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Biomedical subjects

E Berta

Publications and source records attributed to E Berta.

17 recordsLinked to original sources
PubMed2006

[Development of incidence of post-dural puncture headache in patients undergoing caesarean section in spinal anaesthesia at the Department of Obstetrics and Gynecology in Olomouc during 2003-2004].

BACKGROUND: Paper gives the analyse of the incidence of post-dural puncture headache in patients undergoing caesarean section in spinal anaesthesia at the Department of Obstetrics and Gynecology in Olomouc in 2003-2004. METHODS AND RESULTS: Post-dural puncture headache following caesarean section in spinal anaesthesia in 2003 was retrospectively analysed. Subsequently, measures to reduce the incidence of this complication (use of Whitacre and Atra ucan needles) were implemented. 2004 patients were followed prospectively. 54 caesarean sections - 16.3% (54/331) were performed in spinal anaesthesia in 2003. Following needles were used to establish spinal blockade: Quincke 22G - 35.2% (19/54), Quincke 25G - 50% (27/54), Atraucan 26G - 14.8% (8/54). Post-dural puncture headache occurred in 9 cases - 16.6% (9/54) (22G - 7x, 25G - 2x), the onset of symptoms occurred after 24 to 65 hours after the spinal blockade (mean 41.7). It was necessary to perform epidural blood patch (EBP) in 7 cases - 77% (7/9) - 12.9% (7/54) (22G - 5x, 25G - 2x). Epidural blood patch (EBP) was performed after 7 to 45 hours after the onset of symptoms (median 28.4). The age of patients at the time of delivery ranged between 22 to 43 years (median 34.5). 36 caesarean sections - 8.4% (36/426) were performed in spinal anaesthesia in 2004. Following needles were used to establish spinal blockade: Whitacre 27G - 63,9% (23/36), Atraucan 26G - 13,9% (5/3), Quincke 25G - 11,1 (4/36), Quincke 22G - 11,1% (4/36). Post-dural puncture headache (PDPH) occurred in 3 cases - 8.3 (3/36) (25G - 1x, 22G - 2x), the onset of symptoms occurred after 24 to 54 hours after spinal blockade (median 36.0). It was not necessary to perform epidural blood patch. The age of patients at the time of delivery ranged between 22 to 39 years (median 28.5). CONCLUSIONS: Incidence of post-dural puncture headache (PDPH) is significantly higher in pregnant women and in puerperal period compared to general population. The use of appropriate needles for spinal blockade and adequate level of anaesthesiologist's skills lead to lower incidence of post-dural puncture headache (PDPH) after caesarean section performed in spinal anaesthesia.

Adult↗
PubMed2001

The costs of childhood epilepsy in Italy: comparative findings from three health care settings.

PURPOSE: To determine the direct costs of epilepsy in a child neurology referral population, stratified by disease, duration, and severity, comparing three different health care settings [i.e., teaching or clinical research (CR) hospitals, general hospitals, and outpatient services]. METHODS: Patients were accepted if they had confirmed epilepsy and were resident in the center catchment area. Eligible subjects were grouped in the following categories: (a) newly diagnosed patients; (b) patients with epilepsy in remission; (c) patients with active non-drug-resistant epilepsy; and (d) those with drug-resistant epilepsy. Over a 12-month period, data regarding the consuming of all resources (i.e., consultations, tests, hospital admissions, drugs), were collected for each patient. Using the Italian National Health Service tariffs, the unit cost of each resource was calculated and indicated in Euros, the European currency. RESULTS: A total of 189 patients was enrolled by two teaching-CR hospitals, two general hospitals, and two outpatient services. The patients were evenly distributed across the four categories of epilepsy. The mean annual cost per person with epilepsy was 1,767 Euros. Drug-resistant epilepsy was the most expensive category (3,268 Euros) followed by newly diagnosed epilepsy (1,907 Euros), active non-drug-resistant epilepsy (1,112 Euros), and epilepsy in remission (844 Euros). Costs were generally highest in teaching-CR hospitals and lowest in outpatient services. Hospital services were the major cost in all epilepsy groups, followed by drugs. CONCLUSIONS: The cost of epilepsy in children and adolescents in Italy tends to vary significantly depending on the severity and duration of the disease Hospitals services and drugs are the major sources of costs. The setting of health care plays a significant role in the variation of the costs, even for patients in the same category of epilepsy.

Adolescent↗
PubMed2000

Clinical ictal symptomatology and anatomical lesions: their relationships in severe partial epilepsy.

