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Biomedical subjects

A Mangoni

Publications and source records attributed to A Mangoni.

At least 55 records · Page 3Linked to original sources

Warning signs in subarachnoid hemorrhage: a cooperative study.

The present study is part of a survey of subarachnoid hemorrhage cases observed in 16 neurosurgical and 8 neurological departments in Italy between June 1985 and June 1986. Warning signs preceding major hemorrhage were analyzed in 364 patients with intracranial aneurysms confirmed by angiography and reliable clinical history. Seventy-four (20.3%) had warning signs. Clinical features of premonitory warning signs were compared with symptoms of 78 patients without a history of minor leak and clinical grade 1 (according to the criteria of Hunt & Hess) at admission. Symptoms of warning signs are generally clear enough to be considered a misdiagnosis of intracranial aneurysm. Thunderclap headache described as severe, unusual and sudden was the main symptom in every case though the higher frequency of focal of diffuse signs in groups with a correct diagnosis attracted more careful attention in referral and diagnostic-therapeutic management. Improving the identification of minor leak and defining diagnostic strategy are discussed.

Adult↗

Effects of a MAO-B inhibitor in the treatment of Alzheimer disease.

119 patients were enrolled in a double-blind randomized parallel study versus placebo carried out to assess both the efficacy and tolerability of L-deprenyl (10 mg/day) for treatment of patients with organic mental disorders of the Alzheimer type (DAT). The treatments were given for 3 months, starting after a run-in period of 15 days to evaluate efficacy. A complete neuropsychological battery was administered monthly after the start of treatment whereas tolerability was assessed by checking, recording and classifying all the unfavorable experiences occurring. According to the results, L-deprenyl would seem to be a useful and reliable tool for the treatment of DAT patients in an attempt to improve their cognitive functions and reduce behavioral alterations, without frequent or severe side effects.

Activities of Daily Living↗

Sympathetic skin response versus maximum motor and sensory conduction velocity to detect subclinical neuropathy in non-insulin-dependent diabetics.

Conventional motor (MCV) and sensory conduction velocity (SCV) of the ulnar (UN), peroneal (PN) and median nerves (MN) and the areas of sympathetic sudomotor response (SSR) recorded from the middle finger were measured on both sides in 20 normal and 20 non-insulin-dependent diabetic (NIDD) subjects. Conventional statistical tests (t test, linear correlation coefficient r) and discrimination analysis were applied to the above electrophysiological parameters. To evaluate the capability of the tests to separate NIDD diseased from normal nerves, the results were represented as generalized distances, i.e., difference between mean discriminant normalized combinations adjusted for intra-group variability. The r values were 0.92 (P less than 0.01) for the UN, 0.40 (P greater than 0.05) for the PN, and 0.86 (P less than 0.01) for the MN sensory action potential (SAP) amplitudes. No significant differences were found for normalized latencies. The r values of the SSR areas were 0.62 (P less than 0.01) at the right and 0.77 (P less than 0.01) at the left, homolaterally to the side of stimulation. SR and MCV generalized distances were 1.35 and 1.39, respectively. The discriminating power of SSR, MCV and SCV considered together was higher (2.40) than that of MCV and SCV (1.70). Since motor, sensory and autonomic alterations often did not coexist in NIDD, it was possible to find at least one type of involvement in most of the diabetic subjects.

Adult↗

The palmomental reflex from mechanical stimulation in normal man: normative data.

The authors report normative data on the electrical response (EMG response) recorded from the mentoneal muscles by repetitive mechanical stimulation of the palmar and dorsal surface of the hand in 23 normal adults: the palmomental reflex (PMR). An early and late response was observed in 11 cases. The PMR potentials showed great variability in latency, amplitude and duration and were present in about 70% of the subjects in whom the PMR was undetectable by visual inspection. In 3 cases the reflex was also observed contralaterally to the side of stimulation. The afferent branch of the normal PMR is constituted of impulses originating mainly from the median nerve skin and muscle receptors. Such impulses could reach facial motor nuclei either through short-(paucisynaptic) or long-loop (thalamocortical) circuits.

Action Potentials↗

Propranolol, clonidine, urapidil and trazodone infusion in essential tremor: a double-blind crossover trial.

Accelerometric tremorgrams were recorded from 25 subjects affected by essential tremor and analysed by a Berg-Fourier frequency analyser before and during venous infusion of the following drugs: propranolol (beta-blocker), clonidine (alpha-presynaptic adrenergic agonist), urapidil (alpha-postsynaptic blocker), trazodone (adrenolytic agent) and placebo. The washout interval between infusions was 3 days. Recordings and data analyses were performed in a double-blind crossover trial. Tremor was classified as: at rest; postural (arms hyperextended); and intention (finger-nose test). Analysis of the results showed that propranolol and clonidine reduced significantly (P = 0.01 and P = 0.009, respectively) the power spectrum of postural tremor, but left at rest and intention tremors unchanged. No significant effects on the tremor power spectrum were observed after placebo, urapidil or trazodone administration. None of the drugs had any effect on tremor frequency.

Adult↗

Cerebral complications of coronary by-pass surgery. A prospective study.

A prospective study was undertaken of cerebral complications in 91 patients undergoing coronary by-pass surgery. Patients showing clinically relevant neurological complications had longer pump-times but did not differ in pre-operative variables. Worsening of neurological state correlated with duration of pump-time but not with pre-operative variables. Duration of pump-time appears to be the main predictor of neurological complications after coronary by-pass surgery.

