Biomedical subjects

B Napolitano

Publications and source records attributed to B Napolitano.

At least 19 recordsLinked to original sources

PubMed2005

Brain-derived neurotrophic factor val66met polymorphism and volume of the hippocampal formation.

Magnetic resonance (MR) imaging studies have identified hippocampal structural alterations in the pathogenesis of schizophrenia. Brain-derived neurotrophic factor (BDNF) is one of the neurotrophins that is widely expressed in the hippocampal formation and has been implicated in the neurobiology of schizophrenia. Polymorphisms in the BDNF gene may therefore confer risk for schizophrenia through hippocampal pathogenesis and/or making the hippocampus more susceptible to environmental insults. In this study, we investigated whether val66met, a functional and abundant missense polymorphism in the coding region of the BDNF gene, was associated with the volume of the hippocampal formation in 19 patients with first-episode schizophrenia and 25 healthy volunteers. A total of 124 contiguous T1-weighted coronal MR images (slice thickness=1.5 mm) were acquired through the whole head using a 3D Fast SPGR IR Prep sequence on a 1.5 T GE imaging system. Volumes of the right and left hippocampal formation were measured manually by an operator blind to group status and genotype. All participants were genotyped for the BDNF val66met locus. Mixed model analyses revealed a main effect of BDNF val66met genotype such that in the combined sample of patients and healthy volunteers, val/val homozygotes (N=27) had larger volumes of the hippocampal formation compared to val/met heterozygotes (N=17). In separate analyses by group, however, val66met genotype accounted for a greater proportion of the variance in the volume of the hippocampal formation in patients compared to healthy volunteers. These findings implicate genetic involvement of BDNF in variation of human hippocampal volume and suggest that this effect may be greater among patients compared to healthy volunteers.

Adult↗

PubMed2004

Impaired postural control in patients affected by tension-type headache.

Sixteen subjects, affected by chronic tension-type headache (TTH) accordingly to the International Headache Society Classification (1988) criteria, in presence of tenderness in pericranial muscles,with a mean age of 37+/-11.8 years, and ten healthy volunteer subjects, age and sex matched, were submitted to postural analysis by Static Posturography (S.Ve.P. Amplaid). Aim of the study was to evaluate whether patients with TTH have disturbed postural control, as compared to normal subjects. Postural analysis considered all posturographic variables but focused on spectral frequency analysis of body sway. In both open (OE) and closed eyes (CE) condition, spectral frequency analysis showed a significantly increased body sway at low (OE= p < or = 0.01; CE= p < or = 0.01) and middle (OE= p < or = 0.01; CE= p < or = 0.01) frequencies on the antero-posterior (y) plane and at low frequencies (OE= p < or = 0.05; CE= p < or = 0.05) on the lateral (x) plane. Statistical analysis was performed using the Student's t test for unpaired data, p value 0.05 defined significant. The proprioceptive input seems to be predominant at middle and high frequencies in maintaining posture, our results seem then to suggest a proprioceptive disturbance in TTH patients. The disturbance is likely related to chronic pericranial muscle contraction and tenderness. Posturography and spectral analysis may help not only in the diagnosis of a postural disturbance but even more in the follow-up of TTH patients, during and after a medical and/or a rehabilitative treatment.

Adult↗

PubMed2004

Nose: aesthetics and function. Rhinoplasty and functional problems related to anterior ethmoid.

Aesthetic nasal surgery has progressed in the last years, as concerning both surgical techniques and surgical instruments, which allowed the finding of new and more sophisticated surgical solutions. Clinical practice led to observe sometimes functional surgical failures, due rather than an inaccurate surgical technique, to an incomplete diagnostic approach to the patient. It has been observed that modifying the external conformation of nasal pyramidis inner-nose volumes and spaces will be subsequently reduced, giving as a result a condition which is only aesthetically but not functionally valid. 32 subjects, selected for a rhinoplasty and presenting nasal respiratory obstruction and anterior ethmoid abnormalities, confirmed by nasal endoscopy and nasal CT, were evaluated and subdivided into two groups: the first (A) group underwent only to an aesthetic rhinoplasty, the second group (B) was operated of a rhinoplasty combined with functional endoscopic sinus surgery (FESS) in order to correct the above mentioned anatomical abnormalities. The nasal airflow, and though the nasal cavities patency, was evaluated pre- and post-operatively in the two groups of patients, referring to rhinomanometric conductance values. Patients of group A reported decreased post-operative conductance values, patients of group B reported increased post-operative conductance values, showing though the functional involvement of anterior ethmoid in nasal obstruction and the necessity of correcting its anatomical abnormalities, in order to reach not only a new nasal profile, but also a better respiratory performance.

