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Biomedical subjects

M Gilli

Publications and source records attributed to M Gilli.

At least 19 recordsLinked to original sources
PubMed1993

[Correlated study of visual evoked potentials-polyneuropathy in diabetic patients without retinopathy].

The functional study of visual pathways by means of pattern reversals VEPs (visual evoked potentials) was used as a noninvasive method in the study of diabetic patients, but the correlations between alterations in VEPs and the involvement of peripheral nervous system were not explored. Among 35 diabetic patients not suffering from retinopathy, we tested early deteriorations in visual pathways by means of pattern reversals VEPs and we considered similarities between these alterations, clinical metabolic parameters of the disease and clinical and paraclinical aspects of polyneuropathy (PNP). Four of these patients were insulin-dependent and 31 non-insulin-dependent, all with normal electroretinography and fluorangiography. Monitoring control of diabetes was performed by measuring hemoglobin HbA1. The control group was composed of 35 healthy subjects with normal neurologic and ophthalmologic examinations and normal visual acuity. In all subjects we tested four peripheral nerve conduction velocities (PNCV) (sensory and motor conduction of median nerve, motor conduction of peroneal nerve, anthidromic sensory conduction of sural nerve) diabetic patients were distributed in two groups according to the presence (group A, 15 patients) or absence (group B, 20 patients) of polyneuropathy. Pattern reversals PEVs were recorded after mono and binocular stimulation; screen was 25 x 18 cm with black and white check board pattern, check size 1.1 cm. Subject-to-stimulus distance was 1 m, corresponded to a visual angle of 38 degrees. Active electrode were located in Oz, O1 and O2, reference electrode in Fz.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Major depression in Parkinson's disease and the mood response to intravenous methylphenidate: possible role of the "hedonic" dopamine synapse.

The euphoric response to equivalent doses of intravenous methylphenidate (MTP) was assessed in a group of 13 Parkinsonian patients affected by major depression, in a group of 11 nondepressed Parkinsonians, in a group of 14 nonparkinsonian subjects suffering from major depression, and finally in a group of 12 controls with no CNS or psychiatric disease. Subjects of all four groups were matched for age, sex and other main characteristics. Depressed and nondepressed Parkinsonians were also matched for duration and severity of illness, and for the type of antiparkinsonian treatment. The response to MTP was evaluated in the context of a double-blind, placebo-controlled study. Parkinsonian patients with major depression exhibited a significant lack of sensitivity to the euphoriant effects of MTP, in comparison with the other three groups. Euphoria produced by central stimulants has been shown to depend on the activity of a dopamine synapse in humans, which is thought to be situated at the limbic terminals of dopamine neurons located in the ventral tegmental area. Degeneration of this system may have predisposed our Parkinsonian patients to major depression.

Adult↗
PubMed1988

Analgesic action of methylphenidate on parkinsonian sensory symptoms. Mechanisms and pathophysiological implications.

Intravenous administration of methylphenidate hydrochloride, a central stimulant, was unexpectedly found to exert a potent analgesic effect on primary sensory symptoms in a group of patients with Parkinson's disease. This effect, which has now been studied in a short-term, double-blind, placebo-controlled experiment, subsequently disappeared if patients were pretreated with a beta-blocker or with a serotonin antagonist. Cerebrospinal fluid monoamine metabolites were determined in some of these patients, and the 5-hydroxyindoleacetic acid level was found to be significantly lower than in parkinsonian patients without pain and in normal volunteers. Given the mechanism of action of methylphenidate on the central nervous system, the adrenergic and serotoninergic mediation of its analgesic effect, and the demonstration of impaired central serotonin metabolism in the patient group, it is concluded that not only central dopaminergic deficiency but also altered noradrenergic and serotoninergic transmission in the spinal cord are quite likely to play a role in the pathophysiology of pain in Parkinson's disease.

Aged↗
PubMed1988

Peripheral pharmacokinetic parameters of levodopa/carbidopa and the on-off phenomenon in parkinsonian patients.

The principal peripheral pharmacokinetic parameters of the levodopa/carbidopa association were investigated in 11 healthy volunteers and in 16 patients at various stages of Parkinson disease, with and without the on-off phenomenon. After oral administration of a standard dose of drug (levodopa 250 mg + carbidopa 25 mg) the peak plasma concentrations, peak onset time and area under the curve/time proved to be similar across the groups. There was no difference in peripheral pharmacokinetics of the association between parkinsonian patients with swings in response and those without.

Age Factors↗
PubMed1986

Bornaprine vs placebo in Parkinson disease: double-blind controlled cross-over trial in 30 patients.

The study covers 30 patients with idiopathic Parkinson disease, 13 men and 17 women, aged between 50 and 70, on stabilized L-Dopa and/or bromocriptine, which failed to ensure adequate control of the symptoms, especially tremor. To this regimen was added Bornaprine/placebo in randomized sequence. The patients were tested according to the Webster Rating Scale before, during and after each stage of the treatment. Statistical analysis of the results showed the superiority of Bornaprine over the placebo in reducing tremor (p less than 0.01) and, to a lesser degree, some other parkinsonian symptoms. No noteworthy side effects were found apart from dryness of the mouth, which was more frequent with Bornaprine.

Adult↗
PubMed1986

Mood changes associated with "end-of-dose deterioration" in Parkinson's disease: a controlled study.

