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Biomedical subjects

A Agnoli

Publications and source records attributed to A Agnoli.

At least 19 recordsLinked to original sources
PubMed1992

Intravenous boluses and continuous infusions of L-dopa methyl ester in fluctuating patients with Parkinson's disease.

In six patients with Parkinson's disease exhibiting severe "on-off" phenomena, a 200-mg intravenous bolus of either L-DOPA or of its methyl ester were equally effective in reversing motor deficits, although the duration of action of the methyl ester was shorter. There were no marked differences in pharmacokinetic parameters for L-DOPA plasma levels after administration of L-DOPA and the methyl ester. In three patients, optimal infusion rates for the maintenance of mobility were established for L-DOPA and L-DOPA methyl ester. Both drugs were able to maintain patients "on" throughout a 12-h infusion period. However, on average the optimal infusion rate of L-DOPA methyl ester was 2.7 times greater than that for L-DOPA. There was no marked difference in the plasma levels of L-DOPA achieved, but 3-O-methyl DOPA levels increased more after infusion of L-DOPA methyl ester than after infusion of L-DOPA itself. The half-life of elimination and volume of distribution of L-DOPA formed from the methyl ester were markedly increased compared with values obtained after either an intravenous bolus of methyl ester or after an intravenous infusion of L-DOPA itself. An intravenous bolus of L-DOPA methyl ester produces an equivalent magnitude of clinical response to the same dose of L-DOPA. However, higher optimal infusion rates of methyl ester than L-DOPA are required to produce continuous effect. The pharmacokinetic handling of L-DOPA methyl ester given by intravenous infusion may differ from that of L-DOPA when given by the same route.

Aged↗
PubMed1992

CBF and cognitive evaluation of Alzheimer type patients before and after IMAO-B treatment: a pilot study.

Ten patients diagnosed as affected by primary degenerative dementia of the Alzheimer type, with a mild to moderate cognitive and behavioral impairment, were studied in a double blind design when taking for 60 days 5 mg twice a day of L-deprenyl or placebo. Cognitive functions and cerebral blood flow were assessed at the beginning and at the end of treatment by a wide array of memory, attention, and language efficiency measures and by SPECT-99TcHMPAO procedure. Reduced CBF on the parietal lobes was demonstrated in the patients at baseline together with a reduction of memory and cognitive efficiency. At the end of the treatment patients who received L-deprenyl showed an improvement in cognitive efficiency and no changes in CBF, while patients treated with placebo showed a worsening of cognitive efficiency and further reduction of parietal lobe CBF.

Aged↗
PubMed1992

Transcranial Doppler in spontaneous attacks of migraine.

BACKGROUND AND PURPOSE: Our aim in this study was to compare headache-free and spontaneous migraine measurements of blood flow velocity and the pulsatility index in the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery. METHODS: Thirty-one patients (nine having experienced migraine with aura and 22 migraine without aura) were studied in headache-free periods and during spontaneous migraine attacks with transcranial Doppler ultrasonography. RESULTS: During attacks of migraine with aura, blood flow velocities (particularly the diastolic velocity [p = 0.05]) were reduced while the pulsatility index increased (p = 0.05), whereas a generalized increase in diastolic velocity (p less than 0.02) and a decrease in the pulsatility index (p = 0.05) were observed during attacks of migraine without aura. Significant variations of blood pressure and heart rate were never found. CONCLUSIONS: These findings are consistent with constriction of resistance vessels in migraine with aura and dilatation of the vessels in migraine without aura. This disparity could be due to a difference between the two migraine types or could be related to the fact that in this study the time interval between headache onset and transcranial Doppler was shorter in the migraine-with-aura group. The latter explanation would apply if, in fact, both types of migraine evolve from hypoperfusion to hyperperfusion during their time course, although perhaps with a difference in intensity.

Adult↗
PubMed1991

Nimodipine in migraine: clinical efficacy and endocrinological effects.

Serum prolactin is increased during chronic flunarizine treatment of patients suffering from migraine. In order to clarify the role of calcium in control of the secretion of anterior pituitary hormones, a study has now been made of the effects of chronic nimodipine and propranolol treatment of migraine patients on prolactin (PRL), luteinizing hormone (LH) and growth hormone (GH) levels. 11 patients were treated with nimodipine and 8 with propranolol for four months. A statistically significant reduction in the frequency of the attacks was demonstrated in both groups. No significant change was found in the hormones levels during nimodipine treatment.

Adult↗
PubMed1991

The clinical efficacy of oral levodopa methyl ester solution in reversing afternoon "off" periods in Parkinson's disease.

