Biomedical subjects

F Lamanna

Publications and source records attributed to F Lamanna.

9 recordsLinked to original sources

PubMed2004

Benign paroxysmal positional vertigo: diagnosis and treatment.

Benign paroxysmal positional vertigo (BPPV) has been recognized as the most common vestibular disorder; it is a term coined in 1952 by Dix and Hallpike, and it is most commonly used to describe a disease with a characteristic clinical presentation believed to be caused by free-floating particles leaving the macula and entering one of the semicircular canals, usually the posterior one, more rarely the horizontal or superior ones. A lot of studies showed as the prevalence is higher in females than in males with a ratio of 2:1; furthermore, prevalence increases with the age: the mean age at onset is 54 years, with a range of 11 to 84 years. The most important clinical manifestations of BPPV are: vertigo, lightheadedness, dysequilibrium and sometimes nausea, vomiting, pallor and sweating. The diagnosis of BPPV is very simple through the Dix-Hallpike test or the diagnostic Semont's maneuver; the increasing information about the BPPV's pathogenesis has led most authors to consider the rehabilitative therapy, and in particular the so-called Semont's "liberatory" maneuver, as the first choice treatment of BPPV, in relation to its quickness and efficacy. In this treatment the debris are moved from the posterior semicircular canal to another location within the vestibular labyrinth. In our review we consider the possible pathogenesis of this disease and the best therapies, like repositioning maneuvers, in a patient affected by BPPV.

Adolescent↗

PubMed2003

Dysphonia and cervical hyperostosis: a case report.

We report a case of a 77-year-old man with a 3-year-history of progressive dysphonia, without dysphagia. His voice sounded breathy; the pitch and the loudness were low. He complained of a few episodes of voice breaking. At laryngostroboscopy the adduction motion of the left true vocal cord was slower than the contralateral one. A cervical spine X-ray demonstrated a generalized vertebral osteophytosis and a 3-centimeter-long anterior osteophytic spur, originating from C6. Evaluation with barium swallow showed a dislocation of the inferior cervico-oesophagus to the right, with a preservation of its lumen. Cervical-thoracic computed tomography showed a mild pressure produced by the osteophyte on the thyroid cartilage and the presence of the radiological criteria for Forestier's disease. Therefore, the presence of dysphonia in older adults without any primary laryngeal cause, indicates a radiological study of the cervical-thoracic region, in order to discover cervical osteophytosis.

Aged↗

PubMed2002

Unilateral endolymphatic hydrops: what about the contralateral ear?

INTRODUCTION: The early recognition of incipient Meniere's disease (MD) in the asymptomatic ear of a patient with known unilateral disease has profound implications for patient management and follow-up, but the criteria for a right and precocious diagnosis is still controversial. MATERIALS AND METHODS: We evaluated forty-nine patients with MD, selected according to Committee on Hearing and Equilibrium guidelines. All patients underwent laminar tonal audiometry, stapedial reflex study, Glycerol dehydration test, Auditory Brainstem Response (ABR) vestibular examination. MRI was performed in 14 patients. RESULTS: A raised hearing threshold in the contralateral ear was found in 27 patients, but only 7 (14.3%) fulfilled the requirements to be considered affected by bilateral MD. The average delay of occurrence in the contralateral ear was 7 years (from 5 to 12 years). The glycerol test was positive only in 4 patients with unilateral MD and moderate hearing loss. It was not positive in any case of bilateral MD. The membranous endolymphatic duct and sac is not well visualised with MRI on the affected side in the majority of patients. CONCLUSION: A MRI study must be included in the diagnostic protocol for MD and with improvements in this imaging modality will possibly allow detection of variations in the size of inner ear structures. Glycerol dehydration test was useful only in selected cases. A full assessment of incipient disease in the asymptomatic ear in unilateral Meniere's disease should be undertaken. A conservative approach in surgical treatment of unilateral MD is recommended because of the possibility of evolution of a bilateral form, which can occur even 10 years after the onset of the disease.

Adult↗

PubMed1992

Controlled study on L-carnitine therapeutic efficacy in post-infarction.

A controlled study was carried out on 160 patients of both sexes (age between 39 and 86 years) discharged from the Cardiology Department of the Santa Chiara Hospital, Pisa, with a diagnosis of recent myocardial infarction. L-carnitine was randomly administered to 81 patients at an oral dose of g 4/die for 12 months, in addition to the pharmacological treatment generally used. For the whole period of 12 months, these patients showed, in comparison with the controls, an improvement in heart rate (p < 0.005), systolic arterial pressure (p < 0.005) and diastolic arterial pressure (NS); a decrease of anginal attacks (p < 0.005), of rhythm disorders (NS) and of clinical signs of impaired myocardial contractility (NS), and a clear improvement in the lipid pattern (p < 0.005). The above changes were accompanied by a lower mortality in the treated group (1.2%, p < 0.005), while in the control group there was a mortality of 12.5%. Furthermore, in the control group there was a definite prevalence of deaths caused by reinfarction and sudden death. On the basis of these results, it is concluded that L-carnitine represents an effective treatment in post-infarction ischaemic cardiopathy, since it can improve the clinical evolution of this pathological condition as well as the patient's quality of life and life expectancy.

