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Biomedical subjects

G Nappi

Publications and source records attributed to G Nappi.

At least 55 records · Page 3Linked to original sources
PubMed2003

Neuroprotective effects mediated by dopamine receptor agonists against malonate-induced lesion in the rat striatum.

In rats, intrastriatal injection of malonate, a reversible inhibitor of the mitochondrial enzyme succinate dehydrogenase, induces a lesion similar to that observed following focal ischemia or in Huntington's disease. In this study we used the malonate model to explore the neuroprotective potential of dopamine agonists. Rats were injected intraperitoneally with increasing concentrations of D1, D2, or mixed D1/D2 dopamine agonists prior to intrastriatal injection of malonate. Administration of increasing doses of the D2-specific agonist quinpirole resulted in increased protection against malonate toxicity. Conversely, the D1-specific agonist SKF-38393, as well as the mixed D1/D2 agonist apomorphine, conferred higher neuroprotection at lower than at higher drug concentrations. Our data suggest that malonate- induced striatal toxicity can be attenuated by systemic administration of dopamine agonists, with D1 and D2 agonists showing different profiles of efficacy.

Analysis of Variance↗
PubMed2003

Sleep attacks in Parkinson's disease: a clinical and polysomnographic study.

The objective of the study was to evaluate daytime sleepiness, (the features of episodes of sudden sleep onset), i. e., so-called sleep attacks (SAs), in three male Parkinson's disease (PD) patients (mean age 66 years) on chronic therapy with ropirinole or pramipexole. A structured clinical interview, the Epworth Sleepiness Scale, and continuous 24-h ambulatory polysomnography were used to assess the features of SAs occurring in the patients in their normal home environments. The polysomnographic patterns characterizing SAs (sleep occurring against a background of wakefulness, and not preceded by a feeling of sleepiness or by other heralding symptoms) were analyzed. The results showed that SAs can be clearly documented through polysomnographic monitoring and really, but rarely, occur in PD. SAs seem to represent the extreme of the continuum of daytime sleepiness observed in PD patients.

Aged↗
PubMed2003

Autosomal dominant external ophthalmoplegia and bipolar affective disorder associated with a mutation in the ANT1 gene.

The authors report on a family with dominantly inherited progressive external ophthalmoplegia and a diagnostic and statistical manual (fourth revised edition) diagnosis of bipolar psychiatric disorder in several members. Skeletal muscle biopsy from the proposita showed decreased cytochrome c oxidase staining, several ragged-red fibers, and multiple mtDNA deletions. The authors identified a missense mutation (leucine 98-->proline) in the adenine nucleotide translocator 1 gene. The presence of bipolar affective disorder expands the phenotype of adenine nucleotide translocator 1 allelic variants.

Adenine Nucleotide Translocator 1↗
PubMed2003

Clinical, functional and quality of life changes after balneokinesis with sulphurous water in patients with varicose veins.

BACKGROUND: Purpose of this study was to assess the effects of thermal hydrotherapy (balneokinesis) with a sulphurous water on clinical symptoms, quality of life and some functional parameters in patients with varicose veins. PATIENTS AND METHODS: 70 patients with primary or secondary symptomatic varicosis were enrolled and submitted to elastic compression therapy. Patients were then randomized to receive (50 pts, group A) or not receive (20 pts, group B) balneokinetic treatment for 12 days "on top" of elastic compression. Clinical symptoms, quality of life and functional parameters obtained with light reflex plethysmography (PPG) and laser Doppler fluxmetry (LDF) were assessed after 3 and 6 months. RESULTS: Scores for subjective symptoms as pain, edema, and venous claudication were decreased after 6 months in both groups, but more evidently in group A submitted to balneokinesis. Some parameters related to quality of life evaluation as "bodily pain" and "emotional role" were improved only in patients undergoing balneokinesis. Regarding functional parameters, with PPG venous refilling time after foot exercise moderately increased in both groups. With LDF a significant improvement in the veno-arteriolar reflex was seen in the group treated with balneokinesis. CONCLUSIONS: These results show additional benefits of balneokinetic treatment in patients with symptomatic varices submitted to elastic compression. In fact, clinical and quality of life improvements were observed. The associated amelioration in the veno-arteriolar reflex may support these subjective benefits.

