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Biomedical subjects

C Gandolfo

Publications and source records attributed to C Gandolfo.

At least 55 records · Page 3Linked to original sources
PubMed1994

Focal cerebral ischemia and patent cardiac foramen ovale.

By means of transthoracic contrast echocardiography, the prevalence of a patent foramen ovale (PFO) was studied, in a continuous series of 48 patients aged less than 50 years with a recent episode of acute cerebral ischemia. A PFO was found in 11 subjects (23%). In the subgroup of younger patients (aged less than 30 years), the prevalence was much higher than in those aged 30 or more (58% against 11%, p = 0.0022). In the 19 patients with clear evidence of extracardiac causal factors of cerebral ischemia, there was no PFO; of the remaining 29 subjects, a PFO was present in 11 (38%) (p = 0.0015). In conclusion, the possible presence of a PFO must be carefully investigated in subjects with cerebral ischemia aged less than 30, as well as in subjects aged between 30 and 50 in whom there is no acceptable explanation for their cerebral ischemic episode.

Adult↗
PubMed1994

Twenty-four-hour beta-endorphin secretory pattern in stroke patients.

BACKGROUND AND PURPOSE: Abnormalities of hypothalamo-pituitary-adrenocortical axis function have been observed frequently in stroke patients. The aim of this study was to investigate plasma beta-endorphin and cortisol 24-hour secretory patterns in patients early after stroke and in the convalescent period to evaluate a possible influence of brain damage on hormonal circadian pattern. METHODS: Patients (n = 15; age, 46 to 75 years) were evaluated in the first 24 hours and 10 days after hospital admission for ischemic cerebral stroke and compared with 15 age- and sex-matched normal subjects. Blood samples for beta-endorphin and cortisol determination were drawn every 4 hours from 8 AM to 8 PM and every 2 hours from midnight to 6 AM. RESULTS: Mean 24-hour beta-endorphin and cortisol levels, recorded in the acute phase, were significantly (P < .05) higher than those recorded in normal subjects; circadian rhythm was not demonstrable for either hormone. In the convalescent period, plasma cortisol 24-hour mean values and circadian rhythm returned to the normal range, whereas the plasma beta-endorphin 24-hour mean values and circadian rhythm did not. CONCLUSIONS: Cerebral stroke induces abnormalities of beta-endorphin and cortisol circadian secretion. Whereas cortisol abnormalities are transient, those of beta-endorphin last longer. The dissociation between beta-endorphin and cortisol 24-hour secretory patterns might potentially serve as a marker of psychoneurological abnormalities occurring after stroke.

Aged↗
PubMed1994

[Changes in dialysis methods. 10 years' experience].

A retrospective survey has been done on 175 chronic patients who underwent dialysis in one center, between January 1982 and June 1992. The purpose of the work was to evaluate the use of the first treatment and the cause which determined a change of treatment. Diffusive haemodialysis and CAPD were the most frequent first choice techniques, respectively in extracorporeal and peritoneal dialysis, whereas changes were conditioned by the need for a more personalized treatment, especially in the filed of extracorporeal dialysis.

Adult↗
PubMed1993

Focal cerebral ischemia in young adults: a collaborative case-control study. The National Research Council Study Group.

Because there is uncertainty about the role of atherogenic and nonatherogenic risk factors for cerebral ischemia in the young, we carried out a multicenter, hospital-based, case-control study. 333 patients (15-44 years) with focal cerebral ischemia (transient ischemic attack or stroke within 8 weeks of admission) were eligible. 25 patients were excluded, according to the protocol. 308 cases were matched by age and gender to one hospital and one population control. Independent risk was shown by logistic conditional regression for migraine with aura [odds ratio (OR) = 14.8], smoking (OR = 3.7), alcohol (OR = 2.8), serum triglycerides (OR = 1.6), arrhythmias (OR = 9.5), mitral stenosis (OR = 56), coronary heart disease (OR = 4.3) and carotid stenosis or occlusion (OR = 41). Serum HDL-cholesterol had a relative protective effect (OR = 0.8). These data confirm the role of atherosclerosis and cardiac diseases as well as migraine with aura and alcohol consumption in the pathophysiology of cerebral ischemia in the young. More thorough prevention programs may contribute to earlier detection and control of all of these risk factors, but further investigations in patients with as yet unidentified risk factors are warranted because the above-mentioned factors do not account for the total risk of ischemic stroke in the young.

Adolescent↗
PubMed1992

Prognosis of transient global amnesia: a long-term follow-up study.

A long-term follow-up study was performed on patients with transient global amnesia (TGA) in order to evaluate the prognosis, the recurrence rate and the occurrence of stroke and dementia. 102 patients (57 women, 45 men; mean age 62.8 +/- 9.4 years) were prospectively included and followed up. The follow-up duration ranged between 12 and 241 months with an average value of 82.2 +/- 51.1 (mean +/- SD). The death rate showed no difference from that of sex- and age-matched subjects. TGA recurred in 19 cases (18.63%). Only 4 patients suffered subsequent stroke, and only 3 showed intellectual deterioration. TGA prognosis was shown to be better than that of RIA and lacunar patients.

