No evidence of association between prothrombotic gene polymorphisms and the development of acute myocardial infarction at a young age

Background : we investigated the association between 9 polymorphisms of genes encoding hemostasis factors and myocardial infarction in a large sample of young patients chosen because they have less coronary atherosclerosis than older patients, and thus their disease is more likely to be related to a genetic predisposition to a prothrombotic state Methods and Results : this nationwide case-control study involved 1210 patients who had survived a first myocardial infarction at an age of 45 years who underwent coronary arteriography in 125 coronary care units and 1210 healthy subjects matched for age, sex, and geographical origin. None of the 9 polymorphisms of genes encoding proteins involved in coagulation (G-455A -fibrinogen: OR, 1.0; CI, 0.8 to 1.2; G1691A factor V: OR, 1.1; CI, 0.6 to 2.1; G20210A factor II: OR, 1.0; CI, 0.5 to 1.9; and G10976A factor VII: OR, 1.0; CI, 0.8 to 1.3), platelet function (C807T glycoprotein Ia: OR, 1.1; CI, 0.9 to 1.3; and C1565T glycoprotein IIIa: OR, 0.9; CI, 0.8 to 1.2), fibrinolysis (G185T factor XIII: OR, 1.2; CI, 0.9 to 1.6; and 4G/5G plasminogen activator inhibitor type 1: OR, 0.9; CI, 0.7 to 1.2), or homocysteine metabolism (C677T methylenetetrahydrofolate reductase: OR, 0.9; CI, 0.8 to 1.1) were associated with an increased or decreased risk of myocardial infarction Conclusions : this study provides no evidence supporting an association between 9 polymorphisms of genes encoding proteins involved in hemostasis and the occurrence of premature myocardial infarction or protection against it

Role of Gated-SPECT in the early diagnosis of ischaemic cardiopathy in the diabetic.

Diabetes presents a higher risk of both symptomatic and asymptomatic coronary artery disease (CAD). Myocardial perfusion SPECT, particularly associated with Gated acquisition, makes it possible to diagnose CAD on the basis of the presence and extent of perfusion defects, and to carry out the stratification of the cardiological risk (infarction or cardiac death) by analyzing the results of perfusion and of the functional data (ejection fraction, EF, and wall movement). Gated myocardial SPECT in the diagnosis and stratification of risk has proved superior to clinical evaluation or the exercise test alone, and it is also superior to echostress/dobutamine in the evaluation of monovasal disease. These data have been confirmed not only in the population at large but also in the diabetic population, making the technique important also in such patients also affected by coronary disease which is earlier and more advanced in diagnosis. Scintigraphic data make it possible to classify patients into various risk categories (low, intermediate and high) on the basis of which a specific therapeutic approach can be established. The present review develops the above concepts, taking into consideration the consolidated studies present in the literature, for the purpose of pinpointing the diagnostic approach in which exercise or SPECT myocardioscintigraphy can be assigned

Diagnostic accuracy of right ventriculography in arrhythmogenic right ventricular cardiomyopathy.

IF JCR 2007: 3.60

Hormone replacement therapy and urogenital disease in postmenopausal women

Estrogen deficit in postmenopausal women causes urogenital atrophy, which is responsible for a wide range of urinary disorders (urinary incontinence, urge incontinence, recurrent urinary infections) and genital disorders (prolapse, dispareunya, vaginal dryness). The efficacy of estrogen therapy on urinary incontinence is not yet demonstrated, but it is widely recognized that the topical use of estrogens lowers the risk of recurrent urinary infections and improves urogenital atrophy

Bone ultrasonometry measurements during pregnancy

Abstract Purpose During pregnancy we can have changes of the calcium metabolism that can determine a loss of bone mass. Some studies used single-photon absorptiometry (SPA) or dual-energy X-ray absorptiometry, but these exams are inadvisable in pregnancy for the teratogenic eVects on the fetus. We used quantitative ultrasonometry (QUS). The aim of this study is to determine prospective changes of bone density with an ultrasonometry measurement during pregnancy in healthy Italian women. Methods The study population was represented by 59 pregnant women. Quantitative ultrasonometry measurements were performed at the phalanges during the Wrst, second and third trimester. Results We found a progressive decrease of bone time transmission (BTT) from the Wrst to the third trimester, while amplitude dependent speed of sound (AD-SoS) remained stable between the Wrst and the second trimester and decreased at the term of pregnancy. The z- and t-scores decreased more during the second and third trimester. Conclusions These results show an important reduction in the third trimester of pregnancy, of all ultrasonometry variables and then an increase of remodelling with bone demineralisation in the mother. These results show that there is a diVerent bone metabolism in pregnancy in pluriparous and nulliparous women