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Biomedical subjects

M Mauri

Publications and source records attributed to M Mauri.

At least 73 records · Page 4Linked to original sources

Slowly progressive aphasia: report of a case.

We report on the case of a 66-year-old right-handed woman, who shows the clinical and behavioral features of "slowly progressive aphasia" described by MESULAM. At the age of 63 the patient began to develop progressive disturbances of word fluency and naming. The neuropsychological examination revealed amnestic aphasia and a mild impairment of verbal memory. Neuroradiological findings demonstrated left temporo-parietal atrophy. A neuropsychological evaluation performed two years later showed a worsening of language disorders and only a slight compromission in other cognitive areas, while the activities of daily living and the occupational functioning remained unimpaired.

Aged↗

Cognitive abnormalities and disease progression in a selected population of asymptomatic HIV-positive subjects.

A selected population of 41 homosexual/bisexual asymptomatic HIV-positive subjects were administered neurophysiological tests to assess language, memory, attention, logic faculties and visuo-motor functions. HIV-positive subjects differed from individually matched control subjects only in certain measures of verbal memory. Longitudinal evaluation performed after 1.5 years, however, did not indicate any further development of this mild amnesic deficit. Despite the small number studied in our sample, there seems to be a trend for older subjects to be at greater risk of developing AIDS and cognitive abnormalities than younger subjects, while differences in immunological status play a significant role in disease progression.

Adult↗

Circadian continuous chemotherapy of renal cell carcinoma with an implantable, programmable infusion pump.

The authors treated 42 metastatic renal cell carcinoma (RCC) patients who had received no previous chemotherapy or radiation therapy with circadian venous continuous infusion of 5-fluoro-2-deoxyuridine (FUDR). The drug was delivered by Medtronic Synchromed implantable pump (Medtronic, Inc., Minneapolis, MN) in 14-day cycles alternating with 14-day intervals of heparinized physiologic saline infusion. In the course of 24 months 444 cycles of therapy have been given for a total of 12449 days of pump function. Of the patients observed for at least 3 months (range, 3 to 23 months; median, 7 months) three showed complete response (7%; 95% confidence interval, 0% to 15%), three partial response (7%; confidence interval, 0% to 15%), 18 stable disease, and 18 showed progression. Eighteen patients, all with advanced disease at the time of implantation, were living 6 months after treatment started. Circadian continuous central venous infusion of FUDR is minimally toxic. The FUDR can be delivered safely and conveniently in this way for long spans. This therapy is as active as any currently available treatment, is administered in an entirely outpatient setting, and is associated with a normal quality of life.

Adult↗

[Diagnostic usefulness of the determination of serum neuron-specific enolase in small cell bronchial carcinoma].

The plasma level of neuron-specific enolase (NSE) was measured in 55 patients with small cell bronchial carcinoma (SCC) with cytohistological confirmation to evaluate its diagnostic usefulness. As a control group, 132 patients with non-small cell bronchial carcinoma, 81 with non-neoplastic disease and 37 healthy individuals were used. The sensitivity of the test was 84% with a specificity of 79% when values below 13 ng/mg were considered as normal. To achieve a specificity of 95% and 99% cutoff values had to be increased to 25 and 50 ng/ml, respectively, and then the sensitivity was reduced to 51% and 38%. There were false positive findings in the three control groups, although they were more common (28%) and had higher values in patients with widespread disease the sensitivity was significantly higher (p less than 0.005) than in those with limited disease. Carcinoembryonic antigen, which was measured with comparative purposes, had a lower sensitivity. In our area, a NSE level over 50 ng/ml is closely correlated with the diagnosis of SCC, whereas values over 13 ng/ml select a wider group of individuals where most patients with this type of carcinoma are included.

Adenocarcinoma↗

Follow-up of oral leukoplakia after carbon dioxide laser surgery.

We evaluate the 3-year result of 145 oral leukoplakias operated on by outpatient carbon dioxide laser surgery at the Istituto Nazionale Tumori, Milan, Italy. The surgical technique that was used consisted of excision in 140 patients and vaporization in 5 patients. Cancer was found in 14 out of 140 patients who underwent excision (10%). In the analysis of the disease-free survival rate and of the unfavorable pattern of events, only 131 patients with benign postoperative histologic diagnosis were considered. Fifty-eight patients developed unfavorable events. The probabilities of remaining free of disease or of developing local relapses or new lesions at 3-year survival was 0.57, 0.27, and 0.19, respectively. Two patients had oral carcinomas after the operation. Forty patients modified their alcohol or tobacco habits or their teeth and/or prosthesis. Moreover, only two patients modified these factors before the unfavorable events occurred.

