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Biomedical subjects

M Mauri

Publications and source records attributed to M Mauri.

At least 55 records · Page 3Linked to original sources

Longitudinal neuropsychological evaluation of HIV-infected intravenous drug users.

The present study aimed to describe the cognitive status of a group of HIV-positive asymptomatic intravenous drug users (IVDU) and changes which occurred over a 12-month follow-up period. Forty-two HIV positive IVDU were selected and matched for age, sex, educational level and pattern of drug abuse with 39 seronegative IVDU controls. Baseline and follow-up evaluation included neuropsychological tests exploring attention, language, memory, logic and visuomotor abilities, biological markers and clinical parameters. About one-third of both seropositive and seronegative subjects showed at baseline slight cognitive deficits, which did not change during the follow-up period.

AIDS Dementia Complex↗

Acute and chronic changes in atrial natriuretic factor induced by ventricular pacing: a self controlled clinical trial.

A self controlled clinical trial was carried out to study the acute and chronic effects of ventricular pacing (VVI) on the atrial natriuretic factor (ANF). Eleven people were selected from a pool of 20 DDD paced patients. Pacemakers were programmed to the VVI mode for 1 month and their effectiveness tested by ECG at rest and after an effort test. AnF was measured by radioimmunoassay at baseline, after 15 minutes, and again 1 month after programming. The reliability of the radioimmunoassay was confirmed using the coefficients of variation between (12.5%) and within assay (9.7%). Data analysis was done using Wilcoxon's test. Our results showed that the onset of VVI pacing led to a sudden sharp rise in ANF in all patients (P < 0.0001). During VVI pacing, three patients were dropped from the study (2 were withdrawn because of symptoms and 1 voluntarily withdrew). After 1 month of VVI pacing, a significant increase of ANF above the baseline was observed (P < 0.05). The results showed that ventricular pacing led to an immediate rise in ANF and, that with long-term VVI pacing, there was an increase in ANF levels as well. The role of these findings in the pathophysiology of the pacemaker syndrome calls for further research.

Adult↗

Symptomatic headaches.

This paper is aimed to discuss some aspects of so-called symptomatic or secondary headaches with particular reference to the diagnostic criteria proposed by the IHS Classification Committee on headache disorders, cranial neuralgias and other head pain. Symptomatic headaches, in fact, represent an heterogenous group of conditions, sometimes with relevant clinical importance as warning symptoms of major intracranial pathology, sometimes benign in nature and with ill-defined clinical pictures and unclear relationship with the causative factor or event. It is therefore important to establish general principles for a more systematic approach to the problem of this group of headaches, also considering that some particular forms of secondary headaches, may be viewed as reliable "in-vivo" models for pathophysiological investigation in head pain.

Brain Neoplasms↗

Cognitive and neuroradiological findings in congenital adrenal hyperplasia.

Nineteen patients with congenital adrenal hyperplasia (CAH) aged over 16 years were given a neuropsychological evaluation; no significant differences with individually matched normal controls were detected. CAH subjects, however, revealed slightly higher IQs with respect to the expected distribution. No significant learning disabilities could be detected. Fifteen patients underwent nuclear magnetic resonance (NMR); 4 subjects showed small areas of increased signal intensity in the white matter, without prevalence of side; this finding did not correlate with clinical and cognitive characteristics. The results are discussed in the light of possible hormonal influences.

Adolescent↗

Three-year neuropsychological follow-up in a selected group of HIV-infected homosexual/bisexual men.

OBJECTIVE: To evaluate changes in cognition in a selected group of asymptomatic homosexual/bisexual men over a 3-year period. PATIENTS AND METHODS: Sixty HIV-infected (Centers for Disease Control stage II) subjects and 60 controls (individually matched for age and years in education) were administered neuropsychological tests evaluating attention, language, memory, logic and visuo-motor abilities. None of the patients had a history of alcohol or drug abuse, and all received the baseline cognitive evaluation within 18-24 months of seroconversion. RESULTS: The HIV-infected subjects differed from controls in only one of the six memory tests (P < 0.01). Follow-up evaluation after 18 and 36 months (available for 51 and 36 subjects, respectively) demonstrated a significant deterioration in visuo-motor ability (P < 0.01) only in subjects who had progressed to AIDS, without signs or symptoms of central nervous system involvement. CONCLUSIONS: The data suggest that cognitive alterations in asymptomatic stages of HIV infection are in most subjects minor and do not develop. Percentage rates of CD4 lymphocyte decline appear to be significantly related to deterioration in visuo-motor abilities.

Adult↗

Memory impairment in Cushing's disease.

In the present study the cognitive performance of 25 patients with Cushing's disease (CD) was extensively evaluated in comparison with normal control subjects, matched one by one. The results indicate a selective impairment of memory functions: the number of patients showing a significantly impaired mnesic performance increases with age. Moreover, the neuropsychological impairment tends to recover in those cases who underwent further controls after surgical treatment. The neuropsychological data are discussed in the light of recent evidence in the literature concerning the effects of adrenal steroids on the brain.

Adolescent↗

Usefulness of urinary growth hormone (GH) measurement for evaluating endogenous GH secretion in acromegaly.

We investigated the relationship between urinary growth hormone (u-GH) and spontaneous 24-hour plasma GH secretion in 15 acromegalic patients. To measure u-GH, we have developed a method based on concentrating the sample by centrifugal ultrafiltration and then performing an immunoradiometric assay using commercially available reagents. u-GH correlated well with the integrated concentration of plasma GH (r = 0.66, p < 0.02). Additionally, u-GH excretion in acromegalic patients was significantly higher than in the control group (190 +/- 100 vs. 3.89 +/- 0.56 pg/min, mean +/- SEM, p < 0.001). Immunoreactive u-GH showed the same elution pattern in Sephadex G-75 as standard or labeled hGH, proving that the substance measured in urine is authentic GH. In conclusion, u-GH appears to be a simple, noninvasive and inexpensive test for evaluating GH secretion in active acromegaly.

