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Biomedical subjects

A Boschi

Publications and source records attributed to A Boschi.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Neuro-ophthalmological problems in the diabetic patient].

Neuro-ophthalmological complications in diabetic patients are relatively rare, and their prevalence seems to be much less important than the retinopathy and the cataract prevalence. Although the low frequency of the neuro-ophthalmological complications, these might induce severe loss of vision or oculomotor disturbance, as it is reported in acute anterior ischaemic optic neuropathy or in cranial neuropathy. The etiopathogenic mechanism is still uncertain, but actually a metabolic dysfunction seems to be the more plausible hypothesis. In absence of specific treatment, we emphasized the importance of a preventive treatment based on the best control of diabetes and the treatment of the vascular and infection risk factors.

Adult↗
PubMed1995

[Effect of local medications on intraocular pressure control following trabeculectomy].

Longterm administration of topical antiglaucoma therapies had been indicated to be a serious risk for failure of trabeculectomy through inducing a subclinical inflammation of conjunctival tissues and stimulating secondary fibroblastic proliferation. Our study had 3 main aims: (1) to check if this pejorative effect is present in our population of glaucomatous patients, (2) in order to improve the rate of surgical success in theoretically high risk patients (duration of topical treatment longer than 36 months), to determine the usefulness of the following actions: suppression of beta blocking agents 8 days before surgery, suppression of miotics and eventual topical administration of fluorometholone one month before surgery. (3) to correlate the observed clinical results to the cellular profile of preoperative conjunctival biopsies. We presented in a first step the results of a retrospective analysis including 88 trabeculectomies performed between January '93 and April '95 in 62 GCAO patients older than 40 years and without any previous ocular surgery. The mean age of patients was 66,8 years (41 to 87 years). Patients were classified into "complete success", "qualified success" and "failures" according to the "target" IOP was or was not reached in the last examination. Mean follow up was 5,8 months (1 to 26 months). The second prospective part of our study included 20 trabeculectomies performed in 16 patients we chose according to the nature, the duration of the preoperative topical therapy and the preoperative eventual preparation of the conjunctiva. This study also included a semiquantitative count of the different conjunctival cellular colonies in peroperative biopsies. Mean follow up of this study was 2,3 months (1 to 5 months). 31 "complete success", 52 "qualified success" and 5 "failure" were observed in the retrospective study. The reduction of IOP following trabeculectomy was statistically significant at all examinations (mean IOP in the last examination: 14,9 +/- 4,3 mmHg) but the level of success was not significantly different according to the nature, (mono against polytherapy), the duration of preoperative medical topical treatment, as well as the preoperative actions in order to improve the operative success in high risk patients. Preliminary results of our second prospective study did not yet show any failure and did not exhibit any clear correlation between the counts of the different cellular colonies and the level of operative success on one hand and the different topical therapies in the other hand. The results and limitations of this study were compared to those of the literature.

Adrenergic beta-Antagonists↗
PubMed1995

[Unusual manifestation of Horton's disease: apropos of 2 case reports].

Giant-cell arteritis is a polysymptomatic disease of the elderly. We report 2 patients, with positive temporal artery biopsy for giant-cell arteritis and unusual ocular manifestations. The first patient present an unilateral, acute ischaemic ocular and orbital syndrome partially cortico-resistant. The second one present a right Horner syndrome appeared several months after an important malaise, weights loss and pharyngeal and maxillary pain which had been successfully treated with antibiotics and non steroid anti-inflammatory drugs. We discuss the diagnostic and therapeutic management of giant-cell arteritis in our patients, with a review of the literature.

Aged↗
PubMed1994

Virus-induced autoimmunity in hepatitis C virus infections: a rare event.

Serial serum samples from 16 Italian patients presenting with acute hepatitis C virus (HCV) infections (which progressed to chronic hepatitis in six) were screened for the non-organ-specific autoantibodies most frequently associated with autoimmune hepatitis (AIH), as well as for antibodies against the hepatic asialoglycoprotein receptor (ASGP-R) and against the GOR peptide. One patient had low titres (1:10-1:80) of liver-kidney microsomal (LKM-1) antibodies during the recovery phase and three others had transient low titres of anti-smooth muscle (IgM class, 1:10) or anti-ASGP-R (1:150-1:300). Anti-GOR was detected in 43 (65%) of 66 sera from 13 of these patients. There was no correlation between any of these findings and progression to chronicity. By comparison, 18 patients with AIH studied concurrently before institution of immunosuppressive therapy all had antinuclear and/or smooth muscle antibodies, or LKM-1, at 1:40-1:640 and anti-ASGP-R at 1:300-1:2,100. None of these 18 had evidence of HCV infection and all were seronegative for anti-GOR. The findings indicate that the autoantibodies usually associated with AIH are rare in HCV infections but the virus can very occasionally induce a transient autoimmune response. Anti-GOR appears to be an antibody specifically related to HCV infection and is probably not a marker of induced autoimmunity, and it does not predict progression to chronic hepatitis.

