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Biomedical subjects

G Bersani

Publications and source records attributed to G Bersani.

At least 19 recordsLinked to original sources
PubMed2006

Brain abnormalities in schizophrenia. A qualitative comparative study of schizophrenic patients and control individuals assessed by magnetic resonance imaging.

The present study examined, by means of Magnetic Resonance Imaging (MRI), the qualitative brain abnormalities in a group of 58 schizophrenic patients compared to a group of 58 matched control individuals. The possible relationships between these abnormalities and the demographic and clinical features of the participants in the study were also investigated. Schizophrenic patients presented a higher percentage of bland-moderate enlargement of the periencephalic-subarachnoid spaces (p=0.01) and a widespread cerebral atrophy, the latter below the threshold of significance (p=0.06). In the subset of patients with ventricular asymmetry (right larger than left) the age was significantly lower compared to the age of patients without this abnormality (p=0.04). In the subset of patients with cerebellar cisterns enlargement the age as well as the age of onset was higher in comparison to the one of patients without this abnormality (p=0.02; p=0.006). Taking together with previous studies, these findings underline the importance of qualitative assessment of brain morphology in research and clinical evaluation of patients with schizophrenia.

Adolescent↗
PubMed2005

Do ASGE guidelines for the appropriate use of colonoscopy enhance the probability of finding relevant pathologies in an open access service?

BACKGROUND: This prospective study examined the appropriate use of colonoscopy in an open-access system with the American Society for Gastrointestinal Endoscopy guidelines and determined whether the American Society for Gastrointestinal Endoscopy guidelines were associated with relevant endoscopic findings. METHODS: In a cohort of 2221 consecutive patients referred for colonoscopy, the proportion of patients who underwent colonoscopy for appropriate indications was prospectively assessed. The relationship between appropriateness and the presence of clinically relevant endoscopic diagnoses was assessed by calculating (1) the positive and negative likelihood ratio of the indications; and (2) the change in the probability of relevant endoscopic diagnoses in the presence of the American Society for Gastrointestinal Endoscopy criteria. RESULTS: The rate for 'generally not indicated' colonoscopies was 37%. Relevant endoscopic diagnoses were present in 28.5% of cases with American Society for Gastrointestinal Endoscopy indications versus 20.1% of patients without appropriate indications. However, the risk of finding relevant diagnoses was significantly increased by American Society for Gastrointestinal Endoscopy criteria application (odds ratio (OR) 1.58; 99% CI 1.20-2.07; p<0.01). Furthermore, in both endoscopic situations (appropriate and not appropriate), the likelihood ratio, positive and negative, varied very little, suggesting a low predictivity for serious pathologies by the appropriate procedure. CONCLUSIONS: The use of an appropriateness evaluation system makes it possible to increase the probability of finding relevant endoscopic diseases. However, the exclusive use of such a system for selecting patients to undergo colonoscopy involves a relatively high risk of colorectal neoplasms going undetected.

Adenomatous Polyps↗
PubMed2005

Microsatellite instability and gastric non-invasive neoplasia in a high risk population in Cesena, Italy.

BACKGROUND/AIMS: In the natural history of gastric cancer, non-invasive neoplasia (NiN) precedes invasive carcinoma. A histological classification of gastric NiN has recently been proposed by a World Health Organisation international panel of experts. Genetic instability is known to be among the molecular pathways involved in gastric oncogenesis. In this retrospective cross sectional study, microsatellite instability (MSI) was analysed in a consecutive series of NiN and NiN related histological alterations from a northern Italian region at high risk for gastric cancer. PATIENTS/METHODS: Fifty five consecutive cases (indefinite for NiN, 29 cases; low grade NiN, 17 cases; high grade NiN, nine cases) were analysed by radioactive polymerase chain reaction and electrophoresis for microsatellite alterations at six loci (BAT25, BAT26, D2S123, D5S346, D17S250, and D3S1317). MSI was defined according to the Bethesda criteria distinguishing: (1) no instability in the analysed loci; (2) low frequency MSI (MSI-L); and (3) high frequency MSI (MSI-H). Immunohistochemical expression of MLH1 and MSH2 proteins was also analysed in all cases. RESULTS: Overall, MSI was found in 11 of 55 cases (indefinite for NiN, five of 29 (MSI-L, four; MSI-H, one); low grade NiN, three of 17 (MSI-L, one; MSI-H, two); high grade NiN, three of nine (MSI-L, one; MSI-H, two). CONCLUSIONS: In an Italian high risk area for gastric cancer, MSI is part of the spectrum of genetic alterations in gastric non-invasive neoplasia. In European populations at high risk of gastric cancer, DNA repair system alterations are thought to be among the early molecular events in gastric carcinogenesis.