Acromegaly↗

[Clinical and therapeutic aspects of alcohol withdrawal syndrome].

In this review the authors describe the symptomatology, and the etiopathogenetic hypothesis of alcohol withdrawal syndrome. Many drugs are used in the treatment of alcohol withdrawal syndrome: carbamazepine, clonidine, chlormethiazole, phenytoin and other compounds; actually benzodiazepines are the most important drugs for symptomatic relief to prevent major withdrawal syndrome. Particularly attention is recommended to the period of suspension with the aim of reducing alcohol consumption and correcting alcohol-related psychosocial problems.

Alcohol Drinking↗

The cost of hospital stay for operable breast cancer.

The cost of the first hospital stay for operable breast cancer was deducted by analysing a random sample of 100 admissions to the National Institute of Cancer during the period January-December 1989. The aims of the study were: (1) to describe and calculate the cost component of the stay; (2) to analyse whether any procedure, service rendered or stage of the pathology might explain differences in the total costs of the stay; and (3) to acquire a better knowledge of the organizational aspects to be improved. With an average length of stay of 14.1 days, the overall total cost observed was 4.9 million lira (US $3.800, 1989 US dollars). A significant correlation between total cost and duration of stay was found (R2 = 0.982), while no or very little correlation was found between cost and the anatomical extent of disease (TNM stage) and different cost items (laboratory, imaging tests, operating room, etc.). Two homogeneous groups of cases were found: patients with quadrantectomy and patients with mastectomy. The cost of the latter was 40% greater than that of the former (P < 0.001) with a length of stay 52% longer (p < 0.001). This study does not concern the costs immediately following the stay, which namely are higher for the quadrantectomy because the radiotherapy outpatient procedures. Attention should be paid to reducing the length of stay, keeping waiting time for organizational procedures to a minimum during the stay.

Aged↗

[A genetic and hormonal study of 5 patients with the nonclassical form of congenital adrenal hyperplasia due to 21-hydroxylase deficiency].

BACKGROUND: To study the association between the 21-hydroxylase deficiency with the HLA histocompatibility complex in a mediterranean ethnic group. METHODS: 5 patients with late-onset 21-hydroxylase deficiency, diagnosed on the basis of a high plasma level of 17-hydroxyprogesterone, along with 23 family members were typed. 17-hydroxyprogesterone response to iv ACTH stimulus was measured too in the family members. RESULTS: We found a genetic linkage disequilibrium between the late-onset 21-hydroxylase deficiency and the HLA antigen B51. Moreover, similar biologic profiles were observed in the patients and those of their siblings who were HLA identical. The heterozygous carriers showed a intermediate 17-hydroxyprogesterone response to ACTH between propositus and homozygotes and their family members who had no HLA haplotype identical to those of the propositus. CONCLUSIONS: These observations tend to confirm that a close linkage exits between the gene (or genes) for 21-hydroxylase deficiency in late-onset adrenal hyperplasia and the HLA genes. This association may change in the different ethnic groups.

17-alpha-Hydroxyprogesterone↗

The brain as a target for adrenocortical steroids: cognitive implications.

It is well established that a reciprocal control exists between the brain and glucocorticoid hormones. The brain regulates adrenocortical function via hypothalamic corticotrophin releasing hormone-41 (CRH-41), glucocorticoids act at specific receptors in the hippocampus, thus promoting negative feedback mechanisms. Because the hippocampus is a major site for memory processes, a role for excessive/long-lasting plasma glucocorticoid levels has been suggested in conditions of mental impairment. Major depression, Cushing's disease, and dementia of the Alzheimer type are disorders which share hyperactivity of the hypothalamo-pituitary-adrenal axis, as well as symptoms of cognitive decline. Although the mechanisms leading to hypercortisolemia appear to be different in each case, the neuropsychological features of these three disorders accord with the hypothesis of glucocorticoid-associated brain damage. It therefore is important to find pharmacological strategies that will avert or reduce these potential consequences on brain function.

Adrenocorticotropic Hormone↗

Psychotic symptom patterns and the diagnosis of schizophrenia.

In comparing 101 psychotic patients subtyped by DSM-III criteria into paranoia, schizophrenia, schizoaffective, and affective disorders, we failed to distinguish them on the basis of delusional and hallucinatory experiences. These 'productive', 'positive' or 'irritative' symptoms--which the literature tends to link with temporolimbic dysfunction--did not appear specifically linked to schizophrenia. By contrast, 'negative' or 'deficit' symptoms--which the literature tends to relate to frontal lobe dysfunction--appeared more specific--especially for the disorganized subtype of schizophrenia. Although these data tend to support Bleulerian over Schneiderian conceptualization of schizophrenia, the heterogeneity of neuropsychological deficits implied in the negative symptom complexes limits the nosologic utility of the rubric of schizophrenia so defined.

Adolescent↗

Slowly progressive aphasia: report of a case.

We report on the case of a 66-year-old right-handed woman, who shows the clinical and behavioral features of "slowly progressive aphasia" described by MESULAM. At the age of 63 the patient began to develop progressive disturbances of word fluency and naming. The neuropsychological examination revealed amnestic aphasia and a mild impairment of verbal memory. Neuroradiological findings demonstrated left temporo-parietal atrophy. A neuropsychological evaluation performed two years later showed a worsening of language disorders and only a slight compromission in other cognitive areas, while the activities of daily living and the occupational functioning remained unimpaired.

Aged↗