PubMed Health⌕ Search

Biomedical subjects

A Mottola

Publications and source records attributed to A Mottola.

At least 19 recordsLinked to original sources
PubMed2000

Does abnormal neuronal excitability exist in myotonic dystrophy? I. Effects of the antiarrhythmic drug hydroquinidine on slow saccadic eye movements.

The abnormal neuronal excitability hypothesized in myotonic dystrophy (MD) might contribute to psychomotor and behavioral disturbances of MD patients. To gain new insights into the pathophysiology of MD, we determined whether the antiarrhythmic drug hydroquinidine would ameliorate slow saccadic eye movements (SEMs), apathy and hypersomnia in MD patients. SEMs were selected as simple modality for psychomotor investigation. The study was conducted in a randomized, placebo-controlled, double-blind, crossover manner. Ten ambulatory patients without contraindications to hydroquinidine administration were enrolled. Hydroquinidine (450 mg/day) or placebo was given orally for 6 weeks with a washout period of 6 weeks between treatments. SEMs were recorded by electrooculography and analyzed by a computer system. Two patients withdrew in the first week of active treatment because of nausea and epigastralgia. Hydroquinidine significantly increased the normalized peak saccadic velocity and shortened the saccadic reaction time compared to placebo. The drug's effects on apathy and hypersomnia are presented in a companion paper.

Adult↗
PubMed2000

Does abnormal neuronal excitability exist in myotonic dystrophy? II. Effects of the antiarrhythmic drug hydroquinidine on apathy and hypersomnia.

An abnormal neuronal excitability in myotonic dystrophy (MD) might contribute to psychomotor and behavioral disturbances of MD patients. To gain new insights into the pathophysiology of MD, we determined whether the antiarrhythmic drug hydroquinidine could ameliorate apathy and hypersomnia besides slow saccadic eye movements in these patients. The study was conducted in a randomized, placebo-controlled, double-blind, crossover manner. Ten ambulatory patients without contraindications to hydroquinidine administration were enrolled. Hydroquinidine (450 mg/day) or placebo was given orally for 6 weeks with a washout period of 6 weeks between treatments. Apathy was evaluated by means of the apathy evaluation scale (AES) and hypersomnia by a sleep diary. Two patients withdrew in the first week of active treatment because of nausea and epigastralgia. The drug significantly reduced AES scores and daily sleep time compared to placebo. Thus, hydroquinidine can ameliorate apathy and hypersomnia in MD. However, the possibility of proarrhythmia and the high frequency of cardiac disturbances in MD seriously limit the therapeutic perspective. The effects on eye movements are presented in a companion paper.

Anti-Arrhythmia Agents↗
PubMed1999

[Early catheter removal after transurethral resection of the prostate].

BACKGROUND: Thanks to the introduction of new optical systems and advances in technology, transurethral resection is now the most widely used method in the management of prostatic adenoma. METHODS: A study has been carried out on 25 patients aged from 50 to 80 years submitted to an uncomplicated transurethral resection of the prostate for benign hyperplasia. Patients with intense retention of urine, capsular perforation, bladder neck undermining, considerable haemorrhage in the recovery room and postoperative fever have been excluded from the study. The urethral catheter which is normally removed 3 to 5 days post operatively, was removed within 24 hours of surgery. RESULTS: 80% of patients were discharged within 48 hours and the follow-up carried out by means of bacterial urinary culture, urinary pressure monitor and echography, showed that there were no significant complications. CONCLUSIONS: In conclusions, this study made it possible to select patients on which an early catheter removal is possible and to evaluate the real advantages of such a method.

Aged↗
PubMed1998

Hepatitis C virus infection and related chronic liver disease in a resident elderly population: the Silea Study.

The prevalence of hepatitis C virus (HCV) infection increases with advancing age, but the disease has been poorly studied in the elderly. A population-based study was therefore carried out to investigate the prevalence of HCV infection and the severity of HCV-related chronic liver disease in the elderly. One thousand and sixty-three people (> or = 60 years of age) were screened for antibodies to HCV (anti-HCV) and for possible abnormalities of common liver function tests. Positive subjects and sex and age-matched anti-HCV-negative controls were recalled 12 months later for measurements of liver enzymes, confirmatory testing of anti-HCV, HCV RNA analysis and HCV genotyping. All subjects answered a specific questionnaire concerning medical history and possible risk factors. Forty-four subjects were positive for anit-HCV, the prevalence being 4.1%. Thirty-five positive subjects and 35 controls were investigated further. Risk factors for acquiring HCV were found to be: blood transfusion, surgical intervention and the use of non-disposable syringes. Abnormal alanine aminotransferase levels were found in 13 patients (37.1%). HCV RNA genotyping showed type 1b in three (15.8%), type 2a in 13 (68.4%) and not classified in three (15.8%) patients. There was no relationship between abnormalities of serum aminotransferase, the rate of HCV RNA positivity and HCV genotypes. Ultrasound abnormalities were present in 13 (37.1%) patients. In this elderly population the relatively high prevalence of HCV infection was thought to be caused by previous parenteral exposure. The low incidence of liver disease could be related to the prevalence of HCV genotype 2a in the majority of these patients, and hints at the possibility of an HCV carrier state in elderly individuals.