High-resolution imaging techniques can demonstrate anatomic alterations in most patients identified as candidates for surgical treatment of their partial epilepsy. The demonstration of an anatomic lesion is only one step in the presurgical diagnostic procedure, which includes video-EEG and, when necessary, video-stereo-EEG recordings of seizures. A review of the literature shows that the simple removal of the magnetic resonance imaging (MRI)-evident lesion ("lesion-ectomy") reduces but does not completely suppress seizures in a large percentage of patients, especially those with neuronal migration disorders. This phenomenon could, at least in part, be explained by preliminary data (in 33 patients) showing that less than 20% of seizures correspond to a well-localized, intralesional discharge in about 40% of stereo-EEG-investigated patients with at least one intralesional electrode. The authors illustrate some anatomo-electroclinical examples of intraindividual variability of the ictal symptomatology, raising the problem of the decision about the extent of the surgical removal. Recent histologic and immunohistochemical studies have demonstrated several kinds of structural alterations in the stereo-EEG-defined epileptogenic zone, not always overlapping with the MRI-visible lesion. This aspect can further explain some failures of MRI-guided lesionectomies. That relationships between "lesions" and epileptogenic zones may be variable is also suggested by reports of patients who present with multiple lesions (i.e., cavernous angiomas, Bourneville syndrome) and are cured by removal of only one of them.

Adult↗
PubMed1996

[Clinical characteristics critical for patients "recovered" after surgical treatment for temporal lobe epilepsy].

We analyse subjective and objective clinical manifestations, in 33 patients, among the 63 with "pure" temporal lobe epilepsy, for which we obtained at least a video-EEG or video-stereo-EEG ictal recording. We compared video-EEG recordings (103 seizures, mean 3.9; min 1, max. 23) and video-stereo-EEG recordings (77 seizures, mean 3.2; min 1, max. 13) with anamnestical data, in order to define the degree of reliability of patient and relatives reports. Overall agreement between anamnestic and video-recorded informations is excellent for subjective symptoms, and fairly good for objective signs. Subjective manifestations (reported in 90.1% of this group) are described in detail as well as the objective ones, these latter split divided into early and late manifestations.

Electroencephalography↗
PubMed1996

[EEG video recording].

We analyse EEG data from video-EEG recordings of 24 patients, selected among the 63 with "pure" temporal lobe epilepsy. As to interictal EEG features, 62.5% of patients show a less regular background activity on the affected side, in 70% of patients slow waves are either localised or lobar, while in 58% are spikes. Slow waves and spikes have the same well-defined localisation in 37.5% of the patients. Ictal recordings show an initial EEG pattern with high localising value (low-voltage fast activity, flattening or slow waves interruption) in 74/121 seizures (61%). Five out of these 24 patients were operated on without invasive recordings on the basis of ictal video-EEG data. In the 19 patients left, video-EEG ictal informations were used for the planning of the stereo-EEG exploration.

Electroencephalography↗
PubMed1996

[Surgical treatment of temporal lobe epilepsy: reality and prospectives].

This chapter provides a synthetic overview of the topics treated in this issue. Presurgical diagnostic procedures are schematically described and an analysis of surgical results is made in comparison with those obtained from other epilepsy surgery groups. Surgical complications linked both to invasive presurgical diagnostic procedures and therapeutic surgical acts are described. Finally, the creation of new epilepsy surgery centres is suggested on the basis of epidemiological data, which demonstrate the discrepancy among the patients operated on at present and those who could benefit from the surgical treatment.

Decision Making↗
PubMed1995

Acoustic nerve in peripheral neuropathy: a BAEP study. Brainstem Auditory Evoked Potentials.

We performed BAEP study to evaluate acoustic nerve involvement in 102 patients affected by peripheral neuropathies of different etiology, predominantly hereditary and inflammatory acquired neuropathies. Prolonged latency of early waves, indicative of slowing in VIII nerve conduction, was found in a high percentage of cases. Abnormalities were far more frequent (44% vs 14%) and severe in patients with demyelinating rather than axonal neuropathy. Among demyelinating neuropathy, the most severe latency delay was found in Hereditary Motor and Sensory Neuropathy type III. The pattern of acoustic nerve involvement differed slightly between Hereditary Motor and Sensory Neuropathy type I and acquired inflammatory demyelinating polyradiculoneuropathy, perhaps reflecting different pathogenetic mechanisms and different sites of VIII nerve demyelination.

Adolescent↗
PubMed1994

Removal of antiacetylcholine receptor antibodies by protein-A immunoadsorption in myasthenia gravis.

