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Biomedical subjects

D Cucinotta

Publications and source records attributed to D Cucinotta.

At least 19 recordsLinked to original sources

Multicentre clinical placebo-controlled study with buflomedil in the treatment of mild dementia of vascular origin.

A study was carried out in 73 male or female patients suffering from mild vascular dementia. The experimental protocol involved an initial run-in period (14 days) and subsequent double-blind, randomized treatment with 300 mg buflomedil or placebo given orally twice daily for 90 days. At the end of this treatment period, all patients received buflomedil for a further 90 days and, thereafter, patients received buflomedil or no further treatment for another 90 days. The efficacy of buflomedil was monitored using rating scales and neuropsychological tests. The findings of the study indicate that buflomedil improved the symptoms of vascular dementia; the most improvement was recorded in patients who had received buflomedil for the longest period. Inadequacy, cooperation, psycho-affective disorders, self-care and somatic complaints were positively influenced by buflomedil. The efficacy of buflomedil may be due to its effects on platelet aggregation and improvement in blood flow distribution to the ischaemic brain and oxygenation of brain tissue.

Aged

Insulin secretion, glycosylated haemoglobin and islet cell antibodies in cystic fibrosis children and adolescents with different degrees of glucose tolerance.

In comparison with 12 weight-matched controls, 39 children and adolescents with cystic fibrosis (CF) showed higher fasting glycaemic levels and both delayed and enhanced blood glucose responses to OGTT. Glycaemic response was normal in 30/39 patients (76.9%), impaired in other 7 cases (18%) and diabetic in the remnant two (5.1%). Fasting insulin levels and total insulin output during OGTT did not differ in patients and controls, but insulin peak in CF group was delayed and sustained. In the whole CF series mean HbA1c was higher than in controls but no difference was found between patients with normal and those with impaired glucose tolerance. Islet cell antibodies were absent in the entire CF group. In conclusion, our results confirm the raised prevalence in CF of glucose tolerance abnormalities, which do not seem to depend on auto-immune factor involvement. Delayed insulin response to OGTT can be considered a very early expression of beta cell impairment in the course of CF. In our experience HbA1c assay did not constitute a sensitive and specific screening test for detection of the C patients with glucose intolerance.

Adolescent

Beta cell function, peripheral sensitivity to insulin and islet cell autoimmunity in cystic fibrosis patients with normal glucose tolerance.

Beta cell function, peripheral sensitivity to insulin and specific pancreatic autoimmunity were studied in 30 youngsters with cystic fibrosis (CF) accurately selected in order to fulfill the criteria for normal glucose tolerance. With respect to weight-matched controls, patients with CF exhibited a significantly lower glucose tolerance and a globally preserved, although delayed, insulin response to oral glucose tolerance test, while first-phase insulin secretion after i.v. glucose was blunted. Peripheral sensitivity to insulin, assessed in vivo by both the euglycemic clamp technique and the number of insulin receptors, directly measured in circulating monocytes, was superimposable in patients and controls. Serum islet-cell antibodies were not found in any of the patients. In conclusion, disorders of beta cell function may be observed in CF patients even when glucose tolerance is within the normal range. Such abnormalities are not associated with changes in peripheral sensitivity to insulin and do not seem to depend on specific autoimmune events.

Autoantibodies

Acetyl-L-carnitine in the treatment of mildly demented elderly patients.

It has been hypothesized that acetyl-L-carnitine has a cholinomimetic action. It is for this reason that it has been used in the therapy of Alzheimer's type senile dementia impairment. In the present controlled double-blind study the authors followed two randomized homogeneous groups of both sexes of 30 patients each, aged over 65 years and suffering from mild mental impairment. One group of patients underwent therapy with acetyl-L-carnitine, 2 g/day for three months, while the other group was treated with a placebo. The statistical evaluation of the results was carried-out using non-parametric methods (Friedman-Nemenyi two-way ANOVA). It was possible to affirm that the acetyl-L-carnitine treated patients showed statistically significant improvement in the behavioural scales, in the memory tests, in the attention barrage test and in the Verbal Fluency test. These satisfactory results confirm the therapeutic importance of acetyl-L-carnitine in the treatment of elderly patients with mental impairment, which could be related principally to acetylcholine defects.

Acetylcarnitine

Ateroid in the clinical treatment of multi-infarct dementia.

