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C Silvestrini

Publications and source records attributed to C Silvestrini.

11 recordsLinked to original sources
PubMed1999

Disruption of nocturnal melatonin rhythm and immunological involvement in ischaemic stroke patients.

The aim of this study was to evaluate nocturnal and diurnal urinary melatonin excretion in a group of ischaemic stroke patients, and to verify if a possible impairment of this excretion could be linked with some changes of immunological and neuro-psychic status. We assessed 13 ischaemic stroke patients and five healthy controls for nocturnal urinary melatonin excretion, which was found to be impaired in stroke patients (patients, 0.05 +/- 0.01 ng/ml; controls, 30 +/- 3.0 ng/ml; P < 0.001). No differences were found between the groups with regard to diurnal excretion. Patients with impaired nocturnal melatonin excretion presented: a decreased cell-mediated immunity (assessed by a skin-test); a prevalence of anergic status (69% of patients were anergic compared with 0% of controls; P < 0.05); a slight (but not significant) enhancement of plasma cortisol levels; and some changes in lymphocyte subsets (an overall decrease in CD3 lymphocyte number). In almost all the ischaemic stroke patients there was an impairment of cortisol/melatonin ratio (a marker of depression) and an altered sleep rhythm with mood disorders. Our data suggest that ischaemic stroke patients had an impairment of nocturnal urinary melatonin excretion, which was associated with an impaired cell-mediated immunity and some changes of lymphocyte subsets. In addition, reduced melatonin excretion might be associated with neurological and psychical symptoms.

B-Lymphocytes↗
PubMed1996

Unreliability of TRH test but not dexamethasone suppression test as a marker of depression in chronic vasculopathic patients.

Thirteen vasculopathic nondepressed men, admitted to the hospital 2 weeks earlier because of stroke, 10 age- and weight-matched patients with major depression, and 10 age- and weight-matched normal controls were tested with TRH and on different occasion with the dexamethasone (DEX) suppression test (DST). Patients with stroke were tested again with TRH and DST after 1 year. All subjects were euthyroid. A blunted TSH response to TRH was observed in 77% of vasculopathic patients, 64% of depressed patients, and 27% of controls. Some depressed patients showed serum GH or cortisol increments in response to TRH. Nonsuppression to DEX was observed in 45% of depressed patients and 15% of vasculopathics but not in normal controls. These data indicate that, in contrast to cortisol nonsuppression to DEX, blunted TSH response to TRH has poor diagnostic value as a marker for depression after stroke and may merely represent the expression of neuroendocrine dysfunction associated with cerebral vasculopathy.

Aged↗
PubMed1995

[Parma Stroke Data Bank: embolic stroke].

Cerebral infarction is one of the three main causes of death in most countries. It is very frequent and, since it is more often disabiliting rather than fatal, it is of high social impact. The correct classification of patients and the accurate diagnostic definition of the various subtypes of stroke is of great prognostic and therapeutic importance since cerebral infarction is not a single entity. In this study we report our findings concerning 244 patients with embolic infarction recorded in the Parma Stroke Data Bank hospital register. Clinical features were studied (risk factors, symptomatology of the onset, degree of severity within 3 days of the onset, post-stroke complications) as were instruments readings (TAC) and evolution (outcome, mortality, personal performance and environmental integration, both 4 weeks after the clinical onset and after one year).

Aged↗
PubMed1994

[Parma stroke data bank: atherothrombotic and lacunar stroke].

In an epidemiological research about stroke, we studied 235 patients with atherothrombotic brain infarctions and 81 patients with lacunes. It was a longitudinal study concerning patients admitted to our Medical Division during the acute phase and followed up for one year after the onset. We report some anamnestic data, the frequency of positive brain CT scan, main risk factors, symptoms at the onset, severity degree of the stroke within the first 72 hours, complications during, and outcome after, the first four weeks, including personal performances and environmental fitness, mortality rate and frequency of relapses. We also report some of these data after one year from the acute episode.

Adult↗
PubMed1993

Prevalence and prognostic value of peripheral arterial disease in stroke patients.

As atherosclerosis is a multi-systemic disease, each patient presenting clinical manifestation of atherosclerosis such as a stroke or RIND should be, from a vascular point of view, globally evaluated. The availability of Doppler ultrasound technique enables us to discover the presence of Peripheral Artery Disease (PAD) which is not always overt in the patient's history. Furthermore the presence of PAD is associated with a poorer prognosis in stroke patients.

Aged↗