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Biomedical subjects

G Villa

Publications and source records attributed to G Villa.

At least 127 records · Page 7Linked to original sources

Focal brain lesions and intelligence: a study with a new version of Raven's Colored Matrices.

Contrasting results have been obtained in previous investigations, which have used the standard version of Raven's Colored Progressive Matrices for studying the effects of localized brain lesion on visual-spatial intelligence. Some of these discrepancies might be due to the fact that specific factors, such as unilateral spatial neglect, could contribute to decreased performance obtained on Raven's test by patients with focal brain lesions. A new set of Colored Matrices, devised to minimize the influence of unilateral spatial neglect without changing the essential features of the original task, was therefore constructed. The test was administered to 76 normal controls, 74 right brain-damaged patients, 87 aphasics, and 61 nonaphasic left brain-damaged patients, in order to study the effect of laterality of lesions and of language impairment on Raven's scores. The results show that, if the influence of unilateral spatial neglect is minimized and Raven's scores are corrected in reference to age, educational level, and lesion size, then: no significant differences are observed between right and left brain-damaged patients; aphasics score worse than nonaphasic left brain-damaged patients; impairment is greater in patients with Wernicke's and Global aphasia (i.e., in patients with severe language comprehension disorders) than in patients classified as Broca's, Anomic, or Conduction aphasia; impairment is greater in patients with semantic-lexical discrimination errors than in patients free from semantic-lexical comprehension disorders.

Aphasia↗

Dual asthmatic reactions to inhaled Dermatophagoides pteronyssinus: reproducibility and antagonism by cromolyn sodium.

Twenty-four asthmatic patients sensitized to Dermatophagoides pteronyssinus were challenged with a standardized extract of this allergen. All the patients selected on the basis of skin tests and RAST, had an early asthmatic reaction (EAR). Seventeen of them also had a late asthmatic reaction (LAR). Eleven patients were rechallenged in order to study the reproducibility of both EAR and LAR. Six patients were also challenged after cromolyn sodium premedication Results show that (1) reproducibility of both EAR and LAR is satisfactory (coefficient of variation = 14%), (2) patients with reproducible EAR also have reproducible LAR, and (3) a single dose of cromolyn given before challenge can prevent EAR and markedly attenuate LAR.

Adolescent↗

Acid-base balance and respiratory response during biofiltration with polyacrylonitrile membrane.

To further elucidate the mechanisms responsible for the hypoxemia we studied ventilation, pulmonary gas exchanges, blood gas pressures and exchanges of CO2-T, CO2-D and HCO-3 in six patients during AD and BD on 1 m2 cuprophan filter and during BF on 1.2 m2 polyacrylonitrile filter. Blood passing through the dialyzer lost 172.8 mM/h of CO2-T in AD, 149.2 mM/h in BF and gained 25.6 mM/h in BD. In AD VE, VA and PaO2 decreased significantly after 30 and 60 min., in BF for the whole duration of dialysis. PoO2 showed a significant decrease both in AD and BF after 60 min. In AD PaCO2 was significantly reduced after 120 and 180 min. All the above parameters remained unchanged in BD. VCO2 remained unchanged in all. VCO2 and R decreased both in AD and BF. However, when VCO2 was corrected for CO2 loss across the dialyzer, overall CO2 loss (ventilated plus filtered) and R returned to basal values. In AD, HCO-3 and pH fell in the first 120 min., while in BD and BF they increased from the beginning of dialysis. In AD hypoventilation, hypoxemia and inadequate correction of acid-base balance were due to the loss of HCO-3 across the filter. In BF also hypoventilation and hypoxemia were due to the loss of HCO-3 across the filter but the acid-base balance was adequately corrected by HCO-3 reinfusion. In BD, there was HCO-3 gain across the filter which induced a gradual correction of acid-base balance without impairment of ventilation.

Acid-Base Equilibrium↗

Cadralazine, a new vasodilator, in addition to a beta-blocker for long-term treatment of hypertension.

51 hypertensive outpatients, whose diastolic blood pressure exceeded 100 mmHg after a 2-week period on atenolol alone (100 mg once daily) participated in this long-term study. They received, in addition to atenolol, the vasodilator cadralazine (ISF 2469; 10 to 30 mg once daily) for a standard period of 24 weeks, according to an open design. Cadralazine caused a progressive and important decrease in both systolic and diastolic blood pressure, from 173/111 mmHg (end of atenolol alone) to 154/99 mmHg (12th week, p less than 0.01/p less than 0.01; mean dose, 24.5 mg/day). At this time a diuretic was added as a third-step drug in 15/51 initial patients (29%), and final blood pressure in all patients was 150/96 mmHg (p less than 0.01/p less than 0.01), with positive results in 88% of the cases. During cadralazine treatment, heart rate was always significantly lower than before atenolol alone; the most common side effects, many of which were already present during treatment with atenolol alone, included headache, asthenia, dizziness, palpitation and flushing, and tended to disappear spontaneously as therapy progressed. Routine laboratory tests did not show important changes; sodium excretion was not reduced. In conclusion, the therapeutic efficacy of cadralazine, its low or absent salt and water retention effects, its good tolerability, and the high compliance obtained with once daily administration allowed the use of this vasodilator as a second-step drug for long-term treatment of hypertension.