Adult↗

PubMed1992

[The hypotriglyceridemic action of the combination of L-carnitine + simvastatin vs. L-carnitine and vs. simvastatin].

Previous studies had determined the role played by L-carnitine and simvastatin in the treatment of altered lipidemia in dialyzed patients with chronic uremia. The authors carried out a study on the above substances either singly or together administered to the same patients with chronic uremia in hemodialysis. This study was aimed at demonstrating the possible synergic normolipidemic action of both substances in comparison with their single administration, because their different mechanism of action could be metabolically enhanced. The obtained results demonstrated that the therapeutic association proposed is preferable to the use of the single substances. Moreover, a higher and more rapid normolipidemic effect was obtained after using L-carnitina associated with simvastatin with respect to the separated substances.

Aged↗

PubMed1992

Clinical investigation on the hypolipidemic effect of simvastatin in primary hypercholesterolemia.

Simvastatin, 20 mg daily, was given orally to 21 hypercholesterolemic outpatients for 16 weeks. During treatment a significant reduction was found in plasma total and LDL cholesterol; plasma HDL-cholesterol levels increased during the treatment. Results indicate that simvastatin, because of its activity and lack of toxicity and side effects, can be considered a drug of first-choice for the treatment of primary hypercholesterolemia.

Anticholesteremic Agents↗

PubMedDate not supplied

Long-term therapy using GHB (sodium gamma hydroxybutyrate) for treatment-resistant chronic alcoholics.

Thirty-five alcohol-dependent patients according to DSM-IV criteria who also met criteria for treatment resistance were treated with doses of gamma hydroxybutyrate (GHB) ranging between 25 and 100 mg/kg/die in an open one-year study. The results show that no patients discontinued the program during the first month of treatment. Sixty percent of these patients successfully completed the protocol; 11.4% showed complete abstinence (full responder patients); 14.3% strongly reduced their alcohol intake (partial responder patients) and 34.3% of the patients were still under treatment after one year. Forty percent of the patients were nonresponders. The retention rate under treatment of the studied sample was statistically higher than that found during the last treatment of the same subjects. No significant differences were found between full responder and partial responder patients regarding changes in clinical features, alcohol intake or social adjustment. Patients still in treatment after one year significantly differed from nonresponder patients on all the variables investigated. A six-times/daily fractionated administration of the GHB dose was the only significant predictor of the retention rate.

Adjuvants, Anesthesia↗

PubMedDate not supplied

Benign paroxysmal positional vertigo: a comparative prospective study on the efficacy of Semont's maneuver and no treatment strategy.

PURPOSE: The present study investigates the efficacy of Semont's repositioning liberatory maneuver by comparing it with no-treatment in a population of patients with benign paroxysmal positional vertigo (BPPV). MATERIALS AND METHODS: In this randomised, controlled, 6-month efficacy trial, 40 patients affected by BPPV were treated with Semont's maneuver. Outcomes were measured subjectively by patients about their Activities of Daily Living (ADL) and quality of life, based on the "Vestibular Disorders Activities of Daily Living Scale". Results were compared to those obtained in 40 non-treated BPPV patients. RESULTS: During the first month of the study, 92.5% of patients of Semont's group resolved their symptoms. Cure rates with Semont's maneuver were significantly higher than those obtained with no-therapy (92.5% versus 37.5%). Within a six month follow-up, relapse rates were lower among patients treated with Semont's maneuver than among the no-treated ones (5% versus 60%). All patients with a resolution of symptoms and a negative Dix-Hallpike's test presented a great improvement in daily activities and quality of life. CONCLUSIONS: BPPV is easy to solve with a successful repositioning maneuver. Since BPPV is a very common cause of vertigo and can represent a medical emergency, we believe that it is of interest for every general practitioner to be able to promptly recognize this frequent balance disorder and to be able to treat a patient affected by BPPV with a safe repositioning maneuver.

Activities of Daily Living↗

PubMedDate not supplied

What is vertigo?

Vertigo is one of the types of dizziness with dysequilibrium, presyncope and lightheadedness. But what does vertigo mean? Vertigo indicates a sensation of false movement (generally described like a rotation) but sometimes the patient can describe it like a sensation of tilt. Instead, the word dizziness indicates a sensation of disturbed relation to surrounding objects in space with feelings of rotation or whirling characteristic of vertigo as well as non-rotatory swaying, weakness, faintness and unsteadiness characteristic of giddiness. In our review we describe, after brief considerations about functional anatomy of the vestibular system, the most important cause of vertigo considering the duration of the symptom; moreover we underline the importance of anamnesis and of the objective examination for a correct differential diagnosis of a dizzy patient. As to objective examination we describe the most important characteristics of nystagmus, that is the only objective sign in vertigo, of central and peripheral origin. At last we consider the most efficacious therapies, like as medications (specific and aspecific), surgery (conservative and destructive) and rehabilitation, in relation the characteristics and the causes of vertigo.

Age Factors↗