We compared the efficacy of a single dose of an oral solution of levodopa methyl ester (ME) to that of standard levodopa, in the form of a single dose of Madopar, in reversing afternoon "off" periods in 12 patients with Parkinson's disease (PD). The highly soluble ME solution led to a significantly more rapid reversal of "off" periods. This preparation may therefore convey a clinical advantage in patients experiencing motor fluctuations whilst taking multiple daily dosages of levodopa, particularly in those with long or highly variable latency to the next "on" period.

Administration, Oral↗
PubMed1991

Antagonist effect of terguride in Parkinson's disease.

The effects of the partial dopamine agonist terguride (9,10 transdihydrolisuride; THDL) on striatal dopamine receptors were studied by its i.v. administration to 13 patients with Parkinson's disease. Patients were maintained in a steadily mobile state with abnormal involuntary movements by a constant i.v. infusion of levodopa. Terguride showed dopamine antagonist properties in nine patients. In two of these nine patients, a decrease in dyskinesia score was observed without a concomitant worsening of parkinsonian symptoms, whereas in the remaining seven, full parkinsonian akinesia followed THDL administration. The subsequent i.v. injection of the dopamine agonist lisuride reversed THDL-induced akinesia in these seven patients. In the remaining four patients, no clinically significant motor effects were observed. These results show dopamine antagonist activity of terguride in patients with Parkinson's disease treated with Levodopa. Further studies using a wider dose titration are required to evaluate the possible role of dopamine partial agonists in the therapy of levodopa-induced dyskinesias.

Adult↗
PubMed1991

Headache in the use and withdrawal of opiates and other associated substances of abuse.

The incidence and character of headache were retrospectively studied in 40 opiate addicts and 40 control subjects. The relationships between headache and use and withdrawal of opiates or other associated substances of abuse were investigated. In the opiate-dependent patients, the effects of opiate intake and withdrawal on headache were also investigated during detoxification treatment. A higher (p less than 0.001) incidence of headache was found in the opiate addicts (60%), particularly those with a longer history of addiction, than in the control subjects. A history of different types of headache (tension type headache, migraine-like headaches), which seemed respectively to be associated with the use of certain types of heroin, cocaine intake, and opiate withdrawal, was reported by the addicts who suffered from headache. Out of the 24 patients who completed the detoxification therapy, a migraine-like headache occurred in 37.5% of the subjects after opiate withdrawal.

Adult↗
PubMed1991

Transcranial Doppler (TCD) after nitroglycerin in migraine without aura.

Nitroglycerin, a vasodilating agent, was administered sublingually in migraine without aura patients and in healthy volunteers. Systolic, diastolic and time-mean flow velocity and pulsatility index, were measured by transcranial Doppler sonography in the major intracranial arteries before and after nitroglycerin administration. Following nitroglycerin administration, a significant decrease in systolic and time-mean velocity and pulsatility index was observed in migraine patients, whereas in control subjects only time-mean velocity decreased significantly. Based on those findings we hypothesize a more marked responsiveness to nitroglycerin in migraine patients as compared to healthy subjects.

Adult↗
PubMed1991

Continuous intravenous infusion of TRH-T: clinical, cardiovascular and endocrinological effects.

Seven patients, six suffering from amyotrophic lateral sclerosis (ALS) and one from Friedreich ataxia, were treated with a placebo i.v. infusion during the first day and with TRH-T i.v. infusion at a rate of 2 mg/h for 8 h daily (total daily dosage 16 mg) on the 2 consecutive days. Continuous blood pressure (BP) and EKG monitorings were performed during 3 days infusion. Blood samples were collected for endocrinological evaluations. The neurological evaluation after acute TRH-T treatment showed an objective improvement in 3 of the 8. We found significantly higher values of systolic (max. difference of 10.1 mm Hg) and diastolic (max. difference of 8.8 mm Hg) BP than during placebo, beginning from the 5th h of the infusion (p less than 0.05). A trend in progressive increase of the heart rate (HR) reached statistical significance (p less than 0.01) at the 8th h of the second TRH-T infusion. The cardiovascular changes during the i.v. continuous TRH-T infusions were clinically irrelevant and never required the interruption of the treatment.

Adult↗
PubMed1991

Post-endarterectomy headache and the role of the oculosympathetic system.

