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Biomedical subjects

N Caputo

Publications and source records attributed to N Caputo.

At least 37 records · Page 2Linked to original sources

A community-based study of incidence, risk factors and outcome of transient ischaemic attacks in Umbria, Italy: the SEPIVAC study.

The SEPIVAC study is a community-based epidemiological survey of incidence and outcome of transient ischaemic attacks (TIAs) and strokes in the territory of the 6th Local Health Unit, Umbria, Italy, where 49,218 people live, from 1 September 1986 to 31 August 1989. All cases were registered with the study either by notification from general practitioners (GPs) or by a check of hospital admission within the study area and in the two hospitals of Perugia. There were 94 incident cases of TIAs (45 males, 49 females), thus giving a crude rate of 0.64 per 1000 per year [95% conficence intervals (CI) 0.52/0.78]. The rate adjusted to the European population is 0.42 (CI 0.33/0.54). Mean age was 69.4 years, and females were significantly older than males. The weighted relative risk for males was 1.19 (CI 0.79/1.79). Thirty-one patients were treated at home by their GPs. Females had hypertension more frequently than males, whereas males smoked more frequently; we did not find any other statistically significant difference in the distribution of risk factors. Twelve patients out of 58 who had CT had an infarct, and 29 out of 54 submitted to Doppler ultrasonography had carotid stenosis. At 1 month, 4 patients had suffered an ischaemic stroke, 1 of whom died. At 6 months, 3 further strokes and 2 further deaths (1 due to myocardial infarction) had occurred.

Aged↗

Prognostic value of the dense middle cerebral artery sign in patients with acute ischemic stroke.

The presence of a dense appearance of the horizontal part of the middle cerebral artery (the "dense middle cerebral artery sign") was looked for on CT scans taken on admission in 90 consecutive patients with ischemic stroke in the carotid artery distribution. The outcome of the 14 patients with the sign was poorer than that of 76 patients without the sign (Odds ratio 4.3). We suggest that this sign could be a useful prognostic variable in the acute phase of an ischemic stroke.

Brain Ischemia↗

SEPIVAC: a community-based study of stroke incidence in Umbria, Italy.

The SEPIVAC study is a community-based epidemiological survey of incidence and outcome of acute cerebrovascular disease in the Sixth Local Health Unit, Umbria, Italy (population 49,218). The study was carried out from 1 September 1986 to 31 August 1989. There were 375 patients who were registered with a first ever stroke, with a crude rate of 2.54 (95% confidence limits 2.29-2.81) per 1000 per year; the rate adjusted to the European population is 1.55 (CL 1.36-1.77). The age adjusted relative risk for males is 1.35 (CL 1.10-1.66). Up to 15% of the patients were not admitted to hospital during the acute phase of their disease. At least 286 (76.3%, CL 72-80.6) of the cases were due to cerebral ischaemia; in 56 of these (19.6%, CL 15-24.2) a clinical diagnosis of lacunar ischaemia was made. The 30 day case fatality rate was 20.3% (CL 16.2-24.3); between one and six months 7.5% (CL 5-10.6) of patients died.

Aged↗

Neuroendocrine markers in aging brain: clinical and neurobiological significance of dexamethasone suppression test.

The dexamethasone suppression test (DST) is commonly accepted as an indicator of hypothalamus-pituitary-adrenal (HPA) axis functioning in clinical practice. In this study, DST was carried out in a geriatric population composed of patients with dementia of Alzheimer type (DAT), stroke and age-matched controls. The stress state of the subjects was also functionally assessed by the Symptoms Rating Test (SRT). The results disclosed no significant differences in basal cortisol levels in the three groups. A positive correlation between age and log-transformed basal cortisol levels was found in the entire population as well as in each group. After dexamethasone administration, 20% of controls, 49% of DAT patients, and 48% of stroke patients were non-suppressors. At 8.00 a.m. and 11.00 p.m. after dexamethasone, cortisol levels were significantly lower (p less than 0.02) in controls than in pathological groups. A significant positive correlation between age and symptoms of depression and anxiety was found. One-third of stroke patients showing lesions in the right hemisphere were non-suppressors, and presented mostly subcortical infarcts, while 1/4 of them had depressive disorders. This study demonstrated a progressive increase in basal cortisol levels and depressive symptoms with age, a poor diagnostic value of DST in age-related pathological conditions such as DAT and stroke, and the role of these cerebral pathologies in amplifying the neuroendocrine dysregulation due to the ageing process itself. DST is a useful biological marker for disclosing the vulnerability of the ageing brain, but it has no diagnostic value.

Aged↗

Is multi-infarct dementia representative of vascular dementias? A retrospective study.