Adolescent↗

PubMed1999

Numerical dose-compensated in vitro fertilization inseminations yield high fertilization and pregnancy rates.

OBJECTIVE: To evaluate in cases with morphologically abnormal sperm whether fertilization and pregnancy rates are increased by normalizing the number of sperm inseminated and whether biomarkers can identify cases of reduced or failed fertilization. DESIGN: Prospective studies of sperm morphology and function. SETTING: University hospital assisted human reproduction program. PATIENT(S): Partners of 308 women undergoing IVF. INTERVENTION(S): Motile sperm populations were assessed for sperm head morphology, for surface receptors for mannose and progesterone binding, and the ability to undergo a free mannose-induced acrosome reaction. Zinc in seminal plasma was determined by atomic absorption spectroscopy. MAIN OUTCOME MEASURE(S): Sperm morphology was associated with fertilization and clinical pregnancy rates. Biomarker analyses were correlated with fertilization rates using Kruskal-Wallis tests, chi2 tests, and Spearman rank order correlations. RESULT(S): Fertilization and pregnancy rates after numerical dose compensation inseminations were indistinguishable between men with differing percentages of normal sperm. Biomarker deficits were identified irrespective of sperm head morphology in 96% of cases of reduced or failed fertilization. CONCLUSION(S): Fertilization and pregnancy rates in cases of abnormal morphology are optimized by inseminating at least 25,000 sperm/mL with normal acrosomes. Reduced or failed fertilization can be predicted by testing for molecular deficits in mannose receptor expression and mannose-stimulated acrosome loss.

Biomarkers↗

PubMed1998

Electrophysiological changes in children with learning and attentional abnormalities as a function of age: event-related potentials to an "oddball" paradigm.

This study investigated age-related electrophysiological differences between children diagnosed with Learning Disabilities (LD), Attention Deficit Hyperactivity Disorder (ADHD), LD-ADHD and Conduct Disorder, using Event-Related Potentials recorded during a two-tone discrimination test. Although age-related (N1 and N2 amplitude), as well as diagnostic group-related (P3 latency and amplitude) ERP changes were found, there was no significant interaction between the diagnostic groups and age grouping. We conclude that: 1) Electrophysiological abnormalities in LD and ADHD do not significantly change with age during childhood. This study does not, therefore, support a hypothesis of age-related brain abnormalities in LD and ADHD. 2) Significant group differences for P3 latency and amplitude were found between normal children and the LD groups (LD and LD-ADHD), but not between normal children and those with ADHD alone, suggesting that main correlates of P3 abnormalities in these children are "processing" and not attentional problems.

Adult↗

PubMed1996

24-hour blood pressure monitoring in patients with anterior ischemic optic neuropathy.

