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Biomedical subjects

A Mamoli

Publications and source records attributed to A Mamoli.

At least 37 records · Page 2Linked to original sources
PubMed1993

Prognostic factors in first-ever stroke in the carotid artery territory seen within 6 hours after onset.

BACKGROUND AND PURPOSE: We sought to detect prognostic factors related to functional outcome during the first 6 hours after a first-ever stroke in the carotid artery territory. METHODS: All patients with these characteristics seen during a 3-year period were included. Outcome was evaluated according to a modified Rankin scale. The following variables were examined at univariate analysis: sex, age, severity of deficit at entry and at day 7, level of consciousness at entry, time after symptom onset, history of smoking, history of hypertension, diabetes, myocardial infarction, atrial fibrillation, rheumatic heart disease, dilated cardiomyopathy, all potential cardioembolic sources, presence of a consistent lesion on computed tomography at entry and at days 5-9, and the size of such lesion. RESULTS: All entry criteria were met by 172 patients. Age > or = 70 years, a Canadian Neurological Scale score < 6.5 at entry and at day 7, atrial fibrillation, presence of a potential cardioembolic source, and a "large" lesion (involving more than half the cerebral lobe) on computed tomography at days 5-9 were associated with a significantly worse outcome both at 30 days and at 6 months. After multivariate analysis, a Canadian Scale score < 6.5 at entry (p < 0.0001) and atrial fibrillation (p = 0.005) were associated with a significant handicap or death at 30 days, whereas only a Canadian Scale score < 6.5 (p < 0.0001) was associated with a worse prognosis at 6 months. An association of age > or = 70 years with a worse outcome at 6 months was of borderline significance (p = 0.054). CONCLUSIONS: Some prognostic indicators are available during the first few hours after onset of a carotid ischemic stroke and may be useful in the stratification of patients in clinical trials. Severity of deficit is the most important indicator, whereas the presence of atrial fibrillation worsens the prognostic outlook with respect to early handicap but not mortality.

Adult↗
PubMed1992

A case control study of CSF copper, iron and manganese in Parkinson disease.

To elicit possible variations in the CSF concentrations of copper, iron and manganese due to Parkinson disease (PD) or to the stage reached, we tested 11 patients with idiopathic PD, 6 untreated and 5 on long term L-dopa, versus 22 age and sex matched patients with other neurological disorders (control group-CG). The CSF levels of the three metals, measured by electrothermal atomization, did not differ significantly between the PD group and CG or between either of the PD subgroups and CG. Our findings therefore do not support the hypothesis that CSF Cu is a marker of PD.

Aged↗
PubMed1992

A clinical, electrophysiological, morphological and immunological study of chronic sensory neuropathy with ataxia and paraesthesia.

We have observed 9 patients (8 men and 1 woman), 58 to 77 years of age with neuropathy with only sensory symptoms and insidious onset. Five of them (4 men and 1 woman) aged 65 to 77 years, had normal serum electrophoretic profiles, while the others (all men), 58 to 74 years, had IgM monoclonal gammopathy of undetermined significance (MGUS). Clinical data were consistent with a sensory neuropathy affecting predominantly the kinesthetic sense (position and vibration sensation). The electrophysiological data indicated predominant sensory axonal neuropathy. Morphological data confirmed the primary axonal damage. Western immunoblot showed that the IgG from a patient without MGUS reacted with a 55 kD protein of dorsal root ganglion homogenate. Three of four patients with IgM MGUS were serum reactive against chondroitin sulfate C (ChS-C) in double immunodiffusion. After absorption with ChS-C the monoclonal peak completely disappeared from two patients and was decreased in the third patient. Our data indicate that immunological abnormalities are part of the pathogenesis for a subgroup of chronic neuropathy with only sensory symptoms.

Aged↗
PubMed1992

Local intraarterial thrombolysis for acute stroke in the carotid artery territories.

