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E Ettorre

Publications and source records attributed to E Ettorre.

12 recordsLinked to original sources
PubMed2004

Correlation between cognitive impairment and the Rey auditory-verbal learning test in a population with Alzheimer disease.

Patients affected by Alzheimer disease (AD) need an accurate diagnosis, to the extent allowing us to find the best therapy or polytherapy, in order to take under control their cognitive impairment. In our Alzheimer Evaluation Units (from the Italian name abbreviated: UVA), the patients undergo a multidimensional evaluation, which can address us towards a proper diagnosis and of other weakening, or even dementia-related diseases. The patients are also subject to neuropsychometric and neuropsychological evaluations, allowing a more focused analysis on cognitive impairments. Among the tests, we use the Rey auditory-verbal learning test (RAVLT), evaluating the patient's verbal memory. A list of 15 words is read to each patient. N the first part of the test, the clinician repeats 5 times such a list. the patient is hen asked, at the end of every repetition, to tell all words he/she remembers. This part is useful to evaluate the immediate recall (IR) ability. The score, i.e., the total number of recalled words, ranges from 0 to 75. After 15 minutes, the delayed recall (DR) ability is evaluated: the patient is newly asked to repeat as many words as he can recall from the list. The score for this part ranges from 0 to 15 minutes. The score is corrected of rage and education, with a cut-off of 28.5 for IR and 4.7 for DR. We made a survey with the purpose of deciding if there was a correlation between cognitive impairment and verbal memory lack, whose deficiency appears earlier in AD. To this aim, we selected several patients with AD, diagnosed during the period between September 2002 and February 2003. We only considered those patients whose AD was not associated with other weakening diseases, and whose clinical dementia rating scale (CDR) score was between 0.5-2.0. A sample of 35 individuals (11 men and 24 women) could be obtained. A meaningful correlation was observed between CDR and IR (r = -0.725, p < 0.01), as well as between CDR and DR (r = -0.470; p < 0.05). Such a result confirms the importance of evaluating immediate and long-term memories, for the early diagnosis of AD, because it is the only symptom of clinically not yet diagnosed dementia, as proven also by other studies.

Aged↗
PubMed2004

Smoking and longevity: an incompatible binomial?

In Western countries data from clinical and epidemiological studies have induced the public health offices to promote a great deal of advertising and informative campaigning for smoking reduction. Cigarette smoking has been clearly linked to the most common causes of death in the elderly and contributes to the higher death rate and disability rate associated with many chronic illnesses that are common in this age group. The combination of smoking along with other risk factors like hypertension and diabetes increase high frequency diseases, disability as well as adding to an increase in mortality rate. In order to verify if a healthy lifestyle really favors longevity and how much smoking is incompatible with extreme longevity we investigated the prevalence of smokers and the total smoking exposure of a sample of centenarians in relation with residual survival and health conditions. Our sample consists of 157 centenarians living in Rome, 39 males and 118 females (ratio m/f =1:3),mean age being 101.59 +/- 1.8 years (+/-SD), 83.8% of the centenarians have never smoked,13.5 % are former smokers, and 2.7% are active smokers. The average starting age of smoking is 21.2 years, while the average age of quitting is 65.7 years with an average of 44.7 +/- 17.1 smoking years. The average number of smoked cigarettes per day is quite low,less than 10 cigarettes, so that the total average number of smoked cigarettes is 158,045,well under 280,000 which is considered the cut-off point in many studies of when tumors are noticed. There seemed to be a significant difference (p < 0.001) in gender results in smokers: among male centenarians smokers reached 46%, while female smoker centenarians reached only 8.1%. Statistically significant chronic illnesses were noted among centenarian smokers over the age of 65 (p < 0.02). Moreover, Cox's regression has shown in centenarians a lower survival rate (p < 0.05) in smokers (20.7 +/- 11.2 months) than in non-smokers (27.0 +/- 19.0 months). In conclusion, our study evidences that smoking is for all but some exceptional subjects, incompatible with successful aging and compromises life expectancy even in extreme longevity.

Aged↗
PubMed2004

The management of psychogeriatric patient.

