Giornale di clinica medica最新文献

A study on circadian and circannual rhythmicity in the episodes of fatal pulmonary thromboembolism has been conducted in 152 cases. The data demonstrate that the incidence in the episodes of pulmonary thromboembolism, evaluated as hour and day of onset in the clinical symptoms, presents a temporal, both circadian, and circannual distribution. The greater incidence occurs in the morning hours and in the winter season. The rhythmometric analysis by "cosinor" method showed a significant circadian and circannual rhythms in incidence of episodes of fatal pulmonary thromboembolism. The temporal distribution does not seem to be casual, but the effect of interrelationship between exogenous rhythms, such as those in the haemostatic system, endogenous rhythms, such as the cold temperature, and disease. These results demonstrate that the pulmonary thromboembolism is a disease with an high "chrono-risk", i.e. it is an expectable disease in its temporal recurrence.

Several studies have shown an influence of cigarette smoking on serum pepsinogen group I (PGI) levels in duodenal ulcer patients and in control subjects. The elevation of PGI in smokers has just been interpreted as reflecting some degree of smoking-induced inflammation of the gastric mucosa. We have determined fasting serum PGI by radioimmunoassay in 163 healthy subjects investigated by a survey conducted on a sample population of an urban area in the North-East of Italy by means of a random selection based on the public registers of home addresses. The data reported confirmed that PGI levels are increased by smoking in a healthy population. The main contribution of this study consists in demonstrating in a non-selected population an increase of the only parameter up to date claimed to be a possible serological predictive index for ulcer disease.

The relationship between body weight excess and hypertension has been widely demonstrated. Some body-builders can reach an important body weight excess because of the skeletal muscle hypertrophy; their body mass index is comparable to that of obese subjects, although body fat excess is responsible for overweight in the latter. Blood pressure, fasting plasma glucose and insulin, Na+, K+, Ca++ urinary excretion have been compared in three groups of young males: 1. body builders with BMI greater than 27; 2. obese subjects with BMI greater than 27; 3. normal subjects with BMI less than 25. Systolic blood pressure was similar in body-builders and obese and significantly higher than in the control group. Diastolic blood pressure, fasting plasma glucose and insulin were similar in normal subjects and in body-builders and significantly lower than in obese subjects. Although our results confirm the relationship between increased diastolic blood pressure, hyperinsulinemia and body fat excess, the finding of increased systolic blood pressure suggests caution in body-building, because systolic hypertension has been demonstrated to be a risk factor for vascular diseases.

The Authors have used, on a group of 51 patients, a score-system for the clinical diagnosis of pulmonary embolism. This system is based on clinical examination of the patients and utilizes a different value for each sign and symptom: each sign and symptom correspond to a positive number. Every patients was also undergone instrumental tests to confirm the diagnosis (i.e.: perfusion lung scanning and venous doppler) according to previously defined diagnostic program. A good relationship between the instrumental diagnosis and clinical probability was found with above mentioned score-system. The AA believe that this score-system is valid and that it can be used in elaborating diagnostic decision, particularly in those cases in which the diagnosis is not established by the instrumental tests and in which is not possible to perform pulmonary angiography.