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Biomedical subjects

E Magni

Publications and source records attributed to E Magni.

At least 37 records · Page 2Linked to original sources
PubMed1996

Executive dysfunction in early Alzheimer's disease.

Twenty five patients with probable mild Alzheimer's disease were assessed for deficits in executive functioning and the impact of these deficits on performance in other neuropsychological domains. The Wisconsin card sorting test, the release from proactive interference paradigm, the verbal fluency test, and the Stroop test were adopted to classify patients with (AD+) and without (AD-) executive deficits. Seven of the patients showed an impairment in executive function (AD+), defined as a performance below the cut off score in at least two of these tests. There were no significant differences in clinical assessments, demographic features, or other cognitive functions between patients. Executive dysfunction may be an early additional feature in a subgroup of patients with mild Alzheimer's disease. Impairment on frontal lobe tests does not seem to be related to the severity or duration of disease, or to a different pattern of impairment in other cognitive domains.

Aged↗
PubMed1996

Risk of mortality and institutionalization in demented patients with delusions.

Delusions are a common symptom during the course of dementia. Despite their clinical relevance, however, it is still unclear whether they are of prognostic value. This longitudinal study involving, at baseline, 99 demented Alzheimer disease (AD) and multi-infarct dementia (MID) patients, investigates the risk of mortality and institutionalization at 2 years after discharge from a dementia unit in patients with and without delusions at baseline. Results indicate that the presence of delusions is a significant predictor of future institutionalization (odds ratio 3.6, confidence interval 1.3-9.6), even when confounding factors such as age, educational level, and severity of cognitive and functional impairment are statistically controlled. No significant impact on survival was found.

Aged↗
PubMed1995

The Italian SEPSIS study: preliminary results on the incidence and evolution of SIRS, sepsis, severe sepsis and septic shock.

This prospective, multicenter, epidemiological study was carried out in 99 Italian ICUs, distributed throughout the country, from April 1993 to March 1994. In the study, we applied the new ACCP/SCCM classification system for sepsis (SIRS, sepsis, severe sepsis and septic shock) and determined the prevalence, incidence, evolution and outcome of these categories in critically ill patients. The preliminary analysis of 1101 patients showed that on admission SIRS accounted for about half of the diagnoses (52%) with sepsis, severe sepsis and septic shock accounting for 4.5%, 2.1% and 3% of patients, respectively. Patients with severe sepsis or septic shock more frequently had high SAPS scores than patients without sepsis. Mortality rates were similar in patients with SIRS (26.5%) and without SIRS or infection (24%), but rose to 36% in patients with sepsis, to 52% in those with severe sepsis and to 81.8% in those with septic shock. Sepsis, severe sepsis and septic shock were more common in patients with medical diagnoses, and neither severe sepsis nor septic shock was observed in trauma patients. With respect to evolution, the incidence of septic shock was progressively higher in patients admitted with more severe "sepsis-related" diagnoses, while only a trivial difference in rates of incidence was observed between SIRS patients and those admitted without SIRS or any septic disorder (nil). The breakdown of the various ACCP/SCCM "sepsis-related" diagnoses at any time during the study was: SIRS in 58% of the population, sepsis in 16.3%, severe sepsis in 5.5% and septic shock in 6.1%. It seems reasonable to expect from the final evaluation of our study answers to the questions raised by the ACCP/SCCM Consensus Conference about the correlations between "sepsis-related" diagnosis, severity score, organ dysfunction score and outcome.

Hospital Mortality↗
PubMed1995

Release from proactive interference in early Alzheimer's disease.

