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Biomedical subjects

R Di Perri

Publications and source records attributed to R Di Perri.

At least 37 records · Page 2Linked to original sources

Prevalence of diabetic neuropathy with somatic symptoms: a door-to-door survey in two Sicilian municipalities. Sicilian Neuro-Epidemiologic Study (SNES) Group.

In a door-to-door survey conducted in two municipalities of Sicily, we ascertained the prevalence of diabetic neuropathy. Our case-finding was restricted to subjects with somatic symptoms. During phase 1, we administered a screening instrument for peripheral neuropathy to 14,540 persons residing in Santa Teresa di Riva (Messina Province) and Terrasini (Palermo Province). During phase 2, neurologists evaluated those subjects who had screened positive. Diagnoses were based on clinical criteria only, and were reviewed by an adjudication panel. We found 39 persons (27 women, 12 men) affected by diabetic neuropathy. The crude prevalence, as of November 1, 1987, was 268.2 cases per 100,000 population. The prevalence increased with advancing age for both sexes and was consistently higher in women. The most common type was distal symmetric polyneuropathy. The median time between diagnosis of diabetes mellitus and onset of diabetic neuropathy was 8 years, and almost all identified persons with diabetic neuropathy were under treatment for diabetes mellitus.

Adult↗

Validating screening instruments for neuroepidemiologic surveys: experience in Sicily. Sicilian Neuro-Epidemiologic Study (SNES) Group.

In a hospital setting in Sicily, we assessed a screening instrument developed for a prevalence survey of parkinsonism, peripheral neuropathies, stroke, and epilepsy. The subjects consisted of (1) hospital patients with any of the above-mentioned diseases, to investigate sensitivity; and (2) hospital visitors free of all these diseases, to investigate specificity. The standard for comparison was a clinical evaluation based on specified criteria. Trained interviewers administered the screening instrument, asking subjects to answer symptom questions and to perform simple physical tasks. For the questions and tasks together, the sensitivity estimates were 100% for parkinsonism (n = 21), 96% for peripheral neuropathies (n = 22), 96% for stroke (n = 22), and 96% for epilepsy (n = 22), while the specificity estimate was 86% (n = 21). Analogous estimates were computed for the set of questions, for the set of tasks, and for each question and task individually. Despite limitations in our approach, we concluded that the screening instrument would be adequate for its intended use.

Adult↗

Elevation of plasma phenytoin by viloxazine in epileptic patients: a clinically significant drug interaction.

The effect of viloxazine (150-300 mg daily for 21 days) on plasma phenytoin levels at steady state was examined in 10 epileptic patients stabilised on a fixed phenytoin dosage. After starting viloxazine treatment, plasma phenytoin concentrations increased by 37% on average (range 7-94%) from a mean value of 18.8 micrograms/ml at baseline to a mean value of 25.7 micrograms/ml during the last week of combined therapy. In four patients the rise in plasma phenytoin was associated with the development of signs of phenytoin toxicity. Discontinuation of viloxazine resulted in return of plasma phenytoin towards baseline values and disappearance of the clinical symptoms. The mechanism of interaction probably involves inhibition of phenytoin metabolism by viloxazine. Careful monitoring of plasma phenytoin levels is recommended in patients treated with phenytoin who need to be started on viloxazine therapy.

Adult↗

[The effect of dihydroergocristine on cognitive functions and sleep in elderly subjects].

The aim of this study was to assess the effect induced by the dopamine agonist dihydroergocristine (DHEC, CAS 17479-19-5), whose memory-improving activity is well-known, on sleep pattern and cognitive function, and the possible relationship between them. Ten elderly volunteers were included in the study. Selected subjects had to be neither demented nor depressed, according to neuropsychodiagnostic criteria (SCAG < 30, Hachinski dementia score < or = 15, Hachinski ischemic score < 6, HRSD < or = 22). All subjects underwent a nightly polysomnographic evaluation during placebo, after single and long-term once-daily 6 mg DHEC administration. Cognitive function and attention were also assessed by the Randt memory test and WAIS digit-symbol subtest. DHEC caused a marked and significant increase in the acquisition subitem, and memory improvement was documented during DHEC treatment. A significant direct relationship between the effect of DHEC on REM sleep and memory test was also evidenced. Our results confirmed the role of REM sleep in the restoration of cognitive function.

Aged↗

Door-to-door prevalence survey of neurological diseases in a Sicilian population. Background and methods. The Sicilian Neuro-Epidemiologic Study (SNES) Group.

In three municipalities of Sicily, a prevalence survey of major neurological diseases was conducted door-to-door using screening and examination to find cases. This was the first large-scale neuroepidemiologic survey of that type undertaken in Italy: 24,496 persons were screened yielding 1,538 positives, of whom 1,408 were examined directly by neurologists and 110 were evaluated on the basis of existing medical documentation. In the article, we provide (1) a description of the population investigated and the survey methods employed; (2) details of the cooperation and the attrition experienced in the survey; and (3) age and sex tallies for the study population, including some on education level and occupation.

Adolescent↗

Narcolepsy and psychopathology. A case report.

The case of a 14-year-old girl presenting with the association of a clearcut narcoleptic syndrome and psychiatric disturbances is reported. Tricyclic anti-depressant drugs and hypnagogic hallucinations seem to play a precipitating role on delusional episodes in a predisposed subject with a positive psychiatric familial history.

