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Biomedical subjects

M Alessandrini

Publications and source records attributed to M Alessandrini.

At least 19 recordsLinked to original sources
PubMed2004

Nicergoline in the treatment of dizziness in elderly patients. A review.

In elderly patients, dizziness occurs very frequently with significant effects on the patient's life. Its frequency increases with age, and may arise from a variety of causes. Chronic dysequilibrium in elderly patients is most probably related to disturbances within the central nervous system, due either to altered neuronal functions or to an underlying vascular disease. Nicergoline, a drug used in the treatment of cognitive disturbances in geriatric patients, improves dizziness in elderly demented and non-demented patients. In a double blind,placebo controlled trial the drug improved (i) the severity of symptoms, measured by the dizziness assessment rating scale (DARS), (ii) the overall clinical conditions revealed by global impression scale, and (iii) the perceived quality of life estimated by the dizziness handicap inventory (DHI). These results indicate a possible positive effect also on posturographic measures. Moreover, the improvement occurred at no expense of the established strategy of postural control suggesting that the effect is mediated by a substitute compensatory mechanism allowing the patient to preserve consolidated postural strategies. The results of previous open clinical studies in about 3000 patients are in agreement with those findings. Overall, severity of symptoms decreased by 68 % (57 % in the control study). Globally, the results indicate a beneficial effect of nicergoline on symptoms related to balance disorders of central origin. Animal studies show that the drug displays a broad spectrum of actions on cellular and molecular mechanisms. Moreover, animal research specifically aimed at vestibular pathophysiology has revealed that nicergoline improves vestibular compensation in models of vestibular lesion. Chronic treatment with nicergoline improved the time-course of behavioral recovery in old rats after hemi-labyrinthectomy and counteracted the regulation of cholinergic receptors observed after lesion in old rats. Nicergoline interacts at several levels by various mechanisms, from the molecular level to cognitive function, probably enhancing spontaneous plasticity phenomena underlying the central vestibular compensation. This effect is not dependent from the interaction with a single-transmitter-identified neural pathway, but from anatomical, functional and neurochemical synergistic adjustments in several brain areas.

Aged↗
PubMed2004

Impaired postural control in patients affected by tension-type headache.

Sixteen subjects, affected by chronic tension-type headache (TTH) accordingly to the International Headache Society Classification (1988) criteria, in presence of tenderness in pericranial muscles,with a mean age of 37+/-11.8 years, and ten healthy volunteer subjects, age and sex matched, were submitted to postural analysis by Static Posturography (S.Ve.P. Amplaid). Aim of the study was to evaluate whether patients with TTH have disturbed postural control, as compared to normal subjects. Postural analysis considered all posturographic variables but focused on spectral frequency analysis of body sway. In both open (OE) and closed eyes (CE) condition, spectral frequency analysis showed a significantly increased body sway at low (OE= p < or = 0.01; CE= p < or = 0.01) and middle (OE= p < or = 0.01; CE= p < or = 0.01) frequencies on the antero-posterior (y) plane and at low frequencies (OE= p < or = 0.05; CE= p < or = 0.05) on the lateral (x) plane. Statistical analysis was performed using the Student's t test for unpaired data, p value 0.05 defined significant. The proprioceptive input seems to be predominant at middle and high frequencies in maintaining posture, our results seem then to suggest a proprioceptive disturbance in TTH patients. The disturbance is likely related to chronic pericranial muscle contraction and tenderness. Posturography and spectral analysis may help not only in the diagnosis of a postural disturbance but even more in the follow-up of TTH patients, during and after a medical and/or a rehabilitative treatment.

Adult↗
PubMed2002

Malignant degeneration of oral lichen planus: our clinical experience and review of the literature.

Lichen planus of the oral mucosa (OLP) is characterized by lymphocytic infiltrate in the epithelial layer and basal cells lysis. Some studies have suggested a high incidence of oral squamous cell carcinoma in patients with OLP that has been implicated as a premalignant lesion. We describe 19 cases of OLP, and the immunopathologic basis for OLP, its potential association with malignancy and the variable clinical pictures in patients with OLP are reviewed. Also, specific recommendations are given for treatment and follow-up of lesions.

