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Biomedical subjects

P Stratta

Publications and source records attributed to P Stratta.

At least 19 recordsLinked to original sources
PubMed2001

Educational level and age influence spatial working memory and Wisconsin Card Sorting Test performance differently: a controlled study in schizophrenic patients.

The influence of educational level and age on executive function, as evaluated by the Wisconsin Card Sorting Test (WCST), and 'working memory,' as evaluated by means of a visual-manual delayed-response task, has been investigated in 25 schizophrenic patients and 35 healthy controls matched for age. Different patterns of correlations between educational level, age and cognitive variables were seen for the 'working memory' task but not for the WCST. No significant correlations between the WCST and the 'working memory' task indexes have been observed. Based on multivariate analyses, poor performance of schizophrenic patients on working memory and executive function tasks was observed; after covarying for the educational level, group differences were no longer significant for executive functions, but the difference in 'working memory' performance persisted. The implications of sociodemographic variables as well as the role of statistical manipulation are evaluated and their differential impact on 'working memory' and executive functions is proposed in further support of these neurocognitive constructs that may be dissociable.

Adolescent↗
PubMed2001

The role of metals in autoimmune vasculitis: epidemiological and pathogenic study.

BACKGROUND: A possible relationship between Silica (Si) exposure and antineutrophil cytoplasm antibodies (ANCA)-associated vasculitis has been reported. Furthermore, tuberculosis (TBC) has been frequently described in patients with silicosis, and TBC infection shares with ANCA-associated vasculitis the formation of granulomas. Therefore, an intriguing network including Silica, Vasculitis, TBC and ANCA might be hypothesized. The aim of this work was to further investigate these correlations using both epidemiological and pathogenic approaches. METHODS: Study I--epidemiological study. A case-control study to compare the occupational histories of 31 cases of biopsy proven vasculitis (18 pauci-immune crescentic glomerulonephritis, 9 microscopic polyangitis, 4 Wegener's granulomatosis) with those of 58 age, sex and residence-matched controls (affected by other kidney diseases), was performed. Occupational Health physicians designed an appropriate questionnaire in order to evaluate a wide spread of exposures and calculate their entity by the product of Intensity x Frequency x Duration. Study II--tuberculosis association. A case-control study to evaluate the frequency of a previous history of tuberculosis (TBC) in 45 patients with vasculitis and 45 controls were performed. Study III--ANCA positivity. A case-control study to evaluate the presence of ANCA was performed by testing blood samples of 64 people with previous professional exposure and 65 sex/age matched patients hospitalized in a General Medicine Unit. Furthermore, the same evaluation was made in a pilot study in 16 patients with ongoing or previous TBC. Study IV--experimental study. The oxygen free radicals (OFR) and IL-12 production (both involved in the pathogenesis of vasculitis) from human phagocytic cells stimulated with an amorphous (diatomaceous earth) and a crystalline (quartz) form of Si at the doses of 10 and 100 microg ml(-1) was evaluated. RESULTS: Study I--a positive history of exposure to Si resulted in significantly more present in cases (14/31 = 45%) than in controls (14/58 = 24%, P = 0.04, OR = 2.4) and no other significant exposure association was found (including asbestos, mineral oil, formaldehyde, diesel and welding fumes, grain and wood dust, leather, solvents, fungicides, bitumen, lead and paint). Study II--past TBC infection was significantly more present in patients with vasculitis (12/45 = 26%) than in controls (4/45 = 8%, P < 0.05). Study III--ANCA was present in 2/64 exposed people (vs. 0/65 controls, P = NS) and 0/16 patients with TBC. Study IV--both amorphous and crystalline Si forms represented a stimulus for OFR and IL-12 production, but quartz resulted as a greater inductor. CONCLUSIONS: We conclude that Si exposure might be a risk factor for ANCA-associated vasculitis, possibly enhancing endothelial damage by phagocyte generation of oxygen free radicals and Th1 differentiation by an excessive IL-12 phagocyte production. Frequency of TBC was significantly higher in vasculitis patients. ANCA was not frequent in the preliminary examination of people with previous professional exposure or patients with TBC, but the number of samples evaluated is too small to allow conclusions.