Acute Disease↗
PubMed1992

Contribution of pattern electroretinogram and pattern visual evoked potential in early diagnosis of primary open angle glaucoma.

Pattern electroretinogram (PERG) combined with visual evoked potential (VEP) has become increasingly useful in clinical assessment of the anterior visual pathways. In regard to the PERG dependence on ganglion cell activity, we studied monocular PERG in 36 patients (71 eyes) with intraocular hypertension (6 eyes under topical beta-blockers) and in 10 patients (18 eyes) with advanced glaucoma, to estimate the potential effect of increased IOP on ganglion cells. We recorded simultaneous VEP to evaluate the retino-cortical conduction time. Referring to normal values obtained from 19 eyes (12 subjects), we found clear-cut PERG abnormalities in 20 eyes among ocular hypertensive patients with increased IOP. They were more altered in the advanced glaucomatous group. Two or three control exams were performed in 10 patients every 6 months: however such a short-time follow-up seems too limited to define the ERG prognosis value in this pathology. Comparing the PERG with the clinical routine assessments, we discuss its place in the diagnosis and in the follow-up of patients with ocular hypertension.

Adult↗
PubMed1990

[Accommodation insufficiency in children].

Insufficiency of accommodation in children is often misdiagnosed, and particularly in preschool age. Subject if symptoms are unspecific, asthenopia, difficulties in nearwork, and for concentration. Differential diagnosis must be done between dyslexia, non refractive accommodative esotropia with high AC/A. In some cases we can't exclude the possibility of myasthenia even if this subject is still in discussion. The authors report two clinical cases of hypoaccommodation in children.

Accommodation, Ocular↗
PubMedDate not supplied

A novel approach to the high-specific-activity labeling of small peptides with the technetium-99m fragment [99mTc(N)(PXP)]2+ (PXP = diphosphine ligand).

A new labeling approach for incorporating bioactive peptides into a technetium-99m coordination complex is described. This method exploits the chemical properties of the novel metal-nitrido fragment [99mTc(N)(PXP)]2+, composed of a terminal Tc[triple bond] N multiple bond bound to an ancillary diphosphine ligand (PXP). It will be shown that this basic, molecular building block easily forms in solution as the dichloride derivative [99mTc(N)(PXP)Cl2], and that this latter complex selectively reacts with monoanionic and dianionic, bidentate ligands (YZ) having soft, pi-donor coordinating atoms to afford asymmetrical nitrido heterocomplexes of the type [99mTc(N)(PXP)(YZ)]0/+ without removal of the basic motif [99mTc(N)(PXP)]2+. The reactions of the amino acid cysteine was studied in detail. It was found that cysteine readily coordinates to the metal fragment [99mTc(N)(PXP)]2+ either through the [NH2, S-] pair of donor atoms or, alternatively, through the [O-, S-] pair, to yield the corresponding asymmetrical complexes in very high specific activity. Thus, these results were conveniently employed to devise a new, efficient procedure for labeling short peptide sequences having a terminal cysteine group available for coordination to the [99mTc(N)(PXP)]2+ fragment. Examples of the application of this novel approach to the labeling of the short peptide ligand H-Arg-Gly-Asp-Cys-OH (H(2)1) and of the peptidomimetic derivative H-Cys-Val-2-Nal-Met-OH (H2) will be discussed.

Amines↗
PubMedDate not supplied

The [(99m)Tc(N)(PNP)](2+) metal fragment: a technetium-nitrido synthon for use with biologically active molecules. The N-(2-methoxyphenyl)piperazyl-cysteine analogues as examples.