Adult↗
PubMed1992

Twenty-four-hour beta-endorphin secretory pattern in Alzheimer's disease.

A chronobiological study was carried out in 6 male patients (67-71 years), suffering from Alzheimer-type dementia (ATD) and 6 male patients (52-74 years) suffering from multi-infarct dementia (MID), to evaluate their 24-hour beta-endorphin and cortisol secretory patterns. Six healthy male adults (28-37 years) and 6 healthy elderly male subjects (78-84 years) constituted the control groups. Blood samples were drawn every 4 h from 8.00 to 20.00 h and every 2 h from 24.00 to 6.00 h. Mean 24-hour beta-endorphin levels were significantly (p < 0.05) higher in the ATD patients (39.2 +/- 1.5 ng/l) than in the other groups (33.8 +/- 1.1, 30.1 +/- 1.6 and 33.2 +/- 1.1 ng/l in the elderly subjects, the adults and the MID patients, respectively). The circadian rhythm was absent in the ATP patients, in the elderly subjects and the MID patients. No differences in plasma cortisol circadian rhythm were observed among the four groups. Our data indicate that changes in circulating beta-endorphin concentrations and circadian pattern may be due to the aging process.

Aged↗
PubMed1992

Dementia associated with lacunar infarction.

BACKGROUND AND PURPOSE: The purpose of this study was to assess the number of patients with lacunar lesions who develop dementia and to evaluate in patients with and without dementia the relevance of risk factors for cerebrovascular disease, the occurrence of leukoaraiosis, the volume and location of vascular lesions, the size of ventricular and subarachnoid spaces, and stroke recurrence. METHODS: One hundred eight patients in whom computed tomograms revealed lacunar lesions that could account for their clinical neurological pictures were followed up for an average of 4 years after their first lacunar stroke. RESULTS: Twenty-five patients (23.1%) developed dementia. The prognosis regarding occurrence of dementia during the follow-up period, evaluated by the Kaplan-Meier method, was significantly worse in subjects with the greatest evidence of cerebral atrophy (p less than 0.009) and in subjects who underwent new focal cerebrovascular episodes (p less than 0.000001). No differences were seen in the frequency of vascular risk factors or the site or volume of lesions between the demented and nondemented groups. CONCLUSIONS: Patients with lacunar infarcts suffer from dementia 4-12 times more frequently than the normal population. Cerebral atrophy and recurrent stroke, as well as other as-yet unclarified factors, are involved in producing dementia.

Aged↗
PubMed1992

Intraperitoneal administration of phosphatidylcholine improves ultrafiltration in continuous ambulatory peritoneal dialysis patients.

Reports in the literature have linked a low phosphatidylcholine content in continuous ambulatory peritoneal dialysis (CAPD) effluent to ultrafiltration loss. Clinical evidence suggests that adding phosphatidylcholine to the dialysis solution enhances ultrafiltration. A clinical study has been designed to clarify the effect of phosphatidylcholine on ultrafiltration in CAPD patients with normal ultrafiltration. A weekly measurement of the peritoneal equilibration test was conducted per patient in the hospital. A comparison between the control dialysis solution (three-week period) and the phosphatidylcholine premixed solution (three-week period) was performed on a total of 12 patients. This study shows that a phosphatidylcholine premixed dialysis solution significantly enhances ultrafiltration. Since ultrafiltration per osmotic driving force (mL/g glucose) is enhanced, the patient's glucose load per day is reduced to achieve equal ultrafiltration. In the presence of phosphatidylcholine, peritoneal permeability remained unchanged, as indicated by membrane transport characteristics. No side effects were observed.

Biological Transport↗
PubMed1991

Protective effect of cyproheptadine in a gerbil model of cerebral ischemia.

The efficacy of Cyproheptadine, a serotonin antagonist, in preventing the cerebral ischemic damage was tested on experimental model of transient global cerebral ischemia in Mongolian Gerbil. The semi-quantitative histological evaluation of the severity of ischemic damage showed a protective effect of Cyproheptadine, mainly in the anterior cortical areas.

Animals↗
PubMed1990

Methodological problems of clinical trials in multi-infarct dementia.

In about 30% of the cases suffering from MID an unequivocal diagnosis can be made only on the basis of histopathological evidence. The imperfect diagnosis has a relevant impact on the methodology to be followed in therapeutic trial. The following points have to be considered in a therapeutic trial: (1) distribution of the patients expected to come to the observation, (2) the expected effectiveness of the treatment, (3) the likelihood of obtaining statistical significant results and (4) the required size of the study. The diagnostic inaccuracy gives rise to a decrease in the chance of yielding a statistically significant result and on the other hand produces an increase in the required number of subjects to be submitted to the trial.

Clinical Trials as Topic↗
PubMed1990

Pseudobulbar palsy: a clinical computed tomography study.

