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Biomedical subjects

A Parma

Publications and source records attributed to A Parma.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Cervical vertebral and spinal cord injury in intensive therapy].

24 of 184 patients with vertebro-medullary trauma admitted to the Neurosurgery Clinic of Milan University in the years 1976-1988 have been examined. A common feature of these was a myelic lesion (transverse, complete or incomplete) at cervical level in which respiratory problems had made a period of intensive care indispensable. The purpose of the research was to assess the reliability of certain parameters in establishing patient prognosis. The following parameters were compared: clinical, objective and instrumental examination for a strictly neurological evaluation and for an evaluation of general condition, quantification of the same clinical examination through two scales, the Sunnybrook Cord Injury Scale (SCIS) for the neurological factor and the APACHE II for general condition, the type of treatment, with the same basic medical-resuscitation treatment. The result of the surgery or non-surgery was considered a posteriori. It is concluded that, in the case of the patients considered (high myelic lesion) the prognosis must be split into two different moments that the patient goes through in succession: the acute phase and the stabilisation phase. In the first phase, in which the vital functions are involved, the SCIS and APACHE II scales (with their sum) have great prognostic value; in the second phase, certain values, already considered on the APACHE II scale, are comparable in all patients and the prognostic problem is based on the other scale (SCIS) and on the adjuvant neurophysiological techniques. The very distinction between the two different phases that the patient traverses appears important also for the purposes of surgical indication.2

Abbreviated Injury Scale↗
PubMed1989

[Diffuse traumatic cerebral injuries in children].

A consecutive series of 41 patients aged less than 16 and admitted to the Department of Neurosurgery of the University of Milan in the period 1977-1978 following serious cranioencephalic trauma with Glasgow Coma Score (GCS) less than or equal to 7, duration of coma longer than 24 h and CT picture of diffuse lesion has been examined. These patients account for 5% of the paediatric cranial traumas observed in the same period and 66% of those in a state of coma. The CT picture made it possible to split patients into 3 groups: a) those without visible cerebral lesions and with subarachnoid and cisternal spaces present; b) those with small hyperdense lesions due to intraparenchymal or median/paramedian subcortical shearing lesions; c) those with marked constriction or absence of the 3rd ventricle and of the perimesencephalic cisterns. The first two pictures (a, b) were considered to be the expression of diffuse axonal damage, the last (c) of diffuse cerebral swelling. Intracranial pressure was monitored in about 50% of patients. The overall outcome of the series was favourable in more than 68% of cases with total mortality of 26.8%. Analysis of individual tomographic categories, however, showed that whereas the group of patients with diffuse axonal lesion presented nil mortality, those with diffuse cerebral swelling had 52% mortality owing to the onset of refractory intracranial hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Chronic granular T lymphocytosis of undetermined significance].

The clinical, morphologic, immunologic, functional, serologic and cytogenetic features of 4 cases of chronic granular T cell lymphocytosis with neutropenia were studied. The records of these patients were reviewed and an infectious event preceding the development of the disorder could be documented in 3 cases, suggesting a cause and effect relationship. A benign monoclonal gammopathy was detected in the remaining patient. The clinical picture was characterized by moderate blood and bone marrow lymphocytosis, neutropenia, hepatosplenomegaly, absence of lymphadenopathy, and a stable course, observed over a period of up to 11 years. Surface marker analysis in all the patients showed the common membrane phenotype of granular T cell lymphocytosis (CD3+, CD4-, CD8+, Leu7+). One patient treated with steroid therapy had reversal of lymphocytosis and severe neutropenia, which both recurred after steroids were withdrawn. The disorder again resolved after pulse steroid treatment. From these findings and a review of the literature, we suggest that granular T cell lymphocytosis with the immunologic phenotype exemplified by our cases is a distinct reactive or immunoregulatory disorder. In view of the similarities in character to benign monoclonal B cell lymphocytosis and idiopathic paraproteinaemia, we suggest that this disorder be termed chronic granular T cell lymphocytosis of undetermined significance.

Adult↗
PubMed1989

[Idiopathic monoclonal gammopathy. Long-term study of 313 cases].

The records of 519 patients with a paraproteinaemia who where examined at our institutions before January, 1, 1983, were reviewed. After patients with multiple myeloma, macroglobulinemia, amyloidosis, lymphoma or related diseases had been excluded, 363 cases remained which fulfilled the criteria for a diagnosis of idiopathic monoclonal gammopathy (IMG). Also excluded were the cases in which follow-up efforts failed and those in which the paraprotein had disappeared. A long-term study was thus possible in 313 patients with IMG. They were arbitrarily subdivided into two groups: 213 patients with a follow-up of 5-8 years and 100 patients whose follow-up was longer than 8 years. Fourteen per cent of the patients from the former group and 18 per cent from the latter developed a malignant B cell dyscrasia, on the average this event becoming clinically detectable after 63 months (27-138 months) from initial recognition of the paraprotein. A retrospective analysis of the clinical data at the diagnosis of IMG, revealed that none of the patients could have been identified in advance in whom a malignant transformation later occurred.

