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Biomedical subjects

G Antonucci

Publications and source records attributed to G Antonucci.

At least 55 records · Page 3Linked to original sources
PubMed1996

Predicting stroke inpatient rehabilitation outcome: the prominent role of neuropsychological disorders.

This study was designed to determine the role of demographic, medical and cognitive factors in the results of rehabilitation in first stroke patients. In a prospective study on 273 consecutive patients admitted to a rehabilitation hospital for sequelae of first stroke, we used multiple regressions to assess the relationship between 11 independent variables and a battery of outcome measures: mortality, length of hospital stay, Barthel Index (BI) and Rivermead Mobility Index (RMI) scores at discharge and their effectiveness. Severity of stroke at admission and hemineglect were the strongest prognostic factors. In a logistic model, cognitive impairment was a significant independent predictor (OR = 4.10) also after adjusting for age and severity of stroke. Patients with hemineglect had a significantly higher relative risk of poor autonomy [RR = 7.30, 95% confidence interval (CI) 4.04-13.18] and impaired mobility (RR = 9.25, CI 4.63-18.45). Global aphasic patients had similar risks for both autonomy (RR = 4.51, CI 2.74-7.41) and mobility (RR = 4.71, CI 2.79-7.97). This study underlines the crucial role of cognitive disorders as predictors of poor functional outcome in stroke survivors and confirms the need for early neuropsychological screening.

Activities of Daily Living↗
PubMed1996

Drug resistance patterns among tuberculosis patients in Rome, 1990-1992.

Prevalence of, and risk factors for, drug-resistance of Mycobacterium tuberculosis were assessed among 407 hospitalized patients with tuberculosis in Rome, Italy, during the period 1990-1992. Resistance to 1 or more drugs was detected in 106 isolates (26%). Resistance to streptomycin was the most common (18.4%), followed by isoniazid (10.3%) and rifampin (7.9%). 23 isolates (5.7%) were resistant to both isoniazid and rifampin. Resistance to at least 1 drug and resistance to both isoniazid and rifampin were significantly more common among recurrent cases (40.7% vs. 22.1%, p < 0.001; and 22.1% vs. 1.2%, p < 0.001). Sex, country of origin and HIV infection were not significantly associated with prevalence of drug resistance. Among recurrent cases, prevalence of resistance to at least 1 drug and of resistance to both isoniazid and rifampin, was higher in subjects who had had a previous episode of tuberculosis later than 1969. In the population studied the prevalence of drug-resistant tuberculosis was high, although the risk of initially becoming infected with a multidrug-resistant strain of M. tuberculosis in this area appears to be low. This study suggests the need for enhanced surveillance of drug-resistance of tuberculosis in our country and for implementation of intervention aimed to ensure adequate and complete therapy for patients with tuberculosis.

Adolescent↗
PubMed1995

Risk factors for tuberculosis in HIV-infected persons. A prospective cohort study. The Gruppo Italiano di Studio Tubercolosi e AIDS (GISTA).

OBJECTIVE: To analyze how demographic, clinical, and laboratory characteristics influence the risk of tuberculosis in human immunodeficiency virus (HIV)-infected individuals; to examine the incidence of tuberculosis associated with change in skin test responsiveness in HIV-infected, tuberculin-negative, nonanergic individuals. DESIGN: Multicenter cohort study. SETTING: Twenty-three infectious disease units in public hospitals in Italy. SUBJECTS: A consecutive sample of 3397 HIV-infected subjects were considered for entry in the study. Of these, 2695 who were followed up for at least 4 weeks were enrolled in the study; 739 subjects (27.4%) were unavailable for follow-up. The median duration of follow-up was 91 weeks. MAIN OUTCOME MEASURE: Culture-proven tuberculosis. RESULTS: Eighty-three episodes of tuberculosis were observed. Incidence rates of tuberculosis were 5.42 per 100 person-years among tuberculin-positive subjects, 3.00 per 100 person-years among anergic subjects, and 0.45 per 100 person-years among tuberculin-negative nonanergic subjects. In multivariate analysis, being tuberculin-positive (hazard ratio [HR], 9.94; 95% confidence interval [CI], 3.84 to 25.72) or anergic (HR, 3.35; 95% CI, 1.40 to 8.00), or having a CD4+ lymphocyte count less than 0.20 x 10(9)/L (HR, 4.87; 95% CI, 2.35 to 10.11) or between 0.20 and 0.35 x 10(9)/L (HR, 2.35; 95% CI, 1.09 to 5.05) were statistically significantly associated with the risk of tuberculosis. Incidence of tuberculosis increased with decreasing levels of CD4+ lymphocytes in the three groups of subjects with different skin test responsiveness. Skin tests were repeated 1 year after enrollment in 604 tuberculin-negative nonanergic subjects; three case of tuberculosis were observed among the 13 subjects who converted to tuberculin reactivity. CONCLUSIONS: Risk of tuberculosis in HIV-infected persons can be more precisely quantified by jointly considering skin test reactivity and CD4+ lymphocyte count. Periodic skin tests in tuberculin-negative nonanergic individuals can be useful in identifying individuals at high risk of active tuberculosis.

