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Biomedical subjects

M Bertini

Publications and source records attributed to M Bertini.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Visual search performance across 40 h of continuous wakefulness: Measures of speed and accuracy and relation with oculomotor performance.

The aim of the study was to estimate the sensitivity of a brief self-paced visual search task to increased levels of sleepiness as a consequence of 40 h of sleep deprivation. Time-of-day effects on this task, on subjective sleepiness and on oculomotor performance changes, were also assessed. Eight normal subjects slept for three nights in the laboratory (adaptation, baseline, recovery). Baseline and recovery nights were separated by a period of 40 h of continuous wakefulness, during which subjects were tested every 2 h from 10:00 to 22:00 h on both days preceding and following the sleep deprivation night, as well as from 24:00 to 08:00 h during the deprivation period. At the same time, subjects filled in a visual analogue sleepiness scale and the Stanford Sleepiness Scale (SSS). As regards cognitive performance, significant effects were found on speed measures, while accuracy was not affected. The number of explored rows was higher after the baseline night than after the sleepless night, and showed a consistent time-of-day trend. Omissions ratio (OR), false positives ratio (FPR) and hits ratio (HR) did not show any significant effect. Subjective ratings of sleepiness varied according to speed measures, being affected by sleep deprivation and time of day. Since similar effects were found with an oculomotor task, detrended functions for all variables across the 40 h of continuous wakefulness were calculated. A circadian effect was found, in which speed measures seem to be more affected than accuracy ones in both visual search and oculomotor tasks. It is concluded that 40 h of prolonged wakefulness significantly impairs performance in a brief cognitive visual search task. Such a performance worsening is evident on speed, but not on accuracy indices, and is strictly related to the deterioration of oculomotor performance, indicating a clear circadian effect.

Adult↗
PubMedDate not supplied

The effects of slow-wave sleep (SWS) deprivation and time of night on behavioral performance upon awakening.

The aim of the present study is to evaluate the effects of selective SWS deprivation on the motor and sensory motor performance impairment immediately after awakening from nocturnal sleep at different times of the night. Ten normal males slept for 6 consecutive nights in the laboratory: one adaptation, two baseline, two selective SWS deprivation, and one recovery night. During the last 4 nights performance was assessed four times: (a) before sleep, as a baseline measure; (b) within 30 s from the first nighttime awakening, after 2 h of sleep; (c) within 30 s from the second nighttime awakening, after 5 h of sleep; (d) within 30 s from the final morning awakening. After each awakening, following a 3-min cognitive test, a simple Auditory Reaction Time task (ART, about 5 min) and a Finger Tapping Task (FTT, 3 min) were administered. Median of Reaction Times (RT) and of Intertapping Intervals (ITI), 10% fastest RT, 10% slowest RT, and number of misses were considered as dependent variables. The selective SWS deprivation was very effective: SWS percentage during both the deprivation nights was close to zero. This strong manipulation of SWS amount interacted with time-of-night factors in influencing sleep inertia. The SWS deprivation procedure caused a worsening of behavioral performance during the deprivation nights. as well as upon the final awakening of the recovery night. Behavioral performance slowing upon awakening is accounted for by: (1) a general decrement in overall response speed (median of RT); (2) an "optimum response shift", i.e., a decrease in speed of the fastest responses; (3) an increase of lapsing, with more marked response delays resulting in a further decrease in response speed in the "lapse domain". Finally, our results do not support the existence of a circadian rhythm of sleep inertia linked to body temperature rhythm.

Adult↗
PubMedDate not supplied

Stage II large B-cell lymphoma with sclerosis treated with MACOP-B.

In a series of 193 patients with advanced stage diffuse large-cell lymphoma (DLCL) treated with MACOP-B, 18 (11%) were defined as having a stage II large B-cell lymphoma with sclerosis of the mediastinum. This type of lymphoma has been reported to have a highly aggressive behaviour and special histological and clinical features. In our series young women were more commonly affected and the most striking clinical feature was the presence of a bulky mediastinal mass in 81%. A comparison was made between stage II patients with DLCL with and without sclerosis. The group of patients with sclerosis had prognostic parameters significantly worse than those of the patients without sclerosis, namely, elevated LDH level and bulky disease. The complete remission rates (89% vs 76%) were similar in the two groups and, with a median follow-up of 23 months, survival and disease-free survival rates were also superimposable. MACOP-B chemotherapy has been proven effective in this subgroup of lymphoma patients with sclerosis that had thus far been reported to have a poor prognosis.

