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Biomedical subjects

G Nappi

Publications and source records attributed to G Nappi.

At least 253 records · Page 14Linked to original sources
PubMed1986

Autonomic disorders in idiopathic parkinsonism.

Clinical evidences and experimental data on various signs and symptoms of autonomic dysfunction in idiopathic parkinsonism are reported and their characteristics related to the effects of the drugs usually administered for the therapy of the extrapyramidal symptoms. The use of instrumental diagnostic criteria may sometimes help to detect alterations of autonomic functions (micturition disturbances, disorders of pupil reactivity, orthostatic and postprandial hypotension, temperature dysregulation), otherwise not easily identifiable. The existence of a large involvement of autonomic structures both at central and peripheral levels underlines the concept of Parkinson's disease being part of a wide spectrum of degenerative disorders where multiple nervous structures are at risk.

Antiparkinson Agents↗
PubMed1985

CSF beta-EP in headache and depression.

Cerebrospinal fluid (CSF) levels of beta-endorphin (beta-EP) were measured in 9 migraineurs with interparoxysmal headache (MIH), in 13 patients with major depression in an active phase (5 suffered from MIH), and in 16 age-matched controls. beta-EP was measured by specific RIA after gel-chromatography. While beta-EP levels of depressed patients (58.5 +/- 21.0 fmol/ml, M +/- SD) were similar to those of controls (65.8 +/- 26.6), those of migraineurs (15.0 +/- 11.1) were significantly reduced (p less than 0.01). In depressed patients also suffering from MIH, beta-EP concentrations (22.8 +/- 7.2, p less than 0.05) were half those reported in depressed patients without pain problems. The reduced CSF beta-EP levels in patients whose headache and depression coexist support the notion that this neuropeptide is concerned with chronic pain, independently of the affective state.

Adult↗
PubMed1985

Effects of lisuride on blink reflex habituation in Parkinson disease.

The blink reflex presents a tendency to habituation (a gradual diminution of the amplitude of the response during repetitive stimulation). Electromyographic analysis of this reflex makes it possible to quantify this phenomenon. A lack of the habituation of the blink reflex is a typical feature of Parkinson disease. L-Dopa and amantadine, but not anticholinergic drugs, are able to partly reverse these abnormalities in blink reflex habituation to a normal pattern. Lisuride, a dopamine agonist with serotoninergic activity, has been recently proposed as antiparkinsonian agent. In our study we observed that lisuride has a positive effect on blink reflex habituation in Parkinson disease. A good correlation between the improvement of this electrophysiological parameter and clinical akinesia was seen. Mechanisms underlying the therapeutic effect of lisuride are complex, but this drug usually has a postsynaptic effect on D2 receptors. Our data suggest that these receptors play an important role in blink reflex habituation.

Adult↗
PubMed1985

Flunarizine in common migraine: Italian cooperative trial. II. Long-term follow-up.

The effects of flunarizine administration (10 mg/day, at bed time) were studied in 120 common migraine patients who were followed for 24 months with quarterly controls. Besides headache index (HI) and analgesic use, other variables were monitored, such as arousal (Tolouse Pieron test), mood (Hamilton rating scale for depression), sleep/wake (hrs) and body weight. The study was open-type and after the 6th month control some responder (R) cases (HI reduction greater than or equal to 60%) presenting HI scores less than or equal to 4 could continue the survey off-treatment. The percentage of R cases was 54.5% at the 3rd month, a figure that further increased up to 72% by the 9th month; relapses on treatment were not observed and rebound-headache occurred in 1/4 of R cases let off-treatment. Lower (p less than 0.05) baseline HI values characterized non-responders. Side-effects not requiring withdrawal were drowsiness (42% within the 1st month) and weight gain (mean 7.9 +/- 6.9 kg) in 54% of the cases, while a retarded type depression was the most frequent cause of drop-out from trial (7.5%). The results, while confirming the high prophylactic activity of flunarizine in common migraine, stress the importance of clinical long-term survey of side-effects using antimigraine drugs and suggest the need for further investigations about flunarizine effects on CNS.

Adolescent↗
PubMed1985

Endorphin patterns within the headache spectrum disorders.

