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Biomedical subjects

G Mapelli

Publications and source records attributed to G Mapelli.

At least 19 recordsLinked to original sources
PubMed1993

The importance of the highest normokalemia in the treatment of early hepatic encephalopathy.

An inverse relation is known to link blood potassium with renal synthesis and the release of ammonia. Given the liability of hyperammonemia for precipitating hepatic encephalopathy (HE), 28 patients affected by stage I HE were equally divided into two groups and maintained up to their death at the highest (5.4-5.5 mEq/l) or the lowest (3.5-3.6 mEq/l) normokalemia levels. When compared with the lowest normokalemia group, the highest one showed an early, albeit transient, improvement in the mental state (as assessed by both EEG and psychiatric investigations) and to a lesser extent in hepatic functions (as assessed by the variations in serum bilirubin, GPT, GGT and plasma prothrombin time). In the highest normokalemia group the survival was also prolonged. The cause of this improvement may be related to the induced decrease in blood pH, the consequent depression of renal ammoniagenesis and the rise in the arterial and urine NH+4/NH3 ratios. These factors reduce the entry of ammonia into the cells and enhance the urinary excretion of this metabolite, respectively.

Adult↗
PubMed1993

An unusual case of epileptic transient aphemia. Clinical and neuropsychological findings.

A patient with unusually prolonged epileptic aphemic attacks following a surgical lesion in the left frontal lobe is described. Clinical, electroencephalographic and neuropsychological findings are reported. True aphemia is relatively rare and the described case affords the opportunity of emphasizing that a relatively rare disorder of language as aphemia might also occur with true epileptic attacks.

Adult↗
PubMed1991

Progression of optic neuritis to multiple sclerosis: a prospective study in an Italian population.

We prospectively studied 40 patients with uncomplicated optic neuritis (ON) to determine the risk of subsequent multiple sclerosis (MS). All patients were followed for at least 12 years. Ten patients (25%) developed MS. Seven of these 10 patients developed MS within 2 years. Both sexes were at high risk if ON occurred between the ages of 21 and 40. There was an overall increased risk of MS with recurrent ON. The course of MS appeared to be fairly benign during the period of observation.

Adolescent↗
PubMed1990

Epidemiologic approach to Huntington's disease in northern Italy (Ferrara area).

As part of a multidisciplinary study program, an epidemiological descriptive survey was carried out in the province of Ferrara, northern Italy. The temporal trend of Huntington chorea (HC) in the last century (1871-1987) was determined in the study area, and the patients and subjects at risk were identified with the aim of creating genetic advisory councils offering preventive interventions to eliminate the disease. The final study population consisted of 10 unrelated families with HC and 47 HC cases who lived in the province of Ferrara in the survey period. The estimate of the prevalence rate varied over the time period considered between 3.09 and 0.36 cases per 100,000 inhabitants. The temporal trend was characterized by increasing and decreasing phases, reflecting the incidence (varying between 0.20 and 0.00 annual cases per 100,000 inhabitants) and mortality (varying between 0.21 and 0.00 annual deaths per 100,000 inhabitants) rates. This trend shows that the frequency of HC in the study area was not stable. It was characterized by a cyclic course with a period of about 50 years. In the recent decades of the study, the incidence and the prevalence rates showed a relative increase. Thus, HC persists in the Ferrara population despite a greater public awareness and the recent lower birth rate. A new peak of prevalence is likely in the near future.

Adolescent↗
PubMed1988

Life-threatening hyponatremia caused by vinblastine.

Some days after the administration of a third bolus of ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) a patient affected by immunoblastic lymphoma underwent a neurotoxic crisis. The episode lasted 1 week and was followed by a dramatic fall in plasma sodium (104 mEq I-1), associated with a proportionally lesser decrease in plasma chloride and phosphate. Despite the lowest plasma osmolality, detectable levels of circulating ADH were present. After 36 h the hyponatremic episode improved after the infusion of hypertonic sodium chloride. Nevertheless the patient lapsed into a hypotonic coma. The urinary concentrations of the main tubular enzymes (gamma-glutamyltranspeptidase, N-acetyl-glucosaminidase, alpha-glucosidase) proved very high and successively decreased slowly. The most likely cause of such hyponatremic episode is vinblastine. The drug acted through: (a) an already known inappropriate release of ADH, and (b) a hitherto unreported tubular lesion, which impaired the reabsorption of sodium and other coupled solutes.

Adult↗
PubMed1987

[Enzyme induction and anticonvulsants].

Serum gamma-GT-activity was significantly (0.01 greater than P greater than 0.001) elevated in 18 of 30 epileptics receiving carbamazepine (CBZ), i.e. in 60%. The incidence of abnormal gamma-GT-levels in the control group (25 neurotic patients taking minor tranquilizers) was lower (12%). The possible relationships between the enzyme induction or chronic hepatic toxicity and the elevation of serum gamma-GT-activity in epileptics taking CBZ are discussed.

Adolescent↗
PubMed1982

Secondary mania.

Explore the source record for details and available documents.

Adult↗
PubMed1981

Neurosyphilis today.

14 cases of tabes dorsalis, 4 cases of dementia paralytica, 3 cases of lues cerebri, and 1 case of syphilitic meningomyelitis are reported as observed over a 10-year period (1967-1976). Tabes has the peculiarity of revealing itself with pictures characterized by scarcity and mildness of objective neurological manifestations. Dementia paralytica, cerebral meningo-vascular syphilis and spinal syphilitic meningomyelitis remain constant in that they still present typical pictures, i.e., those which are classically described in early literature. In our neurosyphilitics, the most vulnerable average age for the late luetic manifestations in the nervous system in 50 years. In most of the patients examined, changes of the histochemical composition of cerebrospinal fluid are present. The colloidal benzoin test that, in almost all the cases, reveals itself by pathological precipitations is extremely important for a correct diagnosis. In more than one third of the 22 neurosyphilitics examined, all the non-treponemal serological reactions are negative both in the blood and in the cerebrospinal fluid. On the contrary, we assign a greater diagnostic importance to TPI and FTA test, which give positive results in the blood in 65 and 70% of the cases, respectively.

Adult↗
PubMed1980

Emotional and psychotic reactions induced by aphasia.

A systematic study of the emotional and psychotic reactions induced by aphasia was conducted on 63 aphasic patients. 'Indifference reaction' was found in 19 cases and 'depressive reaction' in 36 cases. In 3 aphasics, we observed 'Goldstein's catastrophic reaction' and in 3 other patients, a state of 'euphoric unrestrained excitement'. Finally, in 2 aphasics 'psychotic reaction' was found, characterized by a state of psychomotor catatonic excitement. The hypothesis is advanced that the catatonic phenomenology of these subjects may be interpreted as 'Bonhoeffer's acute exogenous reaction' with catatonic symptoms.

Affective Symptoms↗