Antineoplastic Combined Chemotherapy Protocols↗
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[Effects of monotonous computer work on performance].

A monotonous, automated task of prolonged duration performed on a computer is likely to increase the propensity to sleep. Present research shows the physiological effect is not perceived by the subjects in terms of drowsiness or a change of mood. This augments the risk of this effect causing unforeseeable bouts of sleep during the performance of the task.

Boredom↗
PubMedDate not supplied

[Fluoxetine and depression in the elderly. Clinical experience].

Eighty-six patients aged between 60 and 80 years and affected with major depression according to the diagnostic criteria of the DSM III-R were treated with fluoxetine per os at the single dosage of 20 mg/die. At prearranged intervals psychometric reagents were administered for the evaluation of any variations in the depressive symptomatology. Already at the 1st examination after 14 days' treatment a considerable improvement in the psychopathological picture was observed. This improvement remained constant at the subsequent examinations and the follow-up after 90 days. The tolerability was excellent and the side effect mild, with a tendency to regress after the first days of therapy. The clinical assessment and the psychometric findings both suggest that fluoxetine has a useful action on major depression in the elderly.

Aged↗
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Probability of cure in elderly Hodgkin's disease patients.

BACKGROUND: Elderly Hodgkin's disease patients have a poor prognosis. The question arises whether these patients need aggressive treatment or a palliative strategy. So far, as a consequence of the scarcity of trials designed for them, useful information can be obtained only by retrospective analyses. METHODS: We retrospectively studied clinical data from 567 patients recorded from 1982 to 1989 in the Piemonte Hodgkin's Disease Register (PHDR). The 65 patients over 65 years of age were compared to younger ones. We analyzed the role of disease independently of confounding variables, mainly inadequacy of staging and/or treatment, comorbidity and toxicity. RESULTS: In the elderly comorbidity was as high as 35%. Forty elderly patients (60%) entered a suboptimal plan with a low degree of aggressivity, which was different from the usual PHDR protocol. Elderly patients also had a high proportion of subsequent protocol interruptions (25%). Chemotherapy dose intensity was negatively affected by advanced age (p < 0.01 after both 3 and 6 courses of chemotherapy). Toxic deaths were significantly higher in elderly patients than in younger ones (14% vs 1%; p < 0.05). CR rates, overall survival (OS), disease-specific survival (DSS) and event free survival (EFS) were all significantly influenced by age (p < 0.01). Relapse-free survival (RFS) in patients achieving CR did not differ according to age class (77% vs 60%; p = ns). RFS was better in elderly patients entering the PHDR protocols than in those following an alternative plan (75% vs 54%; p = 0.04); however, elderly patients treated according to PHDR guidelines showed a higher incidence of toxic deaths than those treated less aggressively (23% vs 8%). The two groups had similar EFS (36% vs 24%; p = ns). CONCLUSIONS: Elderly patients who achieve CR can have good RFS and cure is possible, but the toxic cost of conventional strategies is unacceptable and selected strategies still must be found.

Age Factors↗
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[Nutritional support in non-Hodgkin's lymphoma treated with polychemotherapy MACOP-B cycle].

The collateral effects of antineoplastic therapy often lead to a deterioration of the cachectic condition induced by the presence of the tumour itself. This study analysed the effects of a programme of dietary surveillance/support in patients with non-Hodgkin's lymphoma undergoing a cycle of MACOP-B polychemotherapy. During the entire course of therapy patients were followed weekly by a nutritional specialist and a dietician in order to assess and if necessary modify food intake, also in relation to the onset of collateral effects. Using this programme it was observed that a satisfactory nutritional state was maintained during the entire cycle, with an increased food intake compared to the start of the cycle and to conditions of good health.

Adult↗
PubMedDate not supplied

[Efficacy and tolerance of aniracetam in elderly patients with primary or secondary mental deterioration].

The study was carried out on 60 patients (mean age 69.9 +/- 10.3 years) suffering from slight-moderate brain pathology primary or secondary to vascular forms. Patients were treated with 1500 mg/day per os of Aniracetam or placebo. Drug efficiency evaluation was performed utilizing the following psychometric tests: Blessed Scale, figures repetition test, Benton test, Corsi test, Rey test, Pieron test, phrases construction test, verbal fluency test. They were carried out during basal visit after two and four month treatment. In Aniracetam treated group the score showed a significant improving during the first and second control. In placebo treated group no change statistically considerable happened in any test. Aniracetam has proved to be a useful drug in slight-moderate brain decay treatment of the elderly.