OBJECTIVE: To define parameters of ambulatory diurnal blood pressure in patients who had experienced anterior ischemic optic neuropathy (AION) in a case-controlled study. PARTICIPANTS AND METHODS: Twenty-four patients with AION and 24 control subjects who were matched for age, gender, medical diagnoses, and medications underwent ambulatory automated blood pressure monitoring for 24 hours. RESULTS: The overall diurnal pattern of blood pressure appeared to be normal in all subjects, showing lower blood pressures at night than during the day, an overnight nadir, and an ascending blood pressure curve in the morning to reach daytime levels. Also, patients with AION did not differ from control subjects with respect to the nighttime diastolic nadir or daytime peak systolic blood pressure. However, during the daytime, patients with AION had lower mean systolic and diastolic blood pressures than did matched control subjects. The widest difference between their blood pressure curves occurred after awakening in the morning, when patients with AION had a less steep and more irregular rise of blood pressure. Patients who had signs of vertebrobasilar insufficiency in addition to AION had lower mean diastolic blood pressure during both daytime and nighttime and a lower minimum daytime diastolic blood pressure. CONCLUSIONS: On ambulatory measurements of diurnal blood pressure, patients with AION consistently had a lower mean blood pressure than did control subjects and a lag in the usual rise in blood pressure in the morning to meet increasing daytime demands for perfusion. Chronic hypoperfusion of small end-arterial vessels that supply the optic nerve head may predispose to AION, and may be caused by relative hypotension owing to overtreated hypertension or to abnormal vascular autoregulation. Internists should be asked to monitor blood pressure carefully when treating hypertensive patients who are at risk for AION, to avoid hypotension, especially on awakening in the morning.

Aged↗

PubMed1996

Home hemodialysis: patient outcomes during a 24-year period of time from 1970 through 1993.

In the United States, from 1983 to 1993, home hemodialysis use has decreased from 6% to 1.3% of the dialysis population, whereas continuous ambulatory peritoneal dialysis (CAPD) has increased to 20%. Most home hemodialysis programs have withered away because of current patient mix, increase in CAPD, proliferation of outpatient centers, disinterest in nephrologists, and fear of self-cannulation by patients. From 1970 through 1993, 896 patients began dialysis at North Shore and were followed up through 1994. During this period, 687 patients were on in-center hemodialysis, 95 on CAPD, 74 on home hemodialysis, and 40 on in-center peritoneal dialysis. The home hemodialysis patients were younger, with a median age of 44 versus 59 years for in-center hemodialysis patients, and had less comorbidity. The home hemodialysis group had fewer diabetic patients and no renal vascular patients. The 5-year and median survival estimates were significantly better for the home hemodialysis patients versus other dialysis modalities. More home hemodialysis patients received transplants. Compared with the other dialysis modalities, home hemodialysis patients showed significantly improved survival rates. When matched by age, sex, and end-stage renal disease (ESRD) diagnosis to corresponding in-center hemodialysis, the home hemodialysis patients still had significantly better survival rates, but the home hemodialysis patients had less comorbidity. In conclusion, home hemodialysis patients survive longer and have better rehabilitation than other dialysis patients. Reasons for better survival in addition to a younger age and more favorable ESRD diagnosis may include less comorbidity, more patient involvement, and longer dialysis time. Because of these better outcomes, home hemodialysis should be offered to more ESRD patients.

Adult↗

PubMed1996

Laboratory diagnosis of infection status in infants perinatally exposed to human immunodeficiency virus type 1.

Accurate and timely diagnosis of infection status in infants born to women infected with human immunodeficiency virus (HIV) is of paramount importance. The comparative accuracy of five diagnostic decision rules was evaluated in 208 HIV-exposed infants (32 infected, 176 uninfected) based on laboratory testing during the first 6 months of life. Diagnostic rules A and B, which required single blood samples analyzed by culture and polymerase chain reaction (PCR) (rule A) or culture, PCR, and p24 antigen detection (rule B) were more prone to incorrect diagnoses than were rules requiring 2 blood samples analyzed by a single assay (rule C) or combinations of culture and PCR (rules D and E). Rule D, which used PCR as the initial test, established the most useful algorithm: a positive PCR result followed by a positive culture in the second sample confirmed infected status, while two consecutive negative PCR results reconfirmed as negative at 6 months of age established uninfected status.

Blood↗

PubMed1996

Visual event related potentials and reaction time in normal adults, normal children, and children with attention deficit hyperactivity disorder: differences in short-term memory processing.

Visual Event Related Potentials were recorded during a memory search paradigm in 30 normal adults, 17 normal children, and 14 children with Attention Deficit Hyperactivity Disorder (ADHD). Group differences were found in P3 latency and amplitude, Reaction Time and number of errors. The findings indicate a different information processing pattern for ADHD children who possibly use a "self-terminating" as opposed to "exhaustive" search strategy.

