Biomedical subjects

E Martignoni

Publications and source records attributed to E Martignoni.

130 records · Page 8Linked to original sources

PubMedDate not supplied

Lisuride and bromocryptine in L-Dopa stable-responder parkinsonian patients: a comparative, double-blind evaluation of cardiopressor and neurochemical effects.

In this study, we compared the haemodynamic and biochemical effects of bromocryptine to those of lisuride, in L-Dopa stable responder parkinsonian (PD) patients. Nineteen PD patients were admitted to the study. A double-blind, parallel group, randomized study was performed. Patients were randomly chosen to receive lisuride or bromoryptine. Both drugs were administered in increasing dosages until a maximum of either 0.6 mg lisuride or 7.5 mg bromocryptine was reached. The following tests were carried out: periprandial study, tilt table test and cardiovascular tests (sustained handgrip test, deep-breathing, lying-to-standing and Valsalva manoeuvre). During the tests, systolic and diastolic blood pressure and heart rate were monitored with an automatic sphyngomanometer. Blood samples for catecholamine assay were taken during tilt table test. In basal conditions 70% of the randomly chosen men in the bromocryptine group showed significant orthostatic hypotension (OH), while only one subject in the lisuride group demonstrated comparable OH values. The deepest derangement of orthostatic regulation was observed in the lisuride group but it should not be attributed to the greater hypotensive effects of this drug. Infact, the cardiopressor effects of bromocryptine may well be "masked" by the alteration detected in baseline conditions. Only bromocryptine significantly reduced supine and orthostatic NE plasma levels on the 14th day of therapy. Neither bromocryptine nor lisuride significantly altered periprandial blood pressure values. In conclusion, this study demonstrates that lisuride and bromocryptine are well tolerated as far as the analysis of the development of hypotensive effects is concerned. Further, more sophisticated study, with other agents that block the peripheral and/or central effects of dopamine-agonists in PD patients should be conducted in order better to define the precise role of these types of agents and the potential cardiopressor risks in these subjects.

Aged↗

PubMedDate not supplied

The effects of physical exercise at high altitude on adrenocortical function in humans.

The combined effects of sustained physical activity and hypoxia on adrenocortical function were investigated in 14 healthy volunteers, 8 males and 6 females (mean age 40.9 +/- 3.3 years), during a scientific expedition in the Himalayas. Plasma cortisol levels were measured in all subjects in basal conditions and after the administration of 1 mg dexamethasone (DXM) p.o. The study was performed before and after 15 days of intense trekking (Leh, altitude 3700 m). While on both occasions subjects retained their cortisol circadian fluctuations, basal and post-DXM cortisol levels at high altitude were significantly higher (p < 0.005 and p < 0.0005) than before climbing. Cortisol suppression was noted in all cases at low altitude, whereas 4 out of the 14 subjects did not show reduced hormone levels after 15 days of trekking. Moreover, nonsuppressor subjects had significantly higher (p < 0.05) baseline cortisol levels than suppressors. Basal and post-DXM hormone levels were found to be unrelated to age and sex of subjects. The present data further suggest that sustained physical activity at altitude activates adrenocortical function in normal individuals; however, in 30% of subjects DXM-induced cortisol suppression does not occur. To explain the latter observation, the concomitant role of hypoxia (and/or other environmental changes) and the subjective perception of physical stressors should be taken into account.

Adrenal Cortex↗

PubMedDate not supplied

A placebo-controlled evaluation of ropinirole, a novel D2 agonist, as sole dopaminergic therapy in Parkinson's disease.

The efficacy and safety of ropinirole, a novel nonergot dopamine D2-like receptor agonist, was assessed as monotherapy for the treatment of patients with early-stage Parkinson's disease. In this double-blind, multicenter trial, patients were randomly allocated in a ratio of 2:1 to receive, over a 12-week period, either ropinirole or placebo. Clinical status was assessed using the Unified Parkinson's Disease Rating Scale (UP-DRS), Clinician's Global Evaluation (CGE), and a finger-tapping score. In all, 41 patients received ropinirole and 22 received placebo. The end-point analysis, on an intention-to-treat basis, revealed a significant difference (p = 0.018) in improvement in UP-DRS motor score from baseline between treatment groups (ropinirole, 43.4%; and placebo, 21.0%). Other parameters, including the number of responders and improvement in CGE, showed similar results. Three patients in the ropinirole group and one patient in the placebo group discontinued the study because of adverse events. There was no significant difference between the treatment groups in the overall incidence of adverse events. Although the dopaminergic side effects were reported significantly more frequently in the ropinirole group than in the placebo group (dizziness, p = 0.0326; nausea, p = 0.001; and somnolence, p = 0.005), none necessitated study withdrawal. There was no evidence of any chronic effect of the study medication on vital signs. In conclusion, ropinirole is a safe and well-tolerated drug and, as monotherapy, provided significant therapeutic benefit compared with placebo to patients in the early stages of Parkinson's disease.

Adult↗

PubMedDate not supplied

Active music therapy and Parkinson's disease: methods.

Music therapy (MT) is an unconventional, multisensorial therapy poorly assessed in medical care but widely used to different ends in a variety of settings. MT has two branches: active and passive. In active MT the utilisation of instruments is structured to correspond to all sensory organs so as to obtain suitable motor and emotional responses. We conducted a prospective study to evaluate the effects of MT in the neurorehabilitation of patients with Parkinson's Disease (PD), a common degenerative disorder involving movement and emotional impairment. Sixteen PD patients took part in 13 weekly sessions of MT each lasting 2 hours. At the beginning and at the end of the session, every 2 weeks, the patients were evaluated by a neurologist, who assessed PD severity with UPDRS, emotional functions with Happiness Measures (HM) and quality of life using the Parkinson's Disease Quality of Life Questionnaire (PDQL). After every session a significant improvement in motor function, particularly in relation to hypokinesia, was observed both in the overall and in the pre-post session evaluations. HM, UPDRS-ADL and PDQL changes confirmed an improving effect of MT on emotional functions, activities of daily living and quality of life. In conclusion, active MT, operating at a multisensorial level, stimulates motor, affective and behavioural functions. Finally, we propose active MT as new method to include in PD rehabilitation programmes. This article describes the methods adopted during MT sessions with PD patients.

Aged↗