61 of 1,590 (3.8%) patients with cerebrovascular disease showed suprabulbar palsy of the pure form (42 patients; 2 had autopsy) and striate form (19 patients; 3 had autopsy). 25 patients with the pallidopyramidal syndrome were included since the clinical picture bordered on the striate form. The pure variety was characterized by dysarthria, dysphagia and automatic voluntary dissociation of facial movements. Half of the patients also had hemiparesis, primitive reflexes and short-step gait. In the striate form, the main signs were dysarthria, dysphagia, automatic voluntary dissociation, rigidity and hypokinesia. Brisk tendon reflexes, primitive reflexes, short-step gait and mental deterioration were also present in half of the patients. The pure variety was caused by multiple infarcts and/or lacunae (85.7%), while the striate form had vascular lesions by computed tomography in only 36.8% of the cases. Histological findings, showing lipohyalinosis of the arterial wall leading to stenosis and occlusion of the lumen and tissue rarefaction and disintegration, support the assumption that microinfarctions, sometimes found only by histopathological examination, are the leading pathogenetic factor in this form. Hypertension, cardiopathy, smoking habit, dyslipemia and diabetes are the most frequent risk factors in both forms.

Aged↗
PubMed1989

Prospected randomized study of two Y devices in continuous ambulatory peritoneal dialysis (CAPD).

To evaluate acceptability, safety, and efficacy of a Y set with two short branches (TAS) filled with electrolytic chloroxidizer solution during the dwell time, 60 patients were randomly allocated to be treated with the traditional Y set (TCS) or with the TAS. Twenty-three were new patients whereas the remaining 37 were patients already on continuous ambulatory peritoneal dialysis (CAPD) with the TCS. The follow-up was 416.5 months in the control group and 387.4 months in the test group. During the study period there were 6 peritonitis episodes in each group with an incidence of 1 episode every 69.4 patient-months in the control group and 1 episode every 64.6 patient-months in the test group. Twenty-four patients (80%) in the control group and 27 (90%) in the test group were free from peritonitis. The probability to remain free from peritonitis was respectively 87% and 83% in the test group and in control group after 12 months, 70% and 78% after 21 months. Seventy-nine percent of the patients who used both systems preferred the TAS for better handling, lower encumbrance, and major safety. One patient preferred the TCS, three patients did not find any differences between the two devices.

Anti-Infective Agents, Local↗
PubMed1989

CAPD versus hemodialysis (HD): 7 years of experience.

The purpose of this work is to compare survival and drop-out in 2 groups of patients undergoing either CAPD (42 pts) or standard HD (48 pts) as first treatment, from November 1981 to December 1988. Mean age and number of risk factors were not significantly different. At the end of the study 50.0% of pts on CAPD and 37.5% on HD were still on first treatment; clinical problems were the most frequent cause of drop-out. The total period of observation was significantly higher in the CAPD group (1391.0 months vs 850.4), but the life table analysis showed no significant differences in the incidence of death and of drop-out in the two groups. The follow-up of the CAPD group was subdivided into two periods, due to the fact that a scheme for clinical and social survey of patients undergoing dialysis and a policy of more frequent home visits were introduced at the end of 1985. A significant decrease of peritonitis episodes was observed in the second period.

Female↗
PubMed1988

Risk factors in lacunar syndromes: a case-control study.

The association between some hypothetical risk factors (previous TIA, hypertension, ECG ischemic abnormalities, diabetes, cigarette smoking, atrial fibrillation, hypercholesterolemia, hypertriglyceridemia, high hematocrit) and lacunar syndromes has been evaluated by a matched sample case-control study involving 108 consecutive, incident cases with lacunar syndrome and 216 hospital control subjects, matched for sex and age. A significant increase of Relative Risk (RR) has been shown for: 1. Previous history of TIA; 2. Hypertension; 3. Smoking; 4. Diabetes. No relevance was shown for: 1. Atrial fibrillation; 2. Hypercholesterolemia; 3. Hypertriglyceridemia; 4. High hematocrit. The analysis of the triplets of subjects (1 case + 2 controls) without hypertension showed a significant RR increase for: 1. Previous history of TIA; 2. Ischemic cardiac abnormalities; 3. Atrial fibrillation. Such findings support the hypothesis that, in a minority of cases with lacunar syndrome, the pathogenetic mechanism could be different from occlusion of penetrating arteries in hypertensive patients.

Aged↗
PubMed1988

Lacunae and cribriform cavities of the brain. Correlations with pseudobulbar palsy and parkinsonism.

Fifty-one brains showing lacunae and 30 with cribriform cavities have been identified out of 191 examined brains. A histologic and immunohistochemical study with the peroxidase-antiperoxidase method for glial fibrillary acidic protein has been carried out in selected cases. The number, site, associated arterial lesions and the microscopic appearance of lacunae and cribriform cavities are reported. Lacunae are small cavities usually, but not always due to softenings; cribriform cavities are dilatations of the perivascular space. Two types of cribriform cavities have been identified, according to the histological appearance of the surrounding tissue: type 1 with normal and type 2 with rarefied and abnormally gliotic surrounding nervous tissue. Sixteen cases showing a cribriform state in the basal ganglia exhibited a pseudobulbar palsy or extrapyramidal rigidity. Pseudobulbar palsy of striate form or parkinsonism may be ascertained in some cases only by histological and immunohistochemical examination.

Aged↗