住院精神分裂症患者十年前后用药情况对比分析

目的对十年前后精神分裂症患者用药情况的变化进行调查分析.方法对十年前后两个五年段的各500份符合精神分裂症诊断标准的病历进行回顾性调查,并对各项指标进行对比分析.结果两组折算用药剂量经t检验差异无显著性(P>0.05);两组合并用药、合并抗胆碱药及疗效经χ2检验差异有显著性(P<0.01);十年后非典型抗精神病药物氯氮平在临床上的应用比例明显增大并上升为首位.结论十年前后两组抗精神病药的应用发生了明显变化,疗效好、副作用轻的非典型抗精神病药的应用比例明显增加.     

Nitrite plasma levels in normolipemic and hypercholesterolemic patients with peripheral occlusive arteriopathy

BACKGROUND: The authors studied the nitrite plasma levels in a group of patients with peripheral obstructive arteriopathy. METHODS: The series consisted of 63 subjects (43 males, 20 females, mean age 64 +/- 9 years) suffering from peripheral arterial occlusive disease of the lower limbs, at II (55 cases) and III (8 cases) Fontaine stage; 21 subjects with total cholesterol (TC) lower than 200 mg/dl were considered as normolipemics, 24 subjects with TC values between 200 and 240 as mild hypercholesterolemics, 18 subjects with TC above 240 mg/dl as severe hypercholesterolemics. For each subject the determination of nitrite plasma levels was carried out, by the Gutman and Hollywood colorimetric method. RESULTS: In the normolipemic arteriopathics the basal value of nitrites was sharply reduced (p < 0.05) compared to the controls; in the mild hypercholesterolemics the mean basal value of nitrites was markedly higher compared to the controls; in the severe hypercholesterolemics the mean basal value of nitrites was statistically (p < 0.05) higher than that of the controls. In the arteriopathic patients, globally considered, the mean basal value of nitrites was superimposable on that of the normal control subjects. CONCLUSIONS: This study, carried out on the nitrite plasma levels in a group of arteriopathic patients allowed us to show the enhanced levels of nitric oxide due to the increase of LDL; this effect, previously observed in hypercholesterolemic diabetic and coronaropathic patients, leads us to the hypothesis of a stimulating effect of LDL upon NO endothelial synthesis; this would be a compensatory response to the damaging and vasoconstricting action of LDL.     

Nitrite plasma levels in normolipemic and hypercholesterolemic arteriopathics after vasoactive and lipid-lowering treatment

BACKGROUND: The authors studied the plasmatic levels of nitrites, stable end-products of nitric oxide in arteriopathic patients before and after vasoactive and lipid-lowering treatment. METHODS: The series consisted of 63 subjects (mean age 64 +/- 9) suffering from peripheral arterial occlusive disease; 21 subjects with total cholesterol (TC) lower than 200 mg/dl were considered as normolipemic (group A); 24 subjects with TC ranging between 200 and 240 mg/dl were considered as mild hypercholesterolemic (group B); 18 subjects with TC higher than 240 mg/dl were consider as severe hypercholesterolemic (group C). All the patients were examined before and after 15 and 30 days of a vasoactive treatment (calciparine, aspirin, buflomedil and pentoxiphylline); group B after vasoactive and diet (NCEP phase 1) treatment and group C after vasoactive, diet and drug (simvastatin) treatment. Nitrite plasma levels were determined by the Gutman and Hollywood colorimetric method. RESULTS: In group A the basal value of nitrites was sharply (p < 0.05) lower than controls; after vasoactive treatment a significant increase (p < 0.05), was observed after 15 and 30 days; in group B the basal value was higher than controls; after 15 days a significant increase (p < 0.5) was noted, but a regression was found after 30 days. Also in group C the basal value of nitrites was higher (p < 0.05) than controls; after treatment significant changes were not found. CONCLUSIONS: The increase of nitrites in group A may be due to an improved endothelial function; this phenomenon, less appreciable in group B and no longer evident in group C may depend on the lipid-lowering treatment.     

Left ventricular pseudoaneurysm after mitral valve replacement

Development of left ventricular pseudoaneurysm is a rare complication of mitral valve surgery and requires urgent surgical intervention. We describe a case of pseudoaneurysm of membranous septum following repeat mitral valve replacement with the use of multimodality imaging.