The role of opioid peptides in modulating the nervous system adaptability has been demonstrated recently; proopiomelanocortin (POMC)-related peptides, in particular, serve in pain perception, in adaptation to stress, and in modulating higher brain functions. Primary headaches, besides pain, involve neuroendocrine/autonomic/adaptive processes as well as mood and personality factors. The view that primary headaches can be taken as a possible model of POMC-related peptides dysfunction led us to evaluate the resting plasma and CSF peptide levels and their plasma changes in response to various stimuli affecting their release. The data obtained from basal and dynamic studies agree with the concept that primary headaches are sustained by opioid system disturbance. In particular the reduced release of endogenous opioids by anterior pituitary in response to physical, endocrine or pharmacological stimuli agrees with a weak adaptive ability of headache sufferers. This impairment of endorphin responsiveness could play a key role in headache susceptibility to environmental stimuli. Primary headaches constitute a wide, intriguing field, including several subgroups bordering on "ischemic" and behavioral/affective disorders. The development of neuroendocrine techniques could be a useful means for supporting the clinical criteria identifying subpopulations of headache sufferers.

Adrenocorticotropic Hormone↗
PubMed1985

beta-Endorphin cerebrospinal fluid decrease in untreated parkinsonian patients.

We measured CSF and plasma contents of beta-endorphin (beta-EP), beta-lipotropin (beta-LPH), and ACTH in 24 patients with Parkinson's disease; 14 had not been treated. CSF beta-EP concentrations in untreated patients were lower than in 15 controls (p less than 0.005), but values did not differ significantly in treated and untreated patients. In untreated and treated patients, ACTH and beta-LPH CSF, and beta-EP, beta-LPH, and ACTH plasma concentrations were in the same range as controls. The Parkinson's disease-related decrease of CSF beta-EP levels further supports the concept that there is a generalized brain disorder in Parkinson's disease affecting more than dopaminergic neurons in the substantia nigra.

Adrenocorticotropic Hormone↗
PubMed1985

Impairment of adrenergic-induced proopiomelanocortin-related peptide release in heroin addicts.

The effects of iv stimulation with clonidine on plasma levels of beta-lipotropin (beta-LPH), beta-endorphin (beta-EP), cortisol, growth hormone (GH) and adrenocorticotrophic hormone (ACTH) were tested in a group of 10 healthy volunteers and in 8 heroin abusers. Hormones were measured either by direct radioimmunoassay (RIA) (GH, cortisol) or after plasma extraction and Sephadex G-75 column chromatography (beta-LPH and beta-EP) or by immunoradiometric assay (IRMA) (ACTH). Plasma levels of GH increased in a similar fashion in the two groups. In the controls, clonidine induced release of beta-LPH and beta-EP after 30 min (from 8.9 +/- 1.0 to 19.1 +/- 4.6 fmol/ml, P less than 0.01 and from 8.1 +/- 0.6 to 17.9 +/- 4.6, P less than 0.01) and of ACTH after 60 min (from 12.1 +/- 1.8 to 18.1 +/- 1.8, P less than 0.05) while in addicts beta-EP but not beta-LPH showed a significant increase (from 8.5 +/- 0.7 to 19.8 +/- 4.2, P less than 0.05), 90 min after the injection. In heroin addicts, plasma cortisol levels decreased continuously after clonidine stimulation while in controls they showed a biphasic pattern, decreasing until the 60th min (from 135.2 +/- 30.4 ng/ml to 74.0 +/- 13.3, P less than 0.05) and regaining basal levels 1 h later (122.0 +/- 24.8, P less than 0.05 vs 60th min value). These data demonstrate the existence in human beings of noradrenergic control of proopiomelanocortin (POMC)-related peptides and indicate that chronic opiate abuse greatly interferes with this control. Clonidine-induced release of plasma beta-EP may be of importance with regard to its therapeutic effects in detoxification.

Adolescent↗
PubMed1985

Intermediate term evaluation of Starr-Edwards ball valves in the mitral position.