The study analyses the performance of 22 mild Alzheimer's disease (AD) patients on the Release from Proactive Interference (RPI) paradigm with the aim to investigate the relationship of RPI with frontal function. Twenty-one normal elderly subjects, age and education matched, constituted the control group. Patients with AD were found to recall less words on each trial of the RPI than did the controls. The analysis of Proactive Interference (PI) and Release from PI, in AD patients, by using Anova (trial x group), showed a significant effect of trial and group but not a group by trial interaction. These results indicate a similarity between the performance of AD patients and normal controls on the Release from Proactive Interference paradigm. Despite the similar pattern of performance, AD patients were significantly inferior to normal controls with regard to global performance level. The AD patients' scores on "frontal lobe" tests were correlated with an index of RPI (shift condition index). The only significant result was with the number of categories on the Wisconsin Card Sorting Test, suggesting a weak correlation between RPI and "frontal lobe" function.

Aged↗
PubMed1995

Semantic memory in Alzheimer's disease: an analysis of category fluency.

In order to study the strategies of access to semantic knowledge and the status of semantic representation, we analyzed the performance in a semantic fluency task (Animal naming) of 70 patients with probable Alzheimer's disease (AD), including 40 mild AD patients and 30 moderate-severe AD patients, and 35 matched elderly normal control subjects. The total amount of words produced, their lexical frequency, the number and type of errors, as well as the presence and the type of clusters of related animal names were recorded. AD patients produced less animal exemplars than controls. In addition to a lower total number of clusters, the AD patients showed a strong limitation in clusters' selection, producing a limited number of different clusters. While normal subjects produced several different clusters, only farm animals were clustered by AD patients. When the total amount of words was considered, the mean lexical frequency was higher in the AD group. On the other hand, the words produced within clusters were comparable to terms of lexical frequency and number. These data confirm the impairment of AD patients in category fluency tasks, and suggest a degradation of semantic knowledge as the most likely underlying mechanism.

Aged↗
PubMed1995

Sensory impairments and mortality in an elderly community population: a six-year follow-up study.

Previous studies have shown that sensory impairments adversely affect the quality of life of elderly people, but have failed to demonstrate consistent results on mortality. We examined the predictive value of hearing and visual impairments on mortality in an urban population of 1140 non-institutionalized elderly subjects, aged 70-75 years. Baseline information was collected in 1986 through a door-to-door interview with a standardized questionnaire and the sensory assessment was performed using bedside tasks: the whispered voice test for hearing and the Snellen chart for vision. Overall mortality rate at 6 years was 25.5%, with a significant sex difference (males = 37.5%; females = 19.8%) and a significant interaction between sex and sensory impairment. Bivariate logistic regression showed that hearing deficit was associated with a significant increase in mortality risk only in the men. This increase remained significant even after control for the demographic variables and the global physical health status. Multivariate logistic regression showed that the effect of hearing deficit on mortality was mediated by psychosocial parameters (mood and social relationships level). Sensory assessment through simple bedside tests should become part of the routine clinical evaluation of elderly people.

Activities of Daily Living↗
PubMed1995

Delusions and dementia: clinical and CT correlates.

INTRODUCTION: Delusions occur frequently during the course of Alzheimer's disease (AD) and multi-infarct dementia (MID). Their clinical significance and their relationship with progression of disease and involvement of selected cerebral areas are still unclear. The aim of the study was to determine the clinical and CT correlates of delusions in patients with dementia. MATERIAL AND METHODS: A series of 67 probable AD and 32 MID patients, underwent computed tomographic scans, psychometric tests, neurologic and psychiatric examination, and blood and serum tests. RESULTS: Twenty-four patients were found to have delusions during the clinical evaluation. Delusional patients showed a significantly higher age when compared with non-delusional patients. The results of a multiple logistic regression (with stepwise deletion of the redundant variables) of the CT lesions on the presence of delusions, showed that only the presence of isolated white matter lesions in the frontal lobes were significantly related to the occurrence of delusions (Exp B = 3.42; Beta = 1.2; S.E. = 0.6; Sig T = 0.04). Frontal white matter changes were significantly related to delusions when a multiple regression analysis, entering age and total number of lesions at CT scans, was carried out. CONCLUSIONS: We found that focal lesions in the frontal areas were the only variable that appeared to be significantly and independently associated with delusional disorders.

