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Biomedical subjects

M Leone

Publications and source records attributed to M Leone.

212 records · Page 12Linked to original sources

Zidovudine and thymus humoral factor gamma-2 in the treatment of HIV infection: preliminary clinical experience.

A case-control, prospective, open-label, clinical trial to evaluate efficacy and safety of a combined zidovudine/Thymus Humoral Factor Gamma-2 (THF) therapy in HIV-infected subjects was conducted in 13 patients. Twenty-six patients were included as controls receiving only zidovudine. The two groups of patients were matched according to sex, age, CDC stage of HIV infection, number of CD4+ T cells and type of previous opportunistic infections (if any) and all patients and controls were naive for antiretroviral therapy at the moment they entered the trial. The observation period was protracted up to 47 months (mean 28 +/- 13 months). No significant difference was observed between the two groups as far as surrogate markers of HIV disease progression are concerned. However, patients receiving zidovudine and THF showed a lower number of opportunistic complications. Only one patient in this group progressed to manifest AIDS while 9 of 18 controls presented disease progression. Four patients died in the case group, all of them were CDC stage IV at admission, and 15 of 26 died in the control group (all CDC stage IV at admission, and four patients who presented disease progression during the study period). Survival time was increased in the case group. The exact immunological effect of thymus hormones in HIV infection has still to be elucidated, but a possible therapeutic role of these agents is foreseeable.

Adult↗

Motor neuron disease in the province of Turin, Italy, 1966-1980. Survival analysis in an unselected population.

We performed a population based survival analysis of all incident cases (220) of motor neuron disease (MND) in the province of Turin, Italy, during the period 1966-1980. 175 cases were diagnosed as amyotrophic lateral sclerosis (ALS), 43 as progressive muscular atrophy (PMA) and 2 as progressive bulbar palsy (PBP). The life-tables of MND, adjusted as to the "expected" mortality, showed a survival rate of 27.8% and 22.0% at 5 and 10 years, respectively. The course of PMA and ALS cases was different, with a 5-year survival rate of 66.8% and 17.7%, respectively. Nevertheless both life-tables showed a similar pattern with a rapidly fatal outcome in the first 3 years after diagnosis and a slower death rate in the following years. In each curve, the slopes suggested the presence of 2 subgroups with different prognosis. It is to be stressed that a percentage of PMA patients (25.7%) showed a rapidly fatal outcome and that a subgroup of ALS patients (26.6%) showed a relatively benign course. This might suggest a different individual susceptibility to the disease.

Adult↗

Sumatriptan in the acute treatment of migraine without aura: efficacy of 50-mg dose.

We conducted an open study on the efficacy of 50 mg of sumatriptan as an acute treatment for migraine without aura. We recruited 200 consecutive patients, with an established history of migraine without aura, presenting at a headache center. The patients were instructed to take half a 100-mg sumatriptan tablet for their next migraine attack, and to record details of their headache in a diary. The primary outcome of the study was headache relief from one migraine attack. Attacks were moderately intense (46%), moderate to severe (7%), or severe (47%). Total or partial benefit at 2 hours from the 50-mg dose was reported by 140 of 200 patients (70%). Thirty-six patients received no benefit from half a tablet, and 24 did not take sumatriptan, preferring their habitual medication. Side effects were few, mild, and short lasting. We conclude that the 50-mg oral dose is generally effective for migraine without aura attacks of both moderate and severe intensity and recommend this dose for all such patients. If, however, sumatriptan is ineffective at that dose it can be increased to a maximum of 100 mg.

Acute Disease↗

Use of the Migraine Disability Assessment Questionnaire in children and adolescents with headache: an Italian pilot study.