The Model 6120 ball valve prosthesis introduced in 1965 is still strongly supported as a mitral valve substitute in many centers around the world. A current reassessment of the performance of this prosthesis is therefore pertinent to current medical practice. In this institution since 1974, 227 Starr-Edwards caged ball valves have been implanted in the mitral position during isolated valve replacement. Two models of caged ball valves were used concurrently: the silastic ball valve in 108 patients (48%) and the composite strut "tract" valve in 119 (52%). Hospital mortality was 7%, and 8-year survival (standard error) was 74 (6%), with 100% follow-up, documenting 752 total patient-years. No late deaths were known to be valve related, and there were no cases of prosthetic thrombosis. The actuarial estimate of patients free from thromboembolism at 8 years was 89 (4%) with a linearized rate of 1.3% per year. At the most recent follow-up, 95% of the patients were in the New York Heart Association (NYHA) Classes I or II. These good results were partly due to an awareness at operation of ventricular outflow tract size requirements and to strict control of postoperative anticoagulation. We conclude that the Starr-Edwards ball valve is the mitral valve of choice in the young patient who is able to take anticoagulation drugs and has a left ventricular outflow tract of satisfactory size.

Journal Article↗
PubMed1984

Central ACTH deficit in degenerative and vascular dementia.

Cerebrospinal fluid (CSF) concentrations of ACTH, beta-lipotropin (beta-LPH) and beta-endorphin (beta-EP) were measured in 15 patients affected by dementia, who underwent also a brain computerized tomography (CT), and in 13 age-matched healthy volunteers. ACTH CSF levels of patients (4.0 +/- 2.4 fmol/ml, M +/- SD) were significantly lower than in controls (9.8 +/- 5.0, P less than 0.01) the lowest values being found in Alzheimer type of dementia (ATD: 3.1 +/- 2.5) and in patients with radiological evidence of cortical atrophy (2.5 +/- 1.2), independently of the probable origin of dementia. Although beta-LPH and beta-EP levels of patients fell within normal range, they were lower in ATD than in dementia sustained on a vascular origin. There was no variation of either peptides concentration in relation to CT findings. These data indicate the ACTH impairment as typical of dementia, supporting in humans the positive role of this peptide on learning and mnesic functions. Moreover, the maintained CSF levels of both beta-LPH and beta-EP in the dementia sustained on a vascular origin, while lower values were found in ATD, could represent a differentiation between vascular and degenerative diseases of the Central Nervous System (CNS).

Adrenocorticotropic Hormone↗
PubMed1984

L-5HTP treatment in primary headaches: an attempt at clinical identification of responsive patients.

The therapeutic response to L-5HTP, a serotonin precursor, was studied in an attempt to identify clinical subgroups of primary headache patients. The results at the 4th month control in 100 patients under L-5HTP treatment at the dose of 300 mg/day confirm previous observations on the activity profile of the drug, the effects of which are equally distributed between recurrent and daily forms as well as among clinical subtypes. The emerging profile of the responsive patients is characterized by such peculiar traits as prevalence of previous major mood disturbances and minor frequency of anxiety, longer duration of the illness and higher occurrence of some associated symptoms, lower incidence of exogenous and hormonal trigger factors, and previously positive response to pizotifen treatment.

5-Hydroxytryptophan↗
PubMed1984

Serotoninergic agonists increase plasma levels of beta-endorphin and beta-lipotropin in humans.

A pharmacological approach was used to investigate the serotoninergic control of plasma levels on beta-endorphin (beta-EP) and beta-lipotropin (beta-LPH) in humans. Acute administration of L5-OH-triptophan, the physiologic precursor of serotonin (SE), induced a significant rise in plasma beta-EP and beta-LPH levels both when injected iv (20 and 40 mg) (four normal men) and when administered orally (200 and 400 mg) (seven normal men) (P less than 0.01 vs. placebo). The iv route of administration induced a prompt (mean peak values after 150 min) dose-dependent increase in beta-EP and beta-LPH levels. The responses evoked by oral administration (mean peak values after 130 and 240 min) were not dose dependent. Fluoxetine (15 and 30 mg orally) a blocker of SE reuptake, induced a significant dose-related rise in plasma beta-EP and beta-LPH levels in a group of seven normal men (P less than 0.01) (mean peak values after 150 min). Pretreatment with methysergide, a SE receptor antagonist (3 X 2.8 mg orally, five men), did not induce any significant changes in plasma beta-EP and beta-LPH levels, but blocked the increase in the two hormones evoked by L5-OH-triptophan (40 mg iv). Plasma cortisol levels changed similarly to those of beta-EP and beta-LPH in all the experiments, indicating that putative serotoninergic drugs exert a positive role on the various corticotropin-releasing hormone-mediated secretions.