Adrenergic beta-Antagonists↗

Speech suppression without aphasia after bilateral perisylvian softenings (bilateral rolandic operculum damage).

The authors describe a patient who suffered two successive, right and left, strokes that caused bilateral rolandic operculum damage. The clinical picture was characterized by selective impairment of volitional facio-pharyngo-glosso-masticatory movements with sparing of automatic and reflex motor activity (Foix-Chavany-Marie syndrome). Though completely speechless, the patient was not aphasic. This dissociation is discussed in the light of the peculiar localization of lesions evidenced by CT-scan.

Cerebral Infarction↗

On the basis for the agrammatic's difficulty in producing main verbs.

Current theories of agrammatism do not provide a clear explanation for the co-occurrence of omission of grammatical markers and main verbs in this disorder. This study tested the hypothesis that the two symptom features have distinct underlying causes. Specifically, that the omission of main verbs in agrammatic speech is caused, at least in part, by a lexical (as opposed to a syntactic) deficit. Agrammatic and anomic aphasics and normal controls were given an object and action naming test. Agrammatic patients showed a marked impairment in naming actions in contrast to anomic aphasics and normal controls who named actions better than objects. The action naming impairment in agrammatic patients was interpreted as evidence for the lexical deficit hypothesis of verb omission in the speech of these patients and as a demonstration that agrammatism is a heterogeneous disorder that implicates damage to both lexical and syntactic mechanisms.

Adult↗

99mTc-aprotinin: comparison with 99mTc-DMSA in normal and diseased kidneys.

Aprotinin (A) and DMSA labelled with 99mTc were compared in patients with normal (NK, n = 12) and diseased kidneys (CRF, n = 13) by means of quantitative serial scans and measurements of blood clearance and urinary excretion. Serial scans only were obtained in additional 13 patients. Scan quality in the NK patients was essentially equal: faster blood clearances, reduced urinary excretions and higher fixations of A in the target compensated for the increased liver uptake. On the other hand, the scan quality in the CRF patients was definitely superior with A, allowing detection of residual functioning parenchyma also in severe kidney failure. Correlation between the net kidney uptake 6 hrs p.i. and the separate hippuran clearance rate was better with A than with DMSA, indicating the feasibility of A in evaluating relative renal function.

Adult↗

A crossover trial of oxdralazine in hypertension.

Twenty-nine moderate and severe essential hypertensive patients completed a crossover study aimed at evaluating efficacy and tolerability of a double combination (chlorthalidone plus propranolol) and of a triple combination (chlorthalidone plus oxdralazine plus propranolol). After one month on 25 mg/day chlorthalidone, which caused nonsignificant reduction in blood pressure of 7/4 mm Hg, patients were randomized to receive either the double or triple regimen for a three-month period. Then, after another month on chlorthalidone alone at the same dose of 25 mg/day, treatments were crossed over and the study continued for another three-month period. The double regimen caused a drop in pressure of 16/11 mm Hg after one month (daily doses 25 mg chlorthalidone, 103 +/- 25 mg propranolol), and this reduction did not change at the third month in spite of dosage increases (daily doses 25 mg chlorthalidone, 222 +/- 77 mg propranolol). The triple regimen reduced blood pressure 35/15 mm Hg after one month (daily doses 25 mg chlorthalidone, 20 mg oxdralazine, 40 mg propranolol), and further increase in dosages caused a reduction of 45/24 mm Hg at the third month (daily doses 25 mg chlorthalidone, 56 +/- 20 mg oxdralazine, 112 +/- 40 mg propranolol). Both treatments were well tolerated; in particular, at the end of the third month of each treatment period, 25 patients on the triple regimen achieved a stable diastolic blood pressure of 90 mm Hg or less, as compared to 10 patients on the double regimen (P less than 0.01).

Adult↗

The production of morphological and lexical opposites in aphasia.

Four unselected groups of Broca's, Wernicke's, conduction, amnesic aphasic patients and a group of normal controls were asked to produce the best opposite of 60 adjectives. For half of the stimuli the expected opposite was morphologically related to the stimulus word (e.g. "formal"/"informal"), for the other half it could be obtained only by selecting a new base-form within the lexicon (e.g. "good"/"bad"). Following some neurolinguistic observations by Hécaen et al., it was predicted that amnesic patients should produce mainly morphological opposites, whereas conduction aphasics should produce mainly lexical antonyms. Results confirmed the predictions, since amnesic aphasics showed a prevalent impairment in the selection lexical opposites, whereas conduction aphasics showed a selective impairment in the production of morphological antonyms.

Anomia↗

Drawing objects from memory in aphasia.