Aged↗
PubMedDate not supplied

Mitoxantrone, etoposide, cisplatin and dexamethasone (MEPD) as salvage chemotherapy in resistant non-Hodgkin's lymphoma.

BACKGROUND: An effective second-line treatment for intermediate and high grade non-Hodgkin's lymphoma is greatly needed since 30% of patients do not achieved complete remission (CR) and another 20% to 30% of the CRs will eventually relapse. METHODS: A four-drug combination with Mitoxantrone, Etoposide, Cisplatin and Dexamethasone (MEPD) was devised for the treatment of patients with relapsing or refractory non-Hodgkin's lymphoma (NHL). So far 22 patients with intermediate or high grade NHL have entered the study. All patients were previously treated with doxorubicin based regimens. RESULTS: Seven patients obtained a complete remission (CR), 3 a partial remission (PR), 4 a minor response (MR) and 8 were treatment failures (F). Thus, an overall response rate of 45% has been achieved. To date three of the complete responders have relapsed at 3, 6 and 15 months. Four patients are still in CR at +2, +4, +9 and +17 months, respectively. Patients with relapsing lymphoma responded better than those with primary refractory disease. Myelosuppression was the most frequent side effect, nevertheless there were no severe infections. CONCLUSIONS: These preliminary results suggest the effectiveness of MEPD as salvage chemotherapy in resistant NHL and warrant further clinical studies.

Adult↗
PubMedDate not supplied

[IgA deficiency in pediatrics].

To evaluate the IgA deficiency we have considered 368 children, admitted to "Day hospital" for different pathologies: 64 of them had serum IgA levels lower than the normal values for their age according to Ellis and Robbin. The age of the children with this deficiency was included from 4 months up to 8 years: 39 were boys, 25 were girls. In 54 cases the IgA deficiency was "partial" that is: the IgA value found out was lower than the normal for the age, but higher than 5 mg%. In 10 cases the IgA deficiency was "severe" (the IgA value was lower than 5 mg%). Six cases, among the 29 ones with intestinal diseases, had a severe deficiency, whereas among the 22 cases with respiratory diseases 3 had a "severe" deficiency. The 2 patients with urinary disease had a partial deficiency; only one case of the remaining 11 with different pathologies had a "severe" deficiency. Among the carriers of serum IgA deficiency an high incidence of chronic pathology has been found out (83%). Nevertheless the percentage of IgA deficiency extrapolated from the all case histories doesn't differ very much (64 cases among 368 = 17.39%) considering only those patients with chronic relapsing pathology (53 cases among 275 = 18.2%). Therefore it seems that the IgA deficiency could be considered a chronicizing factor in the examinated pathology even if in few cases. Anyway the frequency of IgA deficiency has reached major values (29/54; 45.3%) in the patients with enteric diseases. The frequency of IgA deficiency is smaller but still important in those patients with respiratory diseases (22/64: 34.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMedDate not supplied

Role of thoracic computed tomography in the treatment plan of Hodgkin's disease.

Conventional chest X-rays and CT scans, performed at the time of the initial staging in 67 patients affected by Hodgkin's disease, were reviewed and compared. CT scans provided evidence of disease not shown by concomitant conventional chest X-rays in 10 patients (15%). The impact on patient management of the additional CT data was evident in 8 cases (11.9%), either changing the whole treatment plan (4 patients) or enlarging radiation ports (4 patients). Traditional prognostic features did not influence the outcome, and only hilar adenopathy adversely affected event-free survival, without however reaching statistical relevance (p greater than 0.05). Our data suggest that thoracic CT scan is helpful in drawing up the treatment plan, while its role in identifying new prognostic factors is still uncertain.

Antineoplastic Agents↗
PubMedDate not supplied

[Nutrition errors in children].

Errors in the childhood feeding administration are commonly met, particularly during the first and second year of life, according to the poor or vague knowledge among paediatricians. A first proof of this assumption is given when, as a consequence of digestive disturbance, caused by a wrong nourishment, the paediatrician suggests remedies that, substantially, make the same primitive mistakes. A second proof is given when a particular diet, due to the presence of intestinal disturbance and already seen to be inefficacious, is reproposed, even more than once, with industrial aliments which differ from the ones used in the name and the brand but not in the composition. Finally, another proof is given when in the exclusion therapy due to an intolerance towards gluten, towards cow's milk, towards disaccharides, the paediatrician inserts, in the diet, products containing, respectively, the above mentioned components. These and other mistakes are reported in the present casuistry (121 cases), the majority of which (75 cases) is accompanied by specific examples. Between the cases that mostly stand out we find the so called "precocious weaning" as cause of digestive disturbance and, frequently, as initial moment of a chain of errors responsible, in their turn for the protraction and the chronicization of the aforementioned intestinal pathology.