Adaptor Proteins, Signal Transducing↗
PubMed2003

Severity of obstetric complications and risk of adult schizophrenia in male patients: a case-control study.

OBJECTIVE: Obstetric complications may be an etiologically important factor in the development of schizophrenia. The aim of this study was to evaluate whether the risk for developing schizophrenia in adult life is increased in individuals with more severe obstetric complications at birth. METHODS: To this end, mothers were interviewed to gather data about obstetric complications. The 'midwife protocol' of Parnas and colleagues was used to quantify the presence and entity of obstetric complications. We studied the frequency distribution and the severity of obstetric complications in 64 male DSM IV schizophrenic patients. The genetic load was reduced by using 81 brothers who were not psychiatric patients as controls. Odds ratios for the effects of obstetric complications, maternal age, birth order and birth weight were calculated using conditional logistic regression. RESULTS: The only factor found to have a significant effect on the risk of schizophrenia was the overall measure of obstetric complications at birth. The history of obstetric complications was higher in schizophrenic patients than in their siblings. CONCLUSION: The results seem to confirm the hypothesis that obstetric complications may contribute to increased vulnerability to the disease, in addition to genetic risk factors.

Adult↗
PubMed2002

Cannabis and schizophrenia: impact on onset, course, psychopathology and outcomes.

Cannabis consuming schizophrenic patients are younger at onset, are likely to have started abuse before onset of schizophrenia and show more prominent positive symptoms than nonabusers. It has been suggested that cannabis is a risk-factor for schizophrenia. Our aim was to assess prevalence and pattern of cannabis use in 125 chronic male schizophrenic subjects and its impact on socioepidemiological and clinical variables as well as which disorder precedes the other in onset. Assessment of consumption was made with a semi-structured clinical interview. Clinical status was assessed by means of the SANS, SAPS, PANSS and BPRS scales. Cannabis consumption was found in 54 subjects (43%), 66.7% of whom started it at least three years before onset of schizophrenia. Consumers were younger and with lower negative symptoms, specially abusers and polysubstance abusers. Family history positive for psychosis was more frequent in consumers, especially when consumption started before onset of schizophrenia. Subjects whose onset of schizophrenia preceded the beginning of cannabis abuse had more positive symptoms than those who started abuse before the onset of schizophrenia. On these grounds, our sample could be subdivided into two main groups, one that uses substances to counter distressing symptoms of schizophrenia and another in which cannabis might be one of the factors predisposing to the disease; the former had less negative symptoms than nonabusers. Our data support both heterogeneity of schizophrenia and genetic susceptibility to environmental agents.

Adult↗
PubMed2001

Analysis of all-in-one parenteral nutrition admixtures by liquid chromatography and laser diffraction: study of stability.

