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Biomedical subjects

M Franceschi

Publications and source records attributed to M Franceschi.

At least 127 records · Page 7Linked to original sources
PubMed1988

Neuroendocrinological function in Alzheimer's disease.

The neuroendocrine function is regulated by several neurotransmitters (acetylcholine, dopamine, somatostatin and noradrenaline) known to be reduced in brains of patients with Alzheimer's disease (AD). Moreover, the hypothalamus also has pathological changes. In spite of these findings suggesting neuroendocrine dysfunctions, this function has seldom been investigated in AD patients so far. We have compared patients with clinically 'probable' AD of mild-to-moderate severity with nondemented age- and sex-matched controls. Plasma levels of prolactin (PRL), growth hormone (GH) and thyroid-stimulating hormone (TSH) were measured by commercially available radioimmunoassays (RIA) before and after stimulation with metoclopramide, l-dopa or thyrotropin-releasing hormone. Basal plasma levels of beta-endorphin and beta-lipotropin were measured by RIA after high-performances liquid chromatography. Basal and stimulated plasma levels of PRL, GH, TSH and beta-lipotropin were similar in the two groups. Basal lamina levels of beta-endorphin were significantly higher in the patient group. Of doubtful clinical importance, this might be attributed to decreased tuberoinfundibular dopaminergic activity and has also been seen in patients with Parkinson's disease.

Aged↗
PubMed1987

[Diabetic cardiomyopathy: preclinical pathology disclosed by the increase in ventricular afterload].

In order to test the importance of the association of diabetes mellitus and arterial hypertension in generating morphological and functional changes of the left ventricle (LV) consistent with a cardiomyopathy, 37 patients, aged 27 +/- 6.7 years, were studied by standard and digitized M-Mode echo: eighteen of them were affected by diabetes mellitus, 11 by arterial hypertension, 8 by diabetes and hypertension. Each group was compared to the others and with a group of 14 normal subjects. In order to verify the importance of increased ventricular after-load in modifying ventricular performance of diabetic patients, changes of the peak rate of systolic and diastolic variation of LV diameter and changes of the peak rate of interventricular septum and posterior wall excursion (IVSE, PWE) were evaluated after methoxamine hydrochloride infusion in 8 diabetic and 6 normal subjects. In diabetics the ratio between ventricular thickness and diameter (h/r) was greater than normal subjects (p less than 0.02); this ratio resulted higher in patients with diabetic rhinopathy who also exhibited an isovolumic diastolic period longer than normal (p less than 0.02). Both h/r ratio and isovolumic diastolic period (IDP) were higher in diabetic-hypertensive group as compared to normals (p less than 0.001), strictly diabetic (p less than 0.01 and p less than 0.001) or hypertensive subjects (p less than 0.01). Diabetic-hypertensive group, exhibited a lowering of the systolic and diastolic peak rate of IVSE (p less than 0.01) as well as of systolic peak rate of PWE as compared to the other three groups (p less than 0.05).

Adult↗
PubMed1987

Parasympathetic assessment in Parkinson's disease.

There is little evidence of autonomic dysfunction in PD, although autonomic disturbance was included in the original description by J. Parkinson. In addition, there are no data for de novo PD patients. We selected 14 de novo parkinsonians (seven men and seven women), aged 62.7 +/- 8.2 years, with mild disease (stage 1 through 2 on the Hoehn and Yahr's scale), without history of diabetes, heart disease, or alcoholism, and without neuropathy or orthostatic hypotension. Fourteen age- and sex-matched normal persons were controls. We found a highly significant difference in the respiratory sinus arrhythmias during deep breathing (p less than 0.01); the basal heart rate, the respiratory sinus arrhythmias during quiet breathing, and the Valsalva ratios did not differ statistically, however. In the absence of neuropathy and orthostatic hypotension and in the presence of normal Valsalva ratios, we believe that the abnormality found by us may apply only to parasympathetic dysfunction, perhaps at a central level. In addition, the abnormality seems to be independent of stage and therapy.

Aged↗
PubMed1986

Plasma beta-endorphin and beta-lipotropin in patients with Parkinson's disease.