Myasthenia Gravis is an autoimmune disease in which autoantibodies to the acetylcholine receptor interfere with neuromuscular transmission. Plasma exchange is effective in temporarily relieving the symptoms of the disease, but for repeated use the lack of selectivity and need for replacement fluids (which increases the risk of contracting viral diseases) are important drawbacks. Staphylococcal protein A, a potent ligand for immunoglobulins, that interacts negligibly with other plasma proteins, appears to be an optimal candidate for removing antiacetylcholine receptor antibodies, which are mostly IgG. We treated three patients with severe immunosuppression-resistant myasthenia gravis with protein A immunoadsorption. Neurological impairment significantly improved in all patients. After immunoadsorption of 1.5-2 plasma volumes per session, the mean percentage reductions for serum IgG and specific autoantibodies were 71% and 82% respectively. No major side effects occurred. Protein A immunoadsorption appears to be a safe, efficient and effective alternative to plasmaexchange for selected myasthenic patients requiring prolonged apheresis.

Adult↗
PubMed1994

[Use of galactomannan to produce hydrophilic matrix tablets].

Galactomannan currently seems to be a very promising auxiliary. The aim of the present work was to examine the applicability of this auxiliary in tablet-making. Galactomannan is a polysaccharide composed of galactose and mannose, which is distributed by the Swiss firm Meyhall under the name Meyprogat. The products are numbered according to their molecular weight and polymeric degree. Thus, Meyprogat 7, 30, 60, 90, 120 and 150 can be discriminated. It is used in many areas, for example in the food industry as a stabilizing agent, and in medical therapy to cure diabetes and hyperlipidaemia. In pharmaceutical technology, it is used in low concentration (5-10%) as a disintegrant agent and in high concentration (25%) as binding agent. It is able to form a hydrophilic matrix, which results in sustained release. Theophylline was chosen as model agent. After the preformulation examinations, granulations were made by a wet method, and after this tablets were formed. Examinations were made of the granulations, the physical parameters of the tablets were determined, and the release of the effective agent from the tablets was studied. The following conclusions were drawn: 1. Galactomannan yields tablets with very good hardness. 2. Galactomannan is suitable for the formation of hydrophilic matrix tablets. Through use of this macromolecular agent, the rate of dissolution can be influenced in accordance with the desired purpose.

Carbohydrate Conformation↗
PubMed1992

HMSN III phenotype due to homozygous expression of a dominant HMSN II gene.

We describe two siblings with hereditary motor and sensory neuropathy (HMSN) type III. Their parents were both affected with autosomal dominant axonal HMSN. The neuropathy in the siblings probably resulted from homozygous expression of the HMSN II gene. Together with other reports of homozygous HMSN I, this family suggests that HMSN III is heterogenous and encompasses the most severe homozygous expression of neuropathic genes.

Adolescent↗
PubMed1991

A short plasma exchange protocol is effective in severe myasthenia gravis.

Plasma exchange has been reported to be a successful therapeutic procedure for the treatment of severely compromised myasthenic patients, but the optimal regimen in terms of costs or clinical benefit has not so far been determined. We have investigated the efficacy of a short plasmapheresis protocol of two exchanges 1 day apart in a series of 70 patients with severe forms of myasthenia gravis. Patients were evaluated before and 7 days after the first exchange. A positive outcome was observed in 70% of the plasma exchange cycles performed. Disease severity did not seem to be a negative prognostic factor for the efficacy of this short protocol, which was well tolerated by patients. In only 1 case were major side-effects observed. In spite of its short duration, the exchange treatment plus concomitant immunosuppressive drug therapy was not followed by early clinical deterioration.

Adolescent↗
PubMed1978

New enzymatic method for serum uric acid at 500 nm.

We describe a manual method, well suited to mechanization, for quantitating serum uric acid at 500 nm. In the assay mixture (0.10 ml of sample and 3.00 ml of reagent) the hydrogen peroxide produced from uric acid by uricase is coupled with p-hydroxybenzoate and 4-aminoantipyrine in the presence of peroxidase to form a colored complex, which is measured. A separate sample blank is obviated by taking an initial absorbance measurement 20 s after the sample is added. The reaction is complete within 5 min; its sensitivity is 0.001 deltaA/mg per liter. Absorbances are linearly related to uric acid concentrations up to 120 mg/liter. Many substances that may be present in normal serum do not interfere, but bilirubin in moderately above-normal concentrations will interfere. The procedure can be modified to largely correct for this, when necessary. The proposed method (y) correlated well (r = 0.979) with the uric acid 293 nm reference method (x) and the relation is described by the equation y = 0.998x + 2.42.

Humans↗