All-in-one parenteral nutrition admixtures are complex lipid emulsions (oil/water) which require absolute sterility, stability and no precipitates. Particle diameter must be in the range 0.4--1 microm in order to mime the size of chylomicra. Added vitamins must not degrade during infusion time (24 h). In this study, the physicochemical stability of parenteral nutrition admixtures was tested in the course of time at different storage temperatures. Two liquid chromatographic methods, based on solid phase extraction (SPE), were developed for fat-soluble vitamin determination. Stability studies were carried out on three industrial lipid emulsions and on six compounded all-in-one admixtures. They were stored at three different temperatures: 4 degrees C (storage), 25 degrees C (compounding) and 37 degrees C (infusion); then they were analyzed at starting time and at 24, 48 and 72 h after compounding. Particle diameter was determined by means of Laser Particle Sizer Analysette 22, which uses laser diffraction technique (light scattering -- reverse Fourier optics). Fat-soluble vitamins (retinol palmitate and alpha-, delta-, gamma-tocopherol) were determined in admixtures with a branded vitamin compound called Idroplurivit Liofilizzato. Samples were extracted by SPE on C(18) cartridges, then they were separated by reversed-phase liquid chromatography (LC) and detected by ultraviolet detection (retinol palmitate) and electrochemical detection (tocopherols). Laser diffraction analysis pointed out that particle size did not change in the course of time at the tested temperatures. LC analysis showed that vitamins interact each other and degrade after compounding at different times and storage temperatures; only retinol palmitate is stable at 37 degrees C. Retinol palmitate recovery was 98%, coefficient of variation (CV) 5.4%, detection limit 25 microg/l, limit of quantitation 75 microg/l and there were not interfering substances. Tocopherols average recovery was 99%, CV 3.5%, detection limit 15 ng/l and limit of quantitation 50 ng/l. In conclusion, all-in-one parenteral admixtures were proved to be physically stable under analysis conditions, but degradation of retinol palmitate and tocopherols requires admixtures with vitamins to be infused within 24 h after compounding.

Chromatography, Liquid↗
PubMed2000

Melatonin add-on in manic patients with treatment resistant insomnia.

1. A profound alteration of circadian rhythm of sleep is often a central feature in manic syndrome. Melatonin (MLT) is a main synchronizer of the sleep/wake cycle, playing a role of transduction to brain functioning of informations about periodical environmental changes, i.e. the duration of daylength. 2. In several sleep phase disorders, MLT exerts a therapeutic effect, by normalizing the sleep/wake cycle. 3. Eleven patients, 8 males and 3 females, aged 22-43, meeting DSM IV diagnostic criteria for Bipolar Disorder, Manic Type, were selected for the presence of insomnia not responding to usual hypnotic therapies (benzodiazepine). 4. All the patients were on antimanic treatment. MLT 3 mg per os was administrated at 22.30 h for 1 month, without changing the previous antimanic and hypnotic treatments. All patients showed a significantly longer duration of sleep following MLT add-on. The severity of mania showed a parallel significant decrease. 5. The results of this pilot clinical study suggest that MLT add-on can be useful in antimanic therapy to treat resistant circadian sleep alterations as well as consequently exert a global therapeutic action on the manic state.

Adult↗
PubMed2000

Data and hypotheses on the role of nerve growth factor and other neurotrophins in psychiatric disorders.

Nerve growth factor (NGF) was discovered and characterized for its role on the growth, differentiation and maintenance of specific neurons of the peripheral nervous system. Subsequent studies revealed that NGF is synthesized and released within the central nervous system and exerts a trophic and functional role on basal forebrain cholinergic neurons; it is involved in a protective role following brain insults induced by an epileptic status, seizure, as well as surgical and chemical lesions.More recently our collaborative studies provided evidence that NGF is implicated in neurobehavioral response including cerebral alterations associated with psychiatric disorders. In this brief review, ongoing and emerging data are presented and discussed.

Animals↗
PubMed2000

Studies in animal models and humans suggesting a role of nerve growth factor in schizophrenia-like disorders.

Neurotrophic factors, such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), are known to play a crucial role in growth, differentiation and function in a variety of brain neurons during development and in adult life. We have recently shown that environmental changes, aggressive behavior and anxiety-like responses alter both circulating and brain basal NGF levels. In the present review, we present data obtained using animal models which suggest that neurotrophic factors, particularly NGF and BDNF, might be implicated in mechanism(s) leading to a condition associated with schizophrenic-like behaviors. The hypothesis that neurotrophins of the NGF family can be implicated in some maldevelopmental aspects of schizophrenia is supported by findings indicating that the constitutive levels of NGF and BDNF are affected in schizophrenic patients.

