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F Mancini

Publications and source records attributed to F Mancini.

86 records · Page 5Linked to original sources
PubMedDate not supplied

High-dose ropinirole in advanced Parkinson's disease with severe dyskinesias.

Levodopa (LD) is the gold standard of therapy for Parkinson's disease, but it is commonly associated with motor fluctuations and dyskinesias. Dopamine agonists are often used as adjuncts to LD in an attempt to reduce these complications. In this open-label study the authors investigated the effects of high doses of adjunctive ropinirole in 36 patients with advanced Parkinson's disease and normal cognitive status. The daily dose of ropinirole was increased from 18.4 +/- 3.5 mg to 34.7 +/- 5.5 mg, generally in four separate doses. The daily LD dose was decreased from 734.1 +/- 254.8 mg to 502.8 +/- 228.4 mg. After 12 months 25 patients were still on high doses of ropinirole whereas 11 patients had, after either the emergence of side effects or a worsening of their clinical conditions, decreased or interrupted ropinirole. At 12 months, the daily doses of LD and ropinirole were 489 +/- 243 mg and 34.6 +/- 4.6 mg respectively. There was a significant reduction in the Dyskinesia Rating Scale scores during both ON and OFF periods, indicating a reduction in dyskinesias during ON periods and a reduction in dystonias during OFF periods (p < 0.001). Both the intensity and the hours spent during OFF periods were reduced significantly (p < 0.001). Even though these results need to be confirmed through extended controlled studies, the high-dose dopamine agonist strategy is safe for patients with advanced PD in whom a marked motor response to LD (even at very low doses) is associated with severe dyskinesias, and may be used as a means of delaying surgery or as an alternative to continuous apomorphine infusion.

Aged↗
PubMedDate not supplied

Active music therapy in Parkinson's disease: an integrative method for motor and emotional rehabilitation.

BACKGROUND: Modern management of Parkinson's disease (PD) aims to obtain symptom control, to reduce clinical disability, and to improve quality of life. Music acts as a specific stimulus to obtain motor and emotional responses by combining movement and stimulation of different sensory pathways. We explored the efficacy of active music therapy (MT) on motor and emotional functions in patients with PD. METHODS: This prospective, randomized, controlled, single-blinded study lasted 3 months. It consisted of weekly sessions of MT and physical therapy (PT). Thirty-two patients with PD, all stable responders to levodopa and in Hoehn and Yahr stage 2 or 3, were randomly assigned to two groups of 16 patients each. We assessed severity of PD with the Unified Parkinson's Disease Rating Scale, emotional functions with the Happiness Measure, and quality of life using the Parkinson's Disease Quality of Life Questionnaire. MT sessions consisted of choral singing, voice exercise, rhythmic and free body movements, and active music involving collective invention. PT sessions included a series of passive stretching exercises, specific motor tasks, and strategies to improve balance and gait. RESULTS: MT had a significant overall effect on bradykinesia as measured by the Unified Parkinson's Disease Rating Scale (p < .034). Post-MT session findings were consistent with motor improvement, especially in bradykinesia items (p < .0001). Over time, changes on the Happiness Measure confirmed a beneficial effect of MT on emotional functions (p < .0001). Improvements in activities of daily living and in quality of life were also documented in the MT group (p < .0001). PT improved rigidity (p < .0001). CONCLUSIONS: MT is effective on motor, affective, and behavioral functions. We propose active MT as a new method for inclusion in PD rehabilitation programs.

Female↗
PubMedDate not supplied

Selective induction of MCP-1 in human mesangial cells by the IL-6/sIL-6R complex.

