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Biomedical subjects

G Meco

Publications and source records attributed to G Meco.

At least 73 records · Page 4Linked to original sources
PubMed1993

Mortality rates for parkinsonism in Italy (1969 to 1987).

Parkinsonism death rates in Italy were analysed for the period 1969-1987. Crude death rates increased markedly in the above period for both sexes. Age-specific rates underwent important changes during these twenty years. In the years 1969-71 the age-specific death rates reach their maximum values at ages 80-84, after which they decline. In the years 1983-87 the rates continue to increase until the 80-84 age group, when they reach a plateau. Moreover, in the more recent years the age-specific rates for ages < 70-75 are lower, whereas those for the older ages are approximately twice as high as the values in the earlier years. The age-adjusted death rates (1981 Italian population) increased slightly in the period studied for both sexes. Rates for males exceed those for females in all the previous analyses. Minor differences appeared in death distribution between the five large areas Italy was divided into. The observed changes in death rates are likely to reflect: changes in age composition of the population over time, greater attention to parkinsonian patients and especially increased duration of this disease following the discovery of its neurochemical basis and effective medical treatment.

Adult↗
PubMed1992

Mortality rates for Parkinson's disease and parkinsonism in Italy (1969-1987).

The mortality rates (MRs) for Parkinson's disease (PD) and parkinsonism were analyzed for the period 1969-1987 in Italy, considering the population aged greater than or equal to 25. MRs were then age-adjusted taking the 1981 Italian population as standard. We found an increase in MRs for PD during the period studied. The Italian average annual age-adjusted MR was 5.73, ranging from 4.76 (1969) to 6.81 (1985). Moreover we noticed some interesting differences in the geographic distribution of MRs between the five big areas Italy was divided into. We also found that, while the MR for the ages 65-79 years was quite constant in the period studied, there was a marked increase in the MR for ages greater than 79 years from 1980 onwards. The geographic differences we found in MRs deserve to be analyzed in further epidemiological studies.

Aged↗
PubMed1992

TRH test and the continuous dopaminergic stimulation in complicated Parkinson's disease.

Marked, disabling fluctuations in motor performance (on-off phenomena) appear after chronic L-Dopa therapy in Parkinson's disease (PD). Intravenous infusion of L-Dopa greatly reduces these motor fluctuations, but it is not reliable as a chronic treatment. Therefore, infusion of the potent, water-soluble dopaminergic agonist lisuride has been tested. However, many patients did not respond to infusion of lisuride alone, and no clinical parameter is known to correlate with the lacking response. In order to study this problem, we performed the TRH test (200 micrograms i.v.) in 8 PD patients with severe motor fluctuations; before and during lisuride subcutaneous infusion, we measured PRL and TSH responses to TRH. Both PRL and TSH receive an inhibitory control from dopaminergic receptors on pituitary cells, whereas they are stimulated by TRH. The TRH test, given during lisuride infusion, allows an indirect evaluation of the 'brake function' of the dopaminergic system on anterior pituitary, i.e. of dopaminergic receptor sensitivity in vivo. In our study, TRH induced a significant TSH rise in all PD patients, before and during lisuride infusion. Moreover, the lisuride responders (i.e. patients showing constant 'on' period during lisuride infusion, 4 patients) showed a significant lower TSH response as compared to nonresponders. PRL levels followed the same trend without reaching statistical significance. These data are compatible with the presence, in the two groups, of a different pituitary dopaminergic sensitivity which would suggest the presence of pharmacodynamic factors associated with the lacking response to intravenous lisuride infusion.

Antiparkinson Agents↗
PubMed1992

Rehabilitation and Parkinson's disease.

In this study we evaluated the efficacy of physical therapy together with drug therapy in a group of parkinsonian patients, compared with a group of patients treated using drug therapy only. The physical therapy program lasted four months and included passive and active mobilization exercises, adopted for postural control and equilibrium, walking and prevention of contractures and ankylosis. The assessment was accomplished by means of clinical rating scales and motor performance tests. Patients treated by means of physiotherapy showed an improvement at the end of the study in both clinical scales and motor performance tests. This improvement was noted in both patients with less severe and more severe symptoms as well as in those with shorter and longer disease duration. It is not easy to assess the role played by physical therapy due to the difficulty of an objective evaluation; our results, however, show an improvement in the functional performance of patients and suggest the usefulness of physical therapy associated with drug therapy in a comprehensive treatment for Parkinson's disease.

