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F Caroli

Publications and source records attributed to F Caroli.

63 records · Page 4Linked to original sources
PubMedDate not supplied

[Agitation in the elderly (author's transl)].

Agitation in the elderly is a common behaviour disorder. The clinical picture is quite variable: aggressive reactions, anxious agitation, agitation associated with confusion: sometimes, the agitation occurs in episodes, especially during the night. These types of agitation have two basic causes: confusion and dementia. In some cases, they are the clinical expression of an angry, hostile or excited state. In agitation associated with confusion, one must eliminate an intoxication, a neurological disorder, an infection, and notably a past head injury which may have gone undetected. Therapeutic measures are discussed.

Aged↗
PubMedDate not supplied

Incidence of phlogistic complications in infantile posterior fossa surgery according to the different preoperative diagnostic procedures.

Sixty seven infantile patients developing postoperative phlogistic complications as a consequence of posterior fossa surgery (i.e.: neoplasms, arachnoid cysts, A-V malformations) are herein studied. They have been subdivided in 2 groups in accordance to the different preoperative diagnostic procedures they underwent. In the first series 41 cases of posterior fossa anomalies have been diagnosed by means of air contrast ventriculography with or without cerebral angiography; in the other one the 26 patients were submitted to C.A.T. with or without angiography. In the first group the incidence rate of phlogistic complications was 31.7%, in the second one 3.8%. According to the authors this considerable difference is due to the diagnostic procedures employed. Contraindications to air contrast ventriculography and advantages of CT scan are widely discussed and emphasized.

Arachnoid↗
PubMedDate not supplied

[Intracranial tumors during the first year of life: clinicopathologic study of 24 cases].

Brain tumors which manifest themselves neurologically in the first year of life can be declared "congenital". They are considered to be rare. Of a total of 440 central nervous system neoplasms in children, operated between 1951 and 1978, 24 (5,4%) congenital tumors were noted. The Authors report a clinical picture and the follow-up. The histology and topographical distribution of this series of tumors is compared to the literature data. The frequency of supratentorial tumors (15 cases; 62,5%) was much higher than that of infratentorial masses (9 cases); 37,5%). The high incidence of astrocytomas, choroid plexus papillomas and medulloblastomas is emphasized.

Brain Neoplasms↗
PubMedDate not supplied

[Thoracic outlet syndrome. Clinico-instrumental aspects of 36 cases].

The authors report their experience on 36 cases of thoracic tunnel syndrome. They deal with the nosographic arrangement of neurovascular syndromes of the upper limbs. Within the framework of the casuistics 13 patients were operated: the authors present clinical and E.M. Graphic criteria on the ground of which it was decided to operate. Results appear to be positive as to subjective symptomatology; they are less positive as to the objective one.

Angiography↗
PubMedDate not supplied

Differentiation of glioblastoma multiforme from astrocytomas by in vitro 1H MRS analysis of human brain tumors.

In vitro high resolution 1H NMR spectroscopy allows non-invasive metabolic evaluation of specimens derived from surgically biopsied or resected brain tumors, with the aim of identifying potential markers of different malignancy grading, and improving diagnostic and therapeutic strategies. In the present study we evaluated 36 patients affected by different brain gliomas (7 well differentiated astrocytomas, 7 anaplastic astrocytomas, 16 glioblastomas, 6 oligodendrogliomas). These analyses allowed discrimination between well differentiated and anaplastic astrocytomas (AII + AA) and glioblastoma multiforme (GM) samples on the basis of the ratio between the integrated choline-containing resonance (b"Cho") and the creatine peaks (creatine (Cr) + Phosphocreatine (PCr)). While no definite difference was found between AII and AA, significantly higher values were observed for this ratio in GM. Other signals, derived from different metabolites, such as Glycine (Gly) and N-acetyl-aspartate (NAA), may also assume relevance in differential tumor diagnosis. In this study an increased [Gly]/[Cr + PCr] ratio was observed in GM with respect to AII and AA. The NAA levels observed in our tumor specimens may be explained on the basis of tumor cell infiltration into brain adjacent tissue. Interesting, but inconclusive, are the data concerning oligodendrogliomas, which, also in well differentiated forms, exhibit increased levels of b"Cho"/(Cr + PCr) ratio. The present study confirms the role of MRS in the biochemical characterization of neoplastic brain tissue and its potential contribution to a better selection of multidisciplinary treatment strategies.

Astrocytoma↗
PubMedDate not supplied

[Pharmaco-clinical correlations during fluoxetine administration in patients with depressive schizophrenia treated with haloperidol decanoate].