OBJECTIVES: To determine the suitability of the Migraine Disability Assessment (MIDAS) Questionnaire for assessing disability in children and adolescents with headache and to obtain preliminary information about disability in different primary headaches. BACKGROUND: During the last decade, researchers have begun to employ standardized methodologies to investigate the global impact of primary headaches. Disease-specific instruments have been developed to measure headache-related disability. The MIDAS Questionnaire, which is the most extensively studied of these instruments, was designed to assess the overall impact of headaches over the 3 months before compilation. The MIDAS Questionnaire is an optimal tool to assess headache-related disability in adults. METHODS: Ninety-five patients aged 7 to 17 years with tension-type headache, migraine, or both completed the validated Italian form of the MIDAS questionnaire on 2 occasions. Test-retest reliability was assessed by the Spearman rank correlation test. The Cronbach alpha assessed internal consistency. The patients answered questions about the adequacy of the questionnaire. RESULTS: The Cronbach alpha was.8. Correlation coefficients were generally high for the overall MIDAS score and for the items investigating disability in school and in family/leisure activities; they were lower for the items about housework. Most patients thought that the MIDAS Questionnaire was useful (98.9%) and that it captured the impact of their headaches (58.9%); 41% thought that questions about disability in housework were useless, 44.2% suggested adding questions regarding inability to do homework. All primary headaches had a considerable impact on daily activities, but patients with migraine tended to have lower headache frequencies and lower total disability time; those with tension-type headache suffered more days in which activities, although performed, were substantially impaired. CONCLUSIONS: The MIDAS Questionnaire is useful for assessing disability in children and adolescents with different primary headaches. Minimal changes in the phrasing and content of the items would be sufficient to render the MIDAS specific for the younger population with headache.

Adolescent↗

Clinical considerations on side-locked unilaterality in long-lasting primary headaches.

The relevance of side-locked unilateral pain (with no side shift) in diagnosing and differentiating primary long-lasting cephalgias such as tension headache and migraine is not clear. In the present study we have retrospectively examined the frequency of side-locked unilaterality in 1169 primary headache outpatients, whose pain duration was more than four hours. The cases were migraine (66%), tension-type headache (21%) and non-classifiable headache and atypical facial pain (not well defined headaches) (13%). The occurrence of side-locked unilateral pain was more frequent in migraine (17%) than tension headache (4%). However side-locked pain was found to be more frequent in patients with not-well-defined head pain (28%). Of the 1169 patients, 181 (15%) had side-locked unilateral pain: 70% of the 181 had migraine, 25% were not-well-defined head pain cases and 5% were tension-type headache cases. The high percentage of migraine cases in the side-locked unilateral group reflects the high proportion of migraine patients in the studied population.

Adult↗

Research trends in the treatment of prostatic neoplasms.

Prostatic carcinoma, in the male population ranks first as incidence and second as cause of oncologic mortality. In the last decades, significantly better clinical results were achieved both in diagnosis and therapy. The latter covers a broad range of possibilities, including standard surgery, nerve-sparing surgery, combined surgery and hormonotherapy, cryosurgery, external beam radiotherapy, brachytherapy, conformal radiotherapy, combined hormone and radiation therapy, as well as conventional hormonotherapy. However, there is still much controversy on the role of the screening, the most appropriate staging modalities, the most adequate treatment in the various presentations of the disease. The present trends of the clinical research in this field are directed towards the identification of factors involved in the onset of this neoplasm and the possibility of decreasing its incidence with programs of chemoprevention, the identification of new biological markers able to assess the biological potential of the disease, the comparison between the main treatment modalities of localized carcinoma (surgery, brachytherapy, external beam radiotherapy) and the definition of parameters predictive of the response to the various treatments to better personalize the therapy of the single patient, the development of treatments based on genetic therapy and of effective systemic therapies able to control the hormone-resistant advanced disease and to clarify the impact of the different therapies on the quality of life and health care costs.

Humans↗

[The diagnostic course in patients with hereditary ataxias and hereditary spastic paraparesis].

