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M Testa

Publications and source records attributed to M Testa.

At least 37 records · Page 2Linked to original sources

Effects of the type of holds and movement amplitude on postural control associated with a climbing task.

The aim of the present work was to characterize the modifications of the postural adjustments during a climbing task as a function of postural and/or movement constraints. The variations of the horizontal and vertical forces and momentum were analyzed for different movement amplitudes and types of holds. The results show that the horizontal momentum is influenced by all experimental conditions before the onset of movement. By contrast, the vertical momentum is only influenced by the amplitude of the movement, after its onset. These results confirm the hypothesis of a dual function of the anticipatory postural adjustments. The horizontal momentum is mainly involved in the control of equilibrium. The vertical momentum contributes to the movement initiation.

Adolescent↗

Association of neck pain with symptoms of temporomandibular dysfunction in the general adult population.

The association of neck pain with symptoms of temporomandibular dysfunction in the general adult population was evaluated in a sample of 483 subjects selected from the population living in the municipality of Segrate, northern Italy. Subjects were interviewed by a standard questionnaire about oral conditions, temporomandibular symptomatology and neck pain. Symptoms related to the Helkimo Anamnestic Index were the indicators of temporomandibular dysfunction, and the evaluation also included history of trauma of the masticatory system. Troublesome neck pain was experienced within the last year in 38.9% of the total series, and the prevalence of complaints was higher in women than in men (41.7 vs 34.4%). Prevalence increased with age (p < 0.005) and was significantly higher in subjects with than without temporomandibular symptomatology (47.4 vs 28.6%, p < 0.0001). At univariate analysis, facial and jaw pain (p < 0.001) and feeling of stiffness or fatigue of the jaws (p < 0.01) were significantly related to neck pain. Age- and sex-adjusted multiple logistic analysis showed that neck pain is associated with the temporomandibular symptomatology as a whole (p < 0.001), and in particular with facial and jaw pain (p < 0.01). These findings confirm that there is a significant association between neck pain and the temporomandibular symptomatology. Moreover, they suggest that the most relevant relationship is with facial and jaw pain, according to recent neurophysiologic studies on pain mechanism. Further clinical and longitudinal studies are desirable in order to give a better clarification of mutual specific roles of craniocervical and temporomandibular disorders in the aetiology of these pathologies.

Adult↗

Human herpesvirus 6 DNA in cerebrospinal fluid specimens from allogeneic bone marrow transplant patients: does it have clinical significance?

Cerebrospinal fluid (CSF) specimens from 22 allogeneic bone marrow transplant patients with central nervous system (CNS) symptoms (cases) and 107 patients who were immunocompromised but did not have CNS symptoms (controls) were assayed for human herpesvirus 6 (HHV-6) DNA. HHV-6 DNA was detected in CSF specimens from five (23%) of 22 cases and in CSF specimens from one (0.9%) of 107 controls (P < .001, Fisher's exact test). In addition, none of the five cases with HHV-6 DNA detected in CSF samples had any other identified cause of their CNS symptoms, and none of the other 11 cases with known causes for their CNS diseases had HHV-6 DNA detected in CSF samples (P = .03, Fisher's exact test). In three cases, HHV-6 variant B was identified, and the HHV-6 variant could not be defined in the other two cases. Prophylaxis with acyclovir did not prevent the occurrence of HHV-6-associated CNS disease after allogeneic bone marrow transplantation. Four cases' conditions were improved or they were cured after treatment with either ganciclovir or foscarnet, and one case died of CNS disease despite foscarnet treatment.

Adult↗

Correlation between bacterial counts in saliva and subgingival plaque.