The ability of aphasic patients to draw from memory objects with a characteristic shape has been investigated. Their capacity to reproduce the form of real objects was studied by showing them for a short time line drawings of simple objects. When the patient had analysed and recognized the figure, the model was hidden from view and the subject was asked to draw the same object from memory. This Drawing from Memory task was administered to 54 aphasics, 67 patients with right hemisphere lesions, 44 nonaphasic left brain-damaged patients and 23 normal controls. The influence of visuoconstructive disabilities was controlled by administering to the same patients a standard test for constructional apraxia (copying 10 geometrical figures). The severity and clinical form of the aphasia and the presence of semantic-lexical impairment at the receptive level were also examined in the aphasic patients. The following results were obtained. (1) Aphasic patients scored significantly less well than the control groups on the Drawing from Memory task and the intergroup differences became greater when the scores from the test for constructional apraxia were included by an analysis of covariance. (2) No significant correlation was detected between the severity and clinical form of the aphasia and the scores obtained on the Drawing from Memory task. (3) There was a significant correlation between impaired drawing from memory and disruption at the semantic-lexical level of language integration.

Aged↗

[Respiratory response and acid-base equilibrium in acetate dialysis and bicarbonate dialysis].

In order to elucidate the mechanisms responsible for the hypoxemia observed during acetate dialysis, but not found during bicarbonate dialysis, the authors studied ventilation, blood gases and their exchanges in the lungs and across the dialyzer on 9 patients. Oxygen consumption was similar both in acetate and bicarbonate dialysis. At the beginning of acetate dialysis, hypocapnia, due to CO2 losses through the dialyzer, causes hypoventilation and hypoxemia; afterwards, the worsening of acidosis (due to bicarbonate losses) stimulates ventilation, thus correcting the initial imbalance. Authors also hypothesize a pulmonary mechanism for CO2 "sparing" contributing to compensate CO2 losses through the dialyzer. The absence of hypoxemia during bicarbonate dialysis would be due to the absence of CO2 losses through the dialyzer.

Acetates↗

Pressure and humoral changes induced by atenolol and hydrochlorothiazide + amiloride, alone and in free combination. A comparative between-patient study.

The authors have performed a between-patient study in 76 patients with mild or moderate essential arterial hypertension, with the aim of comparing the results of atenolol 100 mg daily, hydrochlorothiazide 50 mg + amiloride 5 mg 1 tablet daily, and the combination of the above two agents at the same daily doses. Thirty-one patients received the free combination diuretic-beta-blocker throughout the study period; 26 patients non-responders to atenolol 100 mg daily (supine diastolic blood pressure greater than 90 mmHg) after a one-month treatment period received the above combination for a further four months; and 19 patients non-responders to hydrochlorothiazide 50 mg + amiloride 5 mg, 1 tablet daily, after a one-month treatment period received the above combination for a further four months. In the patients who were non-responders to either atenolol or the diuretic, supine and upright blood pressure showed a further and clinically consistent decrease as a result of the combination therapy. A similar consistent decrease was seen in the patients receiving the combination therapy throughout the study. Plasma levels of glucose, urea, creatinine, sodium, potassium and uric acid were not modified either by the single agents or during administration of the combination therapy. In particular, plasma potassium concentration did not show any statistical or clinical changes. Any side-effects were of little clinical importance and never required discontinuation of therapy. In conclusion, atenolol combined with hydrochlorothiazide + amiloride (100 mg + 50 mg + 5 mg) provides an effective and well tolerated blood pressure control in most patients with mild or moderate arterial hypertension, including non-responders to diuretic or beta-blocker alone.

Adult↗

Neurophysiological study of normal pressure hydrocephalus.

A neuropsychological Mental Deterioration Battery (MDB) was used to identify deterioration profiles of 43 patients afflicted with normal pressure hydrocephalus (NPH) (n = 18) or other forms of dementia (n = 25). The NPH patients submitted to a shunt-intervention (n = 10) were also evaluated after surgery. A comparison of profiles, obtained from the experimental and control groups, shows that NPH patients seem to be more impaired in tests designed to detect frontal lobe involvement. Some implications of the relatively greater impairment of frontal functions in NPH dementia are discussed.

Cerebrospinal Fluid Shunts↗

A comparative trial of timolol and flutonidin as antihypertensive agents.

In a double-blind cross-over clinical trial, flutonidin (2-4 mg daily) was compared with timolol (20-40 mg daily) in the treatment of mildly or moderately hypertensive patients who concomitantly received fixed diuretic treatment. Each drug was administered for 1 month, with an interval of 2 weeks between the two monthly periods. During administration of flutonidin, blood pressure initially fell but returned to baseline values at the end of treatment. Heart rate was not affected by the drug. Timolol significantly reduced both blood pressure and heart rate. Its effect becomes evident during the 1st week and increases throughout the treatment period. Side effects were more frequent during flutonidin administration than during timolol administration. No significant modifications of the laboratory findings were observed during either flutonidin or timolol treatment.

Adult↗