the LVF group compared with the PL group. A protodiastolic hump was present in four cases of PL. The variability of the interval between A2 and the mitral valve opening (delta A2-MVO) was less than 30 msec in the LVF group and greater than 30 msec in the PL group. The interval between A2 and maximal LV posterior wall (A2-PW) exceeded 60 msec in the PL group and was shorter than 60 msec in the LVF group. IN CONCLUSION: the echo-phonocardiographic technique, especially when by using two newly proposed parameters, seems to be very useful to discriminate between PL and LVF.

[Comparative evaluation of phonocardiogram and echocardiogram in mitral valve prolapse diagnosis (author's transl)]. / Valutazione comparative del fonocardiogramma e dell'ecocardiogramma nella diagnostica del prolasso mitralico.

In order to determine the correlation between echocardiography (ECHO) and phonocardiography (PHONO) in the evaluation of the Mitral Prolapse Syndrome (PM), 87 subjects with echo or phono criteria of PM were studied using both techniques. The phonocardiographic criteria used for PM diagnosis were the presence of a telesystolic click and/or a telesystolic murmur. The echocardiographic criteria were a telesystolic or holosystolic posterior movement of a mitral leaflet continuously seen through systole or of both mitral leaflets seen in part of systole. In the 63 patients with ECHO indicative of PM, the PHONO was positive in 55 cases (87%). Methoxamin administration, in 5 cases whose basal PHONO was normal, allowed the observation of 3 telesystolic murmurs and 2 clicks. The drug also diminished the number of clicks and increased tfhe telesystolic murmurs. In 79 subjects with PHONO indicative of PM, the ECHO was positive in 57 cases (72%): this technique was of particular value in patients with olosystolic murmur; valuable also to evaluate the diastolic diameter of the left ventricle and the left atrium and other signs having a possible use for a more accurate physiopatologic definition of the PM syndrome.