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The systolic and diastolic function of both ventricles was assessed by radionuclide angiography in 21 patients with Friedreich's ataxia and hypertrophic cardiomyopathy. The indices of systolic function of the two ventricles and those of diastolic function of the right ventricle were generally normal. But in patients with Friedreich's ataxia the time to peak filling rate divided by the diastolic time of the left ventricle was significantly larger than normal. The increase correlated with the heart rate (r = 0.79) and this suggests an alteration in the timing of ventricle filling that is more evident at high heart rates. Movement of the left ventricle was little impaired; however, in 48% of the patients with Friedreich's ataxia the right ventricle showed evidence of hypokinetic segments. Because there is a tendency for congestive heart failure to develop in patients with Friedreich's ataxia, this hypokinesis of the right ventricle should be monitored at follow up. [ABSTRACT FROM PUBLISHER]

Objectives: Ankle arthroscopy has become increasingly popular as a less invasive surgical diagnostic and therapeutic procedure for a variety ankle disorder previously managed with open surgery. Despite literature reports encouraging outcomes and low complication rates, nationwide trends in ankle arthroscopy have been poorly investigated. To fully understand the burden of an emerging surgical approach as well as helping to create global standards for the diagnosis and treatment of ankle diseases, this study aimed to evaluate the incidence and demographics of patients undergoing ankle arthroscopy in Italy from 2001 to 2016., Methods: Data were obtained from the National Hospital Discharge Records (SDO) provided by the Italian Ministry of Health. The patient's age, gender, length of hospital stays, primary diagnosis, and primary procedure are among the anonymized data. Population data were obtained from the National Institute for Statistics (ISTAT). According to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) ankle arthroscopy was defined by the following procedure code: 80.27., Results: A total of 23,644 procedures were performed in Italy. The 25 to 29 and 30 to 34 age groups underwent this type of surgery at most. The majority of patients were males. The median length of hospital stay was 2.1 ​± ​2.3 days. Each year in Italy, this surgery costs an average of 2,133,401€ ± 342,143€. The main primary codified diagnoses were: "contracture of joint, ankle and foot" (13.4 ​%), "articular cartilage disorder, ankle and foot" (8.6 ​%), "late effect of sprain and strain without mention of tendon injury" (7.5 ​%) and "other joint derangement, not elsewhere classified, ankle and foot" (6.4 ​%)., Conclusions: The present study evaluated the burden of ankle arthroscopy on the national health care system and the distribution of the main diseases requiring this type of surgery. Surgeons and policy makers can allocate healthcare resources more effectively and provide patients with high-quality care by having a better understanding of national practice patterns., Level of Evidence: III., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The most common induction methods for OA are mechanical, surgical and chemical. However, there is not a gold standard in the choice of OA animal models, as different animals and induction methods are helpful in different contexts. Reporting the latest evidence and results in the literature could help researchers worldwide to define the most appropriate indication for OA animal-model development. This review aims to better define the most appropriate animal model for various OA conditions. The research was conducted on the following literature databases: Medline, Embase, Cinahl, Scopus, Web of Science and Google Scholar. Studies reporting cases of OA in animal models and their induction from January 2010 to July 2021 were included in the study and reviewed by two authors. The literature search retrieved 1621 articles, of which 36 met the selection criteria and were included in this review. The selected studies included 1472 animals. Of all the studies selected, 8 included information about the chemical induction of OA, 19 were focused on mechanical induction, and 9 on surgical induction. Nevertheless, it is noteworthy that several induction models, mechanical, surgical and chemical, have been proven suitable for the induction of OA in animals.

