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Biomedical subjects

M G Grasso

Publications and source records attributed to M G Grasso.

At least 37 records · Page 2Linked to original sources
PubMed1995

Fatigue in MS is associated with specific clinical features.

INTRODUCTION: fatigue is a common and disabling symptom in multiple sclerosis (MS). In this study we evaluated if fatigue is associated with different demographic and clinical features of MS. MATERIAL: A survey was performed on 507 consecutive patients affected by clinically definite MS referred to our centre between January 1 and December 31, 1993. During the examination patients were asked to answer a brief fatigue questionnaire. To evaluate the probability of the occurrence of fatigue in association with several covariant factors (age, sex, duration, disease form, disease severity, month of examination, functional sub-systems on the expanded disability status scale (EDSS), a logistic regression analysis was performed. RESULTS: we confirmed that fatigue is common in MS, recorded in 53% of patients. Patients affected by a more severe disability, by progressive MS, both primary and secondary, with an older age at examination, and assessed during spring, had a significantly higher risk of fatigue. Sex was not associated with the occurrence of fatigue. When the single items of EDSS were considered, we found that fatigue is also associated with the occurrence of cerebellar, sphincteric, pyramidal and sensitive signs, but not with brain stem, visual and cognitive impairment. CONCLUSION: fatigue in MS is more frequent in association with specific clinical features.

Adolescent↗
PubMed1995

A controlled study of potential risk factors preceding exacerbation in multiple sclerosis.

A wide variety of potential risk factors for acute exacerbations in multiple sclerosis were evaluated in a one year case-control study. Eighty nine consecutive patients with clinically definite multiple sclerosis and relapsing remitting course presenting with a relapse between January and December 1992 were compared with patients matched for age, sex, and degree of disability, who did not experience clinical exacerbations during the same period. Only potential risk factors occurring in the three months preceding the interview were considered patients. Relapsing patients reported no significant increase in the frequency of any risk factor in the three month period before exacerbation compared with the control group. These results suggest that most relapses are not preceded by the conditions commonly considered as risk factors.

Adolescent↗
PubMed1994

Mesial temporal cortex hypoperfusion is associated with depression in subcortical stroke.

BACKGROUND AND PURPOSE: This study was conducted to evaluate local cerebral blood flow changes in patients with depression after a subcortical stroke. METHODS: Clinical and neuropsychological assessments were performed in 15 patients with a single subcortical lesion. Depression was assessed by DSM-III-R. In addition, the Hamilton Rating Scale for depression, the Zung Self-Rating Depression Scale, and the Beck scale were administered to each patient. Single-photon emission-computed tomography study was performed with 99mTc hexamethylpropyleneamine oxime. RESULTS: In all patients cortical regions ipsilateral to subcortical lesions were significantly less perfused than the contralateral cortex. Cerebral blood flow values were significantly lower in depressed patients (n = 8) than in nondepressed patients (n = 7) only in the mesial temporal cortex of the affected hemisphere. Cerebral blood flow values in the mesial temporal cortex of the affected hemisphere significantly correlated with the severity of depression. CONCLUSIONS: Temporal lobe hypoperfusion may reflect a dysfunction of the limbic system, suggesting that this location may be critical for the occurrence of depressive symptoms in patients with subcortical stroke.

Aged↗
PubMed1994

Rehabilitation of walking with electromyographic biofeedback in foot-drop after stroke.

BACKGROUND AND PURPOSE: Alterations of gait cycle and foot-drop on the paretic limb are characteristic of stroke patients. Electromyographic biofeedback treatment has been used in rehabilitation of walking, but results are controversial. We performed gait analysis to evaluate the efficacy of electromyographic biofeedback compared with physical therapy. METHODS: Sixteen patients with ischemic stroke were enrolled in the study. The experimental group (4 men, 4 women) received electromyographic biofeedback treatment together with physical therapy. The control group (5 men, 3 women) was treated with physical therapy only. Clinical and functional evaluations before and after treatment were performed using Canadian Neurological, Adams, Ashworth, Basmajian, and Barthel Index scales. Computerized gait analysis was performed in all patients. RESULTS: Electromyographic biofeedback patients showed significantly increased scores on the Adams scale (P < .05) and Basmajian scale (P < .01). Gait analysis in this group showed a recovery of foot-drop in the swing phase (P < .02) after training. CONCLUSIONS: Our data confirm that the electromyographic biofeedback technique increases muscle strength and improves recovery of functional locomotion in patients with hemiparesis and foot-drop after cerebral ischemia.