Aged↗
PubMed1998

[Transitional cell carcinoma of the bladder in the first four decades of life].

BACKGROUND: The transitional cell carcinoma of the bladder is uncommon below the age of 40 years (1%). There is no univocity on the prognosis of such neoplasm. According to some authors such tumours are non invasive low-grade tumours with low recurrence and therefore an improved prognosis. But according to other authors bladder tumours do not have a different progression compared to tumours arising in older patients. METHODS: The authors present their experience on 28 patients, of whom 8 were under 30 years and 29 between 30 and 40 years of age. All patients had transitional carcinoma of the bladder with different grade and stage of tumour. All patients underwent an endoscopic or surgical treatment. RESULTS AND CONCLUSIONS: The follow-up of these patients show that tumours have a low grade of recurrence (5-10%) and an improved prognosis particularly in patients under 30 years.

Adolescent↗
PubMed1997

Relative sparing of extraocular muscles in myotonic dystrophy: an electrooculographic study.

We studied 40 patients with myotonic dystrophy (MD) to investigate whether saccadic eye movement (SEM) abnormalities have a central or peripheral origin. SEMs were recorded by electrooculography and analyzed by a computer system. Six patients were followed up to 2-7 years. Slow SEMs were present in 70% of patients, while saccadic latency and accuracy were within normal ranges. Peak saccadic velocity (PSV) did not correlate with disease duration and muscular disability, and showed a significant reduction only in 1 patient during the follow-up. Muscular disability correlated significantly with age and disease duration and worsened in 4 patients over time. The doll's head maneuver elicited vestibular compensatory eye movements with high velocities. These findings suggest that the extraocular muscles are at least partially spared in MD and that supranuclear structures, most likely the burst cells in brainstem reticular formation, may contribute to the slowing of SEMs.

Adolescent↗
PubMed1996

A one-stage dorsal free-graft urethroplasty for bulbar urethral strictures.

OBJECTIVE: To report the use of one-stage dorsal free-graft urethroplasty to reduce the incidence of urethrocele. PATIENTS AND METHODS: From 1990 to 1994, 20 men (age range 21-86 years) underwent a one-stage dorsal free-graft urethroplasty of bulbar urethral strictures (iatrogenic in 12, traumatic in three, inflammatory in three and unknown in two). All patients except one had been treated previously by optical urethrotomy from one to 14 times. RESULTS: Temporary fistulae were detected on post-operative urethrography in three patients with particularly long grafts, but they all resolved spontaneously. Within a mean follow-up of 46 months, only one patient had a short recurrent stricture, which was treated successfully by optical urethrotomy. Two patients complained of post-voiding dribbling, but radiographic studies never showed graft weakening and the urinary flow rate was always > 14 mL/s. CONCLUSION: Free skin grafts can be applied successfully to the dorsal aspect and by doing so the complications of urethral reconstruction can be reduced.

Adult↗
PubMed1996

[Granulomatous prostatitis].

Granulomatous prostatitis is a rare chronic inflammation and its etiology is not well understood. There is difficulty in differential diagnosis with prostatic cancer. But RMN and ultrasound guided biopsy can confirm the diagnosis. The authors report 15 cases and discuss etiological, clinical and diagnostic aspects.

Granuloma↗
PubMed1994

Verticillium peritonitis in a patient on peritoneal dialysis.

