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Biomedical subjects

M Mauri

Publications and source records attributed to M Mauri.

At least 91 records · Page 5Linked to original sources
PubMed1990

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↗
PubMed1990

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↗
PubMed1990

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↗
PubMed1990

[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↗
PubMed1990

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↗
PubMed1989

[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↗
PubMed1988

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↗
PubMed1988

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↗
PubMed1986

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↗
PubMed1986

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↗
PubMed1985

Plasma concentrations, information and therapy adherence during long-term treatment with antidepressants.

The influence of information on drug plasma monitoring during long-term antidepressant therapy in fourteen ambulant, depressed patients was evaluated as variation in the L/D ratio time course. A larger variability in L/D ratio, with higher coefficient of variation and a poorer clinical outcome, was found in non-informed patients. The data support the hypothesis that verbal information on long-term drug monitoring of antidepressants could improve patients' adherence to therapy.

Adult↗
PubMed1981

Effect of angiotensin-II blockade on systemic and hepatic haemodynamics and on the renin-angiotensin-aldosterone system in cirrhosis with ascites.

We have studied the effect of angiotensin-II blockade with saralasin on the cardiovascular and hepatic hemodynamics and on the renin-angiotensin-aldosterone system in fourteen patients with cirrhosis and ascites. Control measurements showed that most of the patients had a low mean arterial pressure, high plasma volume, normal or high cardiac index, low peripheral resistance and high plasma renin activity and aldosterone concentration. The wedged hepatic venous pressure was increased in each patient and the estimated hepatic blood flow was normal in most of them. Overall, saralasin induced a significant reduction of the mean arterial pressure, cardiac index and peripheral resistance. The decrease of the peripheral resistance was greater than that of the cardiac index. Six of the patients developed a marked reduction of the mean arterial pressure with low doses of saralasin (1--2.5 microgram/kg/min), and they had significantly higher plasma renin activity and lower mean arterial pressure than the remaining eight patients who showed a slight or no hypotensive response in spite of infusing saralasin up to a dose of 10 micrograms/kg/min. Overall, the decrease of the mean arterial pressure correlated directly with the baseline values of plasma renin activity. Angiotensin-II blockade induced a significant reduction of the wedged hepatic venous pressure. The hepatic blood flow did not show any significant change. The decrease of the wedged hepatic venous pressure was directly related to the reduction of the mean arterial pressure and also to the control plasma renin activity. Our study indicates that in most patients with cirrhosis, ascites and high plasma renin activity, arterial pressure is maintained by the effect of endogenous angiotensin II on the peripheral vasculature, and we suggest that a pre-existing arterial hypotension secondary to an arteriolar vasodilatation is the cause of renin release in these patients. Our results also show that angiotensin-II blockade is accompanied by a reduction of the post-sinusoidal hepatic vascular resistance.

Aldosterone↗
PubMed1981

Prognostic significance of the growth rate of breast cancer: preliminary evaluation on the follow-up of 196 breast cancers.

The doubling time (DT) of 196 consecutive breast cancers was studied by means of a double mammographic examination (average time between the 2 mammographies, 30 days) and calculated with the formula of exponential growth. On the basis of DT values the case series was divided into 3 groups of growth: fast (DT from 1 to 30 days), 31 cases (15.8%), intermediate (DT from 31 to 90 days), 84 cases (42.9%), slow (DT more than 90 days), 81 cases (41.3%). No relationship was found between growth rate and size of tumor, or menopausal status of the patient. After mastectomy fast and slow cases were equally distributed in the N- and N+ groups, whereas for the intermediate cases the N- : N+ ratio was 1 : 2. One hundred and thirty-four cases were followed for a period of 12 to 52 months. Evaluation was done on the basis of the subdivision into N- 2nd N+, and the latter group into N+ (1-3) and N+ (greater than 3). For N- tumors the course of the disease was apparently not affected by the growth rate. However, the case of fast growing tumors showed a higher proportion of recurrences with respect to N+ slow growing tumors. This difference was even more noticeable the higher the number of involved lymph nodes, but not statistically significant. The course of slow growing tumors was identical in the N- and N+ groups, but all the N+ tumors were subjected to adjuvant chemotherapy.

Adult↗
PubMed1980

[Oral gestagen treatment of advanced breast neoplasms with norethisterone acetate].

The medical records of 84 postmenopausal women treated with oral norethisterone acetate (NTA) for advanced breast cancer have been analyzed retrospectively. Treatment was devoid of significant toxicity. 21 patients were not evaluable for treatment response, either due to insufficient data or inadequate tratment trial. Among the 63 evaluable patients, complete plus partial response was obtained in 21 (33.3%) with a median duration of 10 months. Disease stabilization was observed in 16 patients (25.4%) for a median duration of 5 months, while 26 patients (41.3%) showed progressive disease while on treatment. The best response was observed in women with predominantly soft tissue metastases (CR + PR: 34.9%) and aged over 70 (CR + PR: 48%). The literature on norethisterone acetate is reviewed and compared with the present results. The role of progestational agents in the treatment of advanced mammary carcinoma is discussed.

Administration, Oral↗
PubMed1979

Treatment of advanced breast cancer with norethisterone acetate.

The medical records of 84 postmenopausal women treated with oral norethisterone acetate (NTA) for advanced breast cancer were retrospectively analyzed. Treatment was devoid of significant toxicity. Twenty-one patients were not evaluable for treatment response either because of insufficient data or inadequate treatment trial. Complete plus partial response was obtained in 21 (33.3%) of the 63 evaluable patients, with a median duration of 10 months. Disease stabilization was observed in 16 (25.4%) patients for a median duration of 5 months, while 26 patients (41.3%) showed progressive disease while on treatment. The best response was observed in women with dominant soft part disease and an age over 70 (CR+PR 48%). The literature on norethisterone acetate is reviewed and compared with present results. The role of progestational agents in the treatment of advanced mammary carcinoma is discussed.

Age Factors↗