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Biomedical subjects

A Muratorio

Publications and source records attributed to A Muratorio.

At least 37 records · Page 2Linked to original sources
PubMed1994

Clozapine in Huntington's chorea.

In an open-label trial, we evaluated the efficacy of clozapine on abnormal involuntary movements in five patients with Huntington's chorea. We administered clozapine at increasing doses of 25, 50, and 150 mg/d for 3 weeks. Subjective self-evaluation of all patients reported reduction of chorea and improvement of daily living activities. At the end of the trial, all patients requested to continue with clozapine. Objective evaluation with the Abnormal Involuntary Movements Scale demonstrated in all patients moderate-to-marked reduction of abnormal involuntary movements without any significant side effects; the improvement was dose-dependent and markedly decreased 1 week after drug withdrawal.

Clozapine↗
PubMed1993

Apomorphine test for dopaminergic responsiveness: a dose assessment study.

The clinical diagnosis of idiopathic Parkinson's disease (IPD) remains difficult and is supported by a favorable response to levodopa, while failure to respond represents an exclusion criterion. Recently, the response to subcutaneous apomorphine has been suggested as a tool in predicting levodopa responsiveness in parkinsonian syndromes. We administered apomorphine at doses of 10, 50, and 100 micrograms/kg subcutaneously against placebo over two consecutive days in 37 patients with parkinsonism and evaluated the motor response for 90 min after each dose. Subsequently, we compared the motor response with the follow-up response to levodopa therapy and to a final diagnosis. Twenty-seven patients of 37 showed a positive response to apomorphine, and 10 had a negative response. All positive responses to the apomorphine test were obtained with 50 or 100 micrograms/kg doses. Because of the high frequency of side effects with the dose of 100 micrograms/kg, 50 micrograms/kg seems more useful. After an adequate period of levodopa/carbidopa therapy (12-month follow-up), 29 patients improved; 25 of these had demonstrated a positive response to the apomorphine test. The final diagnosis of IPD, made on the basis of an exhaustive clinical and neuroradiological evaluation and on the response to chronic levodopa therapy, was in good agreement with the response to the apomorphine test (predictivity of diagnosis, 86.4%). Our data indicate that subcutaneous apomorphine at the dose of 50 micrograms/kg is a useful tool in the differential diagnosis of parkinsonian syndromes.

Aged↗
PubMed1992

Apomorphine in malignant syndrome due to levodopa withdrawal.

We report a case of neuroleptic malignant syndrome (NMS) following abrupt reduction of chronic levodopa treatment in a 71 year old female parkinsonian patient. The NMS resolved within 24 hours of the addition of apomorphine to levodopa therapy.

Aged↗
PubMed1992

Cerebral ischemia and livedo reticularis in a patient with impairment of coagulation factor VII and free protein S.

The association of ischemic cerebrovascular lesions with livedo reticularis is known as Sneddon syndrome. It affects young subjects, primarily women, and its neurological manifestations are TIAs, ischemic stroke, progressive dementia and epileptic seizures. Its etiopathogenesis has still to be clarified. Some authors have associated it with an antiphospholipid antibody syndrome. Recently it has been assumed that a defect in blood coagulation may be involved in its pathogenesis. Here we report a case in which both an increase in coagulation factor VII activity and a deficiency in free protein S were documented.

Adult↗
PubMed1992

Ocular myopathy without ophthalmoplegia can be a form of mitochondrial myopathy.

To characterize muscle pathology in 3 cases affected by ocular myopathy with eyelid ptosis and upper facial weakness, but without ophthalmoplegia, light microscopy and ultrastructural study were performed on levator palpebrae, orbicularis oculi and deltoid muscle biopsies. While levator palpebrae proved uninformative because of the massive fibrous degeneration of muscle, orbicularis oculi biopsies showed histochemical and ultrastructural alterations indicating a mitochondrial involvement, resembling that reported in ocular mitochondrial myopathies (OMM). On the other hand very mild aspecific findings were observed in deltoid. We suggest that these cases with ocular myopathy and without ophthalmoplegia should be considered a partial or initial form of OMM.

Adult↗
PubMed1992

Variability of the expression of muscle mitochondrial damage in ocular mitochondrial myopathy.