Adult↗
PubMed2002

Perilymphatic fistula following trans-tympanic trauma: a clinical case presentation and review of the literature.

The perilymphatic fistula is constituted by an anomalous connection between the perilymphatic space and the middle ear. The principal accuses are to be sought in the intracranial pressure increasement, cranial traumas, barotraumas, congenital anomalies, trans-tympanic traumas, etc. Stapes's dislocation in the vestibule and the fracture of the platina are the most frequent pathogenic mechanisms. In clinical practice, the diagnosis remains a problem rather debated, even if the clinical pattern, the laboratory investigations, the diagnostic images and the tympanic exploration, all together can confirm, in the majority of the cases, the diagnostic suspect. This article presents a clinical case of a transtympanic trauma with perilymphatic fistula caused by a foreign body. The peculiarity of this case must be set in relation with both the aetiopathogenesis of the labyrinthine lesion and the severity of the symptomatology caused by it.

Anti-Inflammatory Agents↗
PubMed2001

A case of solitary nasal schwannoma.

A case of solitary neurilemmoma is presented. The patient was a 35-year-old male with progressive nasal obstruction due to a neoformation of the left vestibule. After the surgery the pathological diagnosis was neurilemmoma.

Adult↗
PubMed2001

Saccadic eye movement and visual pathways function in diabetic patients.

We assessed saccadic eye movements (SEM) and the visual evoked potentials (VEP) with the aim to evaluate whether a correlation exist between SEM and visual pathways function, in insulin-dependent diabetes mellitus (IDDM) patients. In IDDM patients we observed significantly longer SEM latency, while SEM velocity and accuracy were similar to those of the controls; VEP showed a significant delay of the latencies and significant reduction of the amplitudes in IDDM patients no relationship between SEM and VEP parameters were found. In conclusion SEM latency delay suggest an impairment of the saccadic eye movement system, while impaired VEP may be ascribed to a dysfunction of the visual pathways. The lack of correlation between VEP impairment and SEM latency delay suggests that in our IDDM patients the delay of saccadic latency could be ascribed to a difuse neuronal problem exceeding the visual pathways disfunction.

Adult↗
PubMed2001

[Postural changes in systemic sclerosis: preliminary results].

Systemic Sclerosis (SSc) is a generalized disease of unknown etiology which frequently presents neurological involvement of the central or peripheral nervous system. Besides various types of neuropathies, at times postural alterations of uncertain genesis can be found. Such alternations have never undergone organic study. The present work evaluates the static posture of subjects suffering from SSc without any subjective otoneurological symptoms. A total of 30 subjects-10 normal volunteers and 20 patients suffering from SSc-underwent full clinical examination, immunological testing (immunoglobulin; ANA; anti-ENA, anti-centromere, anti-SCL70, anti-DNA, anti-cardiolipin antibodies; C3, C4; circulating immunocomplexes) and capillaroscopy of the periunguis vallecula. The capillaroscopy data showed 2 distinct general pictures of sclerodermic microangiopathy: 1) a "slow pattern", not particularly aggressive, where capillarectasia and neoangiogenesis prevail; 2) an "active pattern", highly aggressive, where architectural disorder, capillary loss with the formation of avascular areas prevail. The 20 SSc subjects following the same therapy and free of any significant otoneurological, vasculo-metabolic or osteoarticular pathologies and the 10 healthy volunteers of compatible age and sex, underwent computerized Static Posturography (S.Ve.P-Amplaid). The immunological examinations showed that all patients were positive for ANA, 12 tested positive for anti-SCL70 antibodies and 7 for anti-centromere antibodies. The results of posturography showed a significant increase in parameter: "surface" and "standard deviation of velocity" with closed eyes. Spectra frequency analysis, processed using a personal method, showed a significant increase in panfrequency oscillations vs. the controls on both axes and both with eyes open and closed. The preliminary results of this study, which from reviewing the literature we believe to be the first of its kind performed, appear to indicate a subclinical suffering upon postural control in SSc: the alterations in the posturographic spectral frequency analysis indicate that all postural control mechanisms are extensively compromised, causing a pluriplanar, multifrequency destabilization both with and without the use of vision.