Fluctuations of mood and psychic activation were assessed in relation to "mobile" and "immobile" periods in 18 patients with Parkinson's disease presenting typical "end-of-dose deterioration". Twelve subjects with chronic but active rheumatoid arthritis presenting increased physical disability due to severe morning joint stiffness with a repetitive pattern of mobile and immobile periods acted as controls. The overall degree of disability and its fluctuations were close enough in the two groups for fair comparison of changes in affective behaviour. Temporary immobility was accompanied by adverse changes of mood and activation, which were significantly more marked in the Parkinson's disease group than in the controls, though to a lesser extent in those Parkinson's disease patients rated depressed even in their mobile periods. The possible correlation between mood changes and fluctuations of central dopaminergic function in the Parkinson's disease patients is discussed.

Affect↗
PubMed1985

[Preliminary open multicenter study on the anti-tremorigenic effectiveness of bornaprine (Sormodren)].

Out of 1500 patients suffering from tremor of diverse origin, reliable data on 521 were selected for analysis. The drug was given for over two months (mean daily dose 8 mg) and effectively reduced all kinds of tremor by an average 50%. The only side-effects occurring with any frequency were dryness of the mouth and constipation. The data collected show bornaprine to have a beneficial effect on all types of tremor.

Aged↗
PubMed1984

A syndrome resembling limbic encephalitis, associated with bronchial carcinoma, but without neuropathological abnormality: a case report.

A patient, suffering from an oat-cell bronchial carcinoma, presented with complex partial seizures, complete loss of recent memory, mild disorientation and confabulation. There was no complaint of anxiety. The rest of the neurological examination and four computed tomographic scans of the head were normal. Repeated EEG recordings were abnormal. Antiepileptic and antipsychotic treatment led to full remission within 10 days. Post-mortem examination of the brain revealed no pathological changes.

Carcinoma, Bronchogenic↗
PubMed1983

[Hypokalemic myopathy caused by fluoroprednisolone in a nasal spray. Observations 2 cases].

Reference is made to the picture observed in two patients with flaccid tetraparesis, severe hypopotassaemia, and myoglobinuric muscle necrosis (hypokalaemic myopathy). Recent onset of hypertension was a feature of both cases. Initially, however, no reason could be assigned for this, nor for the massive loss of potassium. Numerous investigations in the first case (and relatively quick verification in the second) incriminated a steroid, 9-alpha-fluoroprednisolone acetate, in a nasal spray. This has often been reported as the cause of an iatrogenic syndrome due to excess of mineral corticoids, with hypertension, hypokalaemia and alkalosis, suppression of plasma renin activity, and reduction of blood and urinary aldosterone, all of which were observed in these two patients. Withdrawal of the drug and treatment with potassium chloride led to relatively rapid normalisation of the serum electrolytes. Recovery of muscle strength took place after about 20 days, almost at the same time as the normalisation of muscle enzymes. Hypertension, on the other hand, regressed slowly. The nexus between chronic use of the spray and the occurrence of hypokalaemic muscle necrosis is examined in detail. Stress is laid on the importance of specific investigation of the prior use of intranasal steroids in the differentiation of muscle disturbances due to potassium depletion.

Administration, Intranasal↗
PubMed1982

Brainstem auditory evoked potentials in postconcussion syndrome.

Brainstem auditory evoked potentials (BAEPs) were recorded from 55 patients with postconcussion syndrome (PCS) to elicit evidence of an organic and subclinical brainstem disorder. Fifteen patients (27.3%) showed abnormal responses unilaterally or bilaterally, especially for one or more interpeak latencies prolonged beyond the upper 99% confidence limits. Other 9 patients had borderline responses. The BAEP alterations were not correlated either with dizziness at the time of recording, or with vestibular troubles in the routine caloric test. Though BAEP abnormalities may be present a long time after injury, we found an improvement of responses in the majority of 14 re-tested patients. These data show that BAEP can give an objective demonstration of a reversible brainstem disorder in patients with PCS.

Adolescent↗
PubMed1979

Brain stem auditory evoked potentials and blink reflexes in quiescent multiple sclerosis.

Brain stem auditory evoked potentials (BAEP) and blink reflexes (BR) were studied in 25 patients with multiple sclerosis (MS), the diagnosis being definite according to McAlpine's criteria, in the quiescent phase, without signs of brain stem involvement. BAEP abnormalities were found in 64% of the cases and BR abnormalities in 60%. A good correlation between the two tests was found in most patients. The abnormalities consisted of delayed latencies and/or high intraindividual variability in shape and latency of BAEP and BR components. It seems that demyelination of brain stem pathways results not only in conduction slowing but also in more serious dysfunction of the generators of the evoked components.

Adolescent↗
PubMed1976

Further observations on carbamazepine plasma levels in epileptic patients. Relationships with therapeutic and side effects.

Plasma levels of carbamazepine, phenytoin and phenobarbital were monitored weekly over a period of 9 weeks in 20 epileptic patients unresponsive to treatment. No attempts were made to modify phenytoin and/or phenobarbital plasma levels; emphasis was on achieving carbamazepine plasma levels of 4 to 10 mug per milliliter. A remarkable drop in seizure frequency was attained within 2 to 3 weeks of monitoring, with carbamazepine plasma and concentrations within the desired range. Children disposed of the drug faster than adults. No effects of phenytoin and phenobarbital on carbamazepine plasma levels could be observed, while phenobarbital on carbamazepine plasma levels fluctuated remarkably without any relationship to carbamazepine levels. Transient leukopenia was present in most of the patients, while a significant reversible drop in red blood cells was observed in eight patients. The data reported confirm that with a careful monitoring of drug plasma levels, carbamazepine may exert a definite passive effect on seizure frequency in epileptic patients poorly responsive to therapy.

Adult↗