Adolescent↗

PubMed1995

Unmet analgesic needs in cancer patients.

This study was designed to characterize unmet analgesic needs in a group of cancer patients. One hundred one inpatients were surveyed to document pain prevalence and intensity, satisfaction with pain control and factors associated with unmet analgesic needs during the week prior to admission. Forty-four percent had unmet analgesic needs, defined as pain of moderate or greater than moderate intensity. These patients had a significantly greater prevalence of bone and axillary node involvement, higher than pain intensity, and less satisfaction with pain control. Fifty-nine percent were satisfied with pain control. Dissatisfaction was associated with higher usual pain intensity, less satisfaction with physician information about pain etiology, less frequent attribution of pain to disease, sharp pain, constant and intermittent pain, patient perceptions of less physician concern about pain, patient and physician belief that the patient is receiving insufficient analgesic, and patient wanting more control over analgesic regimen. Patients may benefit from improved treatment of specific syndromes and by attention to communication.

Aged↗

PubMed1994

Eating attitudes in urban and suburban adolescents.

We administered the Eating Attitudes Test (EAT), Rosenberg Self-Esteem Scale, and Spielberger Trait Anxiety Inventory to two populations of high school students. The first group, 268 suburban females (mean age 16.2 years), completed their questionnaires in May 1988. The second population, 389 females and 281 males (mean age 16.0 years) in a city school with 92% black of Hispanic students, completed their questionnaires in February 1990 and were also measured for height and weight as part of a health screening. Scores of 21 or higher on the EAT-26 were achieved by 17.5% of the suburban females, 15.0% of the urban females, and 6.0% of the urban males. Significantly more suburban females (63%) considered themselves overweight, compared with both urban females (35%) and males (19%), yet only 14% of suburban females were calculated to be > 10% over ideal body weight, compared with 45% of urban females and 39% of urban males. Contrary to expectations, self-esteem was higher and anxiety lower in the urban students than the suburban students; self-esteem and anxiety were each significantly correlated with higher EAT scores in both populations, but believing oneself overweight was correlated with higher EAT scores in only the suburban students. These data indicate that abnormal eating attitudes are present among both urban and suburban students but with important differences in their manifestations and implications.

Adolescent↗

PubMed1994

The value of routine screening of female serum for antisperm antibodies in assisted reproductive technology cycles.

OBJECTIVE: To determine the effect of antisperm antibodies in the female serum on fertilization and pregnancy rates (PRs) in assisted reproductive technology (ART) cycles. DESIGN: Retrospective case control study. SETTING: Assisted reproductive technology program at North Shore University Hospital. PATIENTS, PARTICIPANTS: All patients undergoing an ART cycle in 1990 whose husbands did not have significant antisperm antibodies in the semen. Thirty-four female patients had significant antisperm antibodies level in the serum (antisperm antibodies-significant); 62 patients with no antibodies or nonsignificant levels constituted the control group (antisperm antibodies-negative). Incubation media were prepared with maternal serum in 37 of the antisperm antibodies-negative and in 10 of the antisperm antibodies-positive patients, whereas donor's serum (DS) was used for 25 and 24 patients, respectively. MAIN OUTCOME MEASURES: Fertilization rate and clinical PR, defined as an intrauterine sac by transvaginal ultrasonography, were recorded for each group. RESULTS: Analysis of variance showed a significant interaction between antisperm antibodies grouping and the type of media used, with fertilization rate in antisperm antibodies-significant patients significantly higher with maternal serum than with DS, whereas fertilization rate in antisperm antibodies-negative was quantitatively, though not statistically lower with maternal serum than with DS. When maternal serum was used, fertilization was higher in antisperm antibodies-significant than antisperm antibodies-negative. Of 29 clinical pregnancies, 11 were in antisperm antibodies-significant and 18 in antisperm antibodies-negative. In 10 of the pregnancies, maternal serum was used, whereas in 19 pregnancies DS was used. No variable was significantly predictive of pregnancy in the logistic regression analysis. CONCLUSIONS: [1] Female patients with significant levels of antisperm antibodies in the serum had similar fertilization rates as patients with nonsignificant levels if DS was used. [2] The use of maternal serum in antisperm antibodies-significant patients did not result in inferior fertilization rates or the occurrence of pregnancy. [3] These findings suggest that a female antisperm antibodies may not hinder fertilization in vitro. [4] This study questions the value of routine screening of female serum for antisperm antibodies in ART.

