Small-volume hypertonic saline solution and high-dosage furosemide in the treatment of refractory congestive heart failure. A pilot study

Objective: To evaluate a new therapeutic approach to hospitalised patients with refractory congestive heart failure (CHF) based on published data on the efficacy of furosemide (frusemide) intravenous infusion in refractory CHF and of small volumes of hypertonic saline solution in the low-flow state. Design and Setting: Prospective, uncontrolled study of hospital inpatients. Study Participants and Interventions: Thirty patients (20 males and 10 females) aged 65 to 85 years with refractory New York Heart Association (NYHA) functional class IV CHF were given a twice-daily intravenous infusion of a small volume of hypertonic saline solution (150 ml of 1.4 to 4.6 NaCl) containing high-dosage fur…

Cardiac involvement in rheumatoid arthritis: Evidence of silent heart disease

Background : Rlieumatoid arthritis (RA) is a systemic disease involving many organ systems and is frequently accompanied by cardiac alterations. However, there is considerable disagreement concerning the cardiac abnormalities found in patients with RA. The purpose of our investigation was to determine, by a non-invasive method such as echocardiography, the nature and extent of cardiac involvement in RA patients with no symptoms of cardiac disease, in comparison with a control sample. Methods : We selected 35 patients affected by rheumatoid arthritis (five men, 30 women), aged 51 ± 11 years. No patient had either symptoms of cardiac disease or extra cardiac complaint. As a control group we s…

Two-dimensional echocardiographic evaluation of left ventricular ejection fraction by the ellipsoid single-plane algorithm: a reliable method for assessing low or very low ejection fraction values?

The reliability of two-dimensional (2D) echocardiographic estimation of left ventricular ejection fraction (EF) is commonly recognized, but no satisfactory data are available about the accuracy of low or very low EF values determined by 2D echocardiography (ECHO-EF). The purpose of our study was to assess the reliability of low ECHO-EF values obtained using a simple time-economical algorithm such as the ellipsoid single-plane area-length method. Radionuclide angiography (RAD-EF) was taken as the standard of comparison. We studied 59 consecutive patients (31 women and 28 men) referred to our echocardiographic laboratory. Both 2D echocardiography and radionuclide angiography were blindly perf…

Safety analysis in the LBE-Cooled XADS plant through an integrated use of HAZOP, FAULT TREE and thermalhydraulic transient analyses

A detailed description of possible accidental scenarios, with their frequency of occurrence and their consequences, taking into account both internal and external causes that might contribute to them, can be attained by using the most important risk analysis methodologies (HAZard and OPerability studies, HAZOP; Event Tree, ET; Fault Tree, FT; etc.). As it is known, the Fault Tree methodology is aimed at the evaluation of the frequency of an undesired accidental event (Top Event, TE), and is used to describe this one as a combination of primary events identified, for example, by a HAZOP analysis [1]. However, the classic HAZOP analysis, while allowing to perform an exhaustive study of the ex…

Preliminary results on the effects exerted in vitro by lycopene extracted from halobacteria living in salt-work of trapani (Western Sicily, Italy).