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N Vanacore

Publications and source records attributed to N Vanacore.

At least 55 records · Page 3Linked to original sources
PubMed1999

Twenty-four-hour heart rate variability to assess autonomic function in Parkinson's disease.

OBJECTIVES: To evaluate the autonomic dysfunction in Parkinson's disease patients by means of a 24-h heart rate variability (HRV) method. MATERIAL AND METHODS: Thirteen patients with a diagnosis of Parkinson's disease were compared with 13 age-matched healthy persons (control group). The 13 patients had a mean age of 70.5 years, and mean disease duration of 10.9 years. The autonomic function was evaluated by HRV analysis using a continuous 24-h ECG. The parameters of SDNN (standard deviation of the normal-to-normal intervals between adjacent QRS complexes), of LF (power in low frequency) and of HF (power in high frequency) were studied during the following 3 periods: 24 h, night and day. RESULTS: The data show a statistically significant difference between groups for SDNN and LF in all the periods, while for HF parameters the difference is statistically significant only in the night period. CONCLUSION: The use of the 24-h HRV method can provide more accurate and reproducible data than other conventional cardiovascular tests.

Aged↗
PubMed1998

Mortality in a population-based cohort of patients treated with antiparkinsonian drugs.

OBJECTIVES: A number of studies have been focused on the mortality of parkinsonian patients, as compared with the rest of the population. In these studies, a mortality greater than expected on the basis of mortality of the general population has been shown. Nevertheless, just a few of these studies have investigated in detail the specific causes of death, probably as a consequence of both small cohort sizes and a short time period of observation. The aim of this study was to estimate cause-specific mortality in a cohort of patients treated with antiparkinsonian drugs. METHODS: The study was performed on a wide population-based cohort of patients identified and followed-up through the computerized health databases of the Italian province of Rome (about 3,800,000 inhabitants). The follow-up lasted from January 1987 to December 1994. Standardized Mortality Ratios (SMR) were calculated for each specific cause of death, using the Rome province population as reference. RESULTS: A cohort of 10,322 subjects, receiving antiparkinsonian drugs, were identified. There were 4328 deaths on an average follow-up of 5.7 years. This figure was 17% higher than was expected. A gradual decrease in SMR was observed in the oldest age groups. Statistically significant (95%) excesses of death were related to the nervous system (SMR = 1037; 95% CI 964-1110), mental disorders (SMR = 182; 95% CI 129-246), and endocrine and metabolic diseases (SMR = 117; 95% CI 102-133). Lower than expected mortality was found to be caused by malignant neoplasms (SMR = 56; 95% CI 51-61). CONCLUSIONS: Apart from deaths specifically related to Parkinson's disease, the main differences between our cohort of patients and the general population were related to mortality due to malignant neoplasms and mental disorders. The gradual decrease in SMR for the oldest age groups, seems to indicate a greater reduction of life expectancy for patients with early onset of symptoms. This age-related trend could explain the relatively small excess of mortality, as in our cohort the median age of patients at entry was 74 years.

Adult↗
PubMed1998

Direct genetic evidence for involvement of tau in progressive supranuclear palsy. European Study Group on Atypical Parkinsonism Consortium.

OBJECTIVE: To confirm whether a dinucleotide repeat sequence in an intron of the microtubule-associated protein tau is associated with progressive supranuclear palsy (PSP) in an independent study population and to establish an improved methodology for allelotyping. BACKGROUND: It has recently been reported that a genetic variant of tau, known as the A0 allele, was represented excessively in PSP patients when compared with control subjects. METHODS: In a multicenter study, the authors examined the allelic distribution of this dinucleotide repeat marker in a set of clinically ascertained PSP patients (n = 30), multiple system atrophy (MSA) patients (n = 35), and matched control subjects (n = 70). Individuals were allelotyped using automated analysis of fluorescently labeled PCR products. RESULTS: The A0 allele was significantly overrepresented in the PSP patients (93.3% versus 76.4%; p = 0.0067; odds ratio [OR] = 4.33; 95% confidence interval [CI], 1.36 to 13.60), but not in the MSA patients. Likewise, A0 homozygotes were overrepresented in the PSP group (86.7% versus 61.1%; p = 0.02; OR = 4.14; 95% CI, 1.19 to 14.48) compared with control subjects. CONCLUSIONS: The findings of this study, which is the largest to date, support those of a previous investigation that used pathologically confirmed PSP patients. These data provide additional strong evidence that genetic variation at or near the tau gene plays an important role in the pathogenesis of PSP.

