Search PubMed⌕ Search

Biomedical subjects

G Nappi

Publications and source records attributed to G Nappi.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

[Pourfour du Petit syndrome and intracranial aneurysms (author's transl)].

A 52 year old female suffered for more than 20 years from a recurrent pulsating headache on the left side. Clinical examination showed the retraction of the superior eyelid and mydriasis on the left. Exophthalmometry revealed 17 mm of protrusion for each eyeball. Angiographic investigations showed two little aneurysms: one of the anterior comunicating artery, the second of the left middle cerebral artery. In view of the clinical and angiographic findings the authors discuss the pathogenetic mechanisms of such oculo-sympthetic syndrome.

Electrocardiography↗
PubMedDate not supplied

Unilateral headaches and their relationship with cervicogenic headache.

The concept of headache originating/starting in the neck is revised and considered in the light of previous descriptions of syndromes and entities and with reference to the current diagnostic systems for the classification of headache and other head pain. Cervicogenic headache (CEH), a clinical picture recently described by Sjaastad and coworkers and listed in the International Association for the Study of Pain (IASP) Classification, is analyzed, also taking into consideration its diagnostic criteria in terms of sensitivity and specificity. The problem of a differential diagnosis with migraine, tension headache and other well defined forms of unilateral headaches is discussed with reference to a case series of 114 patients who were selected based on their adherence to two fundamental criteria: (i) side-locked unilaterality of pain; and (ii) pain starting in the neck and spreading to the fronto-orbital area. Based on the results, these simple criteria can contribute to a preliminary identification of possible CEH cases that may then undergo a sequence of clinical and instrumental procedures in order to confirm the diagnosis and, possibly, to localize the level(s) of dysfunction in the cervical spine which may be the target for therapeutic investigations, whether invasive or non-invasive.

Diagnosis, Differential↗
PubMedDate not supplied

Whiplash injuries: clinical picture and diagnostic work-up.

The term "whiplash" commonly refers to symptoms and signs associated with a mechanical event such as a sudden acceleration and deceleration of the neck (due, in the majority of cases, to a road accident), instead of to the mechanism itself. The recent Quebec Classification of Whiplash Associated Disorders (WAD) contributed to define nosographically all the clinical manifestations usually grouped under the terms acute/post-traumatic and late "syndrome". In the late phase of WAD, neck pain and neck muscle contraction have been reported in all cases, together with headache in over 50%. "Headache stemming from the neck", despite numerous attempts to classify this entity (i.e. cervicogenic headache) according to the IASP classification (headache associated with neck disorders), is still a subject of debate. An adequate multiparametric procedure is required to study WAD, which takes into account: the patient's principal details; an exact reconstruction of the event; description and analysis of the signs and symptoms, with various complications and correlated dysfunctions; an objective neurological and neck-shoulder examination; and a battery of complementary instrumental tests which are described in this study. These investigations include evaluation of muscle tension (manual palpation, algometry, EMG recording), kinematic analysis of the cervical spine, neuropsychological and psychological evaluation, and evaluation of disability. In order to assess cervical spine mobility in WAD patients, a 3D kinematic analysis by means of the ELITE system and clinical evaluation were performed in our setting. Seventy patients with whiplash injury and 46 healthy volunteers were enrolled in the study. Patients were tested at the time of first consultation and again 6 months and 12 months later. Clinical evaluation of the range of motion was performed both in patients and in 41 healthy volunteers. Furthermore, patients diagnosed according to the WAD Classification as grade 2 (n = 68) or grade 3 (16) underwent a Quality of life (QoL) evaluation, measured using the short form (36-item) Health Survey (SF36) and the migraine-specific questionnaire (MSQ). According to our data, whiplash patients showed an impairment of cervical spine mobility, as well as a poor QoL, compared to a control group population, even though we observed a trend towards improvement over time in cervical ROM.

Biomechanical Phenomena↗
PubMedDate not supplied

Current methods for cervical spine movement evaluation: a review.