Activities of Daily Living↗
PubMed2003

Dietary and nutritional patterns in an elderly rural population in Northern and Southern Italy: (I). A cluster analysis of food consumption.

OBJECTIVE: To describe the food consumption patterns of Italian elderly subjects and the factors associated with different dietary habits. DESIGN: Cross-sectional study. SETTING: Population-based study. SUBJECTS: A total of 847 men and 1465 women aged 65 y or older, living in rural areas in the province of Pavia (Northern Italy) and near Cosenza (Southern Italy) in 1992-1993. INTERVENTIONS: The dietary information was collected by means of a quantitative food-frequency questionnaire, with cluster analysis being used to segregate the subjects on the basis of similarities in their food consumption. A generalised logistic regression model including residence, age, living status, education, physical activity and degree of disability was fitted to assess the factors associated with different food consumption habits. RESULTS: Six dietary clusters were selected for men and seven for women. The largest cluster for both genders was "small eaters" (46% of men and 51% of women); "big eaters", "light diet" and "alcohol" clusters were also identified for both genders. The men were also grouped into "balanced diet" and "cheese" clusters, and the women into "sweet", "greens" and "butter" clusters. CONCLUSIONS: In addition to the influence of the area of residence--residents in Northern Italy consume greater amounts of animal fats, sugar and alcoholic beverages, and those living in Southern Italy have a greater intake of fruit, vegetables, fish and olive oil--all of the other studied variables predicted the probabilities of falling into a specific dietary cluster. SPONSORSHIP: National Research Council (Italy)--Invecchiamento Project No. 95.01048. PF40.

Aged↗
PubMed2003

Dietary and nutritional patterns in an elderly rural population in Northern and Southern Italy: (II). Nutritional profiles associated with food behaviours.

OBJECTIVE: To describe the nutritional profiles of the food consumption patterns identified in an elderly Italian rural population. DESIGN: Cross-sectional study. SETTING: : Population-based study. SUBJECTS: A total of 847 men and 1465 women aged 65 y or older, resident in rural areas in the province of Pavia (Northern Italy) and near Cosenza (Southern Italy) in 1992-1993. INTERVENTIONS: A cluster analysis segregated the subjects into six groups for men and seven for women on the basis of similarities in their food intake (see companion paper). The mean daily energy, macronutrient, mineral and vitamin intakes were calculated for the sample as a whole and for each cluster, and then compared with the age- and gender-specific recommended daily allowances for the Italian population. RESULTS: The largest cluster ("small eaters", which included about half of the population) had an insufficient intake of essential fatty acids, calcium, potassium, zinc (men), iron (women), thiamin, riboflavin, niacin, beta-carotene, and vitamins A, D and E. The most noticeable characteristics of some of the other clusters were a high intake of fats, a high proportion of total energy provided by sugars, a high intake of vitamin C, folic acid and beta-carotene, and a high alcohol consumption. Furthermore, sodium intake was too high in all of the clusters and vitamin D intake was generally inadequate. CONCLUSIONS: The dietary habits of elderly Italians living in rural areas combine elements of the Mediterranean and "wealthy" diets. SPONSORSHIP: National Research Council (Italy) - Invecchiamento Project no. 95.01048.PF40.

Aged↗
PubMed2003

Course of migraine during pregnancy and postpartum: a prospective study.