We have tested the feasibility of local intraarterial thrombolytic therapy in ischemic stroke in the carotid artery territories observed within 5 h of the onset of symptoms. Only 5 of 615 consecutive patients were enrolled. They were 1 man and 4 women aged 50 to 75 years. Angiography disclosed occlusion of the M2 tract in one, of the M3 tract in one, of the carotid siphon in one of M4 tract in two. Intraarterial urokinase was infused at a mean dosage of 560,000 units close to the site of occlusion. Four of them had partial or complete recanalisation at early angiographic control and were independent at 6th month control. The one who did not demonstrate recanalisation was confined to a wheelchair. One patient, who had recanalisation, sustained a hemorrhagic transformation of the brain ischemia not interfering with outcome. Our experience, at the light of the low rate of enrollment, despite the results, suggest that intraarterial thrombolysis may be a therapeutic tool for selected patients with stroke in the carotid artery territories and not a routinary treatment for them.

Aged↗
PubMed1991

Polyneuropathy associated with IgA monoclonal gammopathy: a hypothesis of its pathogenesis.

We describe three patients with chronic progressive polyneuropathy associated with IgA monoclonal gammopathy. Two patients had a prominent sensory neuropathy and one had a prominent motor neuropathy. Sural nerve biopsies showed axonal degeneration in all cases. In immunocytochemical studies patients' IgG immunostained axons. By Western immunoblot a band of IgG reactivity with an axonal protein of 66 kDa was found. No band of IgA and IgM were found. We suggest the possibility that the IgA monoclonal protein may act as a stimulating factor of preexisting B cell clones eliciting an immune reaction against nerve antigens.

Aged↗
PubMed1991

Frequency of multiple sclerosis in Valle d'Aosta, 1971-1985.

According to studies done before 1980, the multiple sclerosis (MS) prevalence rate in Italy ranged from 7.2 to 27.1 cases per 100,000 inhabitants. More recent work has consistently put the MS prevalence rate to over 30 cases per 100,000 inhabitants. If these recent data are confirmed in the future, Italy can no longer be regarded as a country at low risk for MS, but must be included among the medium-high risk countries of continental Europe. We report the results of a prevalence and incidence survey conducted in Valle d'Aosta, a region whose special features make it an excellent epidemiological model. The mean annual incidence was 2.1 and on December 31, 1985, the prevalence was 39 cases per 100,000 inhabitants. These results confirm that the incidence and prevalence rate of MS in Valle d'Aosta is close to that of areas at high-risk for MS.

Adolescent↗
PubMed1991

Inherited protein C deficiency and nonhemorrhagic arterial stroke in young adults.

Out of a consecutive series of 50 young people less than 45 years old with nonhemorrhagic arterial stroke, three patients had inherited protein C deficiency. CT revealed hypodense areas consistent with the clinical picture, and angiography showed occlusion of some intracranial arterial vessels. Other possible associated causes of stroke were ruled out. One patient had a transient ischemic attack and a peripheral venous thrombosis prior to the actual stroke, whereas the others were completely asymptomatic, as were relatives with the same deficiency. We suggest determining protein C in ischemic stroke of all young adults, especially when major risk factors are excluded.

Adult↗
PubMed1990

Cardiovascular reflexes in Parkinson's disease: long-term effects of levodopa treatment on de novo patients.

Twelve parkinsonian patients (6 men and 6 women), mean age 60.5 years, range 47-72, were examined with autonomic test when de novo and after 2 years of continuous levodopa treatment. They were all free from any disease interfering with autonomic examination. When de novo they had a significant decrease of heart rate response to deep breathing and to laying to standing tests if compared with an age- and sex-matched control group (15.6 +/- 8.8 vs. 28.6 +/- 12.1, P less than 0.01 and 7.0 +/- 7 vs. 14.2 +/- 5, P less than 0.01). After 2 years of levodopa treatment they had a non-significant decrease of heart rate response to deep breathing test (21.8 +/- 10.6, P N.S.) and a still significant decrease of heart rate response to laying to standing test, but at a lesser level (7.7 +/- 7.0, P less than 0.05). Furthermore, they showed a significant decrease of the systolic and MAP orthostatic pressure to tilting table (-9.2 +/- 12.0 vs. +4.9 +/- 8.9 and -4.5 +/- 8.4 vs. +4.7 +/- 5.1, both P less than 0.01) probably due to medication. The other tests were never significant. We hazard as possible explanation an action of levodopa on dopaminergic neurons in the nucleus dorsalis of vagus.