Experimental and human data in young volunteers suggest that tuberoinfundibular dopaminergic systems physiologically inhibit pituitary secretion of beta-endorphin. This hypothesis was verified in patients with Parkinson's disease, a human model of a selective deficit of dopamine. Both previously untreated patients and patients who had been without chronic treatment for 1 week showed plasma beta-endorphin levels significantly higher than those of healthy age-matched controls. Plasma beta-lipotropin levels of patients and of controls were similar. There was no correlation between plasma opioid levels and age, severity, or duration of the disease. In five patients retested during chronic treatment, plasma levels both of beta-endorphin and of beta-lipotropin significantly decreased. This decrease approximately paralleled clinical improvement. The finding that in Parkinson's disease there is a reversible disinhibition of pituitary secretion of beta-endorphin confirms that this secretion is physiologically inhibited by tuberoinfundibular dopaminergic systems.

Aged↗
PubMed1986

Signs of cardiac autonomic dysfunction during sleep in patients with Alzheimer's disease.

Autonomic nervous system (ANS) failure may be an important complication in some neurological diseases. Conventional tests for the assessment of ANS functions during wakefulness cannot be used for many patients with dementia of the Alzheimer's type (DA) because of their poor cooperation. In 6 of 16 patients with presenile DAT we found signs of sympathetic cardiac dysfunction during sleep, measured as the decrease in body movement-related heart rate variation (Rbm). The study of Rbm during sleep seems to be a useful tool for ascertaining ANS function in DAT. The presence or absence of ANS dysfunction could be a more reliable criterion than age of onset for identifying subgroups of this disease.

Aged↗
PubMed1986

[Electrocardiographic changes and echocardiography variations in ventricular morphology in left ventricular overload].

In order to compare the ECG patterns to several echocardiographic morphological indexes in different left ventricular overloadings, 15 cases of systolic left ventricular overloading (SLVO) and 17 cases of diastolic left ventricular overloading (DLVO) were analyzed. The current ECG changes of left ventricular hypertrophy and some original parameters of ventricular repolarization have been correlated with volumes, ejection fraction and mass of the left ventricle (calculated by Reichek's formula) and with left ventricular diastolic and systolic eccentricity indexes, derived by the application of Fishl's formula to the 2D echocardiographic four or two chamber apical view. In both SLVO and DLVO we found a correlation between the left ventricular mass and Romhilt-Estes point score system (p = 0.02) as well as the degree of ventricular repolarization abnormalities (p = 0.01). In SLVO we found a direct correlation between negative P wave deflection on lead V1 and diastolic as well as systolic eccentricity index: that is, the more negative P wave the more elongated left ventricular geometry. Moreover, in SLVO we found an interesting apposite correlation, compared with DLVO, between the systolic eccentricity index and the degree of ventricular repolarization abnormalities: in SLVO ST depression or T wave inversion on left limb or left precordial leads was associated with the maintenance of an elongated shape of left ventricle, while in DLVO the same ventricular repolarization abnormalities were associated with the loss of the elongated geometry of left ventricle which became spheric. Thus ECG correlates with echocardiographic left ventricular mass if poliparametric voltage indexes are considered.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve Insufficiency↗
PubMed1986

[Hypertrophic cardiomyopathy. Correlation between the morphologic-quantitative data of the 2-dimensional echocardiogram and electro-vectorcardiographic aspects].

39 patients affected with hypertrophic cardiomyopathy (ICM) have been studied by M-mode and two-dimensional echocardiography (1 and 2D Echo), standard electrocardiogram (ECG) and vectorcardiogram (VCG). For each patient we have outlined the anatomical shape of the left ventricle and we have tried to measure the myocardial hypertrophy by a score system that determines its size and extent. For this reason we have followed the echocardiographic segmental analysis procedure suggested by Edward (1981) but we have modified it dividing the left ventricle into 11 segments and measuring the value of the apex three times. We have given each patient a hypertrophy score by assigning a value 0 to any segment with a thickness less than or equal to 12 mm, a value 1 if the thickness was greater than 12 less than or equal to 17 mm, a value 2 if it was greater than 17 less than or equal to 22 mm, a value 3 if greater than 22 mm. We have also calculated the distribution index of the hypertrophy dividing the number of the hypertrophied segments by the number of the ventricular segments. We have identified five patterns of hypertrophic cardiomyopathy: 7 cases with a partial involvement of the interventricular septum (IVS) (pattern 1), 7 cases with a full involvement of the IVS (pattern 2), 22 cases with involvement of the free wall of the left ventricle (pattern 3), 2 cases with involvement of the distal IVS and the apex (pattern 4), 1 case with involvement of the inferior and lateral wall (pattern 5). The highest hypertrophy score and distribution index was noticed in the third anatomical pattern (p less than 0.001). Comparing the three more frequent anatomical patterns with their Ecg-Vcg aspects, we have found a higher prevalence of the left anterior hemiblock in pattern 1, of the pathological Q waves in pattern 2, of the left ventricular hypertrophy in pattern 3. However this correlation was not significant while the correlation between the Ecg-Vcg aspects and the myocardial hypertrophy score and distribution index was extremely significant (p less than 0.001). Consequently the size and distribution of the myocardial hypertrophy could differentiate the Ecg-Vcg aspects better than the anatomical shape of the left ventricle; when hypertrophy was moderate the left anterior hemiblock and the pathological Q waves were more frequent. On the contrary when hypertrophy was high and widespread the prevailing Ecg-Vcg aspect was the left ventricle hypertrophy.