A postal questionnaire was sent to all patients affected by hereditary ataxias and hereditary spastic paraparesis resident in the province of Turin (Italy) to study their diagnostic process. A 61% response rate was obtained. The mean time interval between onset and diagnosis was 6 years (1 to 32 years). The percentage of late diagnoses dropped from 59% before 1959 to 19% after 1970, mostly because a reduction of the interval between symptom onset and the first contact with the general practitioner. The onset with dysarthria and ataxia led to earlier neurologic consultation, but the whole time requested for the diagnosis was not modified. A reduction of the time needed for the diagnostic process may be important to address the family to an early genetic counselling.

Age Factors↗

[Evaluation of central venous catheters by endocavitary ECG].

Jugular vein catheterization (JVC) is adopted for blood access in patients with acute renal failure, chronic renal failure and when patients demonstrate traditional vascular access (VA) failure. We believe that the best technique, first described by Serafini et al, to establish the position of a central venous catheter (CVC) is endocavitary electrocardiography (EC-ECG) and its use is recommended in all uremic patients requiring hemodialysis (HD). This technique uses the tip of the CVC as a reference point in standard electrocardiography. From 2001 to March 2004, we successfully applied this CVC technique in 33 patients requiring HD. The EC-ECG technique is a method that complies with the Food and Drug Administration guidelines regarding catheter tip location in uremic patients.

Catheterization, Central Venous↗

Cluster headache: lack of central modulation?

Activation of the SPergic pathway may be responsible for the starting of both painful and autonomic symptoms during a typical cluster headache (CH) attack. We utilized Brainstem Auditory Evoked Potentials (BAEPs) and Visual Evoked Potentials (VEPs) to evaluate the possibility of underlying asymmetries in central functions in CH attacks. We studied 14 CH (7 right and 7 left cluster) and 14 normal subjects. All the CH patients showed a significant VEP asymmetry; the mean P 100 amplitude was significantly reduced on the side of the pain and I-V latency of BAEP was increased on the symptomatic side. No check was made for any significant variation underlying asymmetries in the normal subjects. We postulate that such an asymmetry in VEP and BAEP responses could suggest a neurotransmitters disorder with a different manifestation in each hemisphere.

Adult↗

Dibromochloropropane (DBCP) effects on the reproductive function of the adult male rat.

In order to evaluate the effect of dipromochloropropane (DBCP) on reproductive function, groups of male adult Wistar rats were injected subcutaneously with different doses of DBCP. A strictly dose-dependent effect resulting in histological alteration principally toward the seminiferous tubules was observed. Sperm count and sperm motility showed azoospermia or oligoasthenospermia with a significative recovery in the lower dose of DBCP treated rats. Among the enzymatic activities evaluated as biochemical markers of testicular function: LDH was not appreciably affected by the DBCP treatment while GGT and NADPH-cyt P450-reductase significantly enhanced suggesting an induction of the detoxification processes.

Animals↗

Thyroid hormone affects rat uterine expression of IGF-I and IGFBP-4.

The rat uterus has been shown to be a site of production of insulin-like growth factor-I (IGF-I) and multiple IGF-binding proteins (IGFBP-2, -3, -4, -5, -6) which are involved in estrogen-induced uterine proliferation. The presence of T3-receptors in rat uterus suggests a role of thyroid hormone in the regulation of uterus responses to estradiol. In this study IGF-I and IGFBP-4 mRNAs in uterus, oviduct and cervix from euthyroid, hypothyroid and T3-treated rats were quantified by Northern blot analysis. Our results demonstrate: i) a marked decrease in IGF-I and IGFBP-4 mRNA levels in the uterus but an increase in the oviduct of hypothyroid rats; ii) a marked increase in IGF-I and IGFBP-4 mRNA levels in the uterus but a net decrease in the cervix of T3-treated rats. The uterine changes in IGF-I and IGFBP-4 mRNA levels associated with hypothyroid status were in agreement with those observed in liver.

Animals↗