[Contribution to the scintigraphic study of the lesser circulation in relation to the electrocardiographic examination].
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Adolescent↗
Biomedical subjects
P Stratta
Publications and source records attributed to P Stratta.
Leukocyte behaviour in chronic uraemic patients undergoing regular dialysis.
A review of the literature is followed by the presentation of data obtained during a study of white blood cell kinetics in patients undergoing regular dialysis treatment. It was found that contact between white blood cells and the dialyzer results in a very prompt 'neutropenia-neutrophilia' stage and the deposition of billions of white blood cells on the membranes at the end of each treatment. A comparison of intradialytic leukocyte behaviour and the mean baseline white blood cell values was made in a total of 49 patients subdivided in four groups: 1. patients using coil and parallel flow dialyzers; 2. patients using dialyzers of different surface area; 3. patients of different dialytic age; 4. patients employing monoused or re-usable filters. No differences were noted in groups 1 and 4. In contrast, employing large dialyzers and the increasing dialytic age led to a variety of white blood cell patterns. Contrary to the information in the literature on leukocyte adhesion, it was observed that the cell deposits on the membranes and on the bubble trap filters, while predominantly composed of neutrophils, also contained monocytes and lymphocytes in proportions similar to those of the normal differential blood count.
Adult↗
A computerised tomographic study in DSM-III affective disorders.
The relationship between ventricular brain ratio (VBR) and clinical variables was investigated in 21 DSM-III depressed patients. None of the following dichotomies--major depression vs. dysthymic disorder, suicidal vs. non-suicidal patients, male vs. female patients--showed any statistically significant differences. An association was identified between VBR and age at onset of depression but when current age was controlled such an association failed to reach a statistically significant level except in the group with major depression. When patients were matched with a control group no differences in VBR were seen with age controlled by decade.
Adult↗
Schizotypal Personality Questionnaire and Wisconsin Card Sorting Test in a population of DSM-III-R schizophrenic patients and control subjects.
Phenomenological, biological, genetic, treatment-response, and outcome data support a link between schizotypal personality disorder (SPD) and schizophrenia. Furthermore, SPD and normal schizotypy also seem connected, although the relationship can at times be ambiguous. In this regard, this study was conducted to test the hypothesis of a possible association between neurocognitive performance evaluated by the Wisconsin Card Sorting Test (WCST) and schizotypal personality traits evaluated by the Schizotypal Personality Questionnaire (SPQ) in a nonclinical sample and a sample of schizophrenic patients. The main finding of the study was that WCST performance was correlated with SPQ (total and subscale) scores in the control group; on the contrary, in the patients, the relationship between WCST and SPQ scores was weaker. Taken together, our results seem to support the hypothesis that different cognitive aspects (i.e., elementary WCST subcomponent scores) correlate differentially with some SPQ schizotypal traits in a group of nonclinical subjects. This report underlines the relevance of studying normal subjects within the brain-behavior paradigm to highlight the brain-behavior relationship in the mental illness.
Adult↗
Cognitive function in euthymic bipolar patients, stabilized schizophrenic patients, and healthy controls.
Studies on cognitive function in bipolar disorder have led to contrasting results and few data are available on affected subjects during the euthymic phase. In the present study we investigated the cognitive function of a cohort of bipolar (n=40) and schizophrenic (n=66) patients compared to healthy controls (n=64). Patients were evaluated in the outpatient setting over at least 3 months using a computerized version of Wisconsin Card Sorting Test. Schizophrenic patients showed the worst performance while that of the bipolar patients was somewhere between schizophrenic and controls. A discriminant analysis was able to classify correctly 60.59% of the subjects (schizophrenics 48.5%, bipolars 40%; healthy controls 85. 9%). The scores of the Wisconsin Card Sorting Test were entered into a principal component analysis, which yielded a 2-factor solution. Even in that analysis bipolar patients showed intermediate features in comparison with the other groups. These data indicate that bipolar patients have subtle neurocognitive deficits even after the resolution of an affective disorder. As well as observing quantitative differences between groups, the results show different dimensions of cognitive performance within groups suggesting that the deficit of euthymic bipolars could be a dishomogeneous entity, probably more heterogeneous than that in schizophrenia. Studies administering a more complete neuropsychological battery could further clarify the nature and meaning of the cognitive deficits in schizophrenia and bipolar disorder.
Adult↗
Tower of Hanoi and WCST performance in schizophrenia: problem-solving capacity and clinical correlates.