AIDS-Related Opportunistic Infections↗
PubMed1995

Modulation of the rod-and-frame illusion by additional external stimuli.

The presence of an additional external upright frame was studied in three experiments to separate the role of visuovestibular, global, and local mechanisms in the rod-and-frame illusion (RFI). In the first experiment, carried out in a dark room, the external frame surrounded a large tilted frame. Rod-setting errors to the vertical were abolished with the additional-frame condition (at 22 degrees inner-frame tilt) confirming earlier findings. However, small, residual direct (at 11 degrees inner-frame tilt) and indirect effects (at 33 degrees inner-frame tilt) were still present, indicating the persistence of global visual processing. In the second experiment, the RFI in the dark was compared with the RFI with the lights on. Turning the light on abolished the effect at 22 degrees and 33 degrees frame tilt; however, a small direct effect was maintained at 11 degrees frame tilt. These two studies indicate that the addition of veridical vertical information abolishes the effect owing to visuovestibular mechanisms. In the third experiment, a small rod and frame was used with the lights on (a condition abolishing visual-vestibular interaction). In the case of a small gap between the rod and the inducing frame (a condition which maximises local processing), the effect of the outer upright frame was negligible; this indicates that the additional frame had no effect on local processing. In the case of a large gap (a condition which minimises local processing), the external square reduced the illusion, indicating its modulating effect on visual global processing. Overall, an upright external frame exerts a differential influence depending on which mechanisms contribute most to the RFI in a given experimental condition.

Adult↗
PubMed1995

Visual factors affecting the rod-and-frame illusion: role of gap size and frame components.

In two studies the effect of the distance between the tip of the rod and the frame sides (gap) in the rod-and-frame (RF) illusion was examined and the effect of a full-square condition was compared with that of two different frame amputations. In both studies, there were more rod-setting errors in the direction of the tilt of the inducing figure with a small gap than with a large one. These findings are consistent with the idea that in the case of small gap size local interactions contribute to determining the RF illusion. The actual length of the rod was varied in order to keep the gap constant across different frame tilts; therefore these findings cannot be due to the co-variation between gap size and frame tilt which is typical of standard apparatuses. The effect of frame amputations was compared to the full-square condition. According to Wenderoth and Beh, amputations that maintain the two orthogonal contours of the square produce the typical angular function of the RF illusion. This prediction was confirmed in both studies. However, results indicate that the full square has a stronger illusory effect in the case of a small degree of tilt of the inducing stimulus, irrespective of gap size. It is suggested that this 'square superiority' effect is related to global, not local, mechanisms. To pursue Wenderoth and Beh's observations, amputations close to the vertical meridian were used in one experiment and those close to the horizontal meridian in the second experiment. Contrary to predictions, these conditions produced overlapping results.

Adult↗
PubMed1995

Effectiveness of neglect rehabilitation in a randomized group study.

The effectiveness of neglect rehabilitation training has been studied in two randomly selected groups of right brain-damaged patients. All patients proved heminattentive on a standard battery 2 months or more after the CVA. One group received 2 months of treatment immediately after admission to a clinic, and the other group received only general cognitive stimulation for the same amount of time. At the end of this period a comparison showed significant improvement in the first group, based on a standard test battery and a functional scale. The second group was then given rehabilitation training for neglect for the same amount of time and obtained similar improvement. It is concluded that the rehabilitation program produces significant results, which generalize to situations similar to those of everyday life. The importance of the duration of training on the generalization of learning is briefly discussed with reference to previous negative reports in the literature.