Aggression↗
PubMed1999

Choroid plexus calcification as a possible clue of serotonin implication in schizophrenia.

Choroid plexus calcification (CPC) was measured on computed tomography (CT) scans of 87 schizophrenics and 46 controls divided into age subgroups. We studied the relationship between presence and size of CPC and age in both groups, whilst in the schizophrenic group we also investigated the possible correlation between CPC size and age of onset and duration of illness, duration of formal education, psychopathological features of the illness as well as some neuroradiological brain measures. CPC size correlated with age in healthy controls but not in schizophrenics. In the schizophrenic group, left choroid plexus calcification size correlated with the Scale for the Assessment of Positive Symptoms (SAPS) subscales scores of 'formal thought disorder' whilst right choroid plexus calcification size correlated with the ventricular brain ratio at frontal horns (VBRFH). The data are not conclusive, but a possible correlation with a dysgenetic or functional 5-HT alteration can be hypothesized.

Adolescent↗
PubMed1999

Computed tomography study of pineal calcification in schizophrenia.

Computed tomography studies concerning pineal calcification (PC) in schizophrenia have been conducted mainly by one author who correlated this calcification with several aspects of the illness. On the basis of these findings the aim of the present study was to analyze size and incidence of pineal gland calcification by CT in schizophrenics and healthy controls, and to verify the relationship between pineal calcification and age, and the possible correlation with psychopathologic variables. Pineal calcification was measured on CT scans of 87 schizophrenics and 46 controls divided into seven age subgroups of five years each. No significant differences in PC incidence and mean size between patients and controls were observed as far as the entire group was considered. PC size correlated with age both in schizophrenics and controls. We found a higher incidence of PC in schizophrenics in the age subgroup of 21-25 years, and a negative correlation with positive symptoms of schizophrenia in the overall group. These findings could suggest a premature calcific process in schizophrenics and a probable association with 'non-paranoid' aspects of the illness. Nevertheless the potential role of this process possibly related to some aspects of the altered neurodevelopment in schizophrenia is still unclear.

Adult↗
PubMed1999

Mortality among workers in an Italian cigarette factory.

A cohort study was conducted to evaluate the mortality pattern among female and male workers in a cigarette factory. The study followed 972 female workers and 761 male workers with at least 6 months of cumulative employment from 1 January 1962 through 1 July 1996. Among women, mortality from all causes of death [standardized mortality ratio (SMR) = 0.9; 95% confidence interval (CI) = 0.8-1.1] and mortality from all malignant neoplasms (SMR = 1.1; CI = 0.9-1.3) were consistent with reference rates. Male workers had a significantly reduced overall mortality (SMR = 0.8; CI = 0.7-0.9), while mortality from all malignant neoplasms was as expected (SMR = 0.9; CI = 0.7-1.0). Among female workers the frequencies of deaths from diseases of nervous system (SMR = 2.0; CI = 1.1-3.4) and from non-Hodgkin's lymphoma (NHL) (SMR = 2.7; CI = 1.0-5.6) were elevated at a statistically significant level. No association between duration of employment and diseases of nervous system was observed. A higher risk for NHL, based on three deaths, was reported among female workers with 15 or more years of employment (SMR = 8.1; CI = 2.2-21.0). Although based on small numbers, the excess of NHL here reported suggests that potential exposure to foliar residues of pesticides should be thoroughly considered in tobacco manufacturing.

Adolescent↗
PubMed1999

Ornithine decarboxylase in colonic mucosa from patients with moderate or severe Crohn's disease and ulcerative colitis.