Adult↗
PubMed1993

Anatomical and functional correlates of cognitive deficit in multiple sclerosis.

This brief article reviews the present state of knowledge concerning the relationship between structural and functional cerebral abnormalities and the cognitive deficits associated with multiple sclerosis. Currently available neuroimaging techniques have substantially contributed to a better understanding of the latter, suggesting that cortical-subcortical disconnection is the most likely cause of the cognitive disturbance. Longitudinal studies are needed to determine the natural history of the cognitive deficit and its relationship to the cerebral changes detected by neuroimaging techniques.

Cognition Disorders↗
PubMed1992

T-lymphocyte reactivity to the recombinant mycobacterial 65- and 70-kDa heat shock proteins in multiple sclerosis.

Owing to their conservation and immunogenicity, heat shock proteins (hsps) represent a class of potential autoantigens. Moreover, they could be targets for gamma delta T lymphocytes, which are prominent in various immune disorders. We studied the T cell proliferative primary responses to recombinant M. bovis 65 kDa hsp (hsp65) and M. tuberculosis 70 kDa hsp (hsp70) in 31 patients with multiple sclerosis (MS), 19 patients with other neurological diseases (OND) and 19 healthy individuals. Positive responses to hsp70, but not to hsp65 were significantly more frequent in patients with MS than in patients with OND or in healthy individuals. In order to verify and refine these results and to characterize the hsp reactive T lymphocytes, we screened 147 PPD-specific long-term T cell lines (76 from 10 patients with MS and 71 from 12 healthy donors) for their proliferative response to hsp65 and hsp70. hsp70-reactive T lines were significantly more common in patients with MS than in healthy controls. The number of T lines responding to hsp65 increased in the MS group only slightly. In 19 T lymphocyte lines from patients with MS and healthy donors, a cytofluorometric analysis was performed with special attention paid to distinct T cell receptor gamma delta determinants. With one exception, in each line the population of gamma delta T cells remained a minority. We conclude that an increased T cell response to mycobacterial hsp70 may be present in patients with multiple sclerosis.

Adolescent↗
PubMed1992

HLA determinants in familial multiple sclerosis.

HLA-A, -B, -C, -DR, -DQ antigens were studied in 11 multiplex MS families, 11 single-case MS families and 100 healthy subjects. The HLA DR4 was the most frequent antigen in all MS patients (p = 0.015). When the antigenic frequency in index familial cases was compared with that in single cases, the DR4 antigen was found to be more frequent (p = 0.01) in familial cases only. Furthermore, when the DR4 antigen was excluded from the analysis, we observed an increase in DR2 (p = 0.11) only in the familial MS cases. These results can be compatible with a multifactorial hypothesis according to which the HLA genes have an important role in MS susceptibility in familial cases.

Gene Frequency↗
PubMed1992

Structural brain correlates of neurologic abnormalities in multiple sclerosis.

We examined the relationship between cerebral magnetic resonance imaging (MRI) findings and urinary dysfunction in 70 consecutive patients with definite multiple sclerosis. MRI-weighted lesion scores for seven different brain regions were recorded according to the number and size of cerebral lesions. Thirty-two subjects (46%) had urinary symptoms and 38 (54%) were asymptomatic. Subjects with urinary symptoms exhibited greater overall functional disability and a higher midbrain MRI-weighted lesion score than asymptomatic patients. No statistically significant group differences were found for the other brain regions.

Adolescent↗
PubMed1991

Quantitative assessment of cerebral blood flow in partial epilepsy using Xe-133 inhalation and SPECT.

The Xe-133 inhalation method was used to study rCBF in 12 patients with partial epilepsy during the interictal phase. SPECT images evidenced a focal CBF defect in 10 out of 12 patients, while quantitative analysis showed CBF abnormalities in all the patients. The focal CBF defect corresponded to the site of EEG abnormalities in nine patients. Additional low-flow areas beyond the EEG focus were found. Five patients presented a significant CBF decrease in the cerebellar hemisphere contralateral to the EEG focus. In five patients with unilateral EEG abnormalities, a CBF reduction was found in the contralateral cerebral hemisphere, mirror to the EEG focus. Finally, a widespread CBF decrease involving one or both cerebral hemispheres was observed in seven patients. Global and rCBF values were not correlated with age, duration of disease, frequency of seizures, secondary generalization, or specific therapy. SPECT may be useful in evaluating EEG epileptic foci, and quantitative SPECT allows the detection of functional effects of the epileptic focus on anatomically connected remote areas, probably due to the decrease of afferent inputs (diaschisis phenomenon).

