RESUMO
In the 1990s EEC countries drafted several directives concerning the aquaculture sector, including Directive 91/67/EEC of 28.01.1991 (accepted into Italy by DPR n. 555 on 10.12.1992) and Directive 95/70/EC from 22.12.1995 (accepted into Italy by DPR n. 395 on 20.10.1998). DPR 555 includes among its provisions a list of the diseases that are so serious for production that they must be eradicated from the EEC territory (Annex A, List I), as well as a list of other diseases that also affect production (Annex A, List II). Annex A, List II of DPR 555, includes two mollusc diseases, namely Bonamiosis and Marteiliosis for flat oysters (Ostrea edulis). DPR 395 includes among its provisions that farm owners register their farm with the National Health Service and possess a loading and unloading register of the material introduced from or destined for another farm for reintroduction. When the National Health Service finds a case of unusual death in the wild or in farms, it will apply a sanitary monitoring programme to ascertain or exclude the presence of the diseases included in Annex A to 91/67/EEC or Annex D to 95/70/EC as the cause of death. On February 5th 2003 the EU Commission modified Annex D (2003/83/EC).
Assuntos
Agricultura/métodos , Moluscos/crescimento & desenvolvimento , Animais , União Europeia , Itália , Moluscos/microbiologia , OstreidaeRESUMO
The Authors studied the morphological, biochemical, physico-chemical and biological characteristics of Vibrio anguillarum cultured on different growth conditions, characterized by low osmolarity and high temperature (37 degrees). One culture was subcultured for several days in tryptone soya agar with 0.5% Nacl at 37 degrees C incubation until the cell morphology was stabilized. The low osmolarity, through an osmotic shock, induced remarkable morphological modifications in the strain, evidenced by optic and electron microscopic studied; in addition SDS-PAGE analysis of saline extracts from the culture at 37 degrees C showed a specific new protein band of about 66KDa. This band was correlated with remarkable differences in outer membrane protein composition (OMPs) evidenced by Ag/Ah cross-reactions with rabbit hyperimmune sera against the modified and the reference V. anguillarum strains. Finally, the modified strain proved to be non pathogenic for trout and sea bass.
Assuntos
Vibrio/ultraestrutura , Animais , Bass/microbiologia , Meios de Cultura , Eletroforese em Gel de Poliacrilamida , Doenças dos Peixes/microbiologia , Temperatura Alta , Microscopia Eletrônica , Oncorhynchus mykiss/microbiologia , Concentração Osmolar , Vibrio/metabolismo , Vibrio/fisiologiaRESUMO
The availability of ambulatory ECG monitoring allows identification of transient myocardial ischaemia, the clinical relevance of which is currently being investigated. Ninety-four consecutive patients with ischaemic heart disease and a positive exercise test (greater than or equal to 1 mm ST-segment depression) were studied to evaluate the prevalence of transient myocardial ischaemia (either painless or painful) during 24-h dynamic electrocardiogram (ECG) and the clinical, angiographic and ergometric variables predicting its appearance. Two-hundred-and-eighty-one episodes of transient electocardiographic myocardial ischaemia were recorded in 69 patients (73.4% of all patients). Transient myocardial ischaemia was more frequent, although not significantly so, in patients with diabetes, with previous myocardial infarction, or with multivessel disease. When tested by multivariate analysis, neither the clinical variables nor the severity of coronary artery disease allowed prediction of the occurrence of transient myocardial ischaemia during dynamic ECG. The duration of exercise testing up to the ischaemic threshold (ST-segment depression = 1 mm) and the peak heart rate during exercise were more accurate predictors of transient myocardial ischaemia (P = 0.019 and 0.012 respectively). Patients with transient myocardial ischaemia had a lower ischaemic threshold (355 +/- 175 vs 498 +/- 150 s, mean +/- SD, P = 0.001) despite a lower peak heart rate (129 +/- 18 vs 137 +/- 12 beats min-1, P = 0.047) than patients without transient myocardial ischaemia. In conclusion, exercise testing may help select patients for examination by dynamic ECG.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Doença das Coronárias/diagnóstico , Eletrocardiografia Ambulatorial , Teste de Esforço , Angiografia Coronária , Doença das Coronárias/diagnóstico por imagem , Doença das Coronárias/fisiopatologia , Feminino , Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise MultivariadaRESUMO
The aim of this study was to investigate whether, and to which extent, sustained treatment with transdermal nitroglycerin plasters may lead to the development of tolerance in patients with effort-induced angina pectoris. Ten patients, all men, mean age 62.7 years, took part in a double-blind, cross-over, acute study, comparing the transdermal therapeutic system of nitroglycerin 10 mg/24 hours with placebo. Patients were then treated for 1 month with the active drug in single-blind condition, and finally they took part in a further acute study identical to the first. Cycloergometric exercise tests were carried out 4 hours after dosing. In comparison with placebo, the active drug significantly (P less than 0.01) increased ischaemic threshold (ST depression = 1 mm) after both acute (from 299 +- 92 to 413 +- 120 sec) and chronic treatment (416 +- 107 sec). The same results were obtained for exercise duration to peak exercise (acute study: from 336 +- 65 to 482 +- 90 sec; chronic treatment: 466 +- 118 sec). The final acute study confirmed the stability of angina, showing that the improvement in exercise tolerance after chronic treatment was entirely due to the pharmacological effect of the drug. In terms of single patient response to the active treatment, 7 of the 10 patients showed an improvement in exercise tolerance after both acute and chronic treatment, while in 3 patients no antianginal effect was observed. These results suggest that nitrate tolerance cannot be considered an inevitable finding in patients chronically treated with transdermal patches.
