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Biomedical subjects

A Appiotti

Publications and source records attributed to A Appiotti.

14 recordsLinked to original sources
PubMed1993

[Neurological complications in hyperparathyroidism].

The paper describes the clinico-instrumental diagnostic iter in a 57-year-old patient with amyotrophy of the pelvic and pectoral girdles and of the roots of the limbs, with lively and symmetric R.O.T., and without fasciculation, feeling deficit, bulbar involvement and pathological reflexes; EMG was probative for the neurogenic involvement of all four limbs, whereas muscular enzymes were normal. Laboratory controls showed primary hyperparathyroidism caused by a single operated parathyroid adenoma; other test enabled multiple endocrine adenomatosis to be excluded. The paper discusses the involvement of the nervous system during hyperparathyroidism paying special attention to spinal amyotrophy.

Female↗
PubMed1992

A case of Miller Fisher syndrome: atypical findings and therapeutic considerations.

The Miller Fisher syndrome (MFS) is generally considered to be a disease of the peripheral nervous system. In some cases contemporary involvement of the central nervous system has been described (CNS). We report a case in which it was possible to prove involvement of cranial nerves VII, VIII, IX and X and to exclude CNS involvement. We discuss the possible role of early plasmapheresis treatment on disease evolution.

Adrenal Cortex Hormones↗
PubMed1991

Vogt-Koyanagi-Harada syndrome: clinical and instrumental contribution.

Vogt-Koyanagi-Harada syndrome is a rare disease, which probably has a cell-mediated autoimmune pathogenesis, marked by ocular (anterior and/or posterior uveitis), dermatological (poliosis, canities, vitiligo) and neurological (meningo-encephalitis) disorders of variable severity in variable combinations. The clinical pattern in the case reported here showed severe neurological involvement (headache, ataxia and confusional state) followed by anteroposterior uveitis. Instrumental investigations (cerebrospinal fluid, VEPs, BAEPs, EEG, CT and MRI brainscans) confirmed the diagnosis. The response to cortisone therapy was excellent. We emphasize the importance of the neuroradiological investigations, because of their peculiarities, and review the reports of cases with marked meningo-encephalitic impairment, given the dearth of reports in the neurological journals.

Brain↗
PubMed1990

[Clinical and electromyographic study of the therapeutic effectiveness and general tolerability of a new mixture of internal ester gangliosides in patients with peripheral neuropathy caused by alcoholism].

A clinical and electromyographic study was carried out to assess the therapeutic efficacy and general tolerance of a new mixture of internal ester gangliosides, with retarded neuropathy due to alcoholism. The study included the comparison between treatment for two months with internal ester gangliosides and traditional multi-vitamin treatment; the study was double-blind and randomised, and was performed according to an experimental plan using a double placebo technique. In order to assess damage to the PNS and the therapeutic efficacy of the two treatments, the following EMG tests were carried out: bilateral motory VDC, latency and width of MAP for SPE nerve, bilateral sensory VDC, latency and width of SAP for sural nerve. With regard to the clinical picture, statistical analyses were calculated using Mann-Whitney's test. Statistical evaluations for EMG tests were performed using Student's "t" test for unrelated groups in differences between the basal and final values of the variables taken into consideration. On the basis of results, it is possible to conclude that: a) the clinical variations and symptomatology showed a statistical significance in favour of the new ganglioside in comparison to the group treated with multi-vitamins; b) a statistically significant difference was observed in some electroneurographic parameters, namely VCM and latency of the SPE nerve, which was in favour of the group treated with the new ganglioside.

Adult↗
PubMed1990

[Peculiar clinical pictures of Guillain-Barré-Strohl syndrome. Description of 2 clinical cases].