Adolescent↗
PubMed1984

Richards-Rundle syndrome, cochleovestibular dysfunction and neurofibromatosis in a family.

The Richards-Rundle syndrome (RRS) is characterized by hearing loss, mental deterioration, ataxia, primary hypogonadism and autosomal recessive transmission. In a sibship of six members we found two sisters with RRS together with baldness, impaired GH and PRL secretion after stimulation and different degrees of impaired insulin secretion. Cochleovestibular investigation of the sibship revealed in each subject more or less severe forms of bulbo-pontine cochleovestibular dysfunction. Three members of the same sibship had cutaneous signs of abortive forms of neurofibromatosis: the son of one of these subjects had a severe form of fully developed neurofibromatosis. Whether there is a pathogenetic linkage between the hereditary multisystemic degeneration (RRS), the dysembryopathy (neurofibromatosis) and the cochleovestibular dysfunction in this family is still not clear.

Acoustic Impedance Tests↗
PubMed1984

Effects of long-term antiepileptic therapy on the hypothalamic-pituitary axis in man.

Effects of long-term antiepileptic therapy on the hypothalamic-pituitary axis were evaluated from the basal and stimulated plasma levels of growth hormone (GH) and prolactin (PRL) and from circadian adrenocorticotropic hormone (ACTH)/cortisol rhythms. Data for patients with well-controlled epilepsy of mild-to-moderate severity were compared with those for normal healthy volunteers. Analysis of the effects of each antiepileptic drug (AED) and of combined AEDs revealed minor abnormalities of stimulated GH secretion in all treated patients. In epileptic men, all individual AEDs (except valproate) and AED polytherapy increased both basal and stimulated plasma levels of PRL. In epileptic women, this effect was more variable and less marked, probably because of early depletion of PRL reserves. Each AED and combined AEDs did not significantly change circadian ACTH/cortisol rhythms in epileptic patients. The effects observed seem not to be related to epilepsy per se. Clinical implications, pathways, and neurotransmitters involved and possible mechanisms of the neuroendocrine effects of long-term AED therapy are discussed.

Adrenocorticotropic Hormone↗
PubMed1984

Cognitive deficits and their relationship to other neurological complications in chronic alcoholic patients.

In randomly selected chronic alcoholics hospitalised for the first time for detoxification a high prevalence (68%) of cognitive deficits was found. Peripheral neuronal damage was seen in 74%, autonomic neuronal damage in 24%. Cognitive deficits were not correlated with age, daily ethanol intake, duration of alcohol abuse or severity of liver damage. There was no correlation of peripheral, autonomic and central nervous system damage. Alcohol-induced damage of the nervous system is a common complication of chronic alcoholism, whose clinical importance often obscures possible concomitant liver damage.

Adult↗
PubMed1982

Decreased CSF concentrations of homovanillic acid and gamma-aminobutyric acid in Alzheimer's disease. Age- or disease-related modifications?