The aim of this study was to investigate prospectively the course of migraine during pregnancy and postpartum. Of all the pregnant women consecutively attending an obstetrics and gynaecology department for a routine first-trimester antenatal check-up, 49 migraine sufferers--two were affected by migraine with aura (MA) and 47 by migraine without aura (MO)--who had experienced at least one attack during the 3 months preceding pregnancy were identified, enrolled in the study and given a headache diary. Subsequent examinations were performed at the end of the second and third trimesters and 1 month after delivery. Migraine was seen to improve in 46.8% of the 47 MO sufferers during the first trimester, in 83.0% during the second and in 87.2% during the third, while complete remission was attained by 10.6%, 53.2%, and 78.7% of the women, respectively. Migraine recurred during the first week after childbirth in 34.0% of the women and during the first month in 55.3%. Certain risk factors for lack of improvement of migraine during pregnancy were identified: the presence of menstrually related migraine before pregnancy was associated with a lack of headache improvement in the first and third trimesters, while second-trimester hyperemesis, and a pathological pregnancy course were associated with a lack of headache improvement in the second trimester. Breast feeding seemed to protect from migraine recurrence during postpartum.

Adult↗
PubMed2003

Parenteral indomethacin (the INDOTEST) in cluster headache.

The interval between indomethacin administration and clinical response may be extremely relevant in the assessment of chronic paroxysmal hemicrania (CPH) and other unilateral headache disorders like cluster headache (CH), with which CPH can be confounded. Indomethacin is inactive in CH; however, in some anecdotal reports in recent years, doubt has been cast on the ineffectiveness of indomethacin in CH. In this study, we have re-assessed the effect of indomethacin treatment in a group of 18 patients with episodic CH (three females and 15 males). From the day 8 of the active period, indomethacin 100 mg i.m. was administered every 12 h, for 2 consecutive days, in an open fashion. The mean daily attack frequency before the test (1.6 +/- 0.6) was not statistically different from that on day 1 (2.1 +/- 0.9) and day 2 (1.9 +/- 0.8) after indomethacin administration. The mean interval between indomethacin injection and the following attack (day 1 and day 2) was 4.6 + 1.1 h. We did not observe any refractory period in any patient after indomethacin. Since the 'expected' attack occurred when there theoretically could have been a protective effect after indomethacin administration, it can be reasonably assumed that there is no such protective effect. The use of a test dose of 100 mg i.m. indomethacin (INDOTEST) appears to provide a clear-cut answer in this situation. It may be a useful tool for a proper clinical assessment of unilateral headache with relatively short-lasting attacks when problems of classification arise. A correct diagnosis of CPH or CH is important, since a CPH diagnosis may imply a lifelong treatment with a potentially noxious drug.

Adult↗
PubMed2003

Nitric oxide pathway and response to nitroglycerin in cluster headache patients: plasma nitrite and citrulline levels.

Nitric oxide (NO) may participate in the mechanisms underlying vascular headaches, such as migraine and cluster headache (CH), by triggering neurogenic inflammation and activation of fibres conveying nociceptive inputs to the trigeminal ganglion. Similarly to migraine, the administration of the NO donor glyceryltrinitrate (GTN) to CH patients is a known model of inducing spontaneous-like attacks. We carried out a GTN test (0.9 mg, sublingually) in 18 patients with episodic CH in active phase and 12 controls. The plasma levels of NO metabolite nitrites (NO2-), after conversion of nitrates to NO2-, were measured spectrophotometrically at baseline, at the maximum intensity of the induced response (or 45 min after GTN in controls), and 120 min after GTN administration. The basal plasma levels of L-citrulline were also assayed in patients and controls using high-performance liquid chromatography. Basal NO2- levels, similar in GTN-responsive patients and controls (48.3 +/- 10.6 and 44.6 +/- 9.5 micromol/l, respectively) were found to be increased significantly at pain peak in patients (76.1 +/- 10.2 micromol/l) and after 45 min in controls (78.2 +/- 9.6 micromol/l) (P < 0.01 vs. respective baseline values), but not after 120 min, without differences between groups. L-citrulline levels in basal conditions showed no differences between groups (patients 64.8 +/- 11.7, controls 67.3 +/- 10.8 micromol/l). These data do not support the presence of a basal hyperactivity of the L-arginine-NO pathway in CH patients. Increased NO production may be of importance in the mechanisms leading to CH attacks, but other factors are likely to render CH patients hyperresponsive to NO, and ultimately to cause the occurrence of pain and associated features.