Adult↗
PubMed2001

[Dermoid cysts of the floor of the mouth: case report].

Dermoid cysts are for the most part benign neoformations most likely deriving from ectodermic differentiation of totipotent cells. Although localization on the floor of the mouth has been described for more than a century it is still reported as rare and can give rise to problems in differential diagnosis. This work presents a case of dermoid cyst of the floor of the mouth in a 16-year-old patient and provides considerations on clinical approach, diagnosis and therapy for this type of lesion.

Adolescent↗
PubMed1999

Impaired saccadic eye movement in diabetic patients: the relationship with visual pathways function.

The aim of this study was to evaluate whether a correlation existed between saccadic eye movements and visual pathways function in diabetic patients. Saccadic or fast Eye Movement System (EMS) and Visual Evoked Potentials (VEPs) were assessed in 20 insulin-dependent diabetic mellitus (IDDM) patients without long-term complications and in stable metabolic control and in 21 age-matched control subjects. In IDDM patients we observed significantly (p<0.01) longer EMS latency, while EMS velocity and accuracy were similar to those of controls; VEPs showed a significant delay in N75, P100, N145 latencies and significant reduction of N75-P100 and P100-N145 amplitudes. In IDDM patients no relationships between EMS and VEP parameters were found. In conclusion, EMS latency delay suggests an impairment of the saccadic eye movement system, while impaired VEPs may be ascribed to a dysfunction of the visual pathways. The lack of correlation between VEPs impairment and EMS latency delay suggests that in our IDDM patients the delay of saccadic latency cannot be exclusively related to a visual pathways dysfunction and could be ascribed to a diffuse neuronal involvement.

Adult↗
PubMed1999

[Study on cell proliferation in nasal polyposis as predictive index of recurrence].

The purpose of the present research has been to identify a cellular parameter to be used as an index of increased cell proliferation and, therefore, the likelihood of recurrence. A total of 114 patients with bilateral nasal polyposis underwent naso-ethmoid dissection under endoscopy. Of these, 36 were affected by allergic rhinopathy, 6 bronchial asthma, 9 ASA syndrome and 9 diabetes mellitus; in addition 33 cases were classified as recurrences. The polyp material from each patient was analyzed using a Coulter XL cytofluorimeter, evaluating the cycles of approximately 10-20 thousand cells. The objective was to identify the nasal polyp activity status in the various patients, evaluating cell proliferation indicated by the percentage of cells in phase S and G2 + M. Of the 114 patients, 21 were ruled out of the study because of a high degree of cell debris. Cytofluorimetry made it possible to identify 3 groups based on the different percentage of cells in the genomic synthesis phase. In the first group (A) of 42 patients, the number of cells in the active phase ranged from 2.1% to 10%. The second group (B) of 21 patients showed a percentage in the 14.7-41.9% range. The third group (C) of 30 patients--all affected by recurrent polyps--showed a high percentage (25%-49.8%) of cells in the active phase. It is interesting to note that: 1. A full 91% of the allergic patients fell within group A. 2. Of the 9 patients with ASA, 7 were in the group with recurrences. 3. The 30 patients affected by recurrent polyps were all in group C and that of these 12 had more than one recurrence, expressing a higher percentage of active cells. The above appears to indicate that the cell parameter evaluated here cytofluorimetrically may be a new, simple, reliable index to predict nasal polyps recurrences.

Adult↗
PubMed1998

[Postural stabilization after otolithic repositioning for posterior semicircular canal canalization].