Adult↗

Alterations in vasopressin regulation in Alzheimer's disease.

A decreased concentration of vasopressin (AVP) in the plasma of patients with Alzheimer's disease has been shown recently and suggests damage to hypothalamic neurosecretory cells. To verify this, osmolar and hypotension (sodium nitroprusside) stimulations on AVP release were applied. The effect of metoclopramide, a powerful stimulator of AVP, was also assessed. Patients with Alzheimer's disease released AVP normally after hypotension. However, AVP response to osmotic stimulation was altered in eight out of 10 patients, owing to low osmoreceptor sensitivity and/or high threshold. Metoclopramide increased AVP in controls but not in patients. Normal AVP response to hypotension in patients with Alzheimer's disease makes it unlikely that there is a significant anatomical loss or damage of hypothalamic neurosecretory cells. Alterations in osmoreceptor function and AVP unresponsiveness to metoclopramide point to damage in the control of AVP release in Alzheimer's disease.

Aged↗

Myopathy during amiodarone treatment: a case report.

The case of a 69-year-old woman who developed muscle weakness on chronic amiodarone treatment is reported. Muscle biopsy showed vacuolar alterations and a marked accumulation of amiodarone and of its metabolite desethylamiodarone was found in the muscle sample despite normal blood levels. Amiodarone-induced morphological alterations of the muscle may be related to the actual tissue concentration rather than to the blood level.

Aged↗

Clonidine in essential tremor: preliminary observations from an open trial.

The authors present ten cases of essential tremor, studied before and after administration of clonidine with clinical tests and electrophysiological recordings. Improvement due to the desynchronizing effect of clonidine on tremor was observed in all cases. Possible mechanisms acting on the central and peripheral nervous system are discussed.

Aged↗

Suppression of REM and delta sleep by apomorphine in man: a dopamine mimetic effect.

Apomorphine, a direct stimulant of dopamine receptors, was given in nonemetic doses by continuous IV infusion for 180-240 min during night sleep in normal subjects. During apomorphine infusion, a significant reduction of stage (S)4 and an abolition of rapid eye movement (REM) sleep occurred. The percent duration of S2 was significantly increased. In the 240 min following interruption of 240-min infusion of apomorphine, a significant increase of S4 and REM percent duration was observed. The effect of apomorphine infusion on sleep was prevented by the administration of haloperidol or sulpiride, two dopamine receptor blocking agents. This suggests that it is due to a dopamine mimetic action.

Adult↗

Effects of tiapride on homovanillic acid levels in human cerebrospinal fluid drawn at pneumoencephalography.

The effect of tiapride on HVA and 5-HIAA levels in the CSF drawn at pneumoencephalography (PEG) was studied. Five consecutive 5 ml fractions of CSF were drawn from control and tiapride-treated subjects. In both groups, a linear increase in HVA concentrations was found between the first and subsequent fractions. On the contrary, no significant difference in 5-HIAA concentrations was found in sequential CSF samples. Tiapride increased the mean HVA concentrations and caused a steeper caudocranial gradient of this metabolite but failed to modify 5-HIAA concentrations. The results suggest that tiapride blocks dopamine (DA) receptors and increases DA synthesis.

Adult↗

Lymphocyte subpopulations in cerebrospinal fluid and peripheral blood in multiple sclerosis.

Lymphocytes subpopulations in cerebro-spinal fluid (CSF) and peripheral blood (PB) from multiple sclerosis (MS) patients were studied. PB of MS patients contains the same prevalence of E and EA rosette forming cells compared with controls, consisting of patients affected by various "nonimmunological" neuropsychiatric diseases. Cytochemical identification by the method of acid esterases in PB demonstrated in MS a prevalence of lymphocyte subpopulations similar to controls, and a relatively high percentage of macrophages compared with other methods, especially in MS patients: this may partially account for variable results obtained by various authors with the rosette technique. In CSF a significant decrease of total T, and particularly of T gamma cells, was found. Since T gamma lymphocytes have a suppressor effect on B cell proliferation and Ig synthesis, their decrease could be related with Ig hypersynthesis commonly found in the central nervous system of MS patients.

Adolescent↗

Therapeutic efficacy of apomorphine combined with an extracerebral inhibitor of dopamine receptors in Parkinson's disease.

Apomorphine in combination with a peripheral dopamine receptor blocker (domeperidone) was administered to four parkinsonian patients in a double-blind placebo-controlled study. The therapeutic efficacy of apomorphine was not reduced by domperidone, while nausea, drowsiness, sedation, and arterial hypotension were prevented. Combination of domperidone with dopamine agonists may result in more effective treatment of Parkinson's disease.

Apomorphine↗

Parkinsonism by haloperidol and piribedil.

Three groups of schizophrenic patients were treated with haloperidol, with a low dose of piribedil (a dopamine agonist), and with a combination of the two treatments, respectively. After a few days, all 7 patients treated with the drug combination showed marked rigidity and akinesia, while patients treated with haloperidol alone (4) and piribedil alone (4) showed either mild or no symptoms of parkinsonism. The drug combination induced mainly an akinetic-hypertonic syndrome, while tremors were absent or mild. The results suggest that low doses of the DA-agonist potentiate the extrapyramidal side effects of haloperidol by acting on self-inhibitory DA receptors, thereby blocking the compensatory increase in dopaminergic firing elicited by the neuroleptic agent.

Adolescent↗