Adult↗
PubMed2003

Trigeminofacial reflexes in primary headaches.

Nociceptive processing in trigeminal system is likely to undergo to significant changes in chronic pain disorders such as in primary headache. The electrophysiological testing of brainstem reflexes seems to offer a valuable adjunct to the clinical evaluation, providing direct evidence for central dysmodulation of sensory and pain neurotransmission, i.e. dishabituation pattern and reduced pain threshold. We review the contribution of trigeminofacial reflex studies in the light of those recent data supporting the view of a dysfunctional sensory processing in primary headache.

Animals↗
PubMed2003

Peripheral and central activation of trigeminal pain pathways in migraine: data from experimental animal models.

Animal models for migraine have provided substantial advances on the mechanisms and mediators underlying migraine attacks. The neurogenic inflammation model has helped understanding the perivascular mechanisms underlying the pathophysiology of migraine attacks, the receptors involved and the effect of specific antimigraine drugs. The model based on probing the neuronal effects of nitroglycerin--an organic nitrate known to induce spontaneous-like migraine attacks in predisposed subjects--in the rat has provided interesting insights into the neuroanatomic circuits and neuropharmacological mechanisms involved in the initiation and repetition of migraine attacks [corrected].

Animals↗
PubMed2003

Treatment strategies for postinfarction left ventricular free wall rupture: stabilization with peri-operative IABP and off-pump repair.

BACKGROUND: Perioperative management of post-infarction left ventricular free wall rupture (LVFWR) is not clearly standardized and surgical repair is the only therapeutic option. Role of off-pump surgery and stabilization with perioperative intraaortic balloon pumping (IABP) were here analysed. METHODS: Seven patients underwent surgery for LVFWR between 1990 and 2002. Clinical picture included electromechanical dissociation (3 patients) and sudden hypotension (4 patients). Except in one patient who was reanimated through femoro-femoral cardiopulmonary bypass, off-pump repair through on-lay patching technique was always performed. IABP was employed in the immediate postoperative period in five cases. RESULTS: A satisfactory hemodynamic state was restored in all cases and there were no reoperations for bleeding or rerupture. Hospital survival was 100%. One patient underwent successful surgical myocardial revascularization two months after LVFWR. Two patients died at follow-up. The survivors present with good NYHA and CCS functional classes. CONCLUSIONS: When the anatomy of the LVFWR is favourable, off-pump external patching repair proves a good choice. Postoperative IABP provides satisfactory hemodynamic support.

Aged↗
PubMed2003

Peripheral markers of apoptosis in Parkinson's disease: the effect of dopaminergic drugs.

In this study, we measured the lymphocyte levels of proteins involved in apoptosis regulation, such as Bcl-2, the peripheral benzodiazepine receptor (PBR), caspase-3, and Cu/Zn superoxide dismutase (Cu/Zn SOD), in patients with Parkinson's disease (PD), either untreated or under therapy with dopaminergic agents (l-Dopa alone or l-dopa + dopamine agonists) and in healthy volunteers. All PD groups showed increased activity of caspase-3, compared to controls, particularly those under treatment only with l-Dopa. In this latter group, the increase in caspase-3 activity was also paralleled by an increase in the concentration of Cu/Zn SOD. In addition, patients taking l-Dopa + dopamine agonists showed marked decrease in Bcl-2 levels and increased PBR expression, which seems in keeping with the hypothesis that PBR may be functionally related to Bcl-2. In conclusion, we found clear modifications in the levels of proteins involved in the control of apoptosis in lymphocytes of PD patients. These changes were disease related but also modulated by the pharmacological treatment, which confirms the potential role of apoptosis in PD pathogenesis and the modulatory influence of dopaminergic agents.