A clinical double-bind controlled trial was conducted in 30 aged, stabilized, multi-infarct demented patients who had been diagnosed according to Hachinski and DSM-III criteria. The multi-infarct dementia was not severe enough to preclude the patient's participation in psychometric tests. The patients were divided randomly into two groups of 15 each, one being treated with sulfomucopolysaccharide and the other with placebo. Treatment started after a washout period of 2 weeks and lasted 8 weeks. Clinical symptoms were monitored and a complete assessment was done by the Dementia Rating Scale of Gottfries, SHGRS, Nowlis' Scale for Mood (modified), and the Corsi Cube Test at intake, at 4 weeks of treatment, and at the end (8 weeks). Statistical evaluation of the clusters of those scales revealed a definite difference between active drug and placebo, with various degrees of significance. The most marked difference between the two treatment groups was seen in the SHGRS clusters (p less than 0.05 and p less than 0.005). Overall clinical judgments expressed by the physician and by the patients' relative were in good agreement with the results of psychometric tests. From these data it may be concluded that treatment with sulfomucopolysaccharides must not only be considered as an attempt at correcting risk factors but may represent an active therapeutic approach based on clinical and biological data.

Aged

Blood glucose control and insulin secretion improved with combined therapy in type 2 diabetic patients with secondary failure to oral hypoglycaemic agents.

The influence of combined therapy using insulin and oral hypoglycaemic agents on blood glucose control and on insulin secretion in Type 2 diabetic patients with secondary failure to oral hypoglycaemic agents was evaluated. Type 2 diabetic patients (n = 180) (98 normal-weight, 82 over-weight), at least 3 years from diagnosis, and having poor blood glucose control on oral hypoglycaemic agents for at least 3 months (fasting plasma glucose greater than 10.0 mmol l-1) despite intensive efforts at improvement, were included in the study. A single daily insulin injection (human ultralente), at a dose of 0.22 +/- 0.07 U kg-1 d-1 in normal-weight and 0.33 +/- 0.10 U kg-1 d-1 in over-weight patients, was added to the previous dietary and drug treatment for 6 months. A progressive and significant (2p less than 0.001) reduction of the mean daily blood glucose was observed during the first 3 months of combined therapy (from 13.2 +/- 3.2 to 8.1 +/- 2.1 mmol l-1 in normal-weight and from 13.4 +/- 3.1 to 8.8 +/- 2.3 mmol l-1 in over-weight patients), with no further significant changes thereafter. A significant increase (2p less than 0.001) in the mean daily C-peptide concentration (from 0.50 +/- 0.30 to 0.71 +/- 0.29 nmol l-1 in normal-weight and from 0.78 +/- 0.36 to 1.00 +/- 0.41 nmol l-1 in over-weight patients) took place during combined therapy. No changes of body weight (+ 1.5 +/- 1.2 kg in normal-weight and + 1.0 +/- 1.0 kg in over-weight patients) were observed.

Blood Glucose

Mental impairment in aging: selection of patients, methods of evaluation and therapeutic possibilities of acetyl-L-carnitine.

The authors carried out a double-blind study in two randomized homogeneous groups of both sexes of 15 patients each, over 65 years of age and suffering from mild mental impairment. One group of patients underwent therapy with acetyl-L-carnitine, 2 g/day for three months, while the other group was treated with a placebo. The statistical evaluation of the results were carried out using nonparametric methods (Friedman-Nemenyi two-way Anova and Mann Whitney U-Test). However, the two groups did not differ significantly in either test at the end of treatment. It is possible to affirm that the acetyl-L-carnitine treated patients showed statistically significant improvement in the behavioural performances (Blessed Dementia Scale p less than 0.02; Stuard Hospital Geriatric Rating Scale p less than 0.01), in the memory tests (Rey short-term p less than 0.02; Rey long-term p less than 0.05; Corsi p less than 0.05), in the attention test (Barrage test p less than 0.01) and in the Verbal Fluency test p less than 0.01).

Acetylcarnitine

[Circadian variations in glycemia and IRI in normal subjects, young and adult diabetics and in obese subjects].

Blood sugar and IRI were followed for 24 hr in healthy patients, young and adult diabetics, and in subjects with apparently primary obesity on a standard, normal calorie diet. Morning and nocturnal insulin positivity peaks were noted in the normal subjects, though circadians variations in these parameters were mainly related to meals. This periodicity was altered in young diabetics, for whom insulin responsivity was ruled out, and in the adult diabetics, who displayed deficient insulin secretion in the morning, and delayed secretion after the afternoon meal, and in the obese subjects, the quality of whose response was close to that of the previous group. The usefulness of this type on examination in the planning of diet and drug management, quite apart from diagnosis and prognosis, is stressed.

Blood Glucose