Interleukin (IL) 6, an autocrine growth factor for mesangial cells, and chemokines, which are released from activated mesangial cells and induce leukocyte infiltration, play a critical role in the progression of immune system mediated renal diseases. Since the reciprocal relationship between IL-6 and chemokines in renal inflammation has been barely investigated, we have analyzed whether IL-6 (500 ng/ml), alone or in combination with the soluble form of its receptor (sIL-6R, 200 ng/ml), can induce normal human mesangial cells (NHMC) to release alpha and/or beta chemokines: MCP-1 (monocyte chemoattractant protein 1), IL-8, Rantes (regulated on activation, normal T cell expressed and secreted), and MIP-1alpha (macrophage inflammatory protein 1alpha). Whereas IL-6 or sIL-6R alone were ineffective in inducing significant chemokine release from NHMC, the simultaneous treatment with IL-6 and sIL-6R showed a significant interaction, leading to a strong synergic effect on MCP-1 synthesis and release without exerting any relevant activity on IL-8, Rantes, or MIP-1alpha. Consistently with the unresponsiveness to IL-6, mRNA and protein expression analysis of the two subunits which form the functional IL-6 receptor showed that NHMC express only the gp130 signal-transducing chain and not the subunit-specific IL-6R (gp80). These findings support an unexpected role of the IL-6 system in kidney inflammatory reactions through the selective regulation of monocyte recruitment.

Blotting, Northern↗
PubMedDate not supplied

Remediation of Wisconsin Card Sorting Test performance in schizophrenia. A controlled study.

Previous studies have shown encouraging plasticity in some schizophrenic patients' Wisconsin Card Sorting Test (WCST) performance while receiving detailed specific instructions on task and reinforcement. The present study examines the efficacy of a modified procedure for WCST administration that bound schizophrenic patients to use a conceptually driven cognitive strategy without instruction or reinforcement. The schizophrenics' results were also compared to those obtained with the same procedure from a matched control sample. By using this procedure, 63.2% of WCST schizophrenic poor performers dramatically improved their results. Schizophrenic poor performers who did not achieve remediation were of a younger age at onset and had more negative symptoms. This pattern was strictly associated with more perseverative errors on WCST that increased even more when the conceptually driven processing was forced. Our findings could have important implications for our understanding of the underlying cognitive deficit of the poor neuropsychological performance and allow the distinction of schizophrenic subtypes who show peculiar features that probably reflect a different pathophysiology and would potentially benefit from different modalities of treatment and rehabilitation.

Adult↗
PubMedDate not supplied

Sensorineural hearing loss in otitis media.

Additional evidence is presented to support the hypothesis that both acute purulent otitis media (POM) and chronic suppurative otitis media (COM) can cause high frequency sensorineural hearing loss. In selected patients and in animals (chinchillas) in a pilot study using electrophysiological methods, both temporary threshold shifts and permanent threshold shifts of basal cochlear turn involvement were demonstrated in POM. Data of cochlear involvement in 475 ears with bilateral COM, 607 ears with unilateral COM, and 607 ears serving as controls were obtained from six centers in five countries. In group 1 (15 dB or greater), 43% of ears with unilateral COM and 42% of ears with bilateral COM showed losses, for a combined odds ratio eight times that in controls. In group 2 (30 dB or greater), 16% of ears with unilateral COM and 17% of ears with bilateral COM demonstrated, respectively, seven and ten times that in controls. These statistically significant findings influence clinical considerations.

Acoustic Impedance Tests↗
PubMedDate not supplied

The position of the head in space: a kinematic analysis in patients with cervical dystonia treated with botulinum toxin.

Many instruments have been employed in recent years in order to quantify the posture and motion of the head in normal and pathological subjects. Evaluations of this type present many difficulties related to the influence of individual and external factors and to the accuracy of the system used. In patients with cervical dystonia (CD) the only rating scales currently used are semi-quantitative and subjective. More precise information on disease severity and response to the treatment is needed. Posture and motion of the head were evaluated by means of ELITE motion analyser (BTS, Milan, Italy) in 6 patients with the left laterocollis form of CD undergoing treatment with botulinum toxin (BTX). The method emerged as very useful for the quantification of the therapeutic response (which was more marked in motion than in posture). We found an inverse relationship between the degree of motion improvement and the restriction of motion before treatment.

Adult↗
PubMedDate not supplied

Immediate passive mobilization of the hip after internal fixation of acetabular fractures.