Aged↗
PubMed1991

Cardiovascular reflexes and autonomic dysfunction in Parkinson's disease.

Cardiovascular reflexes were analysed in a group of 20 patients suffering from Parkinson's disease and in 12 age-matched healthy subjects, in order to ascertain the incidence and degree of autonomic dysfunction. The following were measured: heart rate variation during normal breathing, postural change (30/15 ratio) and during the Valsalva manoeuvre: blood pressure variation after standing. These measurements were taken at least 12 h after therapy had been withdrawn and were repeated after therapy had been resumed. Significant changes in the different heart rate variation indices were found in the parkinsonian patients which correlated with the duration and severity of the extrapyramidal symptomatology. After standing the patients showed a significant drop in blood pressure, when compared respectively with their base values and with the response in controls. Anticholinergic drugs had no significant effect on the heart rate variation indices, whereas antiparkinsonian therapy seems to have contributed to the drop in blood pressure after standing.

Adult↗
PubMed1991

Relations between on-off phenomena and cognitive functions in Parkinson disease.

10 patients with Parkinson disease on long term levodopa therapy and with fluctuations in motor performance unrelated to drug administration (on-off phenomena) were assessed on the following neuropsychological tests during the on and off phases: tests of attention (Toulouse-Pieron), memory (Digit Span, Rey forms 1 and 2), psychomotor capacity (maze test, single and multiple choice reaction times) and mood (Maudley Adjective Check List). The extrapyramidal symptoms were assessed on the Webster Rating Scale. We found no significant differences in attention, cognitive performance or mood between the on and off phases despite large fluctuations in motor performance.

Affect↗
PubMed1991

Hypothalamo-pituitary function and dopamine dependence in untreated parkinsonian patients.

Altered prolactin and thyrotropin responses to the TRH test in parkinsonian patients are held to indicate an impairment of the tubero-infundibular dopaminergic axis (TIDA). We correlated the plasmatic prolactin (PRL), thyrotropin (TSH) and somatotropin (GH) responses to TRH and bromocriptine + TRH of 12 parkinsonian patients, who had never received anti-parkinsonian drugs, with the severity, the duration, the age of onset and the dopamine-dependence of the motor symptomatology as indicated by the therapeutic response to a six-month oral treatment with bromocriptine. Patients with basal motor impairment over 9 on the Webster Rating Scale (WRS), those with duration of the disease over 24 months and those with onset earlier than 55 years of age showed lower PRL responses than the respectively matched subgroups. Patients showing a therapeutic motor improvement over 50% on the WRS (dopamine-dependent or "responder") showed lower PRL and TSH and higher GH responses than the non-responders. These findings suggest that the TIDA impairment described in Parkinson's disease develops along with the progressive course of the extrapyramidal involvement and is strictly correlated with the dopamine-dependence of the motor impairment.

Adult↗
PubMed1990

Hallucinations in Parkinson disease: neuropsychological study.

Hallucinations occur fairly frequently in the course of the pharmacological treatment of Parkinson disease. Our aim in this study was to assess first the relation between hallucinations and mental deterioration and second the correlation between the perception disorder and the profile on the Minnesota Multiphasic Personality Inventory (MMPI). Of 304 parkinsonian subjects followed as outpatients at our center 27 (8.88%) had had hallucinations and 17 of these presented marked cognitive deficits (Mini Mental State less than 18) (62.9%) compared with 32 of the other 277 patients (11.5%) (X2 = 55.16, p less than 0.0001). A group of 9 patients who had had hallucinations and 10 controls who had not, all free from marked cognitive deficits, were assessed on the Luria-Nebraska Neuropsychological Battery (LNNB) and on the MMPI. The two groups did not differ significantly in respect of the LNNB but did in respect of the MMPI scales. On this evidence the frequency of mental deterioration is significantly higher in patients who have hallucinated. We discuss the meaning of the MMPI differences both from the biochemical angle and from that of personality factors. These data suggest that the MMPI might be useful for predicting hallucinations in undeteriorated parkinsonian patients on pharmacological therapy.

Aged↗
PubMed1989

The role of the thymus in multiple sclerosis.