In this study we comparatively analysed deltoid histochemistry, biochemistry and mitochondrial DNA (mtDNA) in two groups of ten sporadic ocular mitochondrial myopathies (OMM), respectively with and without ragged red fibres (RRF). (1) All but one RRF--patients presented the mild form of OMM with blepharoptosis but without ophthalmoplegia; (2) the occurrence of cytochrome c oxidase deficient (COX-) fibres was significantly higher in the RRF+ group, but four RRF- cases also showed COX- fibres; (3) no difference was observed in biochemical findings between the groups; (4) two RRF- patients without COX- fibres showed mtDNA heteroplasmy; (5) in two RRF- patients without deltoid mtDNA deletion, biopsy of an eyelid muscle showed significant mitochondrial alterations. These results suggest that the expression of a mitochondrial defect can vary and that the absence of RRF in a skeletal muscle biopsy does not necessarily rule out the diagnosis of OMM, if other data support that.

Adolescent↗
PubMed1992

Dream structure in Parkinson's patients.

Dream reports of patients with Parkinson's disease (PD) were analyzed to ascertain whether cognitive deficits associated with this nonfocal brain pathology influence dream structure or dream recall. Fifteen outpatients with idiopathic PD were sampled (diagnosed from 1 to 10 years and currently in stage II or III of Hoehn and Yarh's scale); all were without psychiatric symptoms or major medical illnesses and were currently being treated with L-dopa. After an adaptation night in the sleep laboratory, each patient spent a night in which he/she was awakened at least twice in rapid eye movement sleep and asked to report dream experience. Thirteen patients were able to report at least one dream. Overall frequency of dream recall (71.4%) was fully compatible with normative data for the elderly. Multiple regression analyses showed that both the length of the dream report as story and the organization of contents into coherent episodes (analyzed using Mandler and Johnson's story grammar) varied significantly in relation to level of cognitive functioning and, in part, of language comprehension, but not in relation to age, illness duration, and dose of L-dopa.

Age Factors↗
PubMed1991

Domperidone-induced acute dystonia and polycystic ovary syndrome.

The occurrence of acute dystonic reactions (ADRs) due to domperidone administration in two young women is reported. In both patients, a typical polycystic ovary (PCO) syndrome was found. The possibility that the relative hyperestrogenism typical of PCO syndrome acted as a facilitating factor for ADR is discussed.

Adolescent↗
PubMed1991

Platelet peripheral benzodiazepine receptors are decreased in Parkinson's disease.

Peripheral benzodiazepine (BDZ) receptors are located in a variety of tissues, including platelets, in the nuclear and/or mitochondrial membranes. We studied the density of peripheral BDZ receptors in platelets of 10 de novo Parkinson's disease (PD) patients, 18 PD patients treated with a levodopa/carbidopa combination, and in 15 healthy subjects matched for sex and age. The binding assay was conducted using [3H]PK 11195, a specific ligand for peripheral BDZ receptors. A significant decrease in the density of [3H]PK 11195 binding sites has been observed in PD patients with respect to controls (p less than 0.01), but not between de novo and treated PD patients. No correlation has been found between the decrease in density of [3H]PK 11195 binding sites in platelets and either the duration or severity of PD. Peripheral BDZ receptors are implicated in the regulation of mitochondrial respiratory function. Thus, their decrease in PD might parallel the abnormalities in mitochondrial function recently found in this neurologic disease.

Aged↗
PubMed1991

Naloxone partly counteracts apomorphine side effects.

The effects of naloxone on side effects provoked by apomorphine (APO) administration in patients with parkinsonian syndrome have been studied. The group under study included eight patients with Parkinson's disease and four with parkinsonism who received 100 micrograms/kg s.c. APO acutely to test dopaminergic responsiveness. All patients were treated with 20 mg domperidone tablets t.i.d. and then for 2 consecutive days (in double blind fashion) were given a 2-hour i.v. saline infusion alone or with naloxone (8 mg) starting 30 min before APO administration. In both groups, naloxone delayed the appearance of sleepiness, and reduced the intensity of yawning, sleepiness, nausea, and vomiting as compared with saline. These findings indicate a potential usefulness of naloxone and other opioid antagonists in preventing acute APO side effects.