We describe a case of peritonitis due to Verticillium spp. in a 33-year-old farmer on continuous ambulatory peritoneal dialysis (CAPD) for 3 months for end-stage renal failure due to chronic pyelonephritis. The etiologic agent was a hyaline hyphomycete which we report as a new human opportunistic pathogen. The fungus was isolated from the peritoneal fluid culture and from the tip of the catheter; identification was made on the basis of macroscopic and microscopic features. The patient had previously been admitted to our hospital for peritonitis caused by mixed enteric flora and treated for 8 days with intraperitoneal broad-spectrum antibiotic therapy. Five days after discharge he was readmitted for severe abdominal pain and cloudy drainage fluid. Two days of intraperitoneal broad-spectrum antimicrobial therapy produced no clinical improvement. Intravenous fluconazole and oral flucytosine were administered upon identifying the fungus. After another 2 days without improvement, peritoneal dialysis was discontinued and the catheter removed. Antimycotic therapy was continued for 4 days with complete resolution of the peritonitis. The patient chose to start hemodialysis and was discharged in good clinical condition.

Adult↗
PubMed1994

[The post-adenomectomy dysuria-hematuria syndrome].

The dysuria syndrome consists of the persistence or accentuation following adenomectomy of the symptoms which caused the patient to seek the urologist's advice. It is frequent event whose causes are largely connected to physiopathological events which are also influenced by the developing role between the urologist and patients in view of prostate disease. The authors analyse the various causes of post-adenomectomy dysuria and emphasise the importance of a precise diagnosis and the correct indications for surgery for the prevention of this disease.

Hematuria↗
PubMed1994

Fungal peritonitis in peritoneal dialysis: critical review of six cases.

Fungal peritonitis (FP) is uncommon in patients on peritoneal dialysis (PD); it is difficult to treat and has a high mortality rate. We report 6 cases of fungal peritonitis observed between 1980 and 1992 in our center. The etiologic agents were: Candida spp., C. guilliermondi, C. parapsilosis, C. albicans, and Verticillium spp. All 6 patients had suffered at least one episode of bacterial peritonitis in the two months before the fungal infection appeared and were all treated by intraperitoneal administration of antibiotics. The catheter was removed early in 3 patients followed by antimycotic therapy, while the remaining 3 patients received antimycotic therapy, with removal of the catheter in a later stage. The result in the first group was that they all switched permanently to hemodialysis, while in the second group there were 2 deaths and 1 transfer to hemodialysis. In the light of these 6 cases, we analyzed 22 published reports to assess risk factors, therapy, and outcome of this pathology. The major predisposing factors were intraperitoneal antibiotics and bacterial peritonitis, and the best results were obtained by continuing PD plus intraperitoneal and systemic antifungal agents.

Adult↗
PubMed1994

[The planning and intervention for bilateral lift augmentation of the sinus floors in implant surgery. A case report].

The authors report a clinical case in which the inadequacy of bone to receive implants at the maxillary level was resolved by bilateral sinus elevation. In the reported case, two sinus elevations were performed as well as two isolations of the mental nerves and 10 osseointegrated implants under general anesthesia in a single session. In a preliminary approach, the patient was studied by CT using an acrylic mask to optimize the grafted sites and improve the interpretation of the CT scan imaging. A description is presented of the technique used for the sinus elevation. Clinical indications for this procedure are described as well as the replacement material. The sinus elevation procedure enlarges the area of utilization of osseointegrated implants and lends itself to a good application in the current studies on active molecules in the cell replication and in guided tissues regeneration.

Anesthesia, Dental↗
PubMed1990

[Fibroepithelial polyps of the ureter].

The fibroepithelial polyps is a rare benign tumor, that can rise at any level of the upper urinary tracts with a major predisposition at the pyeloureteral junction. The exact etiology is not known, even if we remember that chronic irritation, stasis and infection sometimes caused by an associated calculus are important factors in the genesis of the tumor. The authors report 3 new cases with ureteral seat, of which one is associated with a calculus. This fact underlines the importance of an exact differential diagnostic with the carcinoma as well for the conservative treatment as for the prognosis which is favourable.

Adult↗
PubMed1989

[Leydig cell tumor of the testis. Therapeutic and anatomopathologic clinical study of 2 new cases].

Tumors of the testis comprise 1% of male neoplasms. Interstitial cell tumors that originate in Leydig's cells account for 1 to 3% of these testicular tumors. A prognosis is difficult to make since these rare neoplasms manifest clinically in variable forms and it is extremely difficult to distinguish the benign from the malignant. Two new cases of this rare tumor type seen at the Department of Urology of the University Hospital of Florence are reported. The literature is reviewed, highlighting the clinical aspects, particularly the symptomatic, histopathologic, and the differential diagnostic features of the less and highly malignant forms. Furthermore, a protocol for selecting the therapeutic modality for this rare neoplasm is described.

Adult↗