The presence of numerous changes in T lymphocyte activity found in MS patients points to the involvement of the thymus in multiple sclerosis. The etiophathogenetic mechanism of MS is probably an autoimmune reaction that is triggered by a viral infection caused by one or more viruses and that perpetuates itself, causing the disease to progress. It has been proved that the thymus maintains its immunocompetence even in adulthood and that it has a role in the pathogenesis in several autoimmune diseases. In exacerbations of MS there is a decrease in T suppressor lymphocytes while histological and lymphocyte subset changes have been demonstrated in the thymus of MS patients. The lymphocyte response to mitogens is also depressed in MS. The clinical results of thymectomy in MS are not uniform and are on the whole inconclusive, probably through the lack of criteria of selection of patients for surgical treatment. We consider that the morphological and functional study of the thymus biopsy specimen should supply the appropriate criteria of suitability for surgical treatment.

Humans↗
PubMed1988

Complicated migraine: case report.

The occurrence of long lasting focal neurological deficit as a complication of migraine is well known. A high incidence of C.T. scan abnormalities have been seen in subjects affected by severe complicated migraine; in some cases such lesions had the aspect of cerebral infarction. In this report we will relate case of a 29 year old woman with complicated migraine and multifocal suffering within the area of the hind brain circulation. The hypodense area we found with C.T. in the left cerebellar hemisphere and the reversibility of this lesion could support the hypothesis of focal edema in our case.

Adult↗
PubMed1986

Multicenter trial of L-Deprenyl in Parkinson disease.

A multicenter trial was conducted at 9 Neurology Departments to evaluate the action of L-Deprenyl, a specific monoamine oxidase-B inhibitor, combined with L-Dopa in the treatment of Parkinson disease. In all, 76 patients were treated, 33 women and 43 men, on stable treatment with L-Dopa+ aromatic decarboxylase inhibitors (DI) for at least 6 months. After a 50% reduction of the L-Dopa dose, all received L-Deprenyl 5 mg twice daily for 35 day. The combined treatment resulted in a definite improvement in rigidity, bradykinesia and, most of all, tremor. Further, at the end of treatment fewer patients had depressive symptoms and the total daily number of hours of wellbeing and normal movement increased. 12 patients presented modest side effects, in no case serious enough to warrant suspension of treatment. The trial shows that with the L-Deprenyl + L-Dopa combination the dose of L-Dopa needed to control the disease can be drastically reduced.

Adult↗
PubMed1986

Fast complex arm movements in Parkinson's disease.

Fast arm movements involving the shoulder and elbow joints have been analysed in normal controls and in patients with Parkinson's disease. The subjects were requested to draw on a graphic tablet triangles and squares of different size and shape. The patients produced a larger number of EMG burst compared with controls. The movements were accurate, and each segment of the geometric figures was performed with a roughly straight trajectory, but the time necessary to trace the geometric figures and the pauses at the vertices were prolonged. We conclude that in Parkinson's disease the disability in generating two joint ballistic movements depends on a difficulty in running motor programmes for complex trajectories.

Adult↗
PubMed1986

Neuroendocrine effects of setoperone: a new neuroleptic drug.

Setoperone (R 52245), a serotonin S2 and dopamine D2 receptor blocker, was tested on eight healthy male volunteers, receiving 5 or 40 mg orally, in order to assess the modifications of plasma prolactin levels, as an index of receptor blocking activity. Both doses significantly increased plasma levels, confirming the dopamine blocking activity. In vitro and in vivo studies have shown serotonin S2 receptor blockade and lysergic acid diethylamide antagonist activity. Setoperone is proposed as a possible new neuroleptic drug.

Adolescent↗
PubMed1985

A double-blind controlled subjective study of a new pharmaceutical preparation of lormetazepam versus placebo in patients with chronic sleep disturbances.

A double-blind crossover trial was carried out on the sleep-inducing activity of a new preparation (oral drops) of lormetazepam versus placebo. Twenty patients were included and requested to subjectively evaluate their sleep, both by analogue scales and semiquantitative ratings, during 2-night administration of the two products. Also, the usual parameters, sleep duration, sleep latency and number of awakenings were evaluated. Lormetazepam drops appeared to exert the same actions as the capsules' preparation, being significantly different from those of the placebo.

Adult↗