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Biomedical subjects

E Montanari

Publications and source records attributed to E Montanari.

At least 91 records · Page 5Linked to original sources

Acute heroin myelopathy--case report.

Description of a case of benign acute transverse myelopathy in a young woman who had taken heroin I.V. after a two-year free interval. Spinal angiography was negative but CT scanning of the cord showed a swelling at C3.

Acute Disease↗

The effect of amantadine on arousal and EEG patterns in Creutzfeldt-Jakob disease.

In recent years, Creutzfeldt-Jakob disease (CJD) has been supposed to be of viral origin, and amantadine hydrochloride has been suggested as therapy because of its proved antiviral action. We studied nine patients with CJD (confirmed at autopsy in seven). Four were treated with amantadine hydrochloride, in dosages ranging from 3.5 to 15 mg/kg/day for an average period of 32 days. The clinical evolution of their disease was compared with that in five patients receiving only supportive maintenance therapy. The length of survival from the onset of clinical care did not differ significantly between the two groups. Nevertheless, a transient improvement in wakefulness and mentation was observed in three patients treated with amantadine, and EEG changes were observed in two, consisting above all of a reduction in the slow-wave activity and the periodic discharges (PDs). Amantadine administered intravenously did not induce any short-term changes in the PDs or the cyclic alternating pattern.

Aged↗

Amyotrophic lateral sclerosis in the province of Parma, Italy: a clinical and epidemiological study in the period 1960-1980.

A clinical and epidemiological study on ALS was conducted in the province of Parma, Italy, in the period 1960-1980. A total of 78 cases was collected from hospital records. The average annual incidence was 0.93 per 100,000 with no difference between rural and urban areas. On prevalence day (October 24, 1971) a prevalence rate of 2.27 was found. Mean age at onset was 59 years, with no sex difference. In 70% of cases the onset was between 50 and 70 years, this datum being statistically significant (p less than 0.001). Mean duration of the disease was 30.4 +/- 20 months, with no difference for sex and age at onset. A comparison was then made between two decades (1961-70 vs 1971-80), in order to verify the clinical impression of a worsening of some ALS parameters in recent years. Although statistical evaluation did not show any significant data, a tendency to a worsening of some parameters of the disease may be postulated.

Age Factors↗

Chronic pelvic pain: psychosomatic aspects and clinico therapeutical reflections.

After describing the most common causes of chronic pelvic pain in women the Authors stress the importance of psychosomatic factors to the pathogenesis of chronic pelvic pain. Bearing this in mind it is easier to understand why the results of pharmacologic treatments often fail to come up to doctor's and patient's expectations. These limitations have often been stressed in the literature and several alternatives, like individual or group psychological treatment or, more recently, acupuncture, have been suggested. The Authors' proposal for treatment envisaged a dozen meetings to carry out skin reflexotherapy. Significant psychological elements came to light on those occasions and were subsequently discussed. The Authors' experience, though covering 15 cases only, is extremely encouraging and confirms the value of this reflexotherapeutical and psychosomatic approach which can really help patients who are chiefly alexitimic to overcome their problems.

Acupuncture Therapy↗

The problem of subclinical localised paroxysmal rhythmic discharges (psychomotor variant discharges). Report of two cases.

Two cases are reported of patients whose EEGs showed localised rhythmic seizure activity in the midtemporal regions of one or both hemispheres, unaccompanied by any clinical symptoms: the patients' histories differed: one was of classic migraine and the other complex partial epilepsy. The frequency and morphology of the paroxysmal anomalies was identical in the waking state and in sleep. The nosographic classification of the phenomenon is discussed with reference to Gibbs' reports regarding the "psychomotor variant type of seizure discharge", to the work of Lipman and Hughes on "rhythmic mid-temporal discharge" and to that of Westmoreland and Klass on the "subclinical rhythmic EEG discharge of adults". But in contrast to the last phenomenon there were no signs pointing to a diffuse cerebrovascular disease. Reports of such a pattern are rare in the European literature and nonexistent in the Italian literature, facts which make an ordinary interpretation of the phenomenon difficult.

Aged↗

[Petit mal status].

The historical evolution of P.M.S. nosography is pointed out, and his clinical features are exposed, mainly on the ground of the study performed by Lob and Coll., for the Tenth Marseilled Colloquium. Stress is laid upon the onset age of P.M.S., making reference to a review of 133 cases previously reported in the literature. Two paradigmatic cases are reported, selected between six P.M.S. observations we collected, and electroclinically investigated, from 1972 to 1975: a woman aged 34 who was suffering from P.M. and G.M. seizures since she was 12-years old, and also had some other P.M.S. episodes during past years; a woman aged 45 who suffered from a sudden P.M.S. attack, during a febrile illness: it seemed that it was the first occurrence, but an accurate catamnestic search suggested that previous P.M.S. manifestations had probably occurred during the infancy. Finally P.M.S. nosography is discussed for what concerns the variable features emphasized by our observations, the correlation between P.M. and P.M.S., and the problem of P.M.S. as the sole epileptic phenomenon.

Adult↗

Cardiac dysrhythmias induced by extracorporeal shockwave lithotripsy.