Adult↗

PubMed1994

Renal vascular disease causing end-stage renal disease, incidence, clinical correlates, and outcomes: a 20-year clinical experience.

In the United States, the incidence of end-stage renal disease to hypertension has increased sharply over the last 8 years, especially in elderly white dialysis patients who demonstrate very poor survival rates. The 5-year survival rates were near 20% for patients 65 to 74 years old and 9% for those > or = 75 years of age. Our program experienced a sharp increase in cases of end-stage renal disease due to renal vascular disease after 1982. Renal vascular disease was characterized clinically in 83 of 683 dialysis patients either by angiography or asymmetric kidney size in patients with evidence of systemic atherosclerosis, hypertension, insignificant proteinuria, and a benign urinary sediment. The median age was 70 years, with 84% of the patients being older than 61 years. These patients had 56% 2-year, 18% 5-year, and 5% 10-year survival rates, which are quite similar to the 1992 US Renal Data System data. Patients with renal vascular disease have a significantly worse prognosis than other diagnostic groups, most likely due to their older age, underlying vascular disease, and coronary artery disease. We feel that a significant number of elderly white hypertensive patients described in the 1992 US Renal Data Service report have renal vascular disease as a cause of end-stage renal disease, highlighting the need to establish correct renal diagnoses. Hypertension should not be the end-stage renal disease diagnosis in elderly white hypertensive patients if clinical criteria suggest a diagnosis of renal vascular disease.

Adult↗

PubMed1994

Event-related potentials to an "oddball" auditory paradigm in children with learning disabilities with or without attention deficit hyperactivity disorder.

Event Related Potentials (ERP) were recorded during a two-tone discrimination task in 18 children with Learning Disabilities (LD) and 36 children with Learning Disabilities and Attention Deficit Hyperactivity Disorder (LD-ADHD). Twenty-seven normal children served as a control group. P3 wave amplitude was significantly smaller in the LD and LD-ADHD groups compared with normal children. There was no difference between the LD and LD-ADHD groups. It is suggested that the smaller P3 amplitude in children with LD-ADHD syndromes reflects cognitive and processing difficulties, which frequently coexist with ADHD in these children and is not specifically related to an attention deficit.

Attention Deficit Disorder with Hyperactivity↗

PubMed1994

Survival estimates for 683 patients starting dialysis from 1970 through 1989: identification of risk factors for survival.

Survival estimates were performed on 683 chronic dialysis patients who started dialysis from 1970 through 1989 and followed through 1991. Patients were grouped by dialysis type, renal diagnosis, start-year group and age at start. During these 20 entry, years, the median starting age rose from 47 to 61 years. Patients with a renal diagnosis of diabetes mellitus or renal vascular disease increased to 41% of those starting dialysis during the last 8 years of study. Survival analysis for all of the 683 patients revealed a 51-month median survival and a 43% and 23% 5- and 10-year survival estimates, respectively. There was nearly a fourfold rise in the risk ratio as age increased from the youngest to oldest age groups. Home hemodialysis patients had the longest survival, 89% at 5 years; patients on CAPD had a 56% 5-year survival. In-center hemodialysis patients had a median survival of 48 months and a 5-year survival of 39%. Pairwise comparisons of the renal diagnostic groups found patients with polycystic kidneys, interstitial disease and chronic glomerulonephritis to have better survival than patients with diabetes mellitus, renal vascular disease or the "other" diagnoses (log-rank test, p < 0.001). Survival analyses showed age, renal diagnosis, race, type of dialysis and dialysis modality switch to be important predictors of survival. The results of the survival estimates, gross mortality rates and standardized mortality ratios were used as guides to the adequacy of dialysis and quality of care delivered for the years 1989 through 1992.