Aged↗
PubMed1995

Local and global visual mechanisms underlying individual differences in the rod-and-frame illusion.

The role of local and global visual mechanisms in individual differences in the rod-and-frame (RF) effect was investigated. Field-dependent observes, selected on the basis of Witkin and Ash's (1948) classical procedure, were submitted to the small RF test (Coren & Holy, 1986). Four frame tilts and two gap sizes were used. As expected, direct effects (i.e., rod settings in the direction of frame tilt) were observed at small degrees of frame tilt, while indirect effects (i.e., rod settings in the direction opposite that of frame tilt) were observed at larger frame tilts. Field-dependent observers showed larger direct effects in the case of the small gap. Indirect effects were comparable in both field-dependent and field-independent subjects, regardless of gap size. Following the model proposed by Wenderoth and Johnstone (1987), these findings indicate that low-level visual mechanisms, responsible for local orientation interactions, have a different gain in field-dependent and field-independent individuals. In contrast, global visual mechanisms, presumably acting by means of long-range mechanisms, do not distinguish between these two subgroups.

Adult↗
PubMed1994

Tuberculosis and AIDS: a retrospective, longitudinal, multicentre study of Italian AIDS patients. Italian group for the study of tuberculosis and AIDS (GISTA)

We report the results of a retrospective, longitudinal, multicentre study which estimated the cumulative incidence of tuberculosis in patients who eventually develop AIDS, investigated the characteristics of AIDS patients in relation to the development of tuberculosis, and endeavoured to determine the degree of HIV-induced immunosuppression at which tuberculosis occurs. The Infectious Disease Units of 23 hospitals located in 11 of the 20 regions of Italy participated in this study. We investigated 1691 patients with AIDS diagnosed in 1988 and 1989 and reported to the National AIDS Registry by participating units before the end of December 1990. By that time M. tuberculosis had been cultured from 193 patients (11.4%). Compared with intravenous drug users (the largest HIV transmission category), only homosexual men had a statistically significant lower risk of tuberculosis (relative risk = 0.65; 95% confidence interval 0.43-0.99). The median count of CD4+ lymphocytes at the time tuberculosis was diagnosed was 82/mm3 (range 1-752); only four patients (2.1%) had CD4+ lymphocyte counts of more than 500/mm3, and 36 (18.7%) of over 200/mm3. We conclude that in Italy the proportion of AIDS patients who develop tuberculosis is higher than in other industrialised countries and differences in the incidence of tuberculosis among various HIV-transmission categories are less marked than in other western countries. Tuberculosis associated with HIV infection may occur in those with widely differing CD4+ counts, although the risk increases consistently in proportion to the degree of immunosuppression.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Spontaneous canine mammary tumors. A model for monoclonal antibody diagnosis and treatment of human breast cancer.

BACKGROUND: The increasing availability of monoclonal antibodies to human breast tumor-associated antigens offers a new means to evaluate whether antigenic similarities exist between human and animal breast tumors. The study of the biology of spontaneous mammary tumors in the dog, one of the most frequent neoplasias in this domestic animal, may be of interest in providing an experimental model for the clinical management of human breast cancer. EXPERIMENTAL DESIGN: In order to assess whether antigenic similarities do occur between human and canine breast cancer, in the present study we have evaluated the immunohistochemical reactivity of two normal mammary glands and 62 benign and malignant canine breast tumors with a panel of six MoAbs, (HMFG2, MBr1, B72.3, B6.2, X-10, B1.1) recognizing distinct human breast tumor-associated antigens. RESULTS: The results of the present study indicate that mammary neoplasias in dogs display an antigenic phenotype comparable to that observed in female and male human breast lesions. As has already been demonstrated in humans, only three among the six monoclonal antibodies tested (B72.3, B6.2, and X-10) appear to discriminate benign from malignant canine mammary tumors. CONCLUSIONS: These findings demonstrate that (a) this veterinary tumor may represent a suitable model for imaging and immunotherapy studies of human breast carcinoma and (b) the triplet of reagents capable of distinguishing selectively transformed glandular epithelium may be useful in the immunocytochemical presurgical diagnosis of these canine neoplasias.