The aim of this study was to examine the correlation between the number and type of bacteria from periodontal pockets more than 4 mm deep and saliva in 26 patients. Periodontal pocket samples were taken with paper points and transferred to 0.1 ml of enriched thioglicollate broth. Saliva samples were collected simultaneously in aseptic flasks. Both samples were processed within the first hour. They were inoculated in Schaedler agar plus 5 micrograms/ml vitamin K and 5% blood, TSBV agar and MGB agar to perform colony counts and identification. Spirochete counts per microscopic field were obtained by direct light microscopy of Gram-stained preparations. The results show a fair to good correlation between both samples for anaerobic, pigmented gram-negative rods, anaerobic non-pigmented gram-negative rods, spirochetes, facultative gram-negative rods other than Actinobacillus actinomycetemcomitans, anaerobic, gram-positive cocci and anaerobic gram-positive rods (Spearman correlation coefficient 0.51 to 0.96). The correlation coefficient values for A.a., facultative gram-positive rods, facultative gram-positive cocci and facultative gram-negative cocci were lower than 0.21. There were no significant differences between the counts in both samples for all the bacterial groups (Student's t test, p > 0.1). We may conclude that, under the experimental conditions of the present study, saliva samples and periodontal pocket samples are equally useful to detect subgingival organisms associated with periodontal disease in the oral cavity. Saliva samples were useful to evaluate risk and periodontal therapy in individual patients or groups.

Adolescent↗

Comparison of steerable continuous-wave versus pulsed-wave Doppler ultrasonography to renal artery angiography in diagnosing renal artery stenosis.

Pulsed-wave Doppler ultrasonography is widely used to noninvasively diagnose renal artery stenosis. The use of steerable continuous-wave Doppler has never been tested. We compared pulsed and steerable continuous-wave Doppler ultrasonography, demonstrating that although both methods are highly sensitive for severe stenoses, continuous-wave Doppler shows a better sensitivity for mild to moderate stenoses.

Adult↗

Infections with hepatotropic viruses in children treated with allogeneic bone marrow transplantation.

Patients treated with BMT are extremely susceptible to infection with blood-borne viruses that can cause liver disease of variable clinical severity, from minimal biochemical changes to fulminant hepatic failure. Facing a patient with liver disfunction after BMT, one must bear in mind that more than one cause of liver disease, of viral and/or non-viral origin, may coexist. Moreover, besides the most important hepatotropic viruses, other agents, like herpesviruses (including CMV, adenoviruses, Epstein-Barr virus) may also be implicated, sometimes causing a life-threatening fulminant hepatitis, due to their cytopatic effect. Liver disease history and viral markers before transplant, together with the accurate assessment of the timing and type of clinical and biochemical deterioration are useful tools for a differential diagnosis. Liver biopsy, if taken in the early posttransplant period, is often difficult to interpret, while in case of liver disease occurring during immunosuppression tapering, histologic examination may discriminate between an exacerbation of viral hepatitis and an acute onset of chronic liver GVHD. While it seems that hepatitis G virus does not cause liver disease, the presence of hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is a matter of concern for its consequences both early after BMT and for long-term survivors. Despite screening for blood and marrow donors for HBV and, more recently, for HCV markers, the rate of post-transplant infection (4% and 4-15% respectively, confirmed in prospective studies) with those viruses indicates that viral hepatitis still remains an important clinical problem in this setting, although the prognosis of chronic HCV and HBV infection appears more benign than expected, especially in children.

Bone Marrow Transplantation↗

Prevalence and natural history of hepatitis C infection in patients cured of childhood leukemia.

The aim of this study was to ascertain prevalence and natural history of hepatitis C virus (HCV) infection in a large cohort of patients cured of childhood leukemia who had been followed prospectively for liver disease for at least 10 years since chemotherapy withdrawal: 114 consecutive patients entered the study. Liver function tests and ultrasonography were used to assess presence of liver disease. Patients were tested for antibody to HCV and for serum HCV-RNA at the end of chemotherapy and at the end of follow-up. At chemotherapy withdrawal, 56 patients (49%) were HCV-RNA positive, often without detectable anti-HCV, and in these cases, transaminase levels were more elevated during (P = .08) and after (P = .04) chemotherapy compared with HCV-RNA negative cases. Patients were then followed-up 13 to 27 years (mean, 17) after chemotherapy withdrawal. During this period, 38 initially anti-HCV negative patients seroconverted to anti-HCV and 17 initially anti-HCV positive cases lost reactivity. Forty patients were persistently HCV-RNA positive in serum, while 16 initially viremic patients became HCV-RNA negative during follow-up. At the end of the observation period, a persistent transaminase elevation was detected only in four HCV-RNA positive and anti-HCV positive cases, while no patient developed signs or symptoms of decompensated liver disease. Thus, hepatitis C was a frequent finding in long-term survivors after chemotherapy. It was associated with an atypical serologic profile and did not cause severe liver impairment over a period of 13 to 27 years.

