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Biomedical subjects

M Mega

Publications and source records attributed to M Mega.

At least 19 recordsLinked to original sources
PubMed2003

Agitation in Alzheimer's disease is a manifestation of frontal lobe dysfunction.

OBJECTIVES: (1) To investigate the prevalence and characteristics of agitation in patients with Alzheimer's disease (AD) and other forms of dementia; (2) to explore the association between agitation and other clinical variables, including disease severity, functional impairment and other neuropsychiatric symptoms, and (3) to determine the predictors of agitation. METHODS: Data for 427 men and women with dementia from outpatient clinics of the University of California, Los Angeles Alzheimer's Disease Center were analyzed. There were 277 patients with AD, 43 with vascular dementia, 47 with mixed dementia, 45 with frontotemporal dementia and 15 with dementia with Lewy bodies. Patients were evaluated with the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Functional Activities Questionnaire (FAQ), neuropsychological tests and the Caregiver Appraisal instrument. SPSS10 was utilized for statistical analysis. RESULTS: There was no difference in agitation subscale scores among patients with dementia of various etiologies. In patients with AD, there was increased prevalence of agitation with increasing dementia severity. Agitation contributed substantially to caregiver burden and impact. There was a significant correlation between the FAQ and the NPI agitation subscale score after adjusting for MMSE scores. Delusion, disinhibition and irritability subscale scores in AD patients were correlated with agitation across disease severity. Subscale scores of frontally mediated behaviors including irritability, delusions and disinhibition predicted most of the variance in agitation levels. CONCLUSION: Agitation is common in AD and other dementias and has a marked impact on caregivers. It is related to dementia severity and to specific types of associated psychopathology implicating frontal lobe dysfunction. The present study is the largest and most comprehensive assessment of agitation reported. The data suggest that agitation in AD is a frontal lobe syndrome. Frontal lobe dysfunction may predispose AD patients to agitation by exaggerating behavioral responses to many types of coexisting psychopathology or environmental provocations.

Activities of Daily Living↗
PubMed1998

Neuropsychiatric features of corticobasal degeneration.

OBJECTIVE: To characterise the neuropsychiatric symptoms of patients with corticobasal degeneration (CBD). METHODS: The neuropsychiatric inventory (NPI), a tool with established validity and reliability, was administered to 15 patients with CBD (mean (SEM), age 67.9 (2) years); 34 patients with progressive supranuclear palsy (PSP) (66.6 (1.2) years); and 25 controls (70 (0.8) years), matched for age and education. Both patient groups had similar duration of symptoms and mini mental state examination scores. Semantic fluency and motor impairment were also assessed. RESULTS: Patients with CBD exhibited depression (73%), apathy (40%), irritability (20%), and agitation (20%) but less often had anxiety, disinhibition, delusions, or aberrant motor behaviour (for example, pacing). The depression and irritability of patients with CBD were more frequent and severe than those of patients with PSP. Conversely, patients with PSP exhibited significantly more apathy than patients with CBD. The presence of high depression and irritability and low apathy scale scores correctly differentiated the patients with CBD 88% of the time. The irritability of patients with CBD was significantly associated with disinhibition (r=0.85) and apathy (r=0.72). In CBD, apathy was associated with disinhibition (r=0.67); disinhibition was associated with aberrant motor behaviour (r=0.68) and apathy (r=0.67); and aberrant motor behaviour with delusions (r=1.0). On the other hand, depression was not associated with any other behaviour, suggesting that it has a different pathophysiological mechanism. Symptom duration was associated with total motor scores (r=0.69). However, total motor score was not associated with any behaviour or cognitive scores. CONCLUSIONS: The findings indicate that frontosubcortical pathways mediating cognition, emotion, and motor function in CBD are not affected in parallel. Patients with CBD and PSP have overlapping neuropsychiatric manifestations, but they express distinctive symptom profiles. Evaluating the behavioural abnormalities of parkinsonian patients may help clarify the role of the basal ganglia in behaviour.

Aged↗
PubMed1994

The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia.