Adolescent↗

[Patients with stroke treated with TRH-T. Evaluation of electric brain activity using traditional and computerized methods].

This study was aimed at evaluating the EEG effects of acutely and chronically administered protirelin tartrate in patients with acute and chronic cerebrovascular disease by traditional and computerized analysis of cerebral electric activity. Our data showed: a) TRH-T did not induce EEG abnormalities; b) acute and chronic administration of TRH-T increased alpha frequency band and decreased delta and theta activities.

Brain↗

[Electrophysiological findings after TRH-T administration to healthy volunteers].

The central effect of acutely and chronically administered TRH-T were evaluated in ten volunteers by analysis of spontaneous and evoked cerebral electric activity. None of the subjects showed significant BAER changes, of EEG abnormalities. In some subjects acute and chronic administration of TRH-T increased alfa and beta 1 activities.

Adult↗

The effect of nocturnal physiological sleep on various movement disorders.

Thirty-one subjects affected by different movement disorders underwent polygraphic and videotape monitoring during nocturnal sleep, to assess movement patterns during the night. It was possible to distinguish two categories of disorders according to their pattern of movements. In the largest group (Meige's syndrome, blepharospasm, amyotrophic choreoacanthocytosis, Tourette syndrome, tonic foot, hemiballism) abnormal movements were still present during sleep, but decreased in frequency and amplitude in all stages. The second group presented three syndromes (nocturnal paroxysmal dystonia, nocturnal myoclonus, restless legs syndrome), in which light non-rapid-eye-movement sleep induced a strong activation of abnormal movements, whereas rapid-eye-movement sleep suppressed them.

Adult↗

Neuroepidemiological survey on Sicilian population. A feasibility study.

This research was designed as a pilot study in order to determine the feasibility and the reliability of a major door-to-door neuroepidemiological survey to be performed in the near future in 3 Sicilian towns with a total population of 30,000 inhabitants. 1,601 subjects were investigated by means of a questionnaire for the prevalence of stroke, epilepsy, parkinsonian syndromes, peripheral neuropathies, intracranial neoplasm and migraine. This preliminary study proved to be a good starting point, but some difficulties were identified in the questionnaire, in data collecting instruments and in diagnostic criteria.

Adolescent↗

Nocturnal complex partial seizures precipitated by REM sleep. A case report.

A 16-year-old patient presenting with complex partial seizures occurring in the transition from a REM period to wakefulness is described. His baseline EEG showed generalized and symmetrical slow spike and wave complexes, on a normal background activity, activated by NREM sleep. Polygraphic and videotape recordings, carried out for several nights, showed that after nearly each REM period, he would wake up briefly, presenting eye blinking followed by a burst of generalized hypersynchronous theta to start his seizures. These were characterized by moaning and autoaggressive behaviour, the ictal EEG showing generalized slow spike and wave complexes in the midst of several movement artifacts. At the end of each fit he fell back to REM sleep. Carbamazepine treatment completely resolved his symptoms, with full normalization of EEG activity.

Adolescent↗

Paroxysmal electroencephalographic abnormalities genetically transmitted: one family description.

A 10-year-old girl came to our observation since a general rule-out electroencephalogram (EEG) had showed, in absence of any clinical manifestation, generalized and symmetrical 3 c/s spike-and-wave bursts, whose duration was longer than 3 s. The subject, only daughter born from her mother's first marriage, had no family history of neurological diseases; her physical and neuropsychological examinations were normal. A polysomnographic recording showed, during sleep, the same abnormalities observed during wakefulness. Also on this occasion, there were no related clinical manifestations. Subsequent recordings were performed on her 33-year-old mother and on two siblings, 3 and 2 years old, respectively, born from their mother's second marriage, all normal by physical and neuropsychological examinations, with no referral about clinical seizures. Among them, the 3-year-old sister showed asymptomatic left rolandic spikes, while the 2-year-old boy, whose EEG was firstly normal, displayed, 1 year later, a burst of generalized 3 c/s spike-and-wave paroxysmal activity on a 4-7 c/s background activity. The possible unitary genetic transmission of paroxysmal EEG abnormalities is discussed.

Adult↗

Bilateral cortical calcifications with benign clinical course: an unusual case of Sturge-Weber syndrome?

A case of a 13-year-old girl with bilateral cortical calcifications of the Sturge-Weber type at CT examination, without cutaneous lesions and ocular abnormalities is described. She had seizures appearing within the first year of life which never recurred since the age of two years. At the age of ten years she began to suffer from occasional migraine attacks. Her neurological examination and psychological testing did not show any significant abnormality. This case can be regarded as an unusual atypical form of Sturge-Weber syndrome, unless the existence of a new disorder is assumed.

Angiomatosis↗

Spontaneous bilateral anterior cerebral artery occlusion resulting in akinetic mutism. A case report.

An unusual case concerning a patient with akinetic mutism (AM) due to spontaneous bilateral anterior cerebral artery occlusion is reported. Brain CT scan revealed the presence of mild low density foci presenting an irregular enhancement, which followed the distribution of mesial frontal gyri and paracentral lobulus, bilaterally. Right and left carotid angiographies showed bilateral occlusion of the anterior cerebral artery. Our case is characterized by an exclusive localization of the infarction in the frontal cortex. This finding suggests that a limited damage involving the anterior cerebral arteries territory could be, on its own, responsible for the AM syndrome.

Aged↗