Adolescent↗

Morbidity and mortality due to liver disease in children undergoing allogeneic bone marrow transplantation: a 10-year prospective study.

We have conducted a long-term prospective study of children undergoing bone marrow transplantation (BMT) to assess morbidity and mortality for liver disease. One hundred eleven consecutive children were enrolled between June 1985 and June 1995 and were followed-up for a median of 5.5 years after BMT. Before transplant 48/111 children (43%) had abnormal alanine aminotransferase (ALT), none were HBsAg+ and 4/111 were anti-HCV+. After BMT 4/111 patients (3. 6%) died of liver failure. No relationship was found between pretransplant hepatitis B (HBV) or C (HCV) infection or elevated transaminases and development of severe liver damage. Eighty-two out of one hundred and eleven patients (74%) had abnormalities of ALT after BMT, transient (n = 54) or persistent (n = 28). None developed clinical signs or symptoms of end stage liver disease or of cirrhosis during follow-up. No significant difference in prevalence of liver disease, was found between children with normal or abnormal ALT at BMT (relative risk [RR] = 1.04). HCV infection could be implicated in the etiology of chronic liver disease in 14/28 patients; 2 other patients were found infected by HBV alone (1 case) or combined with HCV (1 case). In the remaining 12 the etiology of chronic liver disease could not be defined. Posttransplant hepatitis B occurred in 4/111 children (3.6%), including a recipient from a donor who had been previously vaccinated against HBV, while no patient who had been vaccinated developed hepatitis B. The rate of posttransplant seroconversion to anti-HCV was 15%.

Adolescent↗

Nonselective beta-adrenergic blockade with carvedilol does not hinder the benefits of exercise training in patients with congestive heart failure.

BACKGROUND: Long-term beta-adrenergic blockade does not appear to be associated with drug-induced training in patients with congestive heart failure (CHF); whether exercise training can increase peak aerobic capacity in patients with CHF who are treated with beta-adrenergic blockers is currently unknown. METHODS AND RESULTS: We studied 23 patients with CHF who were treated with carvedilol or propranolol in addition to ACE inhibitors, furosemide, and digoxin. Of the patients treated with carvedilol, 8 underwent exercise training and 8 remained sedentary. All 7 patients treated with propranolol underwent exercise training. Peak oxygen consumption (mL.kg-1.min-1) was serially measured in trained and sedentary patients. Peak reactive hyperemia (mL.min-1.100 mL-1) was determined in the calf and forearm immediately before and after 12 weeks of training. The peak oxygen consumption of trained patients treated with either carvedilol or propranolol increased from 12.9 +/- 1.4 to 16.0 +/- 1.6 (P < .001) and 12.4 +/- 1.0 to 15.7 +/- 0.9 (P < .001) mL.kg-1.min-1, respectively, whereas it did not change in the sedentary patients. Peak reactive hyperemia increased significantly in the calves but not the forearms of trained patients. CONCLUSIONS: Long-term, nonselective beta-adrenergic blockade with carvedilol or propranolol does not prevent patients with CHF from deriving systemic and regional benefits from physical training.

Adaptation, Physiological↗

Hepatitis C virus genotypes and liver disease in patients undergoing allogeneic bone marrow transplantation.