Cervical spine mobility is difficult to investigate accurately because of its anatomic structure and the compensatory movements. Different methods have been conceived in order to obtain a reliable measurement of cervical range of movement (ROM). We reviewed different instruments described in the literature: x-rays, CT and MRI, goniometer, inclinometer, cybex and related devices, and opto-electronic scanners. Cybex and 3D kinematic analysis by means of opto-electronic scanners (Elite system) seemed to be the most reliable and reproducible methods. Cybex equipment is relatively inexpensive and easy to use in a clinical setting, while the Elite system is expensive and requires special training of the personnel. However, the choice of method depends primarily on whether the physician's goal is a clinical screening or a thorough investigation of neck function (e.g., post-traumatic cervical spine disorders). For the first purpose, certain types of goniometers (gravity goniometer, ad modum Myrin), as well as the cybex, show good reproducibility and reliability in evaluating maximal cervical ROM (flexion-extension, rotation, lateral bending), while x-rays and, above all, 3D kinematic analysis (using opto-electronic scanners) are more suitable for diagnostic and follow-up evaluation of neck disorders.

Biomechanical Phenomena↗
PubMedDate not supplied

Migraine as a complex disease: heterogeneity, comorbidity and genotype-phenotype interactions.

Migraine is a chronic illness interspersed with acute signs and symptoms which is currently defined, according to IHS criteria, in terms of "attacks". However, this should not lead us to ignore a critical point emerging from the simple observation of patients, i.e. the variability of the combinations in which the disease manifests itself in the same individual and especially in different individuals. This heterogeneity underpins both migraine "as attacks" (e.g. presence/absence of aura, different pain severity) and migraine "as a disease" (e.g. different onset, occurrence, association with other diseases, evolution, outcome). Genetic determinants are certainly at the basis of some migraine forms, and the role of genetics is now increasing due to the better phenotypical characterization rendered possible by the 1988 criteria. In most cases, however, migraine occurs as multifactorial inherited character. The level of complexity is further increased by the effect of "modifying" genes (such as those encoding for dopamine receptors), by comorbidity (the non coincidental association with other neurological diseases), and by the fact that the expression of comorbidity varies over time (phenotypical heterochronia). The clinical-descriptive approach allows only a partial understanding of migraine, the nature of which is more complex and heterogeneous than previously thought.

Adult↗
PubMedDate not supplied

The position of the head in space: a kinematic analysis in patients with cervical dystonia treated with botulinum toxin.

Many instruments have been employed in recent years in order to quantify the posture and motion of the head in normal and pathological subjects. Evaluations of this type present many difficulties related to the influence of individual and external factors and to the accuracy of the system used. In patients with cervical dystonia (CD) the only rating scales currently used are semi-quantitative and subjective. More precise information on disease severity and response to the treatment is needed. Posture and motion of the head were evaluated by means of ELITE motion analyser (BTS, Milan, Italy) in 6 patients with the left laterocollis form of CD undergoing treatment with botulinum toxin (BTX). The method emerged as very useful for the quantification of the therapeutic response (which was more marked in motion than in posture). We found an inverse relationship between the degree of motion improvement and the restriction of motion before treatment.

Adult↗
PubMedDate not supplied

[Prevalence of primary headache related to work activity in a group of hospital workers undergoing periodic visits (D. Lgs. 626/94 s.s.m. ed i.)].

Since headache is one of the most frequent complaints in clinical practice, its burden in terms of the both social cost and individual sufference is considerable. Headache is a frequent cause of absence from work and decreased productivity; it is therefore clear that investigating its possible relationship with working conditions represents a topic of increasing interest for the scientific community. This study was aimed at identifying specific occupational factors able to modify the prevalence of headache in a population of hospital workers undergoing periodic examinations. It was indeed suspected that the hospital environment could be per se a predisposing factor for headache onset, due to the considerable impact of stress on such working environment. The results obtained suggest that specific occupational conditions such as shift work and P.C. use may play an important role in headache development even in the presence of a wide number of professional risk factors.

Adult↗
PubMedDate not supplied

Distribution of paraquat into the brain after its systemic injection in rats.

Paraquat concentrations were determined in specific brain areas of rats systemically treated with different doses of the herbicide and sacrificed at different time periods following the acute administration. The systemic treatment with paraquat gave rise to a regional differential distribution of the herbicide into the rat brain, the highest levels being detected in the prefrontal cortex and hypothalamus. The rate of paraquat elimination showed time-dependency in the prefrontal cortex and hypothalamus; by contrast, in the other regions studied the initial drop observed at 3 h was followed by a second phase of significant accumulation. The concentrations detected into the cortex may account for the neuronal cell death reported in rats following systemic injection of this herbicide.

Animals↗
PubMedDate not supplied

[Headache as "sentinel" symptom in personnel involved in the preparation and administration of antineoplastic drugs].