Aged↗
PubMed1995

Familial Parkinson's disease: a clinical genetic analysis.

OBJECTIVE: To study the frequency, clinical features and clinical genetics of familial Parkinson's disease (PD). METHODS: Family history for PD and tremors was studied in 100 consecutive PD cases. Spouses served as controls. Clinical features were compared between personally verified familial and sporadic PD cases, from the same consecutive clinical series. Clinical genetic analysis was performed in a larger group of non-consecutive multicase PD families. RESULTS: Family history for PD was positive in 24% of consecutive PD cases and in 6% of spouse controls (p < 0.001). When family history for isolated tremor is also considered, the number of positive cases rises to 43% compared with 9% in controls (p < 0.001). Nine of the consecutive cases had at least one living affected relative, for a total of 20 familial PD cases. These familial cases showed an earlier onset age when compared with sporadic ones from the same consecutive series. Within 22 non-consecutive PD families with at least two living and personally examined PD cases (total 52 PD cases), the crude segregation ratios were similar for parents and siblings and the lifetime cumulative risks approached 0.4 in siblings and tended to be comparable, but at later ages, in parents. Ancestral relatives were all unilaterally distributed. In some families, anticipation of onset age in new generations was observed. CONCLUSIONS: The frequency of positive family history for PD and for PD and tremor is higher among PD cases than controls. Familial and sporadic PD only differ in onset age. The clinical genetic analyses support autosomal dominant inheritance with strongly age-related penetrance as most likely in familial PD.

Age of Onset↗
PubMed1995

Estimate of parkinsonism prevalence through drug prescription histories in the Province of Rome, Italy.

INTRODUCTION: The objective of the study was to estimate the prevalence of parkinsonism in the Province of Rome using antiparkinsonian prescription histories from 1986 to 1991. METHODS: A subject was defined as a case of parkinsonism if he/she had received "specific" and "consistent" antiparkinsonian therapy in the study period. RESULTS: In November 1990, 6,572 patients were defined as prevalent cases of parkinsonism. The crude prevalence ratio, for the total population of the Province of Rome, is 173.5 per 100,000 inhabitants (165.9 per 100,000 in men and 180.5 per 100,000 in women). The method was validated by record-linkage with clinical records of all patients visited during 1990 at the Department of Neurological Sciences of the University of Rome "La Sapienza". The sensitivity of the prevalence study was 83.6%. CONCLUSIONS: The use of a computerized data base of all prescription data, routinely collected for administrative purposes, enabled us to obtain a prevalence estimate based on a very large population, with low costs and in a relatively short time.

Adolescent↗
PubMed1994

Buspirone in levodopa-induced dyskinesias.

We made a double-blind, crossover comparison of buspirone (10 mg orally, twice a day) and placebo in 10 patients with Parkinson's disease and levodopa-induced dyskinesias. The duration of the study was 3 weeks, for both buspirone and for placebo treatment. Chronic therapies remained unchanged. The extrapyramidal symptoms, dyskinesias, and anxious/depressive symptoms were evaluated at the beginning of the study and after the buspirone and placebo treatments. Seven patients concluded the trial. The extrapyramidal symptoms, evaluated in both the "off" and "on" states during an oral L-Dopa test, did not show any worsening during the trial. Buspirone significantly lessened the severity of levodopa-induced dyskinesias in five of the seven patients, whereas it proved ineffective in the two patients with the mildest dyskinesias. There were no changes in the mild anxious and depressive symptoms at any time during the study. The activities of buspirone on the serotonin and dopamine systems might have led to the antidyskinetic effect we observed. At daily dosages of 20 mg, buspirone might prove effective in reducing levodopa-induced dyskinesias without worsening of parkinsonism.

Aged↗
PubMed1994

The mortality rates for multiple sclerosis in Italy (1969-1987).