Animals↗
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[The pediatrician faced with the child with a valvular prosthesis].

Among the acquired or congenital valvular dysfunctions that require conservative valvuloplastic surgical intervention or valvular replacement, the rheumatic valve disease is reported in a limited number of cases among the developed countries, while it is frequent in those with precarious socio-economic conditions. In these countries there are many cases of rheumatic valve diseases during childhood, quickly leading to serious health conditions to require valve replacement during second and third childhood. On the contrary, in the more developed countries, congenital valvular disease prevail by far. The child who underwent valve replacement, once dismissed from cardio-surgical centre, must be nursed domiciliary by his family pediatrician. This assistance consists in a strict supervision for a precocious identification of valvular prosthesis dysfunctions and possible embolic and hemorrhagic complications and in supplying anticoagulant therapy. For this purpose it is important to refer to a well equipped cardiological centre. Besides these fundamental tasks there are others - equally important - directed to preserve health: curing each pathological extracardiac event, intercurrent or recurrent; preventing, with or without compulsory vaccinations, infectious childhood's diseases; preventing especially bacterial endocarditis as the most frequent cause of prosthesis pathology. This work pays particular attention to bacterial endocarditis (prophylaxis and cure). Thromboembolism and anticoagulant therapy (with the list of coumarin drug interventions) have also been dealt. Moreover we have reported brief indications on the prevention and/or cure of diseases for which vaccination is not compulsory, such as: measles, chicken-pox, whooping-cough, typhus, influenza. Our script ends with good suggestions on nourishment and physical activity.

Aftercare↗
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[Anorexia in the first year of life. Case contribution].

The anorexia is a frequent cause for paediatric consultation, especially during the first year of life, during which often it is not due to illness or to some organic cause. Particularly interesting from the etiopathogenetic and most of all from the curative point of view are the protracted anorexias in which the relationships mother-child-surroundings appear disturbed. Generally, the loss or the simple reduction of the appetite could heal, all the same and also in a short while if the mother would accept willingly the new situation, trusting in a spontaneous resolution. On the contrary she usually forces the infant to take the meal even if incompletely, meeting at each new attempt, the infant's resistance initially passive and then more and more active and efficacious. Thus an "anorexia for opposition" is established by the conflict between mother and child that the mother stirfs up to then end looser if not even victim. An exemplar in this connection is given by the anorexias of the 16 personal cases extracted from a larger casuistry: infant of age between 40 days and 12 months in the most part of which the anorexia was arisen from different causes (illness from slight infections, the replacement of the human milk with the adapted milk, the weaning, copious rations); in some infants the loss of appetite was without an apparent cause. The anorexia became worse after the mother's reiterated attempts to force the infant to have a meal. During the hospitalization the mother was detained with the son; the giving of the meals was in a first time done by the paramedical personnel with the mother present an then by the mother only. In 14 infants the cyproheptadine was given. Only in a few cases the mothers were treated with anxiolytic. All the cases have been resolve positively.

Anorexia↗
PubMedDate not supplied

[Ankylosing spondylitis with childhood onset. Description of a clinical case].

The terms "spondyloarthropathy" and "spondyloarthritis" have been recently introduced to indicate a group of syndromes associated in clinical and genetical peculiarities. The "ankylosing spondylitis with childhood onset", that is usually considered very rare, is, as a matter of fact, a disease difficult to diagnose because of the partial overlap with the "pauciarticular juvenile rheumatoid arthritis type II" for clinical and laboratory data. The Authors, after a recapitulation of the "pauciarticular juvenile rheumatoid arthritis type II" and of the "ankylosing spondylitis with childhood onset" diagnosis definition elements, propose a description of a clinical case that came to their observation. The clinical picture described, even though it presented some clinical peculiarities (particularly a primitive affection of the lumbosacral spine), some radiographic peculiarities (the precocious demineralization of the affected segments) and laboratory characteristics (positive F.A.N. to diffuse pattern) seemed a form of "ankylosing spondylitis with childhood onset", apparently primitive.

Adult↗