The role of telecardiology in supporting the decision-making process of general practitioners during the management of patients with suspected cardiac events.

We studied the role of telecardiology in reducing unnecessary hospital admissions of patients with suspected life-threatening cardiac events (CEs), evaluated by general practitioners (GPs). Over one month, 456 consecutive patients (mean age 65 years, SD 19) complaining of typical (10%) or atypical (42%) chest pain, palpitations (19%), dyspnoea (19%) or syncope (10%) were enrolled. Before teleconsultation, the GPs recorded their own opinion (based on clinical evaluation only) about the presence of a CE. Following transmission of the electrocardiogram (ECG), this opinion was compared with that of the cardiologist. In total there was agreement between the GP and cardiologist about the presence of a CE in 316 of the patients (69%) and disagreement in 140 patients (31%). This represents a specificity and sensitivity of the GPs' diagnosis of 76% and 47%, respectively. For 84 of 134 patients judged as having a CE by the GP, telecardiology avoided hospitalization; on the other hand, telecardiology identified a CE in 56 of 322 patients judged as not having a CE by the GP. Telecardiology is a useful tool with which to reduce unnecessary hospitalizations in patients with suspected life-threatening CEs.

Twenty-four-hour endothelin-1 secretory pattern in stroke patients.

Endothelin-1 (ET-1) is a potent and long-acting vasoconstrictor peptide, which may play a role in the pathophysiology of a number of diseases. Controversial data exist on its role in human ischemic stroke. In order to ascertain whether changes in ET-1 plasma levels occur in ischemic stroke, plasma ET-1 levels and mean arterial pressure were determined in 15 patients at their first ischemic cerebral infarction and in 15 control subjects, over a 24-hour period. In stroke patients, mean 24-hour plasma ET-1 levels (4.9+/-0.5 ng/L) were higher (P< 0.05) than in control subjects (3.2+/-0.3 ng/L), and correlated with the mean size of the lesion, but not with the severity score of the neurological deficit. These results support the hypothesis that ET-1 levels reflect an indicator function for the amount of damaged cerebral tissue rather than a pathophysiological role.

Dithiocarbamate pesticides: activity of Propineb in the micronucleus test in mice.

The possible clastogenic activity of Propineb, Propineb technical grade and of its main metabolite, propylene-thiourea (PLTU), was investigated by the micronucleus test in mice according to Schmid. No statistically significant increase in the percentage of micronuclei was observed at any of the tested doses of the above compounds. As positive controls, dose-effect curves were constructed for methyl methanesulfonate (MMS) and mitomycin C (MMC).

[Correlation between preincubation time of the leukocyte feeder-layer and in vitro granulocytic-macrophage colony growth]. / Rapporti tra tempo di preincubazione del feeder-layer leucocitario e crescita in vitro di colonie granulocitiche-macrofagiche.

Granulocytic-macrophage colony in vitro formation depends on the presence of the colony stimulating factor (CSF). When, in double layer agar method, the CSF is provided from leucocyte underlayers, the pre-incubation time of the feeder-layers must be kept constant. The results obtained in this study have demonstrated in fact that the growth of the colonies can be remarkably different if feeder-layers are incubated for 1, 7 or 14 days.