A clinical of 37 patients suffering form Guillain-Baré syndrome has been carried out. Because of their unusual onset and clinical course, two of the cases are reported in full. The first case presented atypical onset modalities characterised by dysarthria, dysphonia and dysphagia with subsequent diplegia of the facial nerve and motor involvement of all four extremities; the second was difficult to diagnose and over time it turned out to be disimmune chronic-recurrent polyneuropathy. The clinic instrumental diagnostic and therapeutic course of this case, which was characterised by the poor response to corticosteroid therapy as a result of which use of immunosuppressor (azatioprine) and plasma-feresis were employed with a reaosable improvement, is described in detail. The differential diagnosis and nosologica classification are discussed.

Diagnosis, Differential↗
PubMed1990

[Clinical and diagnostic considerations on degenerative spino-cerebellar diseases. A clinical and instrumental description of 2 cases].

Two cases of spino-cerebellar heredoataxia are reported. The first patient, aged 18, presented the clinical peculiarities of Friedreich's disease; subjected to encephalic CT and encephalomedullary NMR the proved normal; EMG study and visual, acoustic and somatosensorial evoked potentials were not normal but there was nothing specifically wrong. The second patient, aged 30, followed up for more than 10 years, presented the clinical aspects of Pierre Marie disease; stress is laid on encephalic CT examinations carried out at the age of 20 and 30. These were pathological due to the marked dilatation of the IVth ventricle and the basal cisternae; evoked potential changes were aspecific. The nosography is discussed, especially as regards clinical diagnosis, in the absence of typical neuroradiological or other instrumental aspects and, obviously, in the absence of anatomopathological signs.

Adult↗
PubMed1990

[The individual sociomedical problems of alcoholism].

Some remarks on the individual medical and social problem of alcoholism are presented. The most significant epidemiological data are reported and the most frequently observed medical complications, namely liver, pancreatic, gastroenteric impairment, alcohol and cardiovascular diseases, alcohol and pregnancy, are analysed. Some general remarks are then offered regarding the alcoholism phenomenon, the concepts of physical/mental health and alcoholism are examined and the personality of the alcoholic is analysed.

Alcoholism↗
PubMed1989

[Clinical and neuroradiological aspects of a case of cervical meningioma].

The clinical and diagnostic procedures applied to a 53 year old woman admitted to hospital with left brachiocrural sensory and motor impairment subsequently extending to the right of the body are described. The complete clinical picture featured severe tetraparesis with pyramidal hypertonia and proprioceptive hyperreflexia as well as bilateral Babinski, marked atrophy of the scapulohumeral girdle, thermodolorific anesthesia and severe tactile hypoesthesia from C2 to C4. Magnetic resonance studies of the cervical marrow and spine revealed a meningioma on C1-C2 that was about 1.5 cm in diameter and situated anterior to the marrow with partial extension towards the left. Radical excision of the tumour totally cured the symptoms.

Female↗
PubMed1989

[Study of the motor and sensory neuron conduction velocity and of the H reflex in subjects with chronic opiate poisoning].

As the peripheral nerve often represents the first nervous structure compromised by exogenous toxic substances at clinical and subclinical level, a neurophysiological study was carried out on 20 addicts suffering from chronic opiate intoxication. Although none of the subjects presented signs of clinically active polyneuropathy at neurological examination, an electromyographic evaluation was carried out of motor and sensitive conduction rate in the upper and lower extremities with a study of H reflex so as to ascertain possible peripheral compromise in a subclinical phase. The same study was also carried out in a control group consisting of 20 subjects, homogeneous for sex and age. Analysis of the results obtained points to a slight but statistically significant reduction in two conduction parameters which would seem to point to slight trouble in the peripheral nerve.

Adult↗
PubMedDate not supplied

Comparative study of the analgesic efficacy of flurbiprofen and diclofenac in patients following excimer laser photorefractive keratectomy.