The mortality for multiple sclerosis in Italy was analyzed for the period 1969-1987. The age-adjusted (to Italian 1981 population) death rates decreased slightly during these years for both sexes. The average national female/male ratio of the age-adjusted rates is 1.33 and shows a north-south gradient, with values < 1 in the South-Islands area where multiple sclerosis cases are probably heavily underreported on the death certificates. A positive, significant correlation between the age-adjusted death rates and latitude of the 20 Italian regions exists for the period 1969-1975; in recent years (1981-1987), these parameters show a weaker, but not statistically significant positive correlation. Moreover, the 95% confidence intervals of the death rates in the 20 regions overlapped extensively in both periods studied (1969-1975 and 1981-1987). Death rates for multiple sclerosis are a weak index of the frequency of the disease and their utility is restricted to national surveys. The descriptive epidemiological data (incidence, prevalence, mortality) available at present in Italy do not seem to support a link between multiple sclerosis and latitude.

Female↗
PubMed1994

Mortality of filling station attendants.

OBJECTIVES: Gasoline contains established human carcinogens, such as benzene. The health impact of exposure to this fuel, however, has not been fully elucidated. We report on the mortality of a cohort of 2665 filling station managers from the Latium region (Italy). METHODS: This is the first workplace-based cohort of gas station attendants. However, only self-employed individuals were available for study (about 50% of the whole work force). The follow-up period extended from 1981 through 1992. The mortality experience of the cohort was compared with that of the regional population. RESULTS: The overall analysis for standardized mortality ratios (SMR) showed a significantly decreased mortality from all causes, mainly due to a deficit of cardiovascular diseases and malignant neoplasms. Nonsignificantly increased risks for esophageal cancer [SMR 241, 90% confidence interval (90% CI) 82-551], brain cancer (SMR 195, 90% CI 77-401) and non-Hodgkin's lymphoma (SMR 173, 90% CI 47-448) were found for the men; mortality due to lung cancer and leukemia was lower than expected, and no kidney cancer death was recorded. Among the attendants of small stations (characterized by a small number of employees and high sales of gasoline per full-time employee), the SMR values for esophageal cancer (for men SMR 351, 90% CI 120-803) and brain cancer (for men and women SMR 266, 90% CI 105-559) showed increased values. CONCLUSIONS: Filling station attendants are exposed to gasoline vapors and seem at risk of cancer of various sites. Due to the power limitations of this study, however, a precise estimate of the risk for many causes of death was not achievable. Further cohort studies of greater size are warranted.

Adult↗
PubMed1994

Parkinsonism after chronic exposure to the fungicide maneb (manganese ethylene-bis-dithiocarbamate).

Permanent parkinsonism was observed in a man with chronic exposure to the fungicide maneb (manganese ethylene-bis-dithiocarbamate). Symptoms developed at 37 years of age, two years after exposure had ceased. To our knowledge, this is the second report on parkinsonism associated with exposure to maneb. Manganese is a well-known parkinsonigen toxin in humans. More recently, it has been shown that dithiocarbamates can also induce extrapyramidal syndromes. The biochemical effects of manganese and dithiocarbamates are reviewed and their possible neurotoxic mechanisms are discussed. Both of these components may have played a role in this case.

Humans↗
PubMed1993

Exposure assessment in a historical cohort of filling station attendants.

A historical cohort of service station attendants is underway. It is aimed at evaluating possible excess cancer risk in relation to exposure intensity. In this paper we discuss the feasibility of a retrospective exposure assessment by evaluating the association between indicators of workload and the exposure intensity to some aromatic hydrocarbons measured in a sample of current employees. Available for the analysis were 703 personal samples from 111 filling station workers. Measured concentrations of benzene, toluene and xylenes (8-hour time weighted averages) averaged 0.55 mg/m3, 0.71 mg/m3 and 0.32 mg/m3, respectively. The number of vehicles filled, the daily sales of super premium gasoline and motorbike fuel, and the winter season were all significant predictors of the log concentration of benzene in simple regression analyses. The size of the station acted as an effect modifier. While no single variable was able to predict the benzene level in large stations, for small stations an increase of 0.0579 and of 0.0418 in the log benzene concentration per unit increase in super premium gasoline (100 I) and in motorbike fuel (10 I) dispensed, was estimated. The overall variance explained by the multivariate model, however, was only 12.3%. Therefore, a clear categorization of groups with homogeneous and significantly different exposure levels is not achievable. From the point of view of exposure assessment, workers in small stations with higher sales of super premium gasoline tend to have higher exposure levels. This group should be examined in detail when the final results of the cohort study are available.