Today the canal/cupulolithiasic pathogenesis of benign paroxysmal positional vertigo (BPPV) appears well defined; what is less clear is the origin of the postural "instability" often associated with rotatory vertigo. This form is less marked but still resists all know treatments. The purpose of the present study was to determine the actual postural arrangement of subjects suffering from canalolithiasis (CL) of the posterior semicircular canal (PSC) both before and after the positioning maneuver. In this case a personal method of spectral frequency analysis was used in an attempt to clarify the origin of the residual "instability" following otolithic repositioning. Static posturographic testing was performed on 20 patients with CL of the PSC and another 20 normal subjects of comparable age. In the present study the repositioning maneuver leads to a reduction in latero-lateral oscillation without any anterior-posterior variation. Such stabilization covers all the frequencies if a visual input is also present while it is limited to the lower frequencies when the visual content is lacking. In fact, in the latter case the subject maintains his posture using only vestibular and proprioceptive input. On the other hand, the anterior-posterior oscillations increase in all frequency ranges and this increase remains essentially unchanged after the repositioning maneuver. The authors feel that the anterior-posterior destabilization seen in CL of the PSC may stem from a proprioceptive-macular alteration linked to otolitic detachment rather than abnormal ampullar stimulation. The persistence and residual postural alterations found could, therefore, explain the persistent sense of instability that CL patients often complain of, even after the maneuvers which have encountered such success in controlling BPPV.

Adult↗
PubMed1998

Laryngeal metastasis from a signet ring cell carcinoma of the colon. A case report and review of the literature.

Secondary involvement of the larynx and pharynx by malignant neoplasms arising in contiguous structures is well known, but metastases to the larynx from distant tumors are rare. In the present paper a case of signet ring cell carcinoma of the transverse colon metastatic to the left pyriform sinus is reported. A review of the literature identifies 7 other published cases of metastases to the larynx from a colon carcinoma.

Aged↗
PubMed1998

[Alterations in postural control: the use of spectral analysis in stability measurement].

UNLABELLED: Static posturography studies the frequency at which the center of gravity in the human body oscillates. There is no universal agreement as to the importance of this index or whether it is specific in identifying alterations in the postural control systems (vestibular, proprioceptive and visual). Nevertheless, some hypotheses appear generally accepted: a) visual information dominates; b) proprioception affects anterior-posterior oscillation; c) relatively low frequency body oscillation is affected by vestibular input while higher frequency oscillations are controlled by proprioceptive information. In order to check these hypotheses, four groups of patients underwent spectral analysis of bodily oscillations recorded with static posturography. The four groups of patients were similar in terms of age and broken down as follows: Group A-peripheral diabetic neuropathy (10 cases); Group B-diabetic neuropathy-free patients (10 cases); Group C-pure peripheral vestibulopathy (10 cases); Group D-normal subjects (20 cases). Analysis was performed dividing the frequency spectrum (FFT) into three groups: gr. I) 0.01-0.7 Hz; gr. II) 0.7-1 Hz; gr. III) > 1 Hz. Analysis of the spectra for Group A showed a significant increase in high frequency bodily oscillation (gr. III) with the eyes open in the anterior-posterior direction (M = 8.6 +/- 5.5; p < 0.05) and in the lateral direction (M = 4.0 +/- 2.0; p < 0.05); an increase was also found in both directions with the eyes closed (M = OCX II: 7.4 +/- 1.5; p < 0.05) (M = OCX III: 5.6 +/- 1.6; p < 0.01) (M = OCY II: 16.8 +/- 5.0; p < 0.05) (M = OCY II: 9.2 +/- 4.4; p < 0.05). In Group B the increase was limited to high frequency anterior-posterior oscillations (gr. III) at open eyes (M = 3.6 +/- 1.6; p < 0.05) and at closed eyes (M = 4.4 +/- 1.5; p < 0.05). In Group C there was an increase in high frequency lateral oscillations (gr. III) at open eyes (M = 4.2 +/- 0.5; p < 0.01) and panfrequency oscillations at closed eyes (M = OCX I: 47.7 +/- 5.6; p < 0.01) (M = OCX II: 23.2 +/- 4.9; p < 0.01) (M = OCX III: 7.2 +/- 2.3; p < 0.05). CONCLUSIONS: The diabetic proprioceptive deficit appears to lead to multiplanar destabilization at the medium-to-high frequency range. The labyrinthine deficit, on the other hand, appears to cause lateral destabilization at all frequencies. The method of analysis used appears to provide useful parameters with which to evaluate static posture since they can specifically identify alterations in orthostatic bodily control of various origins.