First-principles molecular dynamics (FPMD) simulations in the framework of Density Functional Theory (DFT) are carried out for the prediction of the infrared spectrum of the fluorinated molecule ClCF 2 CF(CF 3 )OCF 2 CH 3 in liquid and gas phase. This molecule is characterized by a flexible structure, allowing the co-existence of several stable conformers, that differ by values of the torsional angles. FPMD computed spectra are compared to the experimental ones, and to Boltzmann weighted IR spectra based on gas phase calculations., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Recently some Authors observed a low sensitivity of submaximal exercise thallium-201 myocardial scintigraphy for predicting multivessel coronary disease in patients with recent acute myocardial infarction (AMI) treated with thrombolytic therapy. The aim of our study was to evaluate the accuracy of dipyridamole thallium-201 single photon emission computerized tomography (DIP-SPECT) for predicting the location and the extent of coronary artery disease in patients with recent uncomplicated AMI and to compare the results obtained in patients treated with thrombolytic therapy (Group T) to those obtained in patients treated with non-thrombolytic therapy (Group NT). We examined 61 consecutive patients with recent uncomplicated AMI by predischarge DIP-SPECT as well as by coronary angiography. In the Group T the total number of reversible perfusion defects per patient was 2.6 +/- 1.9 of which 2.1 +/- 1.6 at infarct site and 0.5 +/- 0.7 in other coronary territories; similarly, in the Group NT the total number of reversible perfusion defects per patient was 2.5 +/- 1.6 (NS compared to Group T) of which 1.9 +/- 1.2 (NS compared to Group T) at infarct site and 0.5 +/- 0.8 (NS compared to Group T) in other coronary territories. In Group T, DIP-SPECT demonstrated a sensitivity of 84% with specificity of 60% for predicting critical (> or = 70%) stenoses at infarct site as well as a sensitivity of 54% with specificity of 54% in the other coronary territories (data are expressed in number of patients per cent). The sensitivity and specificity observed in Group NT did not differ significantly from those of Group T.(ABSTRACT TRUNCATED AT 250 WORDS)

The prevalence of late reversibility in single photon emission computed tomography (SPECT) thallium 201 stress/redistribution studies is still controversial. The aim of our work was to evaluate the prevalence of late reversibility at infarct site in an unselected population of patients with previous acute myocardial infarction (AMI). We studied by SPECT thallium 201 and pharmacologic stress with dipyridamole (DIP) as well as by two-dimensional echocardiography 58 consecutive patients with previous AMI (50 men of mean age 57 years, range 40-73; 8 women of mean age 58 years, range 50-68). All the patients with perfusion defect at infarct site that was persistent at 4-hour study, were reimaged after 24 hours. Twenty-one (36%) of 58 patients complained about postinfarction angina. Following intravenous DIP (0.56 mg/kg), heart rate increased from 67 +/- 14 to 83 +/- 14 b/min (< 0.0001) and diastolic and systolic arterial pressures dropped from 86 +/- 12 and 139 +/- 25 mmHg to 79 +/- 14 and 132 +/- 27 mmHg, respectively (< 0.0001; < 0.0005). Of 57 patients with stress perfusion defects at infarct site, 16 (28%) demonstrated reversibility after 4 hours and 19 (33.4%) after 24 hours, with a total of 35 (61.4%) patients demonstrating reversibility by combined 4-hour and 24-hour imaging (< 0.0001 versus reversibility at 4-hour imaging alone). Thus, of 41 patients with 4-hour persistent thallium defects at infarct site, 19 (46.3%) demonstrated late reversibility.(ABSTRACT TRUNCATED AT 250 WORDS)

In order to assess myocardial perfusion in patients with Friedreich's ataxia, we carried out dipyridamole-thallium imaging in 13 cardiologically asymptomatic patients (aged 16 to 39; mean age 24) with various degrees of left ventricular hypertrophy; all showed electrocardiographic ST and/or T wave abnormalities before scintigraphy. After dosing with dipyridamole-201 thallium, we found: a completely reversible perfusion defect in the apical and a partially reversible defect in the posterolateral wall of the left ventricle in 1 case; a partially reversible perfusion defect in the anterior and posterior walls of the left ventricle in 1 case; and a persistent anterolateral perfusion defect in 1 case. The remaining 10 patients showed no scintigraphic abnormalities. The fact that only 1 of our patients showed a completely reversible perfusion defect, possibly consistent with regional myocardial ischemia, suggests that ischemia does not play a major role in the pathogenesis of the cardiac involvement in Friedreich's ataxia.

A patient with Prinzmetal's variant angina (PVA) who developed an inferolateral myocardial infarction with right-ventricle involvement was studied using sequential radionuclide imaging until 5 months after the acute event. The patient also underwent-contrast ventriculography and coronary-artery angiography. Equilibrium-gated radionuclide angiography (EGRA) revealed the localization of ventricular dysfunction, the results obtained being in agreement with haemodynamic data. We emphasize the usefulness of the parameters obtained using EGRA (regional wall motion, systolic and diastolic parameters) in planning therapy and follow-up.