The increased prevalence of neoplastic diseases observed over the last years has resulted for in more frequent operations of preparation and administration of antiblastic drugs performed by the medical personnel. In this study, we examined a group of subjects involved in the preparation of ACNU, Methotrexate, Novantrone, Vincristine, Cyclophosphamide, Carboplatinum, Mythoxantrone, in order to elucidate whether headache may represent an early symptom of exposure to these products. At the same time, we measured the degree of pollution in the air surrounding the vertical laminar flow aspiration cabinet used for drug preparation. The 66.6% of the 12 subjects studied, 9 females and 3 males, complained of headache. However, the environmental detection using high performance liquid chromatography coupled with triple quadrupole mass spectrometry (HPLC/MS/MS) gave negative results with respect to a possible environmental damage. These findings suggest that headache is the onset symptom of the toxic effect of antiblastic chemiotherapics in the medical personnel involved in drug preparation and administration.

Adult↗
PubMedDate not supplied

Panic-like attack induced by microinfusion into the locus coeruleus of antagonists and inverse agonists at GABAA-receptors in rodents.

The microinfusion of drugs inhibiting GABA-ergic transmission into the locus coeruleus (LC) of rats and mice produced a dramatic pattern of behavioural stimulation accompanied by marked electrocortical (ECoG) desynchronization. In rats, unilateral microinfusion into the LC of bicuculline (0.5-4 pmol) produced dose-dependent behavioural stimulation culminating in a panic-like attack, ECoG desynchronization and marked changes in ECoG spectrum power. These effects were prevented by a pretreatment into the same site with muscimol. Similarly, in mice, the microinfusion of ethyl-beta-carboline-3-carboxylate (beta-CCE, 4.1 nmol) into the LC of C57BL/6 mice produced an intense state of behavioural stimulation accompanied by intense stereotyped movements and increased excitability to external stimuli; these effects were prevented by prior microinfusion of diazepam or flumazenil into the same site. In conclusion, the present experiments show that in rodents drug manipulations leading to a decrease in the activity of GABA-benzodiazepine receptor complex in the LC are responsible for the occurrence of panic-like attacks.

Animals↗
PubMedDate not supplied

Cognitive and neuroradiological findings in myotonic dystrophy.

Cognitive functions were investigated in 37 patients with myotonic dystrophy (MD) and correlated with clinical and neuroradiological variables. The whole cognitive performance was at a low-average level; in about 1/3 of the subjects, in fact, the scores at the neuropsychological tests were below the normal range. There was a consistent trend for patients with inheritance on maternal side to perform worse on Wechsler verbal score and to present cerebral atrophy. In 7 out of 12 subjects focal white matter lesions were found at nuclear magnetic resonance. The significance of these findings and its relation to cognitive performance are discussed.

Adult↗
PubMedDate not supplied

Evidence that paraquat is able to cross the blood-brain barrier to a different extent in rats of various age.

The brain levels of paraquat were determined in rats of different age after systemic administration of several doses of the herbicide. Two week-, 3, 12 and 24 month-old rats were subcutaneously injected with paraquat (1, 2.5 and 5 mg/kg) and sacrificed 1 h later. A method based on ion-pair solid-phase extraction and reversed-phase high performance liquid chromatography was used to measure brain paraquat concentrations. The acute administration of paraquat resulted in dose-related and age-dependent brain concentrations of the herbicide, higher brain levels being detected in 12 and 24 month-old rats in comparison to young animals (3 month-old). In comparison with 3 month-old rats, higher concentrations of paraquat were also observed in the brain of 2 week-old animals. The present results demonstrate that in rats systemic treatment with paraquat gives rise to higher brain concentrations of this herbicide in very young and old rats in comparison with 3-month-old animals. This suggests that age-dependent changes in blood brain barrier permeability may account for these differences.

Aging↗
PubMedDate not supplied

The trigeminal pupillary reflex as a model of vegetative-nociceptive interaction: physiological and clinical aspects.

The study of pupil response to stimuli applied at the corneal level is particularly interesting for the study of integrative sensory-vegetative functions in both physiological and clinical research. In the present study we tried to evaluate and describe pupil response to quantified corneal stimuli in 7 healthy subjects by means of a binocular TV pupillometric device. The pupil response to corneal stimuli was bilateral, direct and consensual. It was characterized by a biphasic progression with an initial response in mydriasis and a later miotic component which was smaller, slower and of longer duration. A direct correlation was observed between the intensity of the stimulus applied and the extent of the mydriasis and between the intensity of the stimulus at the corneal level and the length of the mydriatic response.

Adult↗