Activities of Daily Living↗
PubMed1994

Hepatitis B virus C gene heterogeneity in a familial cluster of anti-HBc negative chronic carriers.

We studied a familial cluster of adult HBV chronic carriers characterized by serological markers of active viral replication, normal or slightly elevated ALT levels and, in four out of five cases, absence of anti-HBc reactivity. The nucleotide sequence of the pre-C/C region of HBV was analyzed in three patients, showing the presence of wild-type HBV sequences accompanied by different deleted molecules. Some of the variant genomes were able to encode proteins retaining HBcAg and/or HBeAg reactivity, whereas others contained deletions leading to the synthesis of truncated proteins that could not be immunoprecipitated by anti-HBc or anti-HBe mono- and polyclonal antibodies. Defective molecules encoded by the variant C gene sequences might play a role in the determination of the clinical profile observed in the analyzed patients.

Adolescent↗
PubMed1994

Reproducibility of histological diagnoses and diagnostic accuracy of non palpable breast lesions.

Twelve pathologists independently examined and classified a set of 25 cases of non palpable breast lesions selected from the archival files of the Pathology Department in Florence. A final consensus diagnosis was reached for all cases at a slide seminar. Individual diagnoses were first combined in 3 broad categories (benign lesion, in situ and invasive carcinoma), then compared to each other and then to the "consensus". Results show that among these 12 pathologists there was complete agreement in 14 cases. Discrepancies for the other 11 cases varied in the number of pathologists and diagnostic categories involved. Overall agreement was excellent (median kappa 0.86) but cases of potentially harmful errors were evident. The authors discuss these findings in the frame of a breast cancer screening program planning.

Breast Diseases↗
PubMed1994

Frontal dysfunction in early Parkinson's disease.

Recent studies have suggested that patients with Parkinson's disease (PD) share many of the behavioral deficits found following lesions to the pre-frontal cortex. We assessed the performance of a group of 22 mildly impaired, not-demented parkisonians (I or II Hoehn & Yahr stage) in a test of classification and recall of pictures of familiar objects, which has been demonstrated to be sensitive to frontal damage in patients with unilateral cerebral excision. Parkinsonians utilized fewer categories than normal controls for object classification, while no significant difference was found in the immediate and delayed recall scores. These results support the contention that a subclinical dysfunction of frontal type may be present even in the early stages of PD. A subanalysis of the data suggests that this dysfunction could possibly be aggravated by anticholinergic drugs.

Adult↗
PubMed1994

Influence of nutritional intake on 6-year mortality in an Italian elderly population.

Many observations agree on the existence, in older ages, of nutritional deficiencies secondary to dietary intake. This study investigated to what extent dietary intake of calories, protein, iron and vitamins influences the 6-year mortality in an elderly population living at home. To prevent the confounding effect of non-dietary factors, such as gender, functional and health status, socio-economic conditions and health risk habits, these variable have also been considered. The dietary intake was calculated comparing the content of nutrients in self-reported, 24-hour diet, with the 1980 Recommended Dietary Allowances (RDA) obtaining a percentage for each nutrient. The percentage difference from the RDA was tested on 6-year mortality using a bivariate regression model. The intake of protein, vitamin A, thiamin, niacin, vitamin B6 and folate was significantly related to mortality: subjects with a lower dietary intake of those nutrients had a higher risk of death. When nutrient intake was tested in a multiple regression model, adjusted for non-dietary potential confounders, only folate was an independent predictor of mortality. This study shows that most of the dietary nutrient's intake is related to socio-economic and physical factors.

Age Factors↗
PubMed1994

Double-blind, randomised, multi-centre clinical study evaluating the efficacy and tolerability of nimesulide in comparison with etodalac in patients suffering from osteoarthritis of the knee.