The purpose of this study was to assess the clinical usefulness of phase and amplitude images and of the left ventricle time-activity curve (LVTAC) obtained by equilibrium gated radionuclide ventriculography (EGRV) in patients with acute myocardial infarction (AMI). Fifty-six patients were studied within 4 days of the onset of AMI by EGRV; of these 49 also underwent first-pass (FP) angiocardiography, for comparison with EGRV, and 21 underwent repeated EGRV 3 months after AMI. Phase and amplitude images were obtained by Fourier analysis. LVTAC analysis was performed by a third degree polynomial fitting to determine peak ejection rate (PER) and peak filling rate (PFR). A substantial equivalence of EGRV and FP methods was demonstrated, as regards left ventricle ejection fraction (LVEF), while a sharp superiority of EGRV with Fourier analysis was shown with regard to the sensitivity of RWM abnormality detection. With only one exception all the cases showed RWM abnormalities, while LVEF was normal in 21 of 27 patients with less than three affected segments. The most sensitive global function index was the LVPFR. In the acute phase regional dyskinesis was observed in 14 of 56 patients. About 40% of our cases showed an improvement of the kinetic abnormalities 3 months after AMI. The highest rate of improvement was observed in the group with ECG patterns of limited infarction and with normal LVEF.

A method for comparative measurement of hepatic clearance of different hepatobiliary agents is described and the clinical use of diethyl-IDA and parabutyl-IDA is discussed. The study was performed with both radiopharmaceuticals in 13 patients with hepatobiliary disease with serum bilirubin ranging from 0.3 to 16.4 mg/100 ml. Diethyl-IDA is preferable for a qualitative evaluation of hepatobiliary disease because of its higher hepatic clearance and faster biliary excretion rate. Parabutyl-IDA is superior for measuring the hepatocytic uptake function, due to the low urinary excretion and the absence of an apparent re-entry from liver to plasma, even in patients with obstructive jaundice. In contrast, an appreciable re-entry can be demonstrated for diethyl-IDA.

Six characteristic initial clinical neurological patterns were defined and their incidence was determined in one year caselist of patients hospitalized in the Neurology Department of the General Hospital of Saronno. Since the predictive value of a diagnostic procedure depends not only on sensitivity and specificity but also on the prevalence of disease in the population sampled, the prevalence of surgical brain lesions was evaluated retrospectively in this caselist for each of the clinical patterns previously defined, in order to evaluate the predictive value of serial brain scintigraphy and of brain computerized tomography. In this caselist the most frequent clinical patterns (stroke, skull trauma) show a low prevalence of surgical lesions, unlike it happens in the Neurosurgery Department of another hospital chosen as reference. It follows that in the sample of population constituted by the patients hospitalized for "stroke" in the Neurology Department of this hospital the Bayes' theorem yields a predictive value of brain scintigraphy not significantly inferior in respect of computerized brain tomography. In addition a review of the positive scans of patients with cerebral infarction has shown the possibility of a correct diagnosis in 95%. Therefore the serial scintigraphy is thought to keep a high value as a screening tool in this kind of patients where, after a simple clinical selection, the prevalence of brain lesions needing of surgery is low.

A case of left atrial myxoma shown on an equilibrium radionuclide ventriculography is presented. A peculiar abnormality of the Fourier phase image appears more reliable than the other findings previously revealed by first-pass or equilibrium studies. The findings were perfectly consistent with the gross anatomy of the tumour.

A clinical evaluation of the dipyridamole in the myocardial perfusional scintigraphy (MPS) was carried out in a series of patients, comprehensive of cases of unstable angina, aiming to assess the feasibility and diagnostic validity of the test and to state its possible role in comparison with exercise stress test. On the whole, 107 subjects were examined (34 with stable angina, 23 with unstable angina, 19 with recent myocardial infarction, 15 with atypical angina, 10 with chest pain of uncertain origin and 6 healthy volunteers), performing 108 scintigraphic studies (48 after dipyridamole infusion and 37 after bicycle exercise). In the studies with physical or pharmacologic stress a redistribution scintigraphy was also performed (4 hour after the injection). The dipyridamole stress test was well tolerated by patients with unstable angina too and showed a diagnostic sensitivity equivalent to that with exercise stress, although the latter appears better as regards image quality and can give an increase of sensitivity provided electrocardiographic findings are evaluated. Post-stress redistribution of 201 Tl in delayed scans was shown either after dipyridamole or after exercise in patients with typical angina without prior infarction. The computation, by the Bayes's theorem, of the predictive value of the two tests leads the Authors to the following conclusions: in atypical angina (prevalence of CAD: about 40%) the association MPS + exercise ECG is preferable; in patients with chest pain of uncertain origin or with asymptomatic electrocardiographic alterations (prevalence of CAD: about 15%) it is better to take into account only the scintigraphic findings obtained after exercise or pharmacologic stress, to avoid an excess of false positive results.