We developed a new instrument, the Neuropsychiatric Inventory (NPI), to assess 10 behavioral disturbances occurring in dementia patients: delusions, hallucinations, dysphoria, anxiety, agitation/aggression, euphoria, disinhibition, irritability/lability, apathy, and aberrant motor activity. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. Studies reported here demonstrate the content and concurrent validity as well as between-rater, test-retest, and internal consistency reliability; the instrument is both valid and reliable. The NPI has the advantages of evaluating a wider range of psychopathology than existing instruments, soliciting information that may distinguish among different etiologies of dementia, differentiating between severity and frequency of behavioral changes, and minimizing administration time.

Aged↗
PubMed1989

[Serum myoglobin in pregnant women treated with tocolytics and carnitine].

Forty-two pregnant women threatened by miscarriage or premature delivery have been studied. A group of 21 gravidas was treated with ritodrine and potassium chloride. The treatment protocol of another group of 21 gravidas included carnitine (2 g infusion with phleboclysis). It was thus observed that the haematic concentration of myoglobin increases about twice by comparison with normal values during i.v. tocolytic treatment whereas tocolytics per os do not affect the blood level of myoglobin (phenomenon observed in another group of 10 gravidas also suffering from threatened miscarriage or premature delivery). The use of beta 2-mimetics involves the onset of at times serious side-effects and methods have been sought to anticipate and prevent them. Measurement of serum myoglobin is intended as a useful investigation for monitoring tocolytic therapy which, as a result of its myotoxicity in the cardiac and skeletal musculature demands extremely cautious use. Moreover, the use of carnitine did not modify the blood concentration of myoglobin, whereas it obtained beneficial results on the onset of beta 2-mimetic induced side-effects.

Abortion, Spontaneous↗
PubMed1987

Estradiol and progesterone binding in uterine leiomyomata and pregnant myometrium.

In order to verify the endogenous steroid influences on the myometrium, we compared the receptor status in 18 specimens of uterine leiomyomata and 31 specimens of pregnant myometrium. 17-beta-Estradiol and Progesterone receptors were assayed in the cytosol and nuclear extracts. In the uterine leiomyomata we observed the following mean values: PgR/c 279 fmol/mg, PgR/n 89 fmol/mg, ER/c 52.5 fmol/mg, ER/n 12.3 fmol/mg. In the pregnant myometrium we observed the following mean values: PgR/c 5.86 fmol/mg, PgR/n 166 fmol/mg, ER/c 0.76 fmol/mg, ER/n 1.65. It was concluded that direct correlation between estrogen power and progesterone receptor replenishment in the nucleus exists.

Cell Nucleus↗
PubMed1984

Beta-endorphin levels and general anaesthesia for caesarean section. Preliminary report.

Plasma beta-endorphin levels were studied before induction of general anaesthesia for caesarean section and during some phases of surgery. A very high increase of beta-endorphin occurred following induction of anaesthesia. However fifteen minutes after fetal extraction a tendency of the beta-endorphin levels to decrease was noted. Some medical treatment, such as antiasthmatic medication with glucocorticoids and beta-mimetic treatment for controlling uterine hyperactivity, seemed to interfere with pituitary response.

Adrenergic beta-Agonists↗
PubMed1982

Pregnancy in a patient after mitral valve replacement with a porcine bioprosthesis.

The course of two pregnancies in a woman, who had previously undergone mitral valve replacement with a porcine bioprosthesis, is reported. The present case suggests that porcine heterografts are to be considered as the most suitable cardiac valve substitutes in females of childbearing age, since anticoagulants are not needed, avoiding therefore the risks related to both an incorrect anticoagulation and to the recognized teratogenic effect of coumarin drugs.

Adult↗
PubMed1981

Usefulness of cardiotocography in expulsion period.

When an expulsion-period cardiotocographic record is examined, the most important factors, to be carefully controlled, are foetal cardiac frequency, its irregularities, the presence of decelerations and, above all, the appearance of final bradycardia. The Authors have studied 196 cardiotocographic records taken in expulsion period. Apart from the above mentioned factors, they looked for correlations between pathological pictures and parity, length of expulsion period and Apgar score. Satisfactory results lead them to conclude that cardiotocography is indispensable also in expulsion period.

