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Biomedical subjects

L Cocito

Publications and source records attributed to L Cocito.

At least 19 recordsLinked to original sources

MRI findings in epileptic patients on vigabatrin for more than 5 years.

Although vigabatrin is a promising new antiepileptic drug, its safety has been challenged by the report of dose-dependent central nervous system myelin vacuolation in some preclinical animal studies. Since it has been shown that vacuolation is associated with specific magnetic resonance imaging (MRI) findings in rats and dogs, MRI of the brain was performed in 11 patients with complex partial seizures who had been receiving vigabatrin for 64-78 months (mean 74.0 +/- 5.0 sd) as additional treatment for epilepsy, with a cumulative exposure ranging 4200 to 9360 g. In no case did MRI show white matter changes similar to the pathological findings of microvacuolation observed in animals. These results would appear to confirm that current doses of vigabatrin do not cause myelin vacuolation in humans, even for treatment periods of longer than 5 years.

Adult

Focal epilepsy as a possible sign of transient subclinical ischemia.

Late-onset partial epileptic seizures occurred in 10 patients with symptoms and/or signs of ischemic cerebrovascular disease (ICVD) and were associated with transient ischemic attacks in 7 of them. History, somatic and neurological examinations, laboratory and ancillary investigations and follow-up revealed no other disease which might be responsible for the seizures. The anatomical and temporal proximity of signs of ICVD indicate the latter as the most likely cause of seizures. Although the available neuroimaging did not allow us to rule out the presence of silent cerebral infarctions in all patients, it is conceivable that jacksonian seizures, and more rarely complex partial seizures, might occasionally represent a clinical sign due to transient cerebral ischemia and thus herald major cerebrovascular events.

Adult

Preliminary note on the effect of denzimol in partial epilepsy.

The antiepileptic activity of the imidazole derivative denzimol has been evaluated in 10 patients with poorly controlled partial epilepsy by adding on the drug to the current therapy, in an open preliminary trial. A sustained drop in seizure frequency greater than 50% occurred in 5 patients. Although denzimol increased blood concentrations of carbamazepine, correlation analysis indicated that the improvement was more likely due to intrinsic properties of denzimol. No severe side effects were reported, although several patients experienced nausea and vomiting, which caused 2 patients to drop out.

Adult

Preliminary observations on the activity of progabide, administered as monotherapy in complex partial seizures.

Progabide (PGB), a gamma-amino-butyric acid receptor agonist, was administered, according to an open-label long-term design, to 40 adult patients suffering from complex partial seizures, with or without secondary generalization, whose response to carbamazepine (CBZ) monotherapy was unsatisfactory. A reference-baseline period of two months with carbamazepine monotherapy was followed by a two-month "add-on" period where increasing doses of progabide were added without modifying the CBZ regimen; then CBZ was withdrawn over 15-60 days and patients were followed up to 12 months' progabide treatment. Twenty-seven patients completed the trial but 12 of them had to be returned to CBZ + PGB bitherapy due to an increase of seizures following CBZ withdrawal. A definite therapeutic effect could be observed in nine patients on PGB monotherapy and in six patients on CBZ + PGB bitherapy. Side-effects of clinical relevance occurred in three cases and were represented by remarkable anxiety in two patients and a rise in serum glutamic oxalo-acetic acid and pyruvic transaminases with clinical symptoms of liver dysfunction in one, with rapid recovery following progabide discontinuation. In conclusion, progabide was effective against complex partial seizures in about 40% of patients not responding satisfactorily to available antiepileptic drugs. Although the withdrawal of previous antiepileptic drugs was not possible in all patients, progabide monotherapy was sometimes more effective than CBZ monotherapy, and several patients in whom bitherapy had to be restored benefited from the association of progabide.

Adolescent

Carbamazepine and cardiac conduction disturbances.

Carbamazepine-induced cardiac conduction disturbance is reported in 2 patients suffering from epilepsy. The cardiac defects disappeared in both patients after carbamazepine was discontinued, and reappeared in 1 patient after treatment was resumed.

Bradycardia

Cerebrospinal fluid and neuropathological study in Devic's syndrome. Evidence of intrathecal immune activation.

Cerebrospinal fluid (CSF) was studied in 2 cases of Devic's syndrome (DS). In one of these cases autopsy was carried out. The main CSF feature in DS is the association of blood-brain barrier damage and intrathecal IgG synthesis. These findings are in keeping with our neuropathological observation of diffuse central nervous system vasculitis and leptomeningitis. As a whole, our CSF and neuropathological findings in DS are consistently different from those in multiple sclerosis.

Albumins

Preliminary evaluation of the effect of GABA and phosphatidylserine in epileptic patients.