In a double-blind study, the efficacy and tolerability of nimesulide 200mg/day, administered orally, was compared with etodolac 600mg/day in the treatment, for 3 months, of 200 patients suffering from osteoarthritis of the knee. Although spontaneous pain showed a significant improvement during the course of the study, there was no difference in the efficacy of either compound. Similarly, there was a progressive and significant reduction in the Lequesne functional index although no statistical difference was found between nimesulide and etodolac. The physician's overall assessment of efficacy was significantly in favour of nimesulide but the same assessment for patients who completed all 12 weeks showed no such bias. Adverse events (AEs) were generally mild or moderate and were commonly gastrointestinal in origin. There was no difference in the rate of incidence of AEs and, with the exception of week 8 where etodolac was apparently better tolerated, there were no statistical differences in tolerability between the two therapies.

Adult↗
PubMed1993

Loss of heterozygosity and K-ras gene mutations in gastric cancer.

In order to identify relevant genetic lesions in gastric carcinoma, we searched for tumor suppressor gene inactivation and K-ras gene mutations by analyzing tumor and control DNAs from 34 patients. These were from an epidemiologically defined area of Italy characterized by one of the world's highest incidences of stomach cancer. Allele losses were investigated by the Southern blotting procedure at 16 polymorphic loci on 11 different chromosomes. Our data demonstrate that chromosomal regions 5q, 11p, 17p and 18q are frequently deleted, and that 7q and 13q chromosome arms are also involved, although at a lower frequency. Loss of heterozygosity (LOH) at region 11p was not found during other surveys carried out on patients of different geographic origins. No specific combination of allelic losses could be recognized in the samples analyzed, the only exception being that tumors with 17p allelic loss also showed LOH on the 18q region. When matching frequent LOH events and the stage of progression of the tumors, we observed a trend of association between advanced stages and allelic losses on 17p and 18q chromosome arms. The analysis of K-ras, carried out by the polymerase chain reaction and denaturing gradient gel electrophoresis, demonstrated transforming mutations in only 3 out of 32 cases. Colorectal tumorigenesis proceeds by the accumulation of genetic alterations, including K-ras mutations and inactivation of tumor suppressor genes on the 5q, 17p and 18q regions. Our data indicate that, although gastric and colorectal neoplasias share common genetic alterations, they probably progress through different pathways.

Alleles↗
PubMed1993

[Gastric volvulus. A clinical therapeutic contribution].

Gastric volvulus is an infrequent event and few clinical cases are an important experience. Diagnosis, both clinical and radiological, is not difficult if you think of gastric volvulus; abdomen X-ray is often sufficient to clear up diagnostic doubts. First diagnosis can be quickly confirmed by X-ray examination of digestive organs that provides us with further information: contemporaneous ulcerative of neoplastic lesions, characteristics of bowels whirling round. Endoscopic and manometric evaluation must be performed only in recurrent or chronic cases, when there's no symptom of clinical urgency. Authors describe their experience of three cases observed in the last ten years and underline the importance of deciding and performing the surgical treatment quickly to avoid serious complications, in all doubtful cases. It is important to carry out an operation compared to the pathogenesis of volvulus: generally gastropexy is sufficient while radical operations are executed only in cae of gastric necrosis or in the presence of gastric neoplasms or ulcerative lesions.

Aged↗
PubMed1993

Cell kinetics and prognosis in gastric cancer.

METHODS: The potential proliferative activity of primary gastric cancer was determined using the in vitro tritiated thymidine labeling index (LI) technique. RESULTS: The proliferative rate had a wide range (0.1-28.4%) with a median value of 9.3%. The cell kinetics of the primary tumor were not related to clinicopathologic features, such as the patient's age and sex or the tumor's histologic type and stage. The contribution of cell kinetics to prognosis was investigated in a series of 28 patients (median follow-up, 34 months). The 3-year survival rate was 50% for patients with slowly proliferating tumors compared with only 13% for those with rapidly proliferating tumors. Moreover, in patients with high-LI tumors, the risk of death was more than sixfold greater than for those with low-LI tumors. CONCLUSIONS: These data suggest that cell kinetic studies might be an important discriminant to predict prognosis in gastric cancer.

Adult↗