Animals↗
PubMed1993

Deficits of position sense, unilateral neglect and optokinetic stimulation.

The effects of optokinetic stimulation on position sense disorders were investigated in a series of 30 patients with unilateral vascular lesions (10 right brain-damaged patients with visuospatial hemineglect, 10 right brain-damaged patients without visuo-spatial hemineglect, 10 left brain-damaged patients), and 10 control subjects. The position sense deficit was more severe in right brain-damaged patients with neglect, where both the contralateral and the ipsilateral arm were involved. Optokinetic stimulation was effective only in right brain-damaged patients with neglect: stimulation with a leftward movement (contralateral to the side of the hemispheric lesion) improved the position sense deficit, while stimulation with a rightward (ipsilateral) movement produced a worsening of the performance level. These findings suggest that in right brain-damaged patients with neglect the position sense deficit has a nonsensory component, related to neglect, which may be affected by optokinetic stimulation. The role of the derangement of sensory and perceptual-egocentric representations of the body and of extrapersonal space in producing position sense disorders is discussed.

Aged↗
PubMed1993

Early abnormalities of the antibody response against Mycobacterium tuberculosis in human immunodeficiency virus infection.

Among human immunodeficiency virus (HIV)-infected persons, those who react against purified protein derivative (PPD) have higher risk of tuberculosis. Since PPD testing has limited predictive power in HIV-positive populations, new markers of antituberculous immunity were sought by analyzing antibodies to Mycobacterium tuberculosis antigens (PPD and its fraction A60) in 102 HIV-positive subjects, some PPD-positive and some PPD-negative, and in 23 HIV-positive tuberculosis patients. ELISA and Western blotting were used. Forty HIV-negative healthy subjects and 40 HIV-negative tuberculosis patients were evaluated as controls. While all those HIV-negative and PPD-positive had IgG antibodies recognizing the 38-, 28-, and 19-kDa M. tuberculosis antigens, only 26% of those HIV-positive and PPD-positive (all with < 400 CD4+ cells/mm3) and none of the HIV-positive tuberculosis patients recognized them, indicating that the lack of IgG against those antigens, in the presence of a specific IgM response, is a marker of immunodeficiency.

Adolescent↗
PubMed1993

The gap between rod and frame influences the rod-and-frame effect with small and large inducing displays.

The role of the spatial separation between the ends of a rod and a frame's inner edge (gap) in modulating the rod-and-frame effect (RFE) has been studied here with frames subtending either large or small retinal angles. With a large frame, rod settings were always in the direction of frame tilt (direct effects) and varied inversely with gap size. With a small frame, rod settings were in the direction of frame tilt for tilts between 7.5 degrees and 15 degrees; with larger frame tilts, rod settings in the direction opposite that of the frame were observed (indirect effects). Increasing gap size produced a tendency toward negativity (away from frame tilt). Consequently, direct effects were larger for small gaps, while the opposite was true for indirect effects. Overall, these results point to the importance of gap size in modulating the RFE, for both large and small displays.

Adult↗
PubMed1992

The role of frame size on vertical and horizontal observers in the rod-and-frame illusion.

The rod-and-frame illusion was used to examine a proposed distinction between the mechanism responsible for frame effects on rod-adjustment errors with large displays and the mechanism responsible for errors with small displays. It was suggested that visual-vestibular mechanisms are involved only when the rod is surrounded by a large tilted frame. Errors in the perceived vertical with small frame would instead be due to purely visual mechanisms. To examine this dual process model, we compared errors at small and large frame when the body was vertical or horizontal. There is evidence to suggest that tilting the body affects visual-vestibular interactions, but there is no reason to expect that body tilt would affect intravisual interactions. Hence, we hypothesized that body tilt would increase errors for large frame, but not for small frame. Eight subjects were tested in four different conditions, corresponding to the combination of two body orientations (vertical versus horizontal) and two frame sizes (47.5 versus 10.5 deg of visual angle). Fourier analysis of data was performed. Repeated measures ANOVA tested the hypothesis about frame size and body orientation. The hypothesis was not confirmed. More specifically, we found that tilting the body increased errors for the small frame as well as for the large frame. The interaction between frame size and body orientation was not significant. Results are discussed in relation to the proposed dual-process model.