The effect of the combined administration of gamma-aminobutyric acid (GABA) and phosphatidylserine was evaluated in a pilot study of 42 patients with drug-resistant epilepsy. The group included patients with complex partial seizures, simple partial seizures and absence seizures. Patients with complex partial seizures and simple partial seizures showed no significant improvement; on the other hand, there was a remarkable decrease in absence seizures, linearly related to the dose of GABA and phosphatidylserine. Side effects occurred in 9 patients and were usually mild.

Adolescent

Short-latency somatosensory evoked potentials in degenerative and vascular dementia.

Short-latency somatosensory evoked potentials (SEPs) were recorded from 54 patients with dementia as compared to 32 age-matched controls. SEPs were generally normal in patients with senile dementia of Alzheimer type, while patients with multi-infarct dementia showed a prolonged central conduction time, an increased latency of both N13 and N20 and a reduction of the primary cortical response amplitude. These findings suggest that recording SEPs may be useful in the differential diagnosis between degenerative dementia and multi-infarct dementia.

Adult

Skin fibroblasts in Huntington's disease. An electron microscopic study.

Cultured skin fibroblasts of 3 patients with Huntington's disease (HD) and of 3 normal individuals have been examined by electron microscopy during the log phase of growth and at confluence. Though HD fibroblasts achieve higher maximal densities than controls, this is not associated with abnormal ultrastructural aspects of the cells. In particular, microfilaments and microtubules are identical in HD and normal fibroblasts.

Adult

[Further research on the functional asymmetry between the superior and inferior visual hemifields: analysis of the reaction time to simultaneous stimulation of the two hemi-fields].

It has been previously reported that presentation of square-wave gratings to either side of the horizontal meridian of the visual field gives rise to different Simple Reaction Times (RTs), depending upon the spatial frequency of the stimuli. Specifically, for 1 c/deg stimulus RT is faster in the lower hemefield, whereas the reverse is true for 3 c/deg pattern, RT being faster in the upper visual field. In the reported experiment, RT to simultaneous presentation of either the same (alternatively 1 c/deg or 3 c/deg) or different (i.e. 1 c/deg and 3 c/deg combined) spatial frequencies to both hemifields was analyzed. The data show that whenever the two half components correspond to different RTs, the resulting RT equates that of the faster component. Conversely, when the two components give rise to identical RTs, the resulting RT does not differ from the value obtained with each half stimulus. Implications of this result for the functional organization of the visual system are discussed.

Adult

Interactions between central monoaminergic systems: dopamine-serotonin.

Concentration of dopamine and serotonin metabolites (HVA and 5-HIAA) in the CSF was evaluated before and after pharmacological treatment in 19 patients with different neuropsychiatric diseases. In every case a reciprocal modification of the two metabolites occurred after treatment. The result supports the hypothesis of a functional balance between the monoaminergic systems in the central nervous system.

Adolescent

[Neuro-ophthalmological problems: the diagnostic value of contrast sensitivity].

The evaluation of the individual contrast sensitivity function may prove useful in cases affected by lesions of the optic pathways, even when the usual neuro-ophthalmological tests (i.e. visual acuity, visual field examination) are normal. The contrast sensitivity function represents an alternative method to assess the power of spatial resolution of the visual system: in particular, it enables to measure the sensitivity at high, medium and low ranges of spatial frequencies, this being unique to such a procedure. The possible physiological mechanisms underlying the contrast sensitivity function as well as its pathological changes are reviewed.

Form Perception

Trazodone by intravenous infusion in depressions secondary to organic disease.

16 patients with organic depression were treated with low doses of trazodone (100 mg/day) by i.v. infusion. This drug was shown to have a marked antidepressant and anxiolytic action and did not produce any significant side-effects. The authors suggest that on the basis of the diminished 24-hour urinary excretion of 5-HIAA, trazodone seems to have an antiserotonin action at low doses.

Adult

Vigabatrin in complex partial seizures: a long-term study.

The efficacy and safety of oral vigabatrin (VGB) as add-on therapy in the long-term treatment of poorly controlled epilepsy were evaluated in 19 patients with complex partial seizures, either with or without secondary generalization. The study was run with a single-blind, placebo-controlled, crossover design, and included 2 months of placebo and 13-15 months of treatment with VGB, at doses ranging from 1 to 4 g/day. Of the 14 patients who completed the trial, 2 were seizure free, in 5 seizure frequency dropped by more than 75% and in another 5 by more than 50% with respect to baseline. The decrease in seizure frequency in the group as a whole was significant at all observation points of the trial. Three patients were not entered into the long-term phase due to lack of improvement (an increase in seizure frequency was observed in one of them), and 2 were excluded later because improvement disappeared leading to unauthorized changes in comedication. Side effects were mild and never caused discontinuation of treatment. In conclusion, VGB showed a remarkable efficacy and safety in the long-term treatment of complex partial seizures.

Administration, Oral