The incorporation of a bioactive molecule into a nitrido-containing (99m)Tc-complex has been successfully achieved by using the [TcN(PNP)](2+) metal fragment. In this strategy, the strong electrophilic [TcN(PNP)](2+) metal fragment efficiently reacts with bifunctional chelating ligands having a pi-donor atom set, such as N-functionalized O,S-cysteine. The 2-methoxyphenylpiperazine (2-MPP) pharmacophore, which displays preferential affinity for 5HT(1A) receptors, was conjugated to the amino group of cysteine to obtain 2-MPPP-cys-OS, where 2-MPPP is 3-[4-(2-methoxyphenyl)piperazin-1-yl]propionate. The asymmetric Tc(V)-nitrido complexes, [(99g/99m)Tc(N)(PNP)(2-MPPP-cys-OS)] (PNP = PNP3, PNP4), were obtained in high yield (95%), by simultaneous addition of PNP and 2-MPPP-cys-OS ligand to a solution containing a starting (99g)/(99m)Tc-nitrido precursor. A mixture of syn and anti isomers was observed, the latter being the thermodynamically favored species. In vitro challenge experiments using the anti isomers with glutathione and cysteine indicated that no transchelation reaction occurs. Assessment of the in vitro 5HT(1A) receptor-affinity of the technetium complexes revealed that only the anti-PNP4 complex possesses some affinity for the receptor, but displayed negligible brain uptake in biodistribution studies in rats in vivo.

Animals↗
PubMedDate not supplied

Self-inflicted repetitive optic nerve injury: a case report.

PURPOSE: To describe an obsessive-compulsive patient who developed blindness after self-inflicted repetitive optic nerve injury. METHODS: Case report. RESULTS: A myopic 46-year-old male became blind as a result of intermittent rubbing of his eyes, causing stretching of the optic nerves. Extensive ocular, neurologic and systemic work-ups were negative. Cerebral and orbital MR studies showed severe bilateral optic nerve atrophy. Psychiatric evaluation confirmed obsessive-compulsive personality. CONCLUSIONS: Self-inflicted optic nerve injury should be included in the differential diagnosis of progressive optic neuropathy in a young adult.

Blindness↗
PubMedDate not supplied

Bilateral optic neuropathy associated with the crest variant of scleroderma.

We report a case of bilateral optic neuropathy associated with the CREST syndrome, a variant of scleroderma. Immunosuppressive therapy achieved significant improvement of the visual symptoms for two years. The pathophysiological mechanisms underlying this unique association remain unclear.

Adult↗
PubMedDate not supplied

Bilateral transient visual obscurations with headaches during alpha-II interferon therapy: a case report.

A 40 year-old woman receiving alpha interferon therapy for chronic active hepatitis C presented transient bilateral visual obscurations with associated visual field defects and headaches, with elevated cryoglobulin levels. These manifestations mimicked the clinical picture of migraine and were associated with worsening of previous moderate Raynaud's syndrome and diffuse paraventricular lesions of the white matter seen in cerebral MRI. Bilateral posterior cerebral transient ischemic episodes rather than an anterior visual pathway lesion were thought to be responsible for the clinical symptoms though the exact role of interferon in these vasospastic-like disorders remains speculative. Their possible relationship with increased cryoglobulinemia is uncertain. We suggest that Raynaud's phenomenon may have a predisposing role for these manifestations.

Adult↗
PubMedDate not supplied

Simultaneous 24-hour monitoring of intraocular pressure and arterial blood pressure in patients with progressive and non-progressive primary open-angle glaucoma.

We measured and compared diurnal and nocturnal blood pressure (BP) with the Space Labs Holter in progressive and non-progressive glaucomatous patients with a satisfactory diurnal control of IOP in order to identify any link between a progressive worsening of their visual field (VF) defects and the characteristics of their nocturnal BP "dip". Ambulatory 24-hour BP monitoring and inpatient IOP curves were done on two consecutive days on 36 patients (17 women, 19 men, mean age 67.44 +/- 8.06 years) with moderate to severe POAG and good diurnal therapeutic control of IOP (daytime IOP < or = 21 mm Hg). Depending on the stability or progression of their VF defects during the last two years, the patients were classified in two groups: the progressive group comprised 24 patients (14 women, 10 men) and the stable group 12 patients (9 men, 3 women). We compared local and systemic risk factors for POAG, mean and maximum daytime and nighttime IOP in each group. The mean systolic and diastolic daytime BP, mean systolic and diastolic nighttime BP and the nocturnal systolic and diastolic BP dip were calculated for each patient. The distribution of these parameters was then statistically compared with normal reference values and for the two groups. The groups were closely comparable as regards their IOP 24-hour profile. The overall mean daytime, nighttime, and nocturnal dips fell within the normal range of the reference population. We found a significanty smaller systolic and diastolic BP dip in the progressive group and a broader distribution of the lower values both for systolic and diastolyc BP in the progressive group. A broader distribution of the lower values for systolic and diastolic BP dip was also noticed when progressive patients were compared with the reference population. The relative absence of a nocturnal BP dip may be interpreted as another disturbing factor in the self-regulatory mechanisms of the optic nerve head in glaucoma.

Adult↗