Fifteen patients, 48 to 72 years old, with Alzheimer's disease were studied. Clinical status was assessed by neurologic and neuropsychologic examinations and psychometric testing. Patients were divided into two groups on the basis of clinical assessment: group 1, little mental deterioration, and group 2, serious mental deterioration. Nineteen subjects, 27 to 72 years old, without neurologic disease served as controls. Levels of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and gamma-aminobutyric acid (GABA) were determined in lumbar CSF by fluorimetric or radioreceptor binding (GABA) methods. The HVA concentrations increased with age in the controls, whereas the GABA levels decreased with age and 5-HIAA levels were not modified. When compared with the age-matched controls, the patients with Alzheimer's disease showed low concentrations of HVA but not of 5-HIAA or GABA. The decrease in HVA level was more pronounced in patients with severe mental deterioration and therefore appeared to be disease related.

Age Factors↗
PubMed1982

Excessive daytime sleepiness: a 1-year study in an unselected inpatient population.

A prospective epidemiological investigation of excessive daytime sleepiness (EDS) was carried out in an unselected inpatient population admitted to a general hospital during a 1-year period. The study comprised 2518 patients, 1347 female and 1171 male, aged 6-92 years (mean, 55.2). On the basis of histories and clinical and polysomnographic data, EDS was found in 28 cases (1.11%). Of these, 25 (0.99%; 18 female and 7 male; mean age, 61.3) had sleep apnea syndromes (SAS) with predominantly obstructive apnea. Two patients (0.07%; one female and one male; mean age, 65.5) had idiopathic CNS hypersomnia, and one male patient (0.03%) aged 48 years had a combination of narcolepsy and SAS. Differences and agreements of our findings with previous literature data are discussed. The present study shows that in an unselected inpatient population, EDS is a relatively common sleep disorder, usually found in mild to moderate forms. Because it is not severe, it disturbs only relatively domestic activities of elderly retired patients or others who do not work outside the home, and is often masked by other troubles. For these reasons, EDS in the aging population may pass unnoticed in epidemiological studies based only on data from sleep disorder centers.

Adolescent↗
PubMedDate not supplied

Fatal aplastic anemia in a patient treated with carbamazepine.

A case of fatal aplastic anemia due to carbamazepine treatment in an epileptic woman is reported. Despite concerns of fatal bone marrow toxicity due to carbamazepine, this is only the fourth documented and published report. Carbamazepine is a safe drug, but physicians and patients should be aware of the exceedingly rare but potentially fatal side effects, better prevented by clinical than by laboratory monitoring.

Anemia, Aplastic↗
PubMedDate not supplied

Focal cerebral lesions found by magnetic resonance imaging in cryptogenic nonrefractory temporal lobe epilepsy patients.

Brain magnetic resonance imaging (MRI) was studied in patients with mild-to-moderate temporal lobe epilepsy (TLE), well controlled by pharmacotherapy, and with normal computed tomographic (CT) scans. Magnetic resonance imaging abnormalities were found in 19 patients; of these, nine had abnormalities in temporomesial regions and four in temporobasal regions. Six patients had white matter MRI lesions of nonspecific significance. The temporomesial MRI lesions were compatible with sclerosis of Ammonis cornu. Patients with this MRI finding had more severe and longer lasting TLE than those without MRI abnormalities. The temporobasal lesions were interpreted as potentially developing brain lesions. Correlation between EEG and MRI findings was good. We conclude that MRI is more useful than CT for diagnosis of patients with mild-to-moderate TLE.

Adult↗
PubMedDate not supplied

Pattern visual evoked potential mapping in Alzheimer's disease: correlations with visuospatial impairment.

We evaluated pattern visual evoked potentials (PVEPs) in patients with Alzheimer's disease (AD) and correlated the neurophysiological results with visuospatial performances in order to understand better the underlying causes of visual disturbances. Latencies and topographical distribution of PVEP components were evaluated in 20 AD patients who underwent an extensive battery of neuropsychological tests. Mean latencies of N70 and P100 were normal in AD patients, while mean latencies of N140 and P200 were significantly increased in comparison with age-matched healthy controls. The topographical distribution of PVEP components did not show any significant difference between the two groups. Visuospatial impairment was detected in 8 patients (40%). Statistically significant positive correlations were observed between P200 amplitude (posterior right hemisphere mean z score) and performance in visuospatial tests. Our data are consistent with a sparing of foveal retinocortical pathways and with the selective dysfunction of either corticocortical connections between the striate cortex and the visual associative structures or of right temporo-parieto-occipital visual analyzers.

Age of Onset↗