PATIENTS AND METHODS: We evaluated in 269 consecutive patients the incidence and gravity of dysrhythmic complications during nonsynchronized extracorporeal shockwave lithotripsy (SWL) using an electromagnetic lithotripter. RESULTS: Dysrhythmia occurred during treatment in 22 patients (8.8%) with no previous cardiac dysrhythmia. Ventricular extrasystoles occurred in 14 patients, atrial extrasystoles in 7 patients, and sinus bradycardia in 1 patient. It was not necessary to terminate treatment because of the occurrence of dysrhythmia in any of the patients. For 13 of the 22 patients (59%), it was sufficient to interrupt the treatment momentarily to obtain resumption of the normal rhythm. For 8 patients (36%), treatment was continued after triggering the release of the shockwaves with the refractory phase of the heart cycle. For one case of bradycardia (42 beats/min), it was possible to continue with the treatment after intravenous administration of atropine 0.5 mg. Pretreatment dysrhythmias were revealed by the electrocardiographic examination in 16 of the patients studied (6.3%). CONCLUSIONS: Extracorporeal shockwave lithotripsy without ECG triggering has been found to be fast and efficient and not correlated with the occurrence of dysrhythmic episodes of any particular clinical significance. No significant correlation was found between the occurrence of dysrhythmia, the side treated, the number and strength of the shockwaves, or the administration of analgesics. It was found, however, that dysrhythmia occurred almost exclusively in treatments involving the kidneys. The ECG-triggering option was indispensable in some patients in order to complete the lithotripsy without complications.

Adolescent↗

Acute polyradiculoneuropathy occurring after hymenoptera stings: a clinical case study.

Hymenoptera stings may be responsible for both local and systemic reactions; these can be immediate or delayed, depending on the time between the sting and the development of signs or symptoms. Delayed clinical reactions have been reported, although unusual, due to serum sickness and/or affecting organs or systems generally not involved in the immediate reaction, such as heart, kidneys, central and peripheral nervous systems. This paper describes the clinical and immunological findings in a 51-year-old subject, who, after two stings of paper wasps, the second one after the third venom immunotherapy (VIT) injection, presented immediate large local and systemic allergic reactions which quickly improved after e.v. methylprednisolone administration. About 40 hours later, he developed acute polyradiculoneuropathy with muscle weakness, paresthesia, difficulties in standing up and walking. Skin tests and specific IgE determination showed allergy to paper wasp. The activation, by wasp venom, of peripheral blood mononuclear cells in primary culture, evaluated by tritiated thymidine incorporation proliferation assay, showed an important hypersensitivity to wasp venom. Therefore our results suggest the hypothesis that the polyradiculoneuritis causative etiopathogenetic mechanism might be a delayed immunological response to wasp antigens followed by an allergy-triggered autoimmune reaction, as previously suggested by other authors; they found lymphocytic infiltrates in demyelinization areas and at perivascular levels, by histologic examination of autoptical and bioptical material of patients with nervous system lesions after hymenoptera stings.

Acute Disease↗

Idiopathic intracranial hypertension (pseudotumor cerebri): descriptive epidemiology, clinical features, and visual outcome in Parma, Italy, 1990 to 1999.

PURPOSE: To ascertain the annual incidence rate and the clinical features, other than visual outcome, of idiopathic intracranial hypertension (IIH) in Parma, northern Italy. METHODS: Neurologic care of people living in the Parma area is entirely provided by one private and two public hospitals. Medical records related to IIH were retrospectively reviewed for all Parma residents from 1990 through 1999. RESULTS: Ten patients (8 women and 2 men) were identified as having IIH according to modified Dandy criteria. Their age ranged from 16 to 53 years with a mean of 36 years at diagnosis. The annual age-adjusted rate per 100,000 is 0.28 for the total population. For women in reproductive age, the annual incidence rate is 0.65/100,000. For overweight women in reproductive age, the annual incidence rate is 2.7/100,000. CONCLUSIONS: The incidence rate found in this study is lower than the incidence reported in previous US and Libyan studies. A significant difference in overweight distribution is observed comparing percentage of body weight between US and Parma populations. As overweight and obesity are important factors contributing to IIH development, it is possible that their low percentage in the Parma population may, at least partially, explain the low IIH incidence observed.

Adolescent↗

[The problem of spinal myoclonus (author's transl)].

A case of the so called "spinal myoclonus" in a 71 year-old-man affected by lung carcinoma is reported. Clinical manifestations and comparison with similar previously described in literature induce to believe in the existence of a myoclonic syndrome, whose pattern seems to give support to the attribute of "spinal", at least as conventional term. An involvement of intercalated neurons is advanced as pathogenic ground. Anyhow, possible suprasegmental implications are also considered.

Aged↗

[Evaluation of the EEG aspects of rheumatic chorea as related to the clinico-evolutive parameters of the disease].

E.E.G. features as presented by 20 patients of rheumatic chorea (15 females and 6 males, from 11 and up to 16 year old) are examined. Pathological patterns concerned 17 patients (85%); in three cases (15%) no characteristic E.E.G. enregistrations were found. Three types of pathological E.E.G. patterns are reckoned: A type (7 patients, i.e. 35%): increased amount of Posterior Slow Waves. B type (5 patients, i.e. 25%): conspicuous alterations of the alpha rhythm, and appearance of bursts of diffused, monomorphous, slow activities. C type (5 patients, i.e. 25%): inconstant outcoming by bursts, of 2--4 cycles sec. waves on posterior regions. No correlation can be established, on the ground both of E.E.G. features and clinical findings, neither between altered E.E.G. patterns and choreic movements severity, nor between localization of the former abnormalities over the scalp, and distribution of the latter. Yet, E.E.G. alterations, when present, are not to be ruled out, as they can be the demonstration of organical impairment and can give evidence about the course and recovering. To distinguish, in rheumatic chorea between clearly pathological, by the one hand, and "functional" by the other, E.E.G. features, is assumed as difficult, as subjects are in a range of ages in which cerebral biorhythms have not reached ultimate definition.

Adolescent↗