5-Hydroxytryptophan↗
PubMed1983

Cluster headache--clinical findings in 180 patients.

Anamnestic data and clinical features were accurately investigated in 180 patients with cluster headache; 161 were episodic sufferers and 19 were chronic. A significantly high familial incidence of coronary heart disease was found. The patients' medical history revealed a significantly high incidence of peptic ulcer disease and head injury with brain concussion. It is stressed that the side on which head injury took place is very frequently the same side on which cluster headache is located, although the latency between the two events appears to be a long one. The study of timing of cluster periods suggests, for some patients, a constant, typical temporal pattern not necessarily related to seasons or the months of of the year. Cluster attacks frequently occur during certain periods of the day (onset being most frequent between 1 and 3 p.m.). Cluster headache cannot be considered as a nocturnal headache.

Adolescent↗
PubMed1983

Lithium carbonate in cluster headache: assessment of its short- and long-term therapeutic efficacy.

The short- and long-term effects of administration of lithium carbonate in cluster headache (CH) have been investigated. Of the 90 patients treated (78 males and 12 females), 68 had episodic CH and 22 had the chronic form of the disease. The doses used were almost always 900 mg/day. Eleven of the 22 patients with chronic CH showed a definite, constant improvement both short and long term. In 7 of the 22 patients, lithium treatment provided excellent results initially but was later followed by some transient worsening; in the remaining 4 only partial benefits were observed initially and treatment proved still less effective after a few months. The effects of cessation of lithium administration after at least five months of continuous treatment were studied in 9 cases. In 6 of them the attacks re-appeared immediately, whereas in 3 the attacks occurred again only after free intervals of four to six months. Of the 68 patients with episodic CH, 26 proved highly responsive to treatment, 26 only partially responsive, and 16 refractory. In 3 cases, after one to three years of continuous treatment, euthyroid goitre developed, which disappeared after the drug was discontinued.

Adolescent↗
PubMed1983

Beta-endorphin, beta-lipotropin and adrenocorticotropic hormone levels in cerebrospinal fluid, and brain damage in chronic alcoholics.

In 34 chronic alcoholics, subdivided into two groups according to the state of the blood-brain barrier (BBB), beta-lipotropin (beta-LPH), beta-endorphin (beta-EP), ACTH and cortisol levels were determined in basal conditions in the plasma and cerebrospinal fluid (CSF). Hormonal concentrations were correlated with brain damage and mnesic function. The results indicate the reduced CSF beta-EP content in chronic alcoholics and suggest that peripheral beta-EP may penetrate into the CSF compartment when there is BBB damage. They also sustain the different origins of central and peripheral pro-opiocortin-related peptides, and support the concept that beta-EP, beta-LPH and ACTH may be autonomously regulated at the central level. Moreover, both morphological brain damage and mnesic impairment in chronic alcoholics are unrelated to CSF peptide levels. The role of opioid peptides in the nature of alcohol-seeking behavior is supported.

Adrenocorticotropic Hormone↗
PubMed1983

Headache temporal patterns: towards a chronobiological model.

Rhythmical changes in terrain susceptibility and trigger occurrence can induce periodic temporal patterns in headache patients, with readily foreseeable frequency cycles of attacks. The impaired ability of biological functions to adjust to cyclic environmental changes represents the minus, the handicap, the increased risk of clinical symptomatology (headache); attacks occur when the precarious systems of these patients are forced by cyclical environmental stimuli towards phase shiftings or to cope with new levels of performance. A dyschronic hypothesis of primary headache must be based upon observations demonstrating that along with dysfunctions of the pain control systems there is also a vulnerability of the rhythmic physiological organization of CNS.

Adult↗
PubMed1983

Changes of biological rhythms in primary headache syndromes.

The circadian periodicity of some endocrine (PRL, cortisol, GH) and vegetative (oral temperature, blood pressure) functions has been studied in cluster headache, common migraine, atypical facial pain, and "mixed" headache. Changes in several biological rhythms have been found not only in cluster headache (CH) but also in other kinds of headache. Although a great individual variability of rhythometric changes has been observed, particularly in CH, the dysrhythmic condition seems to be more evident in chronic than in episodic CH. The clinical and chronobiological effects of lithium administration and of a short-term sleep deprivation have been studied in CH.

Adult↗