Hepatitis C virus (HCV) genotypes were investigated in 57 HCV-infected patients undergoing allogeneic BMT at four European BMT units where death resulting from liver failure (LF) in HCV-infected patients varied from < 1% to > 80%. The aim of the study was to determine whether differing HCV genotypes could account for the different severity of post-transplant liver disease (LD). Sera from patients with pre (n = 22) or post-BMT (n = 35) HCV infection were collected from Italy (Genova, Monza), Sweden (Huddinge) and Germany (Ulm). Patients were grouped as follows: LF: 19/57; acute hepatitis (AH): 10/57 or chronic hepatitis (CH): 22/57; no liver disease (LD): 6/57. HCV genotypes were identified by hybridisation of the 5'UTR amplified products with type-specific oligonucleotides probes according to Simmonds (Hepatology 1994; 19: 1321-1324). Genotype HCV 1 was identified in 34 patients (60%), HCV 2 in 15 (26%), HCV 3 in three (5%), mixed infection in three (5%) and undefined in two (3.5%). In the LF group HCV 1 was identified in 10/19 and other genotypes in 9/19. Median timing of LF was earlier in patients infected with HCV 1 compared to other genotypes (45 and 68 days, respectively), largely due to the cause of LF; death from veno-occlusive disease (VOD) and hepatitis occurred at 30 and 68 days post-BMT, respectively. Genotype 1 was also identified in cases with no LD. These data indicate that there was no evident correlation between HCV genotype and type or severity of post-transplant liver disease.

Adolescent↗

[Three-dimensional analysis of variations of the forces associated with the climbing task in adolescents].

The efficient performance of voluntary movements requires a precise coordination between posture and movement. Anticipatory postural adjustments are believed to minimize the perturbation of balance triggered by the movement. This is particularly important in rock climbing where the unstable posture requires a fine balance control to preserve equilibrium. The aim of this study was to determine the spatial and temporal characteristics of the postural adjustments and movement in a climbing task for ten right-handed beginner children (5 boys and 5 girls) aged 10 to 15 years. A climbing ergometer was used for the experiment. The apparatus consists of four plates on which artificial climbing holds are secured. Using three-dimensional strain gauges we analyzed the three components of the forces applied at each hold. The signals were sampled at 100 Hz amplified and recorded on a personal computer. The climbing frame was adjusted to the anthropometry of each child. The task was to move one foot from one hold to another, and to actually climb onto the latter. Three levels of difficulty, corresponding to 1/3, 2/3, and 3/3 of shank length were tested. Subjects performed 5 trials with each foot at each level. The effect of three variables were analyzed: gender, laterality (right or left moving foot) and task difficulty. The force distribution was analyzed over a 400 ms period of steady state before the onset of movement. For all subjects and for all conditions, a greater force was applied to the right foot for the vertical forces and on the left foot for the lateral forces. In other words the subjects were standing over their right foot instead of exactly spreading their weight between the two legs. The onset of movement was always preceeded by a reproducible sequence of anticipatory postural adjustments involving the three supporting segments. This sequence was the same for the three components and started with the controlateral hand followed by the homolateral hand and then the controlateral foot. On the hand holds, the anticipation increased with the difficulty of the task, whereas movement time remained constant across all experimental conditions. The effect of task difficulty on the latencies of the anticipatory postural adjustments was more pronounced for the female subjects. The analysis of the load variations occurring during the movement along the three axes showed that the weight was transferred mainly to the controlateral foot but also to the hands. However the homolateral hand was never very involved. On the vertical component, there was a main effect of laterality. For a left foot movement, the force variation on the right controlateral side was more important than for a right foot deplacement. In addition there was a main effect of gender showing that the boys "pulled" more on their hands than the girls. This effect was stronger for a right foot movement. Compared with adults and age-matched boys, the girls seemed to use a more lateral, an expert-like, strategy.

Adaptation, Physiological↗

Abuse liability of testosterone.

Anabolic-androgenic steroids (AAS) are used by athletes to enhance performance and physique. Case reports and observations propose that AAS have mood elevating properties and that chronic use leads to addiction. The aim of this study was to evaluate the subjective and physiological effects of single doses of testosterone. In a double-blind fashion, according to a balanced Latin square, 10 paid adult male volunteers received doses of i.m. testosterone (50, 100 and 200 mg), morphine (10 mg) or placebo for five consecutive days. Subjective and physiological responses were measured during each drug condition. Testosterone produced no significant changes in self-reported or observed measures, unlike morphine, which produced statistically significant changes in several measures, including 'feel the drug', 'like the drug' and 'feel high'. There were no adverse effects of administering high doses of testosterone. In conclusion, single doses of testosterone are devoid of the usual pharmacologic effects that are associated with abuse.

Adult↗

New phenotype definition of attention deficit hyperactivity disorder in relatives for genetic analyses.