Adult↗
PubMed1993

Mortality rates for parkinsonism in Italy (1969 to 1987).

Parkinsonism death rates in Italy were analysed for the period 1969-1987. Crude death rates increased markedly in the above period for both sexes. Age-specific rates underwent important changes during these twenty years. In the years 1969-71 the age-specific death rates reach their maximum values at ages 80-84, after which they decline. In the years 1983-87 the rates continue to increase until the 80-84 age group, when they reach a plateau. Moreover, in the more recent years the age-specific rates for ages < 70-75 are lower, whereas those for the older ages are approximately twice as high as the values in the earlier years. The age-adjusted death rates (1981 Italian population) increased slightly in the period studied for both sexes. Rates for males exceed those for females in all the previous analyses. Minor differences appeared in death distribution between the five large areas Italy was divided into. The observed changes in death rates are likely to reflect: changes in age composition of the population over time, greater attention to parkinsonian patients and especially increased duration of this disease following the discovery of its neurochemical basis and effective medical treatment.

Adult↗
PubMed1992

Mortality rates for Parkinson's disease and parkinsonism in Italy (1969-1987).

The mortality rates (MRs) for Parkinson's disease (PD) and parkinsonism were analyzed for the period 1969-1987 in Italy, considering the population aged greater than or equal to 25. MRs were then age-adjusted taking the 1981 Italian population as standard. We found an increase in MRs for PD during the period studied. The Italian average annual age-adjusted MR was 5.73, ranging from 4.76 (1969) to 6.81 (1985). Moreover we noticed some interesting differences in the geographic distribution of MRs between the five big areas Italy was divided into. We also found that, while the MR for the ages 65-79 years was quite constant in the period studied, there was a marked increase in the MR for ages greater than 79 years from 1980 onwards. The geographic differences we found in MRs deserve to be analyzed in further epidemiological studies.

Aged↗
PubMed1991

Relations between on-off phenomena and cognitive functions in Parkinson disease.

10 patients with Parkinson disease on long term levodopa therapy and with fluctuations in motor performance unrelated to drug administration (on-off phenomena) were assessed on the following neuropsychological tests during the on and off phases: tests of attention (Toulouse-Pieron), memory (Digit Span, Rey forms 1 and 2), psychomotor capacity (maze test, single and multiple choice reaction times) and mood (Maudley Adjective Check List). The extrapyramidal symptoms were assessed on the Webster Rating Scale. We found no significant differences in attention, cognitive performance or mood between the on and off phases despite large fluctuations in motor performance.

Affect↗
PubMed1990

Hallucinations in Parkinson disease: neuropsychological study.

Hallucinations occur fairly frequently in the course of the pharmacological treatment of Parkinson disease. Our aim in this study was to assess first the relation between hallucinations and mental deterioration and second the correlation between the perception disorder and the profile on the Minnesota Multiphasic Personality Inventory (MMPI). Of 304 parkinsonian subjects followed as outpatients at our center 27 (8.88%) had had hallucinations and 17 of these presented marked cognitive deficits (Mini Mental State less than 18) (62.9%) compared with 32 of the other 277 patients (11.5%) (X2 = 55.16, p less than 0.0001). A group of 9 patients who had had hallucinations and 10 controls who had not, all free from marked cognitive deficits, were assessed on the Luria-Nebraska Neuropsychological Battery (LNNB) and on the MMPI. The two groups did not differ significantly in respect of the LNNB but did in respect of the MMPI scales. On this evidence the frequency of mental deterioration is significantly higher in patients who have hallucinated. We discuss the meaning of the MMPI differences both from the biochemical angle and from that of personality factors. These data suggest that the MMPI might be useful for predicting hallucinations in undeteriorated parkinsonian patients on pharmacological therapy.

Aged↗