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Biomedical subjects

A Bassi

Publications and source records attributed to A Bassi.

102 records · Page 6Linked to original sources

Sumatriptan overuse in episodic cluster headache: lack of adverse events, rebound syndromes, drug dependence and tachyphylaxis.

This observational study was designed to examine the pattern of sumatriptan use in patients with cluster headache using more than the recommended daily dose of subcutaneously injected (s.c.) sumatriptan. Thirteen patients suffering from episodic cluster headache were asked to record the characteristics of their attacks and drug intake for 1 year. All reported a high daily frequency of attacks (more than 3 per day) and the related overuse of s.c. sumatriptan. The results show that the overall incidence of adverse events among patients receiving sumatriptan injections for the treatment of cluster headache is low. The extended administration of this drug in episodic cluster headache did not result in tolerance problems or tachyphylaxis. Only 4 patients experienced minor adverse events and recovered more slowly than the others. They suffered from migraine without aura and cluster headache, and showed a family history of migraine. Even though they must be viewed with caution, due to the observational nature of the study and the low number of patients included, these results suggest that the profile of sumatriptan may differ in cluster headache compared with migraine.

Adult↗

Clinical and electrophysiological effects of apomorphine in Parkinson's disease patients are not paralleled by amino acid release changes: a microdialysis study.

We performed a microdialysis investigation of extracellular amino acid (glutamate and GABA) concentrations during sterotaxic neurosurgery (the implantation of permanent electrodes in the internal globus pallidus (GPi) or subthalamic nucleus (STN) for deep brain stimulation in advanced Parkinson's disease (PD) patients, after prolonged therapy wash-out). Electrophysiological single unit recordings and perioperative clinical status assessments were also performed. Amino acid levels were measured in the GPi and GPe (external globus pallidus) of three PD patients and in the STN of another three PD patients. Stable basal release values of the examined amino acids were obtained within one hour. In clinical "off" state, the basal levels of GABA in the GPi were double those in the GPe in all the three patients. This finding could represent a biochemical marker for GPi target identification in PD surgery. Acute subcutaneous apomorphine administration induced electrophysiological changes and clinical amelioration but did not change amino acid concentrations. This result could be due to methodological limitations of the microdialysis technique. Alternatively, it could suggest that the clinical effects of acute apomorphine might also be mediated by direct activation of dopaminergic receptors located in the output nuclei.

Aged↗

LAN-1 human neuroblastoma cells are provided of endothelin-1 receptors linked to [Ca++]i elevation.

Endothelin-1 (ET-1) produced a dose-dependent increase of intracellular Ca++ concentrations [Ca++]i characterized by an early peak phase and a delayed plateau in LAN-1 human neuroblastoma cells. The ET-1 receptor showed a rapid desensitization since a second pulse application of ET-1 did not elicit a further [Ca++]i increase. Furthermore thapsigargin, an endoplasmic reticulum Ca(++)-ATPase inhibitor, completely abolished the ET-1 induced intracellular Ca++ elevation.

Calcium↗

Bacterial contamination of musculoskeletal allografts.

Based on the indications in the literature of the transmission of highly pathogenic bacteria in musculoskeletal allograft implants, the cultural results for allografts removed and implanted in conditions of asepsis between 1997 and 2000 in BTM were analyzed: 4014 allografts (3117 from a living donor, 897 from a cadaver) and 3479 implants (2191 with allografts from living donors and 1288 with allografts from cadavers). Explanted tissues: these were positive to culture in 292 out of 3117 (9.4%) allografts from living donors; the bacteria isolated showed low pathogenicity. Out of 897 allografts 117 cadaver donors bacteria with low pathogenicity were isolated in 68 (7.6%) and high pathogenicity in 12 (1.3%). Implants: cultures were positive in 116/2191 (5.3%) implants with allografts from living donors and in 55/1288 (4.3%) implants with allografts from cadavers. The bacteria isolated are the same as those shown in the explants. In living donors contamination is similar as regards incidence and type of microorganism to that observed in surgical theatres during routine surgery. Contamination seems to be greater in allografts removed from cadavers who died as a result of trauma, in the presence of positive hemocultures, prolonged catheterization and intubation, explantation of the pelvis and removal of several organs and tissues prior to musculoskeletal allograft.

Bacteria↗

Systemic broad-spectrum antimicrobial prophylaxis in hematological patients after intensive antineoplastic chemotherapy.

We performed a pilot study on 13 heavily treated hematologic patients, in whom a systemic broad-spectrum antimicrobial prophylaxis was started after the end of the antineoplastic treatment. Results were compared to a historical control group of patients with similar characteristics, in whom antibody were started at the appearance of fever. We observed a remarkable reduction in infectious fevers (1 versus 7, p = 0.03) and a disappearance of bacterial sepsis (0 versus 7, p = 0.005). The length of treatment was longer (18.6 versus 12.0 days, p = 0.06); no side effects were seen. We conclude that this seems to be a promising and safe approach, whose role in the management of selected neutropenic patients could be evaluated with further, wider studies.

Agranulocytosis↗

Methods of blood saving in revision surgery of the hip.

The blood saving protocol, which is the product of 15 years of experience, has gradually been improved, until the current form has been achieved, which includes predeposit, acute intentional isovolemic hemodilution, controlled hypotension, intraoperative blood recovery, postoperative monitoring and blood recovery, external compressive elastic dressing. The acceptance of values for hemoglobin which may even be < 8 g/dl during the late postoperative period, as long as this is well-tolerated by patients, has allowed us to drastically reduce the use of homologous transfusions. Over the last 2 years, out of 59 autotransfused patients submitted to revision surgery of the hip, only 9 (equal to 15%) required homologous transfusion. An analysis of the data shows that the use of homologous blood is associated with the presence of ischemic cardiopathy (p < 0.001) and with a predeposit which is less than 4 units of blood (packed red blood cell+fresh frozen plasma) (p = 0.05).

Adult↗

Patient education and migraine: a pilot study.

Our study examines the effectiveness of an educational approach to migraine patients. A course in migraine education was set up for 30 patients suffering from this disease; meetings were structured taking into consideration specific educational aims, with parameters evaluated before the course, at the end of the course and at a 3-month follow-up. The results, particularly the increase in the migraineurs' knowledge of their disease and the decrease in the use of symptomatic drugs, suggest the effectiveness of the course. Furthermore, our study suggests that there is a need to build educational processes into therapeutic protocols, as they enable patients to manage their chronic diseases more correctly.

Adult↗