The goal of the present investigation was to create a phenotype definition in relatives of probands that reflects a more genetic form of attention deficit hyperactivity disorder (ADHD). Logistic regression was applied to the first-degree relatives of ADHD and normal control probands to create a quantitative phenotype that combined information across psychiatric, cognitive, and demographic domains. Models were run separately in mothers, fathers, sisters, and brothers. Although there was some overlap between the variables retained in each model, no two models had exactly the same variables. Our results suggest that the use of fitted logits may be valuable as a potential index of caseness. Since different characteristics were included in different groups of relatives, our results suggest that gender and generation may moderate the expression of ADHD.

Adolescent↗

Variable response of the peripheral circulation to acetylcholine in patients with coronary artery disease.

The purpose of this study was to assess endothelium-mediated vasodilation in the peripheral circulation of patients with coronary artery disease who are free from hypertension, hypercholesterolemia, diabetes mellitus, and congestive heart failure. The vascular response of the superficial femoral artery to an endothelium-dependent (i.e., acetylcholine 10-7, 10-6, and 10-5 mol/L) and to an endothelium-independent (i.e., nitroglycerin 10-8 and 10-6 mol/L) dilator was compared in 13 patients with angiographically documented coronary artery disease and in 7 patients with normal coronary angiograms. Vascular response was assessed by Doppler ultrasonography. Whereas the vascular responses to nitroglycerin in patients with abnormal and normal findings on coronary angiograms were similar, the responses to acetylcholine were clearly different. The ratio of mean blood flow velocity (+/-SD) measured during administration of acetylcholine 10-6 mol/L and mannitol was significantly lower in patients with abnormal versus normal results of coronary angiography (1.15 +/- 0.35 vs 2.20 +/- 1.06; p < 0.05). The vascular response to acetylcholine 10-5 mol/L in patients with an abnormal finding on their coronary angiogram was highly variable when compared with that in patients with normal results. Thus, in patients with angiographically proven coronary artery disease, the response of the peripheral circulation to acetylcholine is characterized by a great variability and a reduced sensitivity, when compared with that in patients with normal findings on coronary angiography.

Acetylcholine↗

Direct and indirect assessment of skeletal muscle blood flow in patients with congestive heart failure.

Techniques which are currently used to measure skeletal muscle blood flow (SMBF) in patients with congestive heart failure (CHF) are neither convenient nor accurate. They have led to discrepant results in patients with congestive heart failure and are, in part, responsible for the ongoing debate regarding the factors which limit the rise in body oxygen consumption during exercise in these patients. However, direct measurement of SMBF may not be needed during exercise in patients with severe CHF. Their skeletal muscles maximally extract oxygen. Consequently, increase in oxygen consumption by the skeletal muscles is only mediated by a concomitant increase in SMBF. In patients with severe CHF, peak body oxygen consumption attained during maximal exercise closely depends on the rise in SMBF, and thus provides an indirect measurement of SMBF.

Heart Failure↗

Regional wall motion analysis by dobutamine stess echocardiography to distinguish between ischemic and nonischemic dilated cardiomyopathy.

To distinguish between ischemic and nonischemic dilated cardiomyopathy (DCM), we studied 43 patients with left ventricular dysfunction (15 ischemic and 28 nonischemic detected by coronary angiography) by dobutamine stress echocardiography. At rest, there were more normal segments (p<0.001) and a trend toward more akinetic segments (p, not significant) per ischemic than per nonischemic DCM patient. However, either at rest or with low-dose dobutamine, individual data largely overlapped. At peak dose, in ischemic DCM, regional contraction worsened in many normal or dys-synergic regions at rest (in the latter case after improvement with low-dose dobutamine); in contrast, in nonischemic DCM, further mild improvement was observed in a variable number of left ventricular areas. Thus with peak-dose dobutamine, more akinetic and less normal segments were present per ischemic than per nonischemic DCM patient (both, p<0.001). A value of six or more akinetic segments was 80% sensitive and 96% specific for ischemic DCM. Our data show that analysis of regional contraction by dobutamine stress echocardiography can distinguish between ischemic and nonischemic DCM.

Aged↗