The authors report the results obtained in 16 patients affected with displaced fracture of the acetabulum treated surgically and mobilized passively immediately after surgery by means of a continuous passive mobilization apparatus for the hip. The age of the patients at the time of trauma ranged from 21 to 54 years. The posterior wall was involved in 12 cases, while the anterior column was also involved in 4. Excellent or good reduction of the fracture was obtained in all of the cases. Immediately after surgery, a continuous passive motion apparatus for the hip was applied to be used for approximately 3 weeks. At final follow-up, which was obtained after a mean time of 5 years, all of the patients except 2 had obtained good results. Moderate joint deficit was present in 1 case, while sciatic nerve palsy that had already been observed prior to surgery persisted in another. Evident radiographic signs of coxarthrosis were not present in any of the cases. Based on the opinion of Salter et al. (1980), who in an experimental study had observed better healing of the cartilaginous lesions in the joints submitted to movement, immediately after surgery we applied a continuous passive motion apparatus for the hip in a group of patients affected with fracture of the acetabulum. As none of the patient followed-up by us presented evident signs of hip arthrosis, the authors hypothesize that continuous passive movement, immediately carried out after osteosynthesis, plays a significant role in preventing post-traumatic arthrosis of the hip. In truth, small irregularities of the acetabular cavity, possibly present after an apparently anatomical reduction, could be minimized by the plasmating effect of the head of the femur in movement.

Acetabulum↗
PubMedDate not supplied

Approach to respiratory failure in emergency department.

OBJECTIVES AND BACKGROUND: The goal of this review is to provide update recommendations that can be used by emergency physicians who provide primary cares to patients with Acute Respiratory Failure (ARF), from the admission to an emergency department through the first 24 to 48 hours of hospitalization. This work wants to address the diagnosis and emergency medical care of ARF and the management of medical complications. STATE OF THE ART: A lot of statement has been developed for the early management and treatment of ARF; moreover, over the last fifteen years, we have assisted to the rise of a new technique of ventilation, in the Emergency Department: Non Invasive Ventilation. This kind of ventilation was firsthy applied in intensive Care and in Respiratory Care Unit. Randomized controlled clinical trials have showed its usefulness in the early treatment of several forms of ARF, together with medical therapy.

Acute Disease↗
PubMedDate not supplied

Terguride in stable Parkinson's disease.

Terguride (TER) (2 mg/day) was compared with a placebo in 41 stable Parkinson's disease (PD) patients, so as to test its efficacy as an add-on treatment to spare levodopa (LD). After the 4th week of add-on treatment, LD was reduced by about 25%. The number of "stable" patients (--those with an increase of no more than 20% of the basal Columbia University Rating Scale (CURS) score--remaining after LD reduction was used to compare the two add-on treatments. Most patients, remained "stable" in spite of LD reduction, and no significant differences between the therapies were discovered; the CURS score decreased over time only in the TER group. Hence, TER was shown to be a drug that has DA-ergic properties but with minimal antiparkinsonian efficacy.

Aged↗
PubMedDate not supplied

Active music therapy and Parkinson's disease: methods.

Music therapy (MT) is an unconventional, multisensorial therapy poorly assessed in medical care but widely used to different ends in a variety of settings. MT has two branches: active and passive. In active MT the utilisation of instruments is structured to correspond to all sensory organs so as to obtain suitable motor and emotional responses. We conducted a prospective study to evaluate the effects of MT in the neurorehabilitation of patients with Parkinson's Disease (PD), a common degenerative disorder involving movement and emotional impairment. Sixteen PD patients took part in 13 weekly sessions of MT each lasting 2 hours. At the beginning and at the end of the session, every 2 weeks, the patients were evaluated by a neurologist, who assessed PD severity with UPDRS, emotional functions with Happiness Measures (HM) and quality of life using the Parkinson's Disease Quality of Life Questionnaire (PDQL). After every session a significant improvement in motor function, particularly in relation to hypokinesia, was observed both in the overall and in the pre-post session evaluations. HM, UPDRS-ADL and PDQL changes confirmed an improving effect of MT on emotional functions, activities of daily living and quality of life. In conclusion, active MT, operating at a multisensorial level, stimulates motor, affective and behavioural functions. Finally, we propose active MT as new method to include in PD rehabilitation programmes. This article describes the methods adopted during MT sessions with PD patients.

Aged↗