Adult↗
PubMed2001

[Bright disease in Turin and Italy from the middle of the 19th century to the middle of the 20th century].

For many years the term nephritis was used to indicate renal diseases (in the sense of Bright s disease) in a larger sense. This review summarizes the history of the concept of glolomerulonephritis from Egyptian Medicine up to the Post-Biopsy Era, in particularly in Turin and in Italy. This study reports an epidemiology survey of Bright s disease in Italy from 1880 up to 1960. Towards the end of the 19th century Bright s disease accounted for 26 deaths/year/105 population (in comparison with more than 200 from tubercolosis) in Italy. At the beginning of the 20th century, Bright s disease was the seventh cause of death in Italy. Moreover, in Italy autopsy studies showed a higher percentage of deaths attributed to Bright s disease (5-7%) in comparison with those obtained from vital studies. In 1960, just before the beginning of renal replacement therapy, Bright s disease accounted for 15.7 deaths/year/105 population. Probably it was difficult to recognize in the real incidence of chronic renal diseases leading to death in the 1960s, and vital studies were able to furnish only approximate estimates. However, noteworthy is the fact that these values were very close to those estimated as being the annual need for renal replacement therapy (10-20/year/105 population).

Glomerulonephritis↗
PubMed2000

Behavioral neurodevelopment abnormalities and schizophrenic disorder: a retrospective evaluation with the Childhood Behavior Checklist (CBCL).

This study is a retrospective report of childhood and adolescence neurobehavioral assessment in patients with schizophrenia and their healthy siblings using the Childhood Behavior Checklist (CBCL). The CBCL ratings were obtained from retrospective maternal reports, for five age periods (birth to 3years, 4-7years, 8-11years, 12-15years and 16-18years) in a sample of 32 patients with schizophrenia. The patients showed a variety of childhood and adolescence behavioral problems when compared with their siblings, and the various types of problems differed in the developmental course of the disease. Cluster analysis was conducted on the childhood premorbid behavior ratings for the schizophrenic patients, and two subgroups emerged: a cluster with an initially low level of behavioral abnormalities (B.A. ) that increased over the years, and a cluster with a high level of B.A. that remain relatively stable until early adulthood. The latter group showed more severe current negative symptoms.

Adolescent↗
PubMed2000

Processing of context information in schizophrenia: relation to clinical symptoms and WCST performance.

Failure in contextual information processing has been hypothesized as being the single function responsible for several impairments in cognitive tasks and symptoms, through an involvement of the prefrontal cortex, in patients with schizophrenia. A variant of the Continuous Performance Test (CPT) designed specifically to elicit deficits in the processing of contextual information has been administered to 20 schizophrenic patients and 20 healthy controls. The relation to Wisconsin Card Sorting Test (WCST), relatively specific to prefrontal damage and executive dysfunctioning, and clinical status by using scales for the assessment of positive, negative symptoms and outcome has been investigated. The data show that multi-episode schizophrenic patients manifest inability to use contextual information to inhibit habitual response to an ambiguous stimulus and to maintain information across delay, without a general attention deficit. We also found a relationship between contextual reasoning and WCST unique errors, hallucinations, formal thought disorders, and outcome evaluation. Our results further support the hypothesis that the deficit of contextual reasoning could account for cognitive impairments and symptoms of patients with schizophrenia.

Adult↗
PubMed2000

Qualitative MRI findings in patients with schizophrenia: a controlled study.