Polyamines, as well as ornithine decarboxylase (ODC), the enzyme involved in their synthesis, were reported to be closely related to cell proliferation. In Crohn's disease and ulcerative colitis, cell destruction and proliferation increase in the active stage. The aim of the present study was to determine the ODC in both involved and uninvolved areas of the colonic mucosa of active Crohn's disease and ulcerative colitis patients. The patients were divided in two groups, owing to the different level of activity (severe or moderate), by means of clinical endoscopy, laboratory, and histology evaluations. Subjects with suspected disease, but endoscopically unconfirmed, were used as controls. In all ulcerative colitis and Crohn's disease patients the ODC values both in involved and uninvolved mucosa were significantly lower than in controls. In severe Crohn's disease ODC was significantly reduced versus moderate Crohn's disease only in affected tissues. In all ulcerative colitis patients (moderate or severe) the ODC was significantly decreased in involved mucosa compared with uninvolved mucosa. Severe ulcerative colitis showed the significantly lowest ODC. We suggest that the significant decrease of ODC in the bowel mucosa is closely related to the severity of the disease. The highest decrease of ODC in ulcerative colitis patients would be due both to the enhanced cell destruction, and to the feed-back from exogenous increased polyamine production (bowel bacteria, cell desquamation). Therefore ODC would be considered a sensitive index of the inflammatory derangement of the mucosa, especially in acute ulcerative colitis. We conclude that this behaviour may result in an enhanced risk of neoplasia.

Adult↗
PubMed1997

Haloperidol administration in humans lowers plasma nerve growth factor level: evidence that sedation induces opposite effects to arousal.

Studies reported in recent years have indicated that the level of nerve growth factor (NGF), in both the brain and in the bloodstream, increases following stressful events and anxiety-associated behaviour. These observations prompted us to investigate whether an anti-arousal drug would induce an opposite effect. We have reported that the administration of haloperidol (HA), a neuroleptic drug clinically used for psychiatric disorders, decreases NGF levels in the hypothalamus of adult male mice. In the present study, we showed that HA reduced the basal NGF plasma levels in 8 neuroleptic-free schizophrenic patients. These observations strengthen the hypothesis that NGF may play a functional role in stress-coping responses.

Adolescent↗
PubMed1995

[Familial occurrence and obstetric complications in siblings discordant for schizophrenia].

Obstetric complications seem to play a relevant role in the development of schizophrenia. This study aimed to assess whether not only frequency but also severity of obstetric complications was different in schizophrenic patients when compared with their healthy siblings. Furthermore, we examined whether a family history positive for schizophrenia was related to an increased frequency or severity of obstetric complications in healthy siblings. Frequency and severity of obstetric complications were evaluated in 76 subjects (30 schizophrenics and 46 siblings). The diagnosis of schizophrenia were made according to DSM III-R. Mothers were interviewed to gather data about obstetric complications and the "midwife protocol" by Parnas et al. (1982) was used to quantify presence and entity of obstetric complications. Information regarding family history were collected from mothers. We used the method of segregation analysis to test the mode of inheritance. Complicated births were more frequently found in schizophrenics independently from a family history positive for schizophrenia or schizophrenia related personality disorders and obstetric complications were more severe in schizophrenics with respect to siblings. Obstetric complications occurred more frequently among schizophrenics without genetic risk; the same result was not found in healthy sibs. Our findings show that obstetric complications would play a major role in patients especially if they show a negative family history for schizophrenia. Moreover, a family history positive for schizophrenia or schizophrenia related personality disorder seems not to augment the frequency or severity of obstetric complications in healthy sibs.

Adult↗
PubMed1991

5-HT2 receptor antagonism in dysthymic disorder: a double-blind placebo-controlled study with ritanserin.

Thirty patients suffering from dysthymic disorder participated in a 6-week double-blind trial comparing ritanserin 10 mg and placebo. After a single-blind placebo wash-out period of one week, the test medication was administered during 5 weeks on a double-blind basis. Twenty-three patients completed the study. At the end of the trial, ritanserin was significantly superior to placebo in its effect as manifested on the 19-item Hamilton Rating Scale for Depression, the Hamilton Rating Scale for Anxiety and the State Trait Anxiety Inventory X-1 and X-2. At the end of the study, the therapeutic effect was rated marked or moderate in 75% of the ritanserin-treated patients, but only in 18% of the controls. These data are consistent with the hypothesis of serotonin abnormalities in dysthymic disorder and suggest a therapeutic role of 5-HT2 antagonists. Ritanserin treatment was very well tolerated; no serious adverse experiences were reported.

Adult↗