Adult↗
PubMed1992

Personal and extrapersonal space: a case of neglect dissociation.

Dissociation between personal and extrapersonal neglect has rarely been observed in man. In this study we present a case of severe personal neglect in the absence of a deficit for extrapersonal space. An extensive neuropsychological assessment demonstrates the absence of cognitive impairments in visuo-spatial processing and confirms the selective presence of a severe representational deficit of the left side of the body.

Adult↗
PubMed1992

Cognitive rehabilitation of the hemineglect disorder in chronic patients with unilateral right brain damage.

Thirteen patients with a stabilized hemineglect symptomatology due to right-hemisphere lesions were subjected to a rehabilitation training specifically aimed at reducing the scanning deficit. The training consisted of four procedures (visual-spatial scanning, reading and copying training, copying of line drawings on a dot matrix, and figure description) which lasted 40 sessions. By the end of therapy, the patients as a group showed significant improvements on several standard tests of hemineglect. The results on a Semi-structured Scale for the Functional Evaluation of Hemineglect pointed to the extension of exploratory improvements to situations similar to those of daily life. In contrast, patients improved very slightly on a variety of standard visual-spatial tests, indicating the specificity of training in reducing the scanning defect. Seven patients were examined at a follow-up several months after the end of therapy and appeared stable on both standard and functional tests of neglect.

Aged↗
PubMed1992

Tuberculosis in HIV-infected subjects in Italy: a multicentre study. The Gruppo Italiano di Studio Tubercolosi e AIDS.

OBJECTIVES: To evaluate the strength of the association between tuberculosis and HIV infection in Italy, to assess the pattern of this association in relation to HIV transmission categories, and to describe clinical presentation of tuberculosis in a large group of Italian HIV-infected subjects. DESIGN: Multicentre review of clinical records. SETTING: Twenty-one infectious disease hospital units in nine of the 20 administrative regions of Italy. PATIENTS, PARTICIPANTS: All HIV-infected adults observed by each participating unit (in- and outpatients) between 1985 and 1989. MAIN OUTCOME MEASURE: Culture-proven tuberculosis. RESULTS: A total of 306 cases of tuberculosis were observed. Of these, 85 were pulmonary, 167 extrapulmonary, and 54 both pulmonary and extrapulmonary. The proportion of HIV-infected subjects diagnosed with tuberculosis increased during the study period from three out of 1380 (0.2%) in 1985 to 152 out of 6504 subjects (2.3%) in 1989 (P less than 0.0001). Two hundred and twenty-six of the 2760 (8.19%) patients with AIDS had tuberculosis within 12 months of AIDS diagnosis; the proportion of AIDS patients with tuberculosis remained stable after 1985. Compared with AIDS patients who were intravenous drug users, only homosexual AIDS patients had a significantly lower proportion of tuberculosis (178 out of 1958 versus 30 out of 522; P less than 0.02). CONCLUSIONS: Our data show that tuberculosis is quite common among HIV-infected subjects in Italy, and suggest that the risk of tuberculosis in these subjects has not changed. There are some differences between the pattern of the association between tuberculosis and HIV infection in Italy, compared with other industrialized countries.

Adult↗
PubMed1990

Effect of optokinetic stimulation in patients with visual neglect.

Three groups of subjects, normal controls, right brain damaged patients with and without heminattention, were required to bisect a line in presence of a fixed or a moving background. The stimulus moving horizontally toward the left or the right induced an optokinetic nystagmus with a slow phase coherent with the direction of the movement: together with the optokinetic nystagmus, a displacement of the subjective midpoint, as compared to the condition with a fixed background, was observed in all three groups of subjects. Within the right brain damaged with heminattention the displacement of the line bisection was great for stimuli moving toward the right, but a significant reduction of the left bias was present. In the same group of patients the effect of the optokinetic stimulation was present in a very large proportion of cases and proved to be relatively stable in a test-retest presentation. Theoretical relevance of these data and their potential importance for rehabilitation are discussed.

Attention↗