A variety of brain structural abnormalities, which can be identified only by qualitative methods, have been shown to correlate with clinical presentation and course of schizophrenia. In the present study, MRI scans of 122 patients with DSM-IV schizophrenia and 81 non-psychiatric controls were evaluated. Among males, the frequency of CNS developmental abnormalities (CDAs) was higher in patients than in controls. Lateral ventricular enlargement (LVE) was more frequent in patients than in controls; when subjects were grouped in three age classes, LVE was more frequent in patients than in controls in the youngest and the oldest age group. Patients with LVE or third VE were older than those without these abnormalities. Schizophrenic patients with LVE or cortical atrophy (CA) had a longer duration of illness than those without these abnormalities. Both patients with LVE and those with third VE had a poorer outcome than those without these abnormalities. CDA findings add to the evidence of a higher frequency of neurodevelopmental abnormalities in male schizophrenic patients. Results concerning LVE suggest that both developmental and degenerative processes underlie this abnormality. The association of LVE and third VE with a poor outcome indicates that qualitative MRI evaluation might be of clinical relevance.

Adolescent↗
PubMed2000

Cognitive symptoms of mania in pure and mixed episodes evaluated with the Positive and Negative Syndrome Scale.

To investigate the clinical specificity of mixed affective patients, we compared the clinical characteristics of pure manic patients with those of mixed manic patients. The clinical symptoms of 146 bipolar inpatients hospitalized for a manic episode were assessed by means of the Positive and Negative Syndrome Scale. Mixed patients showed more positive and cognitive symptoms and among these the lack of judgement and insight was prominent. Further studies are needed to clarify the specificity of lack of insight of the mixed bipolar patients.

Adult↗
PubMed2000

Awareness of illness and outcome in schizophrenia.

The purpose of the present study was to investigate whether awareness of illness affects specific measures of outcome in schizophrenia. Patient awareness was evaluated using a shortened version of the Scale to Assess Unawareness of Mental Disorder (SUMD). Patient outcome was assessed by means of the Strauss-Carpenter scale. Our findings indicate that lack of awareness of "negative symptoms" has a considerable impact on outcome: in fact "Social Contacts" highly correlated with Blunt Affect, Anhedonia and Asociality items on the SUMD. Lack of awareness seems then to be a powerful predictor of poor outcome.

Adult↗
PubMed2000

Neuromorphological abnormalities in schizophrenic patients with good and poor outcome.

OBJECTIVE: The present study was designed specifically to assess the relationship between brain morphology and outcome in schizophrenia. METHOD: Fifty-six schizophrenic patients and a matched group of 32 healthy subjects were studied with magnetic resonance (MR) imaging scans. Clinical assessment included the Krawiecka-Manchester Scale (K-MS) and the Outcome scale by Strauss and Carpenter. RESULTS: Along several neuromorphological measures the patients differed from controls only for right and left ventricular volumes. The 'poor outcome' patients had a left and right ventricular enlargement when compared to the 'good outcome' patients and healthy controls. A regression analysis showed that right ventricle volume, left temporal lobe volume and left hippocampal volume entered into the regression equation, accounting for a 27% of the outcome measure. CONCLUSION: The outcome does not seem to be predicted by one particular morphological site but involves different brain regions; however, the ventricular enlargement identifies a subgroup of patients with poor outcome.

Adult↗
PubMed2000

The cognitive bias task (CBT) in healthy controls: a replication study.

Contextual processing is the selection and bringing "on-line" of internal representations of a task that can be used in planning and mediating goal-appropriate behavioral responses and is a relevant issue that probably is involved in many neurological and psychiatric conditions. The Cognitive Bias Task is a measure of context-dependent responding, is sensitive to quadrant-lesion effects, and interacts with gender. The goal of this study was to replicate and detail more completely the method of context-dependent processing for healthy control patients on the Cognitive Bias Task. The results show the presence of three different cognitive patterns that could biases the response of control patients: context-independent, context-dependent, and mixed. Gender, but not handedness, significantly influences contextual processing, with more females than males producing a context-independent pattern of responding. Test results and the relation of contextual processing in psychiatric disorders were discussed.

Adult↗
PubMed1999

Spatial working memory assessment by a visual-manual delayed response task: a controlled study in schizophrenia.