Adult↗
PubMed1998

[Nasal reactivity in systemic lupus erythematosus].

The present study was prompted by the fact that alterations in nasal respiration were observed in patients with active Systemic Lupus Erythematosus (SLE). These alterations were most likely of a disreactive nature and, thus, could not be attributed to pathology-induced vasculitic alterations. The study was performed using the case/control method. Patients with active SLE were selected on the basis of reference symptoms (difficulty in nasal breathing) and the absence of any significant alteration in the rhinological objectives. Basal, positioning and evoked (cold water, 5 degrees C) rhinomanometry was performed in line with the standards suggested by the "Committee Report on Standardization of Rhinomanometry". Positional testing of the SLE patients revealed "paradoxical response" (66% in the supine decubitus, 50% homolateral and 56% controlateral). In addition there was a statistically significant (p < 0.05) increase in resistance vs. the control group both in the positional testing and upon cold water stimulation. The authors recognized that the rhinomanometric values found in the SLE patients--index of nasal mucosa disreactivity--confirm the presence of the distonic-vegetative alterations characteristic of aspecific vasomotor rhinopathy. In conclusion, the authors hypothesize on the pathogenic mechanisms behind the clinical and instrumental conditions revealed in light of the documented autonomic neuropathy present in SLE patients.

Adult↗
PubMed1996

[Giant cervical hyperostosis of the prevertebral space: presentation of two cases and review of the literature].

Swellings of the retropharyngeal area are quite rare and all cases have common symptoms deriving from the site of origin, size, interaction with the surrounding anatomical structures and the presence, or lack thereof, of any associated inflammation. The main symptoms are dysphagia, the feeling of a foreign body in the pharynx and dyspnea. The present work describes two clinical cases of hyperostosis of the cervical column both of which presented discrete dysphagia, intermittent dyspnea and swelling in the area located between the pharynx and the spinal column thus leading to the feeling of having a foreign body in the area. The first case was a hyperostosis of the prevertebral space located on the right side and running medially toward the homolateral palatine tonsil. The pharyngoepiglottic fold area was medialized while the glottic region appeared normal. The second case had an ovoid median swelling in the hypopharynx stemming from the prevertebral space. During normal respiration the upper part of the laryngeal face of the epiglottis came into contact with this swelling while during phonation the glottic plane was normal. CT, MRI and endoscopy all proved able to provide information regarding the anatomy of the neoformation and the relationship with the neighboring structures. Many surgical techniques have been described to gain access to the spinal column osteophytes. The transcervical techniques give better exposure than transoral approaches although they increase the risk of damaging the recurrent laryngeal nerve and the sympathetic nervous system; moreover they require marked retraction of the carotid artery. In the authors' experience surgery was opted for in only one of the cases as the patient was relatively young and in good general health. The transcervical posterolateral approach was chosen as it provided better exposure of the cervical region between C3 and C6 than did the anterolateral approach.

Aged↗
PubMedDate not supplied

Nasal mucosal involvement in systemic lupus erythematosus: histopathologic and immunopathologic study.

The aim of this study was to investigate the pattern of nasal mucosal involvement in patients with Systemic Lupus Erythematosus (SLE). The authors selected patients affected by SLE with a symptomatology based on bad nasal breathing, in absence of anatomical deformities of the nose. Specimens representing eighteen histological sections of nasal mucosa were examined under the light microscope to establish a set of histopathologic and immunophahologic features. A number of significant alterations were identified. The authors indicate the possible physiopathogenetic relationship between nasal mucosal involvement and systemic disease.

Journal Article↗