Age Factors↗

PubMed1993

Death by withdrawal from dialysis: a 20-year clinical experience.

The reasons for withdrawal from dialysis are not well understood. The goals of this study were to determine the risk of dying by withdrawal from dialysis over time and to elucidate pertinent clinical correlates in 716 long-term dialysis patients. These patients were monitored from the initiation of dialysis through the time of death, transplant or transfer to another program during a 20-yr period from 1970 through 1989. The causes of death in the 340 deceased patients were analyzed. Clinical correlates and associated risk factors were evaluated in the patients who died from withdrawal from dialysis. Withdrawal from dialysis was defined as: "Death with manifestations of uremia because of withdrawal from dialysis. Underlying medical conditions should not have been active, leading to rapid deterioration with imminent death." Withdrawal from dialysis and cardiac events were the second leading cause of death, each accounting for 18.5% of the deaths. Patients stopping dialysis were older at the start of dialysis than were patients dying of other causes (P < 0.0006; Kruskal-Wallis test), with 65.1% of these patients 61 yr of age and older. Cancer, malnutrition, catabolism, and "dissatisfaction with life" were important associations with the decision to withdraw. More than 50% of patients withdrawing from dialysis had either diabetic nephropathy or atherosclerotic renal vascular disease. Withdrawal from dialysis was a common cause of death in these dialysis patients especially if they were over 61 and had systemic diseases such as diabetes mellitus and renal vascular disease. The reasons for a higher incidence of withdrawal in certain programs deserve further study.

Adolescent↗

PubMed1993

Human sperm fertilizing potential in vitro is correlated with differential expression of a head-specific mannose-ligand receptor.

OBJECTIVE: To determine whether different patterns of surface expression of mannose-ligand binding sites are correlated with capacitation and predictive of the ability of human sperm to recognize and fertilize eggs in vitro. DESIGN: Analysis of motile sperm populations (from fertile donors, males presenting for routine semen analysis, and men undergoing IVF) before and after incubation in capacitating media. SETTING: Patients from an infertility practice at a major university hospital. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The mannose ligand-binding capacity of sperm populations were initially assayed by solid-phase mannosylated polyacrylamide bead binding studies. Sperm surface D-mannose binding sites thus detected were localized and visualized by fluorescence microscopy after reaction with a mannosylated fluorescein isothiocyanate-labeled neoglycoprotein probe. Results were correlated with acrosomal status, reproductive histories, and IVF outcomes. RESULTS: The percent of sperm with head-directed surface expression of a mannose-specific receptor was increased in fertile donors and males exhibiting normal fertilization in IVF after incubation in albumin-supplemented Ham's F-10 medium (GIBCO Laboratories, Grand Island, NY). In normospermic males exhibiting zona binding failure in IVF, mannose-specific receptor was observed over the head surface of few incubated sperm. CONCLUSIONS: The appearance of D-mannose-ligand binding sites on the surface of heads of human spermatozoa is associated with zona binding ability in IVF and is a putative determinant in human gamete recognition and fertilization.

Acrylic Resins↗

PubMed1992

Use of the Dementia Rating Scale as a test for neuropsychological dysfunction in HIV-positive i.v. drug abusers.

Intravenous drug abusers (IVDAs) represent an increasing proportion of the HIV epidemic. Forty-three IVDA's (22 HIV-negative, 21 HIV-positive) were studied using the Mattis Dementia Rating Scale (DRS). All subjects had used intravenous heroin, but reported that they were drug-free at the time of testing. HIV-positive subjects were predominantly symptomatic and were dichotomized into AIDS and non-AIDS groups. All subjects with abnormal DRS scores were HIV-positive (57% of all HIV-positives). All HIV-negative subjects had normal DRS scores while 43% of the positive group obtained such scores. The DRS reliably identifies neuropsychological impairment, and may be a useful screening tool in this population.

AIDS Dementia Complex↗