Adult↗

Emergency treatment with recombinant tissue plasminogen activator of pulmonary embolism in a pregnant woman with antithrombin III deficiency.

Thromboembolic complications during pregnancy are frequent in patients with congenital antithrombin III deficiency. We report on a 29-year-old patient with congenital antithrombin III deficiency and severe pulmonary embolism treated with recombinant tissue plasminogen activator. The diagnosis of antithrombin deficiency is retrospective. This case indicates that the risk of thrombolytic therapy in this clinical setting might have been overemphasized.

Adult↗

Sleep and the reproductive cycle: a review.

Women of all ages have been found to have a higher rate of sleep disturbances than men. Attempts to determine whether hormonal changes marking their reproductive lives render women more vulnerable to emotional stress and to concomitant sleep disturbances are the focus of this article. Investigations of sleep patterns and sleep-related experiences that occur in connection with the menstrual cycle (normal menstrual cycle and premenstrual syndrome) and are associated with hormonal abnormalities (amenorrhea) and changes in hormonal status (pregnancy and menopause) are reviewed. Methodological problems are discussed and areas of future research are proposed. It is suggested that the triad of sleep, endocrine changes, and mood should be more systematically investigated.

Female↗

Factors affecting the clinical response to haloperidol therapy in schizophrenia.

Fifty-one patients diagnosed as schizophrenics or schizoaffective according to DSM-III criteria were treated with conventional haloperidol regimens for 4 or 6 weeks. The clinical picture and extrapyramidal side effects were assessed by means of the Brief Psychiatric Rating Scale (BPRS), and the Simpson and Angus Scale (EPSE). Evaluations were made at admission and after 4 or 6 weeks of treatment. The clinical response to treatment was reported as the percent change in BPRS scores at the end of treatment from the BPRS scores at baseline. Haloperidol (HAL) and hydroxyhaloperidol (REDHAL) were determined by high-performance liquid chromatography (HPLC) with electrochemical detection in plasma. The mean total BPRS item score at the end of the study was significantly lower than at the beginning of the study. HAL and REDHAL levels were significantly related to the dose, and REDHAL levels were also related to HAL levels. There was no correlation between plasma HAL levels and the percent change in BPRS. The percent change in BPRS at the end of the study was negatively correlated with plasma REDHAL levels and REDHAL/HAL ratios and was positively correlated with the baseline BPRS total score. There was no significant correlation between the duration of illness and improvement, but patients with good improvement had significantly shorter duration of illness. Patients who improved also had higher baseline BPRS scores, lower REDHAL levels and REDHAL to HAL ratios, but not significantly different HAL levels. Therefore, the shorter the duration of the disease, the higher the baseline BPRS and the lower the reduced levels of its ratio to haloperidol levels, the higher the percent improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Long-term effects of cardiac pacing on natriuretic atrial peptide levels in patients with AV block].

In this work we intend to analyze the long term effects of the classic modes of definitive cardiac pacing (VVI and DDD) on the atrial natriuretic peptide levels. A priori hypothesis is: the AV asynchrony raises the hormonal level. The design is a cross-sectional study, and the setting is the pacemaker doctor's room of a tertiary hospital. In 24 patients (17 VVI and 7 DDD) the atrial natriuretic peptide was determined by RIA. A multiple regression model was fitted to analysis. The basic result is: when several factors were controlled (age, sex, hypertension, and cardiac failure story), the atrial natriuretic peptide levels are increased in the VVI group. In conclusion, the lack of AV synchrony induced the increase of atrial natriuretic levels. For an endocrine viewpoint the DDD is more physiological pacing as well.

Aged↗

Neuropsychological changes in demented patients treated with acetyl-L-carnitine.

The study was carried out on 24 patients suffering from mild to moderate dementia. The diagnosis of dementia was made according to DMS III criteria. Patients with cerebrovascular pathologies were excluded by using Hachinski Ischaemic Score less than or equal to 4 and computerized tomography parameters. Patients with depression (Hamilton Rating Scale for Depression greater than or equal to 18) were excluded. All the patients, after a wash-out period of two weeks were treated on a simple blind method with acetyl-L-carnitine (No. = 12 patients) and piracetam (12 patients) by intravenous route (two weeks) followed by an oral one for further 10 weeks. A battery of clinical neuropsychological tests was applied to evaluate the cognitive, attentive and behavioural aspects. The results, analysed by non-parametric variance analysis (Friedman Test) show a statistically significant improvement of the behavioural profile, of attention and of psychomotricity in the patients treated with acetyl-L-carnitine. No significant improvement was found in the piracetam group.

Acetylcarnitine↗

[Diagnostic usefulness of neurospecific enolase determination in pleural fluid].