The exponential growth in the prevalence of cognitive impairment of old patients leads the physicians to deal with a larger incidence of behavioral disorders (such as excitement,aggressiveness), and psychotic symptoms (such as delirium and visual hallucinations). The presence of psychotic troubles in dementia causes a remarkable distress to caregivers and involves higher difficulties in the patient management. The estimates of such troubles range between 15 and 75 %. Geriatric assessment and the management of behavioral troubles require a prompt evaluation of all their possible causes. As a matter of fact, their appearance often reveals a physical disturbance (pain, fever, etc.), or adverse environmental conditions, or it could also be a consequence of a multiple drug therapy. For this reason,the use of antipsychotics should always be preceded by an accurate clinical diagnosis.Anxiolytic, anti-depressive, anti-convulsive and anti-psychotic drugs are among the therapeutic strategies for the management of the psychogeriatric patient. Atypical antipsychotics seem to be able to decrease the psychotic symptoms, with low levels of therapeutic failure. They also reduce extrapyramidal effects and the growth of prolactine hormone, which is quite useful when dealing with very old patients. Risperidone and olanzapine are two atypical anti-psychotics, which already proved to be adequate and well tolerated during the treatment of schizophrenia and of acute maniacal disorders. Our experience, with a population of patients followed by our Alzheimer Evaluation Unit (AEU), confirms that a low dose of olanzapine (5mg/day) and risperidone (0.5-1.0 mg/day) are effective in lowering behavioral disturbances, and psychotic symptoms due to dementia. Even in the long run,low doses of these drugs are still well tolerated. Higher levels of risperidone (> 1 mg/die)often caused extra-pyramidal symptoms such as rigidity and dyskinesia, whereas higher levels of olanzapine (> 5 mg/day) lead to an exceeding sedation. The management of behavioral disturbances is one of the most important goals in the global treatment of patients affected by dementia, to the extent of improving the quality of life. Atypical antipsychotics are preferable compared to old-generation drugs, therefore, they are the key therapeutic strategy we cannot renounce.

Activities of Daily Living↗
PubMed2001

Prenatal screening and genetics.

Although the term 'genetic screening' has been used for decades, this paper discusses how, in its most precise meaning, genetic screening has not yet been widely introduced. 'Prenatal screening' is often confused with 'genetic screening'. As we show, these terms have different meanings, and we examine definitions of the relevant concepts in order to illustrate this point. The concepts are i) prenatal, ii) genetic screening, iii) screening, scanning and testing, iv) maternal and foetal tests, v) test techniques and vi) genetic conditions. So far, prenatal screening has little connection with precisely defined genetics. There are benefits but also disadvantages in overstating current links between them in the term genetic screening. Policy making and professional and public understandings about screening could be clarified if the distinct meanings of prenatal screening and genetic screening were more precisely observed.

Amniocentesis↗
PubMed2000

[Rehabilitation in Alzheimer's dementia].

Alzheimer's disease is a neurodegenerative disease that causes a progressive decline of cognitive and behavioural functions. The simultaneous presence of these disorders requires a treatment not only for cognitive decline, but also for behavioural symptoms, depression and caregiver's stress. Research has made many efforts to develop a wide range of treatments, different from current pharmacological therapy, which is not resolutive, owing to the absence of an exact etiopathogenetic mechanism. Since new drugs have not been shown to be really effective in slowing cognitive impairment, various forms of rehabilitative interventions have been proposed in order to treat Alzheimer's disease. Their efficacy in the improvement of cognitive functions is still not completely clear. Surely, interesting results have been obtained from studies about Reality Orientation Therapy, Occupational Therapy and Memory Training. Music therapy might provide a new form of rehabilitative intervention, especially acting on the reducing of behavioural symptoms. These alternative forms of non pharmacological treatment may have a positive effect on caregiver. The heavy emotional burden of seeing a loved one becoming confused and isolated and of having to accept new responsibilities, may be reduced by rehabilitative supports, complementary to the pharmacological therapy. Caregiver stress could be reduced in two ways: by promoting the hope that something is being done for the patient and providing free time for himself.

Alzheimer Disease↗
PubMed2000

Reproductive genetics, gender and the body: 'please doctor, may I have a normal baby?'.