Multi-infarct dementia (MID) indicates a dementia disorder primarily caused by multiple cerebral infarcts. Since other pathogenetic mechanisms cause vascular dementia we evaluated clinical, CT scan and CSF neurochemical parameters of 134 MID and 67 PVD (probable vascular dementia) patients. We found no differences with regard to the presence of major risk factors. Only TIA/stroke episodes and focal neurological signs were significantly more frequent in MID than in PVD cases, an anticipable result on the basis of MID definition. CT scan findings showed a prevalence of subcortical with respect to cortical lesions in both groups, with a higher frequency in MID patients. Subjects with deep infarcts more frequently showed TIA/stroke episodes and diabetes mellitus. No differences were detectable in CSF monoamine metabolite levels. We conclude that in the majority of vascular dementias subcortical damage seems to have a major pathogenetic role.

Aged↗

Precocious puberty and neurofibromatosis of von Recklinghausen. A clinical report.

A case of a 9-year-old boy with neurofibromatosis of von Recklinghausen and precocious puberty is reported. The patient was referred to us because of an unexplained onset of precocious puberty. Clinical manifestations of neurofibromatosis included multiple café-au-lait spots, skeletal anomalies, progressive impairment of vision and precocious sexual development. CT scan and NMR demonstrated the presence of optic gliomas. The correlation between the lesions of retino-hypothalamic projection and production of the neuroendocrinology mechanism of sexual changes is discussed.

Brain↗

Radiculography with reduced amounts of contrast medium.

Because of the frequency and seriousness of side effects observed after radiculography, due to, among the other things, the amount of contrast medium, the authors describe a method that gives diagnostically satisfactory results using a low dose of contrast and a tangent-beam technique. Among 106 patients undergoing radiculography with a tangent-beam technique and Iopamidol, only 4 developed mild side effects, namely headache in three cases and headache with nausea in one.

Contrast Media↗

[Epilepsy following cisternography with water-soluble contrast (author's transl)].

A case of epilepsy is reported during ventriculography with hydrosoluble triiodate contrast (methylglutamine iotalamate). The cysternal interhemispheric cavities of the midline were flooded. This complication, which could have been lethal was treated with thiopental sodium salt, 6 methylprednisolone, mannitol, curare, trans-larynx intubation, ventilation with oxygen and nitrous oxide. The AA. conclude that the presence of an anaesthetist-resuscitator is essential during ventriculography with triiodate hydrosoluble contrast medium.

Adolescent↗

[Articulation disorders in aphasia. Considerations in several clinical cases].

Selective deficit of verbal output not associated to other anomalies of language, represents a syndrome in which articulatory as well as linguistic aspects can be independently affected. The critical lesion for pure articulatory deficit appears to involve left prerolandic cortico-subcortical structures. Nevertheless, in relation to individual differences in cerebral organization, damage in these structures can be responsible for a simultaneous deficit of articulatory and linguistic mechanisms.

Aphasia↗

[Myelopathic patterns of calcification of the posterior longitudinal ligament].

Three patients with calcification of the posterior longitudinal ligament with myelopathy are reported and discussed. This condition which is frequent in Japan is rarely described in the western population. Such calcification is not only a radiographic finding but is a progressing phenomenon which may extend to compressive lesions of the spinal cord. All patients with calcification of the posterior longitudinal ligament should be fully studied neurologically and followed up.

Calcinosis↗

[Persistent proatlantal segmental artery: description of a case].

A 42 years old man, suffering from pulsating headache, episodes of loss of consciousness and motor difficulty of the right arm, had an angiographic examination, showing a malformation of the right carotid, which connected the external carotid artery with the basilar artery. The AA. have discussed the theories about this condition, trying to find an embryo-genetic explanation. They have evaluated the clinical aspects caused by the abnormality considering mainly its circulatory defect, considering also the possible association with intracranial aneurysm caused by modification of the normal circulation in the brain stem and neck arteries.

Adult↗

[Sacroradiculo graphic and myelographic investigations with iopamidol: study of 610 examinations (author's transl)].

610 sacrorodiculographic and myelographic examinations were carried out injecting at lumbar level Iopamidol at 200, 300 and 370 mg I/ml concentrations. Immediate and early complications have been noticed in 18,52% of cases, i.e. sensation of pain during contrast injection, headache, nausea, vomit, neck stiffness, photophobia, epilepsy. In sacrorodiculographic examinations, side effects especially occurred by using 370 mg I/ml concentrations; in lumbar and thoracic myelographies, incidence of complications did not statistically differ by uing 300 or 370 mg I/ml concentrations. Side effects have occurred most frequently in cervical myelographies carried out with 370 mg I/ml concentration. Analysis of complications as well as radiographic results suggest to use Iopamidol at 300 mg I/ml concentration in sacrorodiculographics, in lower thoracic myelographies and in studies of narrowed, stenosed or obstructed canals; Iopamidol at 370 mg I/ml concentration may be used in upper thoracic studies and cervical myelographies.

Adult↗