A study was carried out on headache after carotid endarterectomy. A specific type of headache, similar in its characteristics to "cluster headache", occurred on the operative side in 30% of 54 patients, whereas no such headache occurred after extra-intracranial bypass or peripheral vascular surgery. This postoperative headache was not spontaneously reported by 56% of patients unless they were specifically asked about it. Pharmacological pupillary testing performed in 37 patients revealed that a decreased oculosympathetic activity (with or without adrenoceptor supersensitivity) was constantly associated with post-endarterectomy headache. Although this same abnormality was also observed in 54% of the patients without headache, a statistically significant (p less than 0.01) higher prevalence of decreased oculosympathetic responses was found in the patients with headache. The results suggest that damage to the sympathetic plexus due to the surgical procedure is involved in the development of postoperative "cluster-like" headache.

Carotid Artery Thrombosis↗
PubMed1990

Botulinum A toxin injection in patients with blepharospasm, torticollis and hemifacial spasm.

Botulinum A toxin was injected into the affected muscles in 20 patients with blepharospasm, 8 with torticollis and 12 with hemifacial spasm. In all cases blepharospasm and hemifacial spasm was abolished or markedly reduced. The only side effect was transient ptosis and diplopia. Patients with torticollis had a mild to moderate improvement of the dystonic posture and pain; dysphagia was the most troublesome side effect. Botulinum A toxin is an effective therapy in patients with focal dystonia and spasms.

Blepharospasm↗
PubMed1990

Increased reactivity to a met-enkephalin analogue in the control of autonomic responses in migraine patients.

The effects of naloxone and a met-enkephalin analogue on head pain, vascular responses, and autonomic-associated symptoms were studied in 24 migraine patients, 12 patients suffering from tension-type headache, and 24 normal subjects in whom headache was induced by intravenous injections of increasing doses of histamine (histamine test). A hypersensitivity to histamine was found in migraine patients. Naloxone slightly increased the intensity of pain in migraine and tension-type headache sufferers. The met-enkephalin analogue did not affect the intensity of pain in migraine patients, tension-type headache patients, and normal subjects, but it reduced the intensity and duration of facial flushing (p less than 0.001) and the autonomic symptoms (p less than 0.001) in migraine patients when the pretreatment was not given shortly before histamine. In migraine patients, there seems to be an increased reactivity (receptor supersensitivity?) to the met-enkephalin analogue at the level of systems that inhibit facial vasodilatation and autonomic symptoms.

Adult↗
PubMed1990

Moclobemide compared with second-generation antidepressants in elderly people.

Two multicentre studies are described here; the first compared moclobemide with mianserin and the second with maprotiline, both in elderly patients with a DSM-III diagnosis of major depressive episode. In the first study, 80 eligible patients were randomized to either moclobemide 300-500 mg or mianserin 75-125 mg per day for 4 weeks. Mean reduction in Hamilton Rating Scale for Depression (HRSD) score was 52% in both groups. The overall assessment of efficacy was good or very good for 60% of the patients, and tolerance was considered good or very good for 85% of the patients in both groups; no significant differences between the 2 treatments were seen. The second study comprised 39 hospitalized patients randomized to either moclobemide 150-300 mg daily or maprotiline 75-150 mg daily for 6 weeks. At the end of treatment, HRSD scores declined 85% in both groups compared with baseline. The overall assessment of efficacy was over 90% good or very good in both groups. Tolerance was rated good or very good for 80% of moclobemide and 75% of maprotiline patients; none of these results differed significantly between the groups, indicating that moclobemide is as effective in elderly patients as the 2 second-generation antidepressants. In view of the safety of moclobemide, it should be considered first-line therapy for depression in elderly people.

Aged↗
PubMed1989

One year treatment with lisuride delivery pump in Parkinson's disease.

1. A group of 14 fluctuating Parkinsonian patients underwent the subcutaneous Lisuride treatment, administered by an insulin delivery pump. Clinical response has been studied during a one year period. 2. Some patients (8 out of 14) were in combined therapy, assuming a relative small amount of oral L-Dopa together with subcutaneous Lisuride. 3. Lisuride confirmed, also by the subcutaneous route, its antiparkinsonian properties, without any loss of therapeutical efficacy during the 12 month period considered. 4. 7 patients dropped-out from the study, due to psychiatric or systemic side-effects and to "technical" management of the pump. 5. The only 2 patients assuming a 24 hour regimen of Lisuride infusion were among the withdrawn subjects. They were also the only to complain severe psychiatric disturbances.

Adult↗
PubMed1989

Effects of terguride in patients with Huntington's disease.

trans-Dihydrolisuride, a partial dopamine receptor agonist, was tested for its effects on chorea in a double-blind, crossover clinical study in 10 patients with Huntington's disease. In eight patients, a neurophysiological evaluation was also performed. No reduction in choreic movements or improvement in voluntary movement performance was observed. However, in some patients, there was a slight improvement in patients' alertness and a reduction of the movement reaction time.

Adult↗