Aged↗
PubMed1989

Considerations after intraoperative monitoring of somatosensory evoked potentials during carotid endarterectomy.

Somatosensory evoked potentials (SEPs) following median nerve stimulation were used to monitor cerebral function during 26 carotid endarterectomies. The patients with minor SEP variations had no neurological deficits on regaining consciousness while the one with more serious SEP variations had a transient deficit. The method thus seems useful in the early detection of ischemic brain impairment.

Aged↗
PubMed1988

Tuberoinfundibular dopaminergic function in Parkinson's disease.

A deficit of nigrostriatal, mesocortical and mesolimbic dopamine systems in Parkinson's disease is well known. We know less about the involvement of tuberoinfundibular dopamine (TID) systems. In untreated (naive or wash-out) men with Parkinson's disease, we studied TID function through basal and stimulated plasma levels of growth hormone, prolactin and thyrotropin. Only minor abnormalities in prolactin responses to thyrotropin-releasing hormone were found, probably reflecting denervation hypersensitivity. TID function is preserved in men with Parkinson's disease.

Aged↗
PubMed1987

Central and peripheral involvement in hemodialysed subjects: neurophysiological and nephrological relationships.

Nerve conduction velocity and visual evoked potential studies were conducted in 31 patients with chronic renal failure undergoing periodic hemodialysis. The results indicate damage to the central nervous system, such as delayed P100 wave, even in the absence of clinical signs, and to the peripheral nervous system, such as distal sensorimotor neuropathy. The degree of peripheral involvement correlates with the duration of dialysis and with some blood chemistry values but not with the evoked potential parameters. There is no correlation between central and peripheral nervous damage, which presumably points to a difference in pathogenesis.

Adult↗
PubMed1987

Polyneuropathy in hypothyroidism: clinical, electrophysiological and morphological findings in four cases.

Clinical, neurophysiological and morphological studies of four patients with polyneuropathy and secondary hypothyroidism are reported. Neurophysiological studies revealed signs of muscle denervation and reduction of conduction velocity in all the patients. Sural nerve biopsies showed axonal degeneration in all cases but one. All the patients were treated with replacement therapy and clinical symptomatology and neurophysiological parameters improved in all patients.

Action Potentials↗
PubMed1987

Parasympathetic assessment in Parkinson's disease.

There is little evidence of autonomic dysfunction in PD, although autonomic disturbance was included in the original description by J. Parkinson. In addition, there are no data for de novo PD patients. We selected 14 de novo parkinsonians (seven men and seven women), aged 62.7 +/- 8.2 years, with mild disease (stage 1 through 2 on the Hoehn and Yahr's scale), without history of diabetes, heart disease, or alcoholism, and without neuropathy or orthostatic hypotension. Fourteen age- and sex-matched normal persons were controls. We found a highly significant difference in the respiratory sinus arrhythmias during deep breathing (p less than 0.01); the basal heart rate, the respiratory sinus arrhythmias during quiet breathing, and the Valsalva ratios did not differ statistically, however. In the absence of neuropathy and orthostatic hypotension and in the presence of normal Valsalva ratios, we believe that the abnormality found by us may apply only to parasympathetic dysfunction, perhaps at a central level. In addition, the abnormality seems to be independent of stage and therapy.

Aged↗
PubMed1986

[Acute myopathy and hyperthyroidism].

A 40 year-old woman with a rapidly progressive proximal muscle deficit of all four limbs had an acute myopathy secondary to hyperthyroidism. Biopsy of the quadriceps femoris revealed signs of non specific muscle impairment with type II fiber atrophy. Treatment with methimazole and correction of the thyroid condition led to rapid disappearance of the disorders. Eighteen months later the clinical status was normal and a second quadriceps femoris biopsy showed that the muscle had normalized.

Acute Disease↗
PubMed1985

Hereditary motor neuropathy, distal type: electrophysiological and pathological studies of a case.

A case of HMN, distal type transmitted as autosomal dominant is described. Clinical findings appear to be consistent with a peroneal muscular atrophy, indistinguishable from HMSN types I and II. The electrophysiological data reveal a pathological involvement of the anterior horns, whereas sensory and motor conduction are normal. A muscle biopsy showed neurogenic atrophy, while the morphology of the sural nerve was normal.

Adult↗