This randomized, patient-masked, crossover trial compared the analgesic efficacy of flurbiprofen and diclofenac in 16 patients following excimer laser photorefractive keratectomy. Patients were randomly assigned to receive one study medication after surgery on the first eye and the other medication after surgery on the second eye (approximately 30 days later). After both surgeries, patients instilled one drop of the assigned medication six times daily for the first 3 days postsurgery and one drop four times daily on postsurgery days 4 through 7. Patients assessed the intensity of postsurgical pain beginning at postsurgery hour 5 and pain relief beginning at postsurgery hour 8 and continued to do so daily thereafter. On the last day (day 7), patients rated the global efficacy of the analgesic treatment. All assessments were performed by patients using descriptor and visual ordinal scales and were recorded in diaries. Patients were queried as to the presence, severity, and duration of any adverse events. Flurbiprofen produced significantly greater reductions in pain intensity than did diclofenac at all evaluations through day 4 and significantly greater relief of pain than did diclofenac at all evaluations through day 3. Significantly more patients treated with flurbiprofen reported being pain free on days 3 and 4 (11 [69%] and 16 [100%], respectively) compared with those treated with diclofenac (3 [19%] and 9 [56%], respectively). Based on patient ratings, flurbiprofen had significantly better global analgesic activity than diclofenac. Both treatments were well tolerated. Mild and transient ocular burning after instillation was the only reported adverse event; it was reported by all patients in both study groups at approximately 50% of study visits.

Adult↗
PubMedDate not supplied

Treatment of keratoconus with laser in situ keratomileusis, photorefractive keratectomy, and radial keratotomy.

BACKGROUND: The authors investigated the refractive treatment of keratoconus to give patients better and more comfortable vision with and without glasses or soft contact lenses. METHODS: Patients with spectacle-corrected visual acuity worse than 20/40 and conus apex greater than 350-micron thick were treated. We used the Nidek EC-5000 excimer laser with a 130-mm plate and special multi-design masks for the conus treatment and the Chiron ALK microkeratome. Patients were followed for 2 years postoperatively. We also used sector radial keratotomy to treat keratoconus. RESULTS: The authors report the advantages of using these new techniques to treat keratoconus. Excimer laser ablation should be performed only when the cornea surrounding the conus is flat, so that it can join the ablated zone (small optical zone) forming a new flat shape, without regression. Ablation did not exceed 50 microns with a 3- to 4-mm ablation diameter for up to -6.00 D myopic correction. CONCLUSION: The authors hope to avoid or delay the need for corneal transplant in keratoconus eyes, giving these patients better vision with and without glasses or soft contact lenses.

Contact Lenses, Hydrophilic↗
PubMedDate not supplied

[A personal case report of subacute sclerosing panencephalitis in an adult].

The paper describes the case of a 37-year woman, with no past history of measles infection, who initially showed behavioral disorders, interpretative and reference deliria with a persecutory content. Extrapyramidal rigidity, bradykinesia, myoclonia, dementia, hyperpyrexia and coma with decerebrate rigidity subsequently appeared. Instrumental tests showed a spinal fluid status with intrathecal IgG synthesis and oligoclonal pattern, aspecific signs of widespread electric anomalies in the EEG. Encephalic CT and NRM were altered showing multifocal damage to the white substance. Anti-measles antibody titres were high in both spinal fluid and serum. Post-mortem histological tests confirmed the clinical hypothesis of subacute sclerosing panencephalitis. The paper reviews existing reports and pays special attention to cases of SSPE in adults and those cases with a psychiatric outcome. Lastly, the role of neuroradiological methods in the diagnostic iter is assessed.

Adult↗
PubMedDate not supplied

[Miller Fisher's syndrome. Clinical and experimental contribution].

A 19-year-old patient with acute idiopathic polyneuritis is described. Clinically, apart from ophthalmoplegia, areflexia and ataxia, the patient presented a serious bilateral and symmetrical deficiency of the VII-IX-X cranial nerve and hypanapallesthesia of trunk and extremities. Liquor examination showed albumino-cytological dissociation with an increase in liquor IgG; encephalic CT and encephalo-medullary NMR were normal; a neurophysiological study (EMG, PEV, BAER) was indicative of the PNS problems. Combined corticosteroid and plasmaferesis treatment produced complete clinical remission after about 3 months. The primary role of PNS involvement in this clinical entity is discussed.

Acute Disease↗