Assuntos
Angina Pectoris/tratamento farmacológico , Nitroglicerina/administração & dosagem , Administração Cutânea , Idoso , Pressão Sanguínea/efeitos dos fármacos , Ensaios Clínicos como Assunto , Circulação Coronária/efeitos dos fármacos , Método Duplo-Cego , Eletrocardiografia , Frequência Cardíaca/efeitos dos fármacos , Humanos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Distribuição AleatóriaRESUMO
To investigate the antianginal efficacy, duration of action and tolerability of 2 doses of the new calcium antagonist felodipine, 15 patients (14 men and 1 woman, mean age 62 years) with stable exertional angina pectoris and angiographically demonstrated coronary artery disease were randomly given felodipine, 5 and 10 mg, and placebo on 3 different days. A bicycle ergometer exercise test was performed 3 and 10 hours after dosing. In comparison with placebo, felodipine 5 and 10 mg significantly increased resting heart rate and decreased resting systolic and diastolic blood pressure 3 hours after administration (p less than 0.001). Ten hours after administration, only supine systolic blood pressure was still significantly lower (p less than 0.001). Anginal (time to mild chest pain) and ischemic (time to 1 mm ST depression) thresholds, as well as duration of exercise and total work at peak exercise, were higher in comparison with placebo at 3 and 10 hours (p less than 0.001). In comparison with the lower dose, 10 mg felodipine induced a decrease in supine (p less than 0.05) and sitting (p less than 0.01) systolic blood pressure at rest and an increase in total work to anginal threshold (p less than 0.01), as well as in total work and duration of exercise at peak exercise (p less than 0.05). These results suggest that a single administration of felodipine, 5 and 10 mg, may improve exercise capacity over a 10-hour period in patients with stable exercise-induced angina due to atherosclerotic heart disease.
Assuntos
Angina Pectoris/tratamento farmacológico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Nitrendipino/análogos & derivados , Esforço Físico , Pressão Sanguínea/efeitos dos fármacos , Método Duplo-Cego , Teste de Esforço , Felodipino , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Nitrendipino/administração & dosagem , Nitrendipino/uso terapêutico , Distribuição Aleatória , Fatores de TempoRESUMO
A patient with primary angina showed intermittent ST elevation (with and without chest pain), during two exercise tests performed on consecutive days; the same ST changes were also seen during the recovery phase. The electrocardiographic changes recorded in this patient may be considered an example of myocardial response to spasm-related ischemia.
Assuntos
Angina Pectoris Variante/fisiopatologia , Arritmias Cardíacas/fisiopatologia , Eletrocardiografia , Teste de Esforço , Angina Pectoris Variante/tratamento farmacológico , Antiarrítmicos/uso terapêutico , Diltiazem/uso terapêutico , Felodipino , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Nitrendipino/análogos & derivados , Nitrendipino/uso terapêuticoRESUMO
Sixty three patients (pts) (aged less than or equal to 50 years) with a history of "lone" atrial fibrillation (AF) and normal heart size at radiological examination were followed-up for a mean period of 95 months (range 1-360). The arrhythmia remained paroxysmal in 43 pts, became chronic in 13, while in 7 could not be reverted to sinus rhythm at the time of first observation. Clinical examination was normal in 58 pts; in 23 echocardiography disclosed mild abnormalities. In 2 pts auscultation revealed a mid-systolic apical click, i n one a mid-systolic murmur and in 2 click and murmur together. These findings were correlated to slightly pathological echocardiographic patterns. M-mode and B-mode echocardiography yielded normal results in 35 pts and showed minor pathological findings in 28 (16 with paroxysmal AF and 12 with chronic AF). Thyroid hormones, tested in 58 pts, were within normal limits in 53, showed decreased T4 in 2 and increased T3 in 3 (2 of whom in treatment with amiodarone). During the follow-up period, no patient had a deterioration of the clinical status from the cardiovascular point of view. However, one patient suffered an episode of cerebral embolism, with rapid resolution, and one a cerebral transient ischemic attack. In conclusion "lone" AF has a favourable prognosis and systemic anticoagulation is not indicated, particularly in the absence of left atrial dilatation.
Assuntos
Fibrilação Atrial/fisiopatologia , Adolescente , Adulto , Fibrilação Atrial/complicações , Fibrilação Atrial/terapia , Fármacos Cardiovasculares/uso terapêutico , Ecocardiografia , Cardioversão Elétrica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos ProspectivosRESUMO
To evaluate the acute and chronic anti-anginal efficacy of a Transdermal Therapeutic System, releasing 10 mg of nitroglycerin over 24 hours (TTS 10), and possible additional effects of isosorbide dinitrate 5 mg (ISDN) sublingually (s.l.), ten patients with stable exercise-induced angina pectoris and pathological coronary angiography were studied. The protocol of the trial consisted of an initial acute study, carried out in double-blind conditions and following a cross-over design, to compare TTS 10 and placebo. Cycloergometric exercise tests were performed on the first and second day, 3 hours after dosing. After a 30 minute rest period, a sublingual 5 mg dose of ISDN was given and 15 minutes later a further exercise test was carried out. Subsequently, patients received TTS 10 in single-blind conditions for 16 days. On the 15th and 16th day, stress test was repeated, 3 hours after the application of active plasters and, 30 minutes later, a further exercise test was performed, 15 minutes after a sublingual dose of ISDN 5 mg or placebo, given in double-blind conditions and in randomized sequence. After acute and chronic administration, TTS 10 significantly improved exercise tolerance in comparison with placebo. During the first acute study, ISDN 5 mg s.l., led to a significant reduction in systolic BP, a reflex increase in heart rate and a further improvement in exercise tolerance, whether patients were on placebo or TTS.(ABSTRACT TRUNCATED AT 250 WORDS)