'Working memory' dysfunction has been proposed as a central cognitive feature in schizophrenia. To further explore this issue we developed a computerized easy and fast to administer test using the standard keyboard as visual-manual subject-computer interface along a delayed-response paradigm. The test has been administered to 25 patients who met the DSM-III-R criteria for schizophrenia and 25 healthy control subjects matched as possible for sex. The data confirm the visuo-spatial 'working memory' dysfunction in schizophrenic patients. The test maintains the discriminative capacity of similar previously devised tasks with the advantages of being usable on almost every standard computer and shorter and more acceptable for severely disabled patients also. The test can be considered an useful tool to study the 'working memory' impairment in the cognitive deficit of schizophrenia.

Adult↗
PubMed1999

Schizophrenic patients use context-independent reasoning more often than context-dependent reasoning as measured by the cognitive bias task (CBT): a controlled study.

The processing of context is a relevant issue that is probably involved in many neurological and psychiatric conditions. Contextual reasoning is conceived as selection and bringing 'on line' internal representations of the tasks that can be used to mediate goal-appropriate behavioral responses. Impairment in contextual reasoning is thought to play a key role in the pathophysiology and symptom formation of schizophrenia. The Cognitive Bias Task (CBT) has recently been designed and is thought to activate contextual reasoning. A study for applying this method to schizophrenic patients and healthy control subjects has been carried out. The data show that a large percentage of the schizophrenic subjects (87.5%) do not use a context-dependent procedure for reasoning. There was a gender difference in CBT performance in the healthy control group, with more females than males using a context-independent procedure, but not in patients. These findings appear to be in agreement with the body of literature supporting the hypothesis that schizophrenic patients utilize a more uneconomic data-driven information-processing procedure. The study of contextual reasoning seems to allow the identification of a fundamental cognitive process and/or crucial regions or circuits that further research could demonstrate parsimoniously account for large parts of the heterogeneous cognitive deficits of schizophrenia.

Adult↗
PubMed1999

Angiotensin I-converting enzyme genotype significantly affects progression of IgA glomerulonephritis in an italian population.

To evaluate the role of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in the progression of immunoglobulin A glomerulonephritis (IgA-GN), genotype distribution in 81 biopsy-proven cases of IgA-GN was studied. A logistic regression model showed that the risk for homozygous DD was not significantly elevated in patients with IgA-GN compared with healthy subjects (odds ratio = 1.16; confidence interval [CI], 0.4 to 3.3). However, the 5-year (78% v 90%) and 10-year (52% v 82%) renal survival rates for 47 patients with serum creatine (Cr) levels of 1.5 mg/dL or less at biopsy was significantly less in DD patients (n = 18; chi2 = 5.41; P = 0.02). The hazard ratio (HR) for DD (multivariate analysis from Cox proportional model after adjustment for known factors of progression, such as hypertension [HPT] and proteinuria [PTO]) was 3.07 (CI, 1.1 to 9.4). The HR for heavy PTO was 6.1 (CI, 1.9 to 19). The association of DD genotype with progression was even more striking when patients with other risk factors (heavy proteinuria) were excluded, as shown by DD-related risk in the absence (HR = 3.6; CI, 1.1 to 12) and presence (HR = 2; CI, 0.4 to 10) of PTO. The risk ratio was further increased by the coexistence of DD + PTO (HR = 9.16; CI, 1.8 to 15.7). Furthermore, in a cross-sectional study among patients with IgA-GN, a logistic regression model showed that the risk for homozygous DD was greater, although not at a statistically significant level in the end-stage renal failure subgroup compared with the normal renal function subgroup (odds ratio = 3.16; CI, 0.7 to 13.7) after adjustment by sex, age at biopsy, HPT, PTO, and therapy. Last, DD was significantly more frequent in those patients who started hemodialysis at an earlier age (chi2 for trend = 6.81; P = 0.009). Our study further supports that ACE genotype is a risk factor not for the development, but for the worsening of IgA-GN clinical course. However, on the basis of current knowledge, we cannot exclude that I/D polymorphism may simply serve as a prognostic marker, eventually linked with other discrete loci involved in the progression of renal damage.

Adult↗