This paper's purpose is to highlight key sociological issues, that come to light when 'the body' becomes a theoretical site in reproductive genetics. By positioning the body as a central feature in this analysis, the paper: (1) describes how a mechanistic view of the body continues to be privileged in this discourse and the effects of this view; (2) examines how reproductive limits are practised on the gendered body through a feminised regime of reproductive asceticism and the discourse on shame; and (3) explores the social effects and limitations of reproductive genetics in relation to disability as a cultural representation of impaired bodies. The central assumption concerning reproductive genetics are that it appears within surveillance medicine as a part of a disciplinary process in society's creation of a genetic moral order, that it is mobilised by experts for the management of reproductive bodies and that it constructs a limited view of the body. Thus, the way reproductive genetics operatives tends to hide the fact that what may appear as 'defective genes' is a result of a body's interaction not only with the environment but also gendered social practices valorised by difference as well as rigid definitions of health and illness. The research is from a 1995-96 European study of experts interviewed in four countries.

Attitude of Health Personnel↗
PubMed1999

Mental distress--gender aspects of symptoms and coping.

The article examines men's and women's views on their reasons for mental distress and on their coping styles, respectively. The data were taken from written statements given on two open-ended questions from a survey questionnaire returned by 43 men and 57 women who were self-reported, long-term users of these drugs, and from taped interviews with 10 respondents. Men's accounts (n = 25) expressed a layered theory of mental health: alcohol was a remedy to alleviate temporary strain caused by external pressure, while the use of psychotropic drugs indicated a loss of a men's assumed self-regulatory powers and autonomy. Women's accounts (n = 31) were stories of emotional pain related to their caring work in the private sphere, and psychotropics restored their capacity to carry out emotional labor.

Adaptation, Psychological↗
PubMed1994

Psychotropic drugs: long-term use, dependency and the gender factor.

The study examines the factors contributing to the initiation, continuation and termination of use among female and male long-term users of minor and major tranquilizers. The findings show the importance of the lay-referral system as a channel of introduction to psychotropic drug use, especially for men. The issue of dependency is explored both in terms of the users' own interpretation of its nature and their reports on the professional responses to their long-term use. The findings indicate that gender and drug use are intricately linked in both the non-professional and professional treatment of anxiety and insomnia.

Anti-Anxiety Agents↗
PubMedDate not supplied

Mortality rates and antihypertensive therapy in extreme old age.

The impact of hypertension on survival in extremely old age has shown different features in different studies, with equal or lower mortality rates in hypertensive patients and lower reduction of risk in treated patients. In a population (n=414) of old community dwellers (mean age 88.4 years) the prevalence of hypertension was 52.2%. Hypertensive patients presented a lower mortality rate (14.2 per 100 person-years) as compared to the general population (15.4) and to non-hypertensives (16.6). Hypertensives were divided into four groups according to treatment. Best survival was shown by patients under treatment with antihypertensives alone (9.8) or in association with diuretics (9.9), and worst survival by patients under a diuretic-based treatment (25.1). These data were confirmed by multivariate analysis. The better survival of hypertensive very old people could be related to the use of a proper pharmacotherapy.

Journal Article↗
PubMedDate not supplied

Long-term users of psychotropic drugs: embodying masculinized stress and feminized nerves.

This article examines long-term users of psychotropic drugs (43 men and 57 women) and their views on women's and men's reasons for using these drugs. The data came from written statements (N= 56) given on open-ended questions from a survey of users and from taped interviews with 10 respondents. Men's accounts expressed a notion of men as experiencing external pressures which created "masculinized stress." On the one hand, this stress could be handled with alcohol, while, on the other hand, the use of psychotropic drugs indicated a loss of men's assumed self-regulatory power and autonomy. Women related the reasons for their psychotropic drug use to their experience of emotional labor. Nevertheless, they did not tend to identify the psychological consequences of their experience as related to work. Rather, they labelled these as health consequences--women being more "emotional" than men and suffering from "nerves." These lay accounts reflect the representations of gender-specific psychological distinctions and the effort to construct gender-specific etiologies.

Anti-Anxiety Agents↗