Administration, Inhalation↗
PubMed1991

The influence of pregnancy on relapses in multiple sclerosis: a cohort study.

The influence of pregnancy on the relapse rate (number of relapses per person per year) in MS was analysed for 52 women who had a pregnancy during the disease. The relapse rate was lower during the pregnancy-year (9 months of pregnancy and 6 months immediately post partum) than the non-pregnancy time. There was a heterogeneous pattern during the pregnancy-year with a sharp decrease in the relapse rate observed during pregnancy and a slight non-significant increase in the puerperium: both these relapse rates were compared with figures observed in the same group of women during the non-pregnancy time. Pregnancy does not appear to be a period at greater risk for exacerbations but, on the contrary it seems to act, on the whole, as a protective event. These data allow physicians to provide reassuring counselling to women.

Adult↗
PubMed1990

24-month follow-up of multiple sclerosis patients treated with cyclophosphamide.

15 patients with remitting-progressive multiple sclerosis received a course of intravenous cyclophosphamide followed by a booster dose every 60 days for 2 years. There were no severe short or medium term side effects. Half of the patients presented clinical stabilization and substantially unchanged Kurtzke rating at 2 year follow-up. Since the aim was stabilization only, our findings argue for continuation of the study in young patients with very short shift.

Adult↗
PubMed1989

Acetazolamide effects on cerebral blood flow in acute reversible ischemia.

Cerebral blood flow (CBF) was studied in 4 patients with acute reversible ischemia (RIND). To test the ischemic areas' vasoreactivity, CBF was measured by the Xenon-133 inhalation method, before and after acetazolamide injected intravenously. At the baseline CBF study, 3 patients presented hypoperfused areas while one patient had increased CBF over the affected hemisphere. The acetazolamide test, showed in this latter case a "steal phenomenon" while in the other 3 an increase of perfusion was evidenced, in areas of normal flow, as well as in areas with reduced flow. These results suggest that in the acute phase of patients with RIND, when brain regions of hypoperfusion and neurological signs are still present, the vasomotor response may be preserved.

Acetazolamide↗
PubMed1989

Multifactorial inheritance and recurrence risks of multiple sclerosis in Italian patients.

This study is based on 166 patients with definite multiple sclerosis (MS) residing in different Italian regions and on 332 parents and 326 siblings. Seven patients had a first-degree relative with a definite diagnosis. The comparison with a population age-matched for specific frequency of MS showed an increase of the disease among relatives. The increase in MS frequency among sibs is compared with that expected under an autosomal dominant, autosomal recessive or multifactorial model. The multifactorial hypothesis appears to better fit the data. The heritability index is calculated for each combination of relative and affected patient sex and compared with estimates of other European and American countries. The recurrence risk rates for male and female relatives have been computed for the more frequent family situations. Our results support the hypothesis of a multifactorial model of inheritance and provide risk figures to be used in genetic counseling.

Adult↗
PubMedDate not supplied

The leisure time and the third age: the experience of a geriatric day hospital.

Leisure time represents an important part of the so-called 'successful aging' and contributes to overcome the problems related to the reduction of the social roles, favoring a better subjective adaptation to old age. In this work we observed the elderly population frequenting our Day Hospital, by estimating the affective sphere (geriatric depression scale, GDS), the autosufficiency (activity of daily living, ADL; and instrumental activity of daily living, IADL) and the schooling years in correlation with the type and length of leisure time activities during the day. These data have been compared with those of the national statistics (ISTAT). The analyses revealed a very wide diffusion of the utilization of mass media and a large interindividual differentiation of the modes of using leisure time. The correlations between the indices of affectivity and autosufficiency show an effect on the types of leisure time activities, while the scholarity of the subjects has no influence on it. These results suggest considering leisure time as an indispensable part of the relational life of elderly subjects, having an important 'valency' for the affective sphere and the individual expectations and needs.

Journal Article↗
PubMedDate not supplied

Suicides and the third age.

The phenomenon of suicide represents a complex problem, the specific aspects of which should be examined by a multifactorial analysis, particularly in the elderly subjects. Although the research on risk factors continues to grow, only a limited knowledge is available on the biological changes increasing the risk for suicide. Similarly, limited information is at our disposal about the contributing psychosocial processes extending beyond the demographic factors. Although the best explored population is the elderly using primary care services, no proven interventions are known for the time being, although some efforts to test certain approaches reaching these older adults are under way. Apparently even more, continued efforts are needed to change the attitudes toward the mental illnesses and their treatments in general, in order to reach the older adults who are still outside of the health care services.

Aged↗