We administered a computerized version of WCST, a well established test, sensitive to executive function deficits in schizophrenia that involves many features of cognitive processing, and of Tower of Hanoi, a test that may offer cognitive challenges more specifically related to planning and sequencing, to 28 schizophrenic patients and 28 matched controls to examine a worthwhile question regarding the relative ability of these two tasks to differentiate schizophrenia and normal groups as well as exploring the relationship of these two instruments to clinical variables. The schizophrenic patients performed significantly worse than normal subjects both on Tower of Hanoi test and on WCST. The discriminant analysis identified in a multivariate way a pattern of indexes that differentiate the two groups. This pattern, characterized by specific indexes of WCST and TOH, could suggest the existence of a common underlying factor that determines the cognitive impairment in problem-solving of schizophrenics. These findings and the relationship with positive and negative symptoms have been discussed in the light of the model of the impairment in the internal representation of context information.
Adult↗
[Subjective response to neuroleptic medication: a validation study of the Italian version of the Drug Attitude Inventory (DAI)].
OBJECTIVE: Aim of the study was to investigate the psychometric properties of the Italian version of the Drug Attitude Inventory (DAI) by exploring its construct validity. SETTING: 90 voluntary admitted patients with DSM III-R Schizophrenic (n.72) and Schizoaffective (n.18) disorders, age range between 18 and 50 years, treated with typical antipsychotics, able to participate in the study, were selected. DESIGN: Exploratory factor analyses with alpha factoring and maximum-likelihood methods with Varimax Rotation were used to analyse DAI scores. RESULTS: Extraction methods found 7 factors which explained 62.5% of the total variance. The first 2 factors could be labelled as "subjective response to treatment" construct and factors 3 to 7 as "attitude to medication" construct. CONCLUSION: Although preliminarily, the Italian version of the DAI seems to maintain the original psychometric properties and it can be used easily to get a valid measurement of the patients' attitude to neuroleptic medication.
Adolescent↗
Subjective experience and subjective response to neuroleptics in schizophrenia.
Although several studies have addressed the issue of the relationship between the subjective response to neuroleptics and drug compliance, very little attention has been given to the study of the subjective experience of psychosis and drug attitudes. The present study was therefore undertaken to examine the relationship between the subjective experience of psychosis as assessed by the Frankfurter Beschwerde-Fragebogen (FBF) and subjective response (SR) to neuroleptics as assessed by the Drug Attitude Inventory (DAI) in a group of schizophrenic patients. Significant correlations were found between the total scores on the FBF and DAI (r= .46, P< .01). The DAI total score also correlated with all four factors (central cognitive disturbances, perception and motility, depressivity, and internal and external overstimulation) on the FBF. This finding suggests that the SR neuroleptics is partly explained by a "positive" subjective experience of psychosis.
Adult↗
MR imaging of white matter lesions in uncomplicated chronic alcoholism.
Chronic alcoholics may have CNS lesions, such as microvasculitis or glial, neural, and myelin degeneration, as documented in postmortem studies on subjects who had Wernicke encephalopathy, corpus callosum degeneration, or central pontine myelinolysis. One may also expect the presence of early white matter disease in patients who do not have neurologic complications of alcoholism. Thirty-five chronic alcoholics (Diagnostic and Statistical Manual III criteria) and 35 normal control subjects were studied by means of magnetic resonance (MR) imaging. Subjects greater than 60 years old, or those with CNS involvement, or clinically evident systemic disorders were excluded. Of the remaining asymptomatic alcoholics, MR detected multiple round hyperintense areas in the white matter of 14 patients, in addition to aspecific corticosubcortical and cerebellar atrophies. None of the normal control subjects showed such a finding. These results suggest an early involvement of the brain in asymptomatic alcoholic patients.
Adult↗
Remediation of Wisconsin Card Sorting Test performance in schizophrenia. A controlled study.
Previous studies have shown encouraging plasticity in some schizophrenic patients' Wisconsin Card Sorting Test (WCST) performance while receiving detailed specific instructions on task and reinforcement. The present study examines the efficacy of a modified procedure for WCST administration that bound schizophrenic patients to use a conceptually driven cognitive strategy without instruction or reinforcement. The schizophrenics' results were also compared to those obtained with the same procedure from a matched control sample. By using this procedure, 63.2% of WCST schizophrenic poor performers dramatically improved their results. Schizophrenic poor performers who did not achieve remediation were of a younger age at onset and had more negative symptoms. This pattern was strictly associated with more perseverative errors on WCST that increased even more when the conceptually driven processing was forced. Our findings could have important implications for our understanding of the underlying cognitive deficit of the poor neuropsychological performance and allow the distinction of schizophrenic subtypes who show peculiar features that probably reflect a different pathophysiology and would potentially benefit from different modalities of treatment and rehabilitation.