The study concerned 7 patients suffering from schizophrenic disorder according to the DSM III R criteria, treated with a stable dose of haloperidol decanoate (Haldol décanoas) added with fluoxetine (Prozac) from 20 mg to 40 mg/day because of major depression. Patients were assessed at baseline and weekly during the first cycle, and then once a month before each haloperidol decanoate injection, using the brief psychiatric rating scale (BPRS), the general clinical impression scale (CGI) and the Montgomery and Asberg depression rating scale (MADRS). Extrapyramidal and anticholinergic side-effects, blood pressure and pulse were noted. Determinations of plasma and red blood cells concentrations of haloperidol and reduced haloperidol, and of fluoxetine and norfluoxetine, were conducted at the same time than clinical evaluations. For all patients, we observed an improvement by the end of the first week, which became significant at the end of the second week, and continued in subsequent weeks (more than 30 per cent). Two weeks after the addition of fluoxetine, a very significant increase in haloperidol concentrations (more than 100 per cent) was noted; fluoxetine seems to have pharmacokinetic interactions with haloperidol, either by inhibiting its hepatic metabolism (inhibition of cytochrome P450 isoenzyme) or/and by displacing it from protein binding sites.

Adult↗
PubMedDate not supplied

Neuroleptic-resistant schizophrenic patients treated by clozapine: clinical evolution, plasma and red blood cell clozapine and desmethylclozapine levels.

The aim of this open study was to determine a more rational therapeutic approach for psychotic patients treated with clozapine for several months, using measurement of plasma and red blood cell levels (P, RBC) of clozapine (cloza) and N-desmethylclozapine (descloza), the major metabolite of clozapine, which has been reported to be less active but more toxic (agranulocytosis) than clozapine itself. The RBC concentration may be considered as more representative of the free fraction drug. The study concerned 7 patients suffering from chronic paranoid schizophrenia according to the DSM-IV criteria. All of them were treatment-refractory schizophrenic inpatients (4 men, 3 women, mean age +/- SD: 38.2 +/- 8.4 years; mean duration of illness +/- SD: 14.4 +/- 5.1 years). They had received at least two different neuroleptics, for 6 weeks, before entering the study. Treatment started in our hospitalization unit with clozapine 25 mg up to a maximum of 900 mg/d (mean stabilized daily dose +/- SD: 507 +/- 211 mg and mean daily dose per kg: 6.91 +/- 3.08 mg). Clinical evaluations (Quality of Life Scale: QLS), regular blood monitoring and biological samples were conducted at the same time, weekly for 18 weeks and then monthly (duration of the study: 4 to 38 months; mean +/- SD: 12.9 +/- 11.5 months). Plasma and RBC (after lysis) levels were determined by reversed phase HPLC and UV detection after extraction with hexane. All the patients improved very quickly after the first week of treatment and six were able to leave the hospitalization unit and start outpatient care such as daily hospitalization, returning home or in sheltered accommodation. With the following plasma (P) and RBC levels: mean cloza +/- SD: (P = 294 +/- 146 ng/ml; RBC = 110 +/- 82 ng/ml) and mean descloza +/- SD: (P = 173 +/- 106 ng/ml; RBC = 76 +/- 54 ng/ml); none of the seven patients developed agranulocytosis. The blood levels, ensuring better surveillance, have a predictive value for clinical improvement. A linear pharmacoclinical correlation was only found between RBC cloza concentrations and the evolution of the QLS scores. Clozapine fulfils the criteria for therapeutic drug monitoring, and determination of plasma, and more particularly RBC, cloza and descloza levels may help to find the lowest effective dose with the fewest side effects.

Adult↗
PubMedDate not supplied

[Use of methylphenidate in adults with attention deficit disorder with hyperactivity].

Attention deficit, hyperactivity disorder was recently described in adults. The clinical individualization of this syndrome progressed but the categorical approach remains to be entirely completed. The residual form of the childhood disorder does not generate diagnostic problem when childhood previous history is known. ADHD without childhood history refer us to retrospective difficulties of diagnosis and various evolutions of the infantile form linked or not, with other psychiatric pathologies. Etiology remains unknown, hypothesis of an hereditary disfunction of neurotransmitters is the more studied. These patients can benefit from a psychostimulant treatment. Four controlled studies with methylphenidate demonstrated to be significantly superior to placebo. Even if there are methodological difficulties not resolved (comorbidity, homogeneous population) results are encouraging.

Adult↗