To investigate the diagnostic usefulness of the measurement of neurospecific enolase (NSE) in pleural fluid 116 consecutive patients with pleural effusion were prospectively evaluated. In 95 of them, carcinoembryonic antigen (CEA) was also measured for comparative purposes. The habit of smoking did not apparently influence the NSE levels. In the 43 malignant effusions the mean value of NSE (25.0 +/- 27.4) was significantly higher (p less than 0.001) than in benign effusions (8.7 +/- 7.1). The values above 12 ng/ml had a sensitivity of 51% for malignancy, with a specificity of only 74%. The specific sensitivity of NSE was lower than that of CEA; neither individually nor as a whole these markers modified the diagnostic yield of cytology (67%). The mean value of NSE in tuberculous pleural effusions (14.4 +/- 8.3), different from that found in malignancies (p less than 0.05), was significantly higher (p less than 0.001) than that found in other benign diseases (6.2 +/- 4.7). The results of this study demonstrate the nonspecific character of an increased level of NSE, and the low diagnostic yield of this enzyme as a pleural tumour marker.

Adolescent↗

Reduced haloperidol/haloperidol ratio and clinical outcome in schizophrenia: preliminary evidences.

1. The possible influence of haloperidol and its metabolite plasma levels on clinical outcome in schizophrenic patients was evaluated. 2. 18 schizophrenic inpatients diagnosed according to DSM III, were treated with conventional haloperidol p.o. for four weeks. 3. Plasma levels of haloperidol and its reduced metabolite were measured by mass-spectrometry assay. Clinical outcome was evaluated by BPRS. 4. Cluster analysis only considering BPRS improvement and reduced haloperidol/haloperidol ratio was able to discriminate two groups of patients: one of non responders and the other of responders. The former group presented higher ratios than the latter. 5. Reduced haloperidol/haloperidol ratio could be considered as a good marker for prediction of the clinical outcome.

Adult↗

Sleep in the premenstrual phase: a self-report study of PMS patients and normal controls.

Sleep disturbances commonly occur in the premenstruum in both Premenstrual Syndrome (PMS) patients and in women from the general population. Reports on the Post-Sleep Inventory were obtained from a clinic sample of PMS patients and samples from the general population dichotomized into a non-clinic group with and without premenstrual disturbance on the basis of their scores on the Premenstrual Tension Syndrome Self Rating Scale. The patients reported degrees of disturbance that were consistently higher than either or both the other two groups. PMS patients reported unpleasant dreams, awakenings, failure to wake at the expected time and tiredness in the morning, and heightened mental activity during the night and upon awakening. The three groups could be reliably discriminated on this basis with an overall accuracy of 82%. Sleep disturbances form an important component of premenstrual disturbance and merit specific clinical intervention and more detailed investigation.

Adult↗

Excision of oral leukoplakias by CO2 laser on an out-patient basis: a useful procedure for prevention and early detection of oral carcinomas.

Several epidemiologic studies have shown that oral cancer develops among individuals with a prior diagnosis of an oral premalignant lesion. Canceration chance in these patients is 17%, with the greatest rate occurring in the second year of observation. Based on this data, since 1981, 92 leukoplakias have been treated by out-patient laser surgery at the Istituto Nazionale Tumori of Milano. The therapeutic technique was laser excision to obtain a specimen for histology. Two groups were distinguished according to the diagnostic procedure. Thirty-three lesions (December 1981 to December 1982) were operated on without preliminary histologic examination, on the basis of a simple clinical diagnosis. Since January 1983 all leukoplakias have been biopsied in a systematic way and those negative for cancer treated with laser. Histology of the specimen showed 5 squamous cell carcinomas (15%) in the group of patients who did not undergo preoperative biopsy. Postoperative histology showed malignancy in 6 of 59 (10.2%) cases in spite of negative preoperative biopsies. Speckled and erosive leukoplakias had the highest canceration rate. Three of 11 patients with cancer were treated by knife excision or interstitial needle implantation because of margins in tumoral tissue or because they were not evaluable for injury by heat. Results have been satisfactory, only 2 of 54 followed leukoplakias and none of the cancers recurred during a 2 year follow-up.

Adult↗

Acupuncture and myofascial pain: treatment failure after administration of tricyclic antidepressants.

A 63-year old depressed woman with a 2-year history of chronic pain on the right side of her face in the area of the zygomatic arch and temporomandibular joint received acupuncture before and after the medical treatment of her depression. During her unmedicated state electroacupuncture provided pain relief, while after prolonged intake of doxepin the treatment no longer produced analgesia. The literature fails to provide a mechanism explaining the differential responses to acupuncture with regard to antidepressant medication. Suggestions on further endorphin related research are made with particular emphasis on gonadotropin activity.

Acupuncture Therapy↗