Adult↗
Dual effect of methylprednsolone pulses on apoptosis of peripheral leukocytes in patients with renal diseases.
It is well known that change in apoptosis may modulate the natural story of illness, and that many drugs may act through modulation of apoptosis, but the role of steroids in acting through apoptosis in different settings, including renal diseases, has still to be elucidated. We studied the in vivo effects of steroids by oral assumption (10 to 25 mg/deltacortene) or by intravenous pulses (300 to 1000 mg/dose) on apoptosis and cellular subsets of peripheral lymphocytes, by evaluating DNA-fragmentation and lymphocyte subsets in 79 subjects: 22 controls and 57 patients with various renal diseases (25 Lupus-GN, 19 membranous-GN (MGN), 6 rapidly progressive-GN (RPGN), 2 acute interstitial nephritis (AIN), 5 on chronic dialysis. Baseline apoptosis was present in 1/22 (4.5%) of controls, 3/25 (12%) SLE, 2/6 (33.3%) RPGN and 10/19 (52.6%) MGN. A significant decrease in CD3+CD8+ cell count and a significant increase of the CD3+CD4/CD3+CD8+ ratio were found in apoptosis-positive subjects. DNA fragmentation did not change after oral steroids, paralleling a 22 to 32% decrease in total lymphocytes. Following intravenous methylprednisolone pulses, a deeper drop of all lymphocyte subsets was observed, while DNA fragmentation turned from present to absent in 2 MGN, but not in 2 RPGN, and from absent to present in 1 ARF and 1 SLE, independently of the dosage. We demonstrated that the presence of apoptosis in renal diseases is associated with decreased CD3+CD8+ cell count. Furthermore, steroid intravenous pulses, besides inducing a profound decrease in lymphocyte subsets, do exert a dual effect on baseline leukocyte apoptosis, eventually leading to a reversal of baseline patterns, either turning from negative to positive or from positive to negative. Oral steroid therapy did not influence baseline apoptosis.
Adult↗
[Dialysis in high risk patients. Problems and results].
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Adolescent↗
[Glomerular diseases with prevalent IgA mesangial deposits. Clinical, histopathological and immunochemical comparative study].
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Glomerulonephritis↗
Silica and renal diseases: no longer a problem in the 21st century?
Silicosis and other occupational diseases are still important even in the most developed countries. In fact, at present, silica exposure may be a risk factor for human health not only for workers but also for consumers. Furthermore, this exposure is associated with many other different disorders besides pulmonary silicosis, such as progressive systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, glomerulonephritis and vasculitis. The relationships between these silica-related diseases need to be clarified, but pathogenic responses to silica are likely to be mediated by interaction of silica particles with the immune system, mainly by activation of macrophages. As regards renal pathology, there is no single specific clinical or laboratory finding of silica-induced nephropathy: renal involvement may occur as a toxic effect or in a context of autoimmune disease, and silica damage may act as an additive factor on an existing, well-established renal disease. An occupational history must be obtained for all renal patients, checking particularly for exposure to silica, heavy metals, and solvents.
Humans↗
Acute pyelonephritis: a new approach to an old clinical entity.
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Adolescent↗
[The Italian Society of Nephrology Guidelines (3rd Edition): principles and methods].
Scientific Societies at both a local and international level are making big effort to prepare their clinical practice guidelines. The Italian Society of Nephrology has already published in two previous editions a series of guidelines relating to various aspects of management and diagnosis of different renal diseases. In this review we present the criteria of the 3(rd) edition of the Italian Society of Nephrology guidelines. This 3(rd) edition of guidelines will be based on the availability of scientific evidence in different areas of nephrology, dialysis and transplantation. Ten key intervention questions have been identified, based on the availability of systematic reviews of randomized trials or individual randomized address them. Systematic reviews and randomized trials are the optimal study design to address intervention questions. These have been summarized based upon rigid methodological criteria and strictly reflect the evidence basis. The different phases of development and publication of the 3(rd) edition of the Italian Society of Nephrology guidelines are presented.
Italy↗
[Symptomatology and clinical aspects of inadequate dialysis].
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Cardiovascular Diseases↗
A computerized tomographic study in patients with depressive disorder: a comparison with schizophrenic patients and controls.
Using computed tomography, Ventricular Brain Ratio (VBR) was assessed in a sample of 42 depressive patients, 36 schizophrenic patients and 37 controls. The values of affective patients laid between, but did not differ significantly from those of schizophrenic patients on the one hand and controls on the other. The schizophrenic patients showed VBR increase when compared to controls. Possible implications of VBR measurement, in patients with affective illness are discussed.
Adult↗