Analysis of Variance↗
PubMed2003

Clinical efficacy and cost-effectiveness evidence of spa therapy in osteoarthritis. The results of "Naiade" Italian Project.

AIM: The "Naiade" Project was carried out in execution of the Decree of December 1994 by the Italian Ministry of Health, with the objective of defining the therapeutic role of spa therapy in the various sectors of medicine. In this study the authors refer to the results obtained in osteoarthritis (OA). METHODS: The OA study included the observation of patients for 2 consecutive years, with the compilation of a series of clinical and socio-economic data. The initial sample was of 11437 patients suffering from primary and secondary OA, and in the 2(nd) year the total number of assessable patients was 6111 (53.4%). All patients underwent 1 annual cycle of balneotherapy and mud packs therapy for 2 consecutive years. The thermal treatments were carried out in 98 Italian spas with sulphurous water, sodium chloride-bromide-iodide water, sulphate water, and bicarbonate water. Analysis of the data collected confirmed the clinical efficacy of spa treatments for OA, particularly for localisations in the cervical and lumbar spine. The benefits of these treatments and the persistence of the therapeutic effects over time were clearly demonstrated by the collection of some socio-economic indicators relative to the year before each cycle of thermal therapy. RESULTS: In fact, the analysis of these indicators showed a significant reduction in recourse to additional treatments (hospital admissions, physical and pharmacological therapies) and absence from work. CONCLUSION: The obtained data was particularly interesting for the number of samples examined, the follow-up over a period of 2 years, and the collection of clinical and, especially, socio-economic parameters. The results of the Naiade Project confirmed the value of spa therapies in the treatment of OA.

Balneology↗
PubMed2002

SPG3A: An additional family carrying a new atlastin mutation.

The authors report on a novel frameshift mutation (c.1688insA) in the SPG3A gene resulting in premature translation termination of the gene product atlastin. These data add a new variant to the second disease gene in autosomal dominant hereditary spastic paraplegia (ADHSP) and lend definitive support to its causative role. By combining direct testing of SPAST and SPG3A, at least 50% of ADHSP families can now receive appropriate genetic diagnosis.

Adult↗
PubMed2002

Hallucinations and sleep-wake cycle in PD: a 24-hour continuous polysomnographic study.

Twenty-four-hour ambulatory polysomnography was performed in 20 patients with PD who were having visual hallucinations (12 men and 8 women, mean age 70 +/- 6 years). Visual hallucinations were clearly related to daytime NREM sleep or nocturnal REM sleep in 33% of the instances. The data reinforce the hypothesis that neural mechanisms implicated in generating sleep and, in particular, in dream imagery play a role in the occurrence of visual hallucinations in PD.

Aged↗
PubMed2002

Effects of the intrastriatal administration of selective dopaminergic agonists on Fos expression in the rat brain.

In this study, we mapped the cerebral expression of Fos protein following intrastriatal stimulation of D(1) or D(2) receptors, in freely moving animals. Animals treated with the D(1) agonist SKF 38393 showed massive Fos increases in the cerebral cortex, ipsilaterally to the injected striatum, which were counteracted by systemic administration of D(1) antagonist SCH 23390. Conversely, D(2) agonist quinpirole suppressed cortical expression of Fos, while systemic administration of D(2) antagonist eticlopride relieved this blockade. As for the basal ganglia, Fos was consistently expressed only in the injected striatum of rats receiving SKF 38393. These results show that striatal dopamine receptors may play a role in the modulation of cortical activity. They also provide new information on a class of drugs--the dopamine agonists--whose role in the therapeutic strategy of Parkinson's disease is continuously evolving.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