We studied 33 patients (28 males, 5 females) with first inferior acute myocardial infarction (AMI) and 12 normal volunteers. They underwent first-pass (FP) and equilibrium-gated radionuclide angiography (EGRA) within 4 days of the onset of symptoms. The parameters [ejection fraction (EF), peak ejection rate (PER), peak filling rate (PFR)] of the time-activity curve (TAC) of both ventricles [left ventricle (LV), right ventricle (RV)] were computed. The regional wall motion (RWM) was evaluated by parametric images (amplitude and phase). In 43% of the patients with AMI, we found a depressed RVEF, while the LVEF was decreased in only 33%. The sensitivity of diastolic parameters was shown to be clearly superior to that of the systolic parameters (RVPFR, 78%; LVPFR, 79%). The abnormalities of the overall performance of both ventricles were significantly correlated with those of the RWM. The abnormal RVEF allowed us to assess the necrotic involvement of the RV, while a depressed RVPFR suggested an impaired RV compliance mostly on an ischemic basis. Congestive heart failure (CHF) and shock syndrome were significantly correlated with depressed RV parameters, while the LVEF, despite RWM abnormalities, was in the normal range. EGRA with computation of the TAC parameters of both ventricles appeared to be useful for in-hospital prognostic evaluation, therapeutic planning and clinical follow-up of patients with inferior myocardial infarction.

Two methods for the analysis of left ventricle time-activity curve (TAC) of equilibrium gated ventriculography were compared in three groups of subjects [8 controls, 13 patients with coronary artery disease (CAD), 11 patients with myocardial infarction (MI). The first method was based on third-degree polynomial fitting, the second on Fourier analysis. The following parameters were calculated: peak ejection rate (PER), peak filling rate (PFR), time to PER and PFR, and filling fraction at the first third of diastole. A preliminary study of changing values of PER and PFR and of the mean error with increasing number of harmonics summed in order to obtain the best fitting of TAC demonstrated that beyond the sum of the first four harmonics there was no further significant improvement. The advantages of Fourier analysis are as follows: it is independent of the operator and fits only one function to the whole cardiac cycle; it requires less computer time; it provides better differentiation between controls and CAD patients. All of the 13 CAD patients had abnormal PFR on Fourier analysis, only 9 on polynomial analysis. At rest, 9 of the CAD patients had wall motion abnormalities, while only two had an abnormal ejection fraction.

Radionuclide ventriculography during stress has been shown a useful and non invasive technique for detecting left ventricular dysfunction induced by ischemia in association with coronary artery disease. The aim of this study was to assess the usefulness of handgrip and cold pressor test as alternative stresses because of the limits that bicycle exercise presents when it is combined with multigated radionuclide ventriculography. A resting cardiac imaging was performed in 8 healthy volunteers and in 21 patients with coronary artery disease. All of them repeated the examination during handgrip; 6 controls and 11 patients also underwent cold pressor test. Abnormal regional wall motion was observed in 17 of the 21 patients with coronary artery disease who underwent handgrip, while all the controls maintained a normal motility. The test elicited no significant difference in average ejection fraction in both patients and normal subjects. All but one the patients who performed the cold pressor test showed an abnormal motility during the stress. Mean ejection fraction decreased significantly (p less than 0.05). All the controls had a normal response to cold pressor. Our results confirm that these two tests can be alternative to stress testing for detecting coronary artery disease by means of radionuclide ventriculography.

By means of equilibrium gated radionuclide angiography (EGRA) 67 patients were studied with first inferior acute myocardial infarction (AMI) within 4 days of the onset of symptoms and 12 normal volunteers. Ejection fraction (EF) of the left ventricle (LV) and right ventricle (RV) was computed. The regional wall motion (RWM) was evaluated by parametric images of amplitude and phase (Fourier analysis). The following major in-hospital complications were diagnosed in 41 patients (61%): postinfarction angina, congestive heart failure (CHF), high-degree atrioventricular (AV) block, ventricular tachycardia or ventricular fibrillation, shock, extension of infarction, pericarditis, pulmonary embolism and acute pulmonary edema. A significant correlation between RVEF and the extent of RVRWM abnormalities and the incidence of major complications was found. In particular, the incidence of shock and CHF was significantly correlated with that of the RV disfunction, while the LVEF was generally in the normal range despite a high incidence of LVRWM abnormalities. In the patients developing high-degree AV block this correlation did not reach statistical significance; in this group, 10 of 12 patients developed other major complications. Also in 10 of 13 cases with CHF, other complications arose during the period of hospitalization. In conclusion the disfunction of the RV can identify the subgroup of patients with inferior AMI who are at high risk for developing major complications, especially shock and CHF. AV block and CHF have a severe prognostic meaning, because they occur usually in association with other major complications.