Apomorphine↗
PubMed1991

Altered neuroendocrine regulation of luteinizing hormone secretion in postmenopausal women with Parkinson's disease.

The secretion of gonadotropins and the role exerted by the endogenous opioid system on luteinizing hormone (LH) secretion were investigated in 6 postmenopausal women affected by idiopathic Parkinson's disease (PD) as well as in 6 age- and weight-matched normal postmenopausal women as controls. The mean plasma follicle-stimulating hormone (FSH) and LH levels were evaluated both under basal conditions and after 20 days of conjugated estrogen administration (1.25 mg/day). At the same time, the activity of the endogenous opioid system was evaluated, as well as the LH response to the 4-hour infusion of the opioid antagonist naloxone (1.6 mg i.v. bolus followed by 1.6 mg/h). Both before and during estrogen administration, plasma FSH levels were similar in the two groups of subjects, whereas plasma LH levels were significantly lower (p less than 0.01) in parkinsonian than in control women. In each subject estrogen administration significantly blunted (p less than 0.01) plasma FSH levels. Plasma LH levels were reduced only in controls (p less than 0.05), but not in women with PD. In each subject, before estrogen administration, the plasma LH levels did not vary during naloxone infusion. In control women after 20 days of estrogen administration, the plasma LH levels significantly increased during naloxone infusion (p less than 0.01). By contrast, in women with PD, conjugated estrogens failed to restore the LH response to naloxone. The present results suggest that the neurotransmitter mechanisms, which regulate LH secretion, are altered, and, in particular, the activity of the endogenous opioid system is deficient in women with PD.

Aged↗
PubMed1990

Reduced luteinizing hormone secretion in women with Parkinson's disease.

Plasma luteinizing hormone (LH) levels were significantly lower in 10 postmenopausal women with Parkinson's disease (PD) compared to age-matched controls. The remaining hypophyseal hormones and gonadal steroids were similar in PD patients and in controls, suggesting a selective alteration of hypothalamic dopaminergic mechanisms which regulate LH secretion.

Aged↗
PubMed1990

Increased platelet 3H-imipramine binding and monoamine oxidase B activity in Alzheimer's disease.

Several biochemical abnormalities in peripheral tissues have been reported in Alzheimer's disease (AD). With this in mind we studied platelet monoamine oxidase B (MAO B) activity and 3H-imipramine (IMI) binding in both AD patients and healthy subjects and found a significantly higher level of platelet MAO B activity and 3H-IMI Bmax values in the AD patients. In view of the part that MAO B plays in metabolizing serotonin (5HT) and of the relationship which exists between 3H-IMI binding and 5HT uptake, our results would suggest that with AD there occurs a complex dysfunction in the 5HT system, at least at a peripheral level.

Aged↗
PubMed1990

Circulating thyroid and gastric parietal cell autoantibodies in patients with multiple sclerosis.

Multiple sclerosis (MS) is associated with complex abnormalities of immunoregulation and a role of autoimmunity in its pathogenesis has been accepted. MS is reportedly associated with several autoimmune diseases, but few studies are available on the prevalence of organ-specific autoantibodies in this condition. The aim of this study was to assess the frequency of anti-thyroglobulin (TgAb), anti-thyroid microsomal (MAb) and gastric parietal cell (PCA) antibodies in 113 patients (63 females, 50 males, age ranging 15-62 years) with MS and in 51 neurological controls. The diagnosis of MS was made according to McDonald and Halliday criteria. TgAb and/or MAb were detected by passive hemagglutination in 19 (16.8%) patients with MS and in 3 (5.9%) of the controls. All positive TgAb and/or MAb were observed in MS females (19/63 = 30.1%), with significantly higher frequency than in female controls (X2 = 5.15, p less than 0.025). The presence of circulating thyroid antibodies was higher in patients with clinically definite or progressive probable MS and in those with long standing disease. In contrast with thyroid antibodies, no difference in the frequency of PCA, as assessed by radioimmunoassay, was observed between MS and controls. These data support a specific association between thyroid autoimmunity and MS. The appearance of thyroid autoimmune phenomena seems to be related to the reliability of the diagnosis of MS and the duration of the disease.

Adult↗