Adult↗
PubMed1988

[Selective hypoaldosteronism with hyperkalemia. Clinical and physiopathological study of 22 cases with hypo- or hyperreninemia].

Twenty-two patients with selective hypoaldosteronism (SH) were studied. In 18 of them decreased levels of plasma renin activity (PRA) were associated with the syndrome: 12 patients showed the idiopathic form of SH, while in 6, the syndrome was attributable to the administration of non-steroid anti-inflammatory drugs. In the remaining 4 patients, the hypoaldosteronism was characterized by associated increased PRA levels but functional studies excluded a diagnosis of adrenocortical insufficiency. From a critical review of the literature and from the present observations it seems likely that SH is a syndrome with a heterogeneous pathogenesis. The possibility exists that the major alterations in potassium homeostasis that characterize the syndrome of SH, though mainly attributable to deficiency of aldosterone secretion may actually depend on the concurrence of underlying mechanisms, in particular on the presence of distal nephron dysfunctions.

Aged↗
PubMed1988

[Chronic idiopathic neutropenia: a benign hematological disorder].

Clinical data in 23 consecutive patients with chronic idiopathic neutropenia are reported. During a long-term follow-up (4 to 11 years), none had leukemia or autoimmune diseases. In particular, in no case did serious recurrent infections develop despite severe neutropenia. Immunological studies showed the presence of antibodies to neutrophils in a unique case and of the marker make-up of K lymphocytes in other two with chronic T8 lymphocytosis and associated neutropenia. The immunological features of this syndrome is briefly discussed. Chronic idiopathic neutropenia, even in the presence of an immunological imbalance, is a benign haematological disorder and does not need any treatment.

Agranulocytosis↗
PubMed1983

Specific and potent interactions of carbamazepine with brain adenosine receptors.

Carbamazepine, a drug effective in pain, seizure, and affective disorders, was screened for its ability to interact with a variety of neurotransmitter and neuromodulator binding sites on brain membranes. The most potent effect was observed on adenosine antagonist ( [3H]DPX) binding to the adenosine receptor (KI = 3.5 +/- 0.4 microM) followed by adenosine agonist ( [3H]CHA) binding (KI = 24.5 +/- 3.6 microM). Lower potency effects were observed on benzodiazepine receptors, and no inhibition was seen in a variety of other systems. The inhibition of adenosine receptor binding by carbamazepine was competitive. No correlation was observed between the potency of a series of carbamazepine analogs as inhibitors of either ( [3H]DPX, [3H]CHA or [3H]diazepam binding and their ability to inhibit electroshock-induced convulsions, suggesting that the anticonvulsant properties of these agents are not mediated by the adenosine receptor, but raising the possibility that other clinical effects of carbamazepine may relate to its ability to act at the adenosine receptor.

Animals↗
PubMed1982

Localization of monoamine oxidases A and B in primate brains relative to neuron-specific and non-neuronal enolases.

Using serotonin and phenylethylamine deamination as measures of MAO A and MAO B activity respectively, positive correlations were observed between the activities of MAO A and MAO B in different areas of rhesus monkey and human brains. When the activities of MAO A and MAO B were compared with those of neuron-specific enolase and nonneuronal enolase (isozymes which are markers for neurons and glia), a slight but non-significant correlation was observed, suggesting that a simple distribution of MAO A in neurons and MAO B in glia is unlikely. This conclusion is supported by studies using synaptosomes, but contrasts with that from investigations of MAO from peripheral tissues, where experiments indicate that MAO A is predominantly localized in neurones.

Animals↗
PubMed1981

[Sodium nitroprusside in neurosurgery. Clinical considerations].

The authors present their experience with SNP as hypotensive drug in surgery at cerebral aneurysms. They stress the effectiveness of SNP which they use to control deep hypotensive in 22 cases. SNP induces hypotensive in few minutes, without depressing myocardial and renal functions. The authors present also some criteria at selection of patients (to be treated with SNP during surgery) and stress the importance of monitoring blood gases during SNP hypotensive, especially te pO2 arteriovenous gradient. Using SNP at the recommended doses, and hydroxycobalamin as preventive treatment, no CN- toxicity was noted. The authors think SNP is the drug of choice for inducing deep hypotension in neurosurgery.

Adult↗
PubMed1978

Neuron specific protein (NSP) in neuroblastoma cells: relation to differentiation.

The spectrum of enolase enzyme forms has been examined in several lines of neuroblastoma cells and compared to those present in whole brain. The neuron specific enolase (NSP) is greatly decreased in the cultured cells as judged by activity profiles and radioimmunoassay. The synthesis of neuronal enolase appears to be extensively depressed in these cells while the total enolase activity is not affected. The non-neuron form of enolase (NNE) apparently compensates for the lack of the neuronal forms in the cultured cells. The preponderance of NNE in cultured neurons suggests that this enzyme is present in immature neurons, and that neuroblastoma cells are not fully differentiated with respect to the enolase function. Dibutyryl cyclic adenosine monophosphate treatment does increase NSP levels in mouse neuroblastoma cells, but not to the levels expected for fully differentiated neurons. The results indicate that NSP is a molecular correlate of fully differentiated neurons.

Animals↗