Bradycardia↗
PubMed1981

Cardiotocographic modifications during continuous epidural anaesthesia in labour.

Cardiotocographic variations certainly attributable to epidural anaesthesia were studied over the period 1972-1980 on 716 patients in labour. Transitory side-effects due to both direct and indirect action of local anaesthetics appeared in 1.4% of the cases, without, however, subsequently creating any particular foeto-newborn problem. On the basis of the experience acquired, it seems justifiable to affirm that the correct use of continuous epidural block, affected by very small doses of bupivacaine (10-20 mg per administration) is almost risk-free. The only inconvenience therefore that may sometimes arise would only be due to the relevation of a concealed cava occlusion when the maintenance of a left lateral position is not observed.

Adult↗
PubMed1981

Toxoplasmosis and habitual abortion. Our experience.

The possibility that toxoplasmosis may be an important cause of single or repeated abortion has been considered for some time. The agreement among various authors is, however, far from being reached, above all in the case of habitual abortion. The present research shows that the frequency of positive serological tests on patients with habitual abortion is not substantially different from that of a control group, and that toxoplasmosis, even if only latent, may only in exceptional cases be considered a cause of habitual abortion.

Abortion, Habitual↗
PubMed1981

Antimicrobic activity of the amniotic fluid.

The amniotic fluid is commonly, though not unanimously, believed to include among its various functions a defensive one, against infections. This is due to the presence of immunoglobulins, immunocompetent cells and such factors like lysozyme, transferrin and zinc. However, evidence of this AF antimicrobic activity had been found only in the second half of the pregnancy period starting from the 20th gestational week. Our study has demonstrated its presence in a very high percentage (58.7%) of AF samples taken in early amniocenteses.

Adult↗
PubMed1980

Therapeutic effects of topical benzydamine in gynecology.

The study was performed on 124 patients divided into 4 groups on the basis of vaginal smears: 1) 60 patients with mild non-specific bacterial vaginitis; 2) 40 patients with moderate or severe non-specific bacterial vaginitis; 3) 10 patients with moderate or severe monilial vaginitis; 4) 14 patients with moderate or severe trichomonal vaginitis. Each group was subsequently divided at random into two subgroups, comprising the same number of patients, who were treated under double blind conditions with vaginal douches of 10/00 benzydamine of placebo (1 douching per day for 10 days). Specific standard therapy with antibiotics, antimycotic and antitrichomonal agents was used concomitantly in groups 2, 3 and 4 respectively. Vaginal smears, performed a few days after the end of the treatment period, and the improvement in symptoms and sings, demonstrated the curative action of benzydamine in mild non-specific vaginitis as well as its symptomatic effect and potentiation of specific therapy in moderate and severe bacterial, monilial and trichomonal vaginitis.

Administration, Topical↗
PubMed1976

[Immunoglobulins and antibody titre in amniotic fluid of Rh-isoimmunized pregnant women (author's transl)].

On 90 samples of amniotic fluid coming from 54 cases of Rh-isoimmunization submitted to amniocentesis one or more times, the following tests were done: 1.) Coombs indirect test; 2) immunoelectrophoresis; 3) quantitative determination of immunoglobulins. The results were related to the degree of immunization as determined by Coombs indirect test on the mothers' serum and spectrophotometric curve of the amniotic fluid. For reasons of comparison, quantitative determination of immunoglobulins were performed on samples of amniotic fluid from 39 pregnant non-immunized patients. It was found that there was a direct relationship between antibody titers in the mothers' serum and those in the amniotic fluid, with the latter values always being inferior. Moreover, it was found that the level of IgG in the amniotic fluid and the degree of maternal immunization were proportional, with higher titers in the more severe cases. In addition to the routine tests, the determination of anti-Rh antibodies and titers of IgG in amniotic fluid can be useful in further evaluating degree of immunization in Rh-incompatibility. Furthermore, small quantities of IgA were found in amniotic fluid: these IgA were probably of secretory type (SIgA) and of amniotic origin, and therefore independent of any active immunization. Finally, all determinations of IgM were negative.

Amniocentesis↗