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Biomedical subjects

P De Bastiani

Publications and source records attributed to P De Bastiani.

At least 19 recordsLinked to original sources

Systemic lupus erythematosus presenting with neurological disorders.

Six patients are described who developed a wide variety of neurological manifestations heralding systemic lupus erythematosus (SLE), which included epileptic seizures, stroke, peripheral polyradiculoneuropathy similar to Guillain-Barré syndrome, transverse myelopathy and multifocal disorders with remitting course mimicking multiple sclerosis. The peculiarity of these cases was that the neurological disorders remained the only manifestations of SLE for many years and the nervous system appeared to be the main target even after the development of systemic SLE. In five patients the prognosis was favourable and corticosteroid treatment led to prolonged remission.

Adolescent↗

Parkinson's disease in Ferrara, Italy, 1967 through 1987.

Epidemiological surveys on Parkinson's disease that have been carried out in different parts of the world have suggested that the disease is uniformly distributed in white populations. The position with regard to the Mediterranean peoples is still controversial, because of the large variation of the frequencies observed in the different areas that have been investigated. We therefore studied the frequency of Parkinson's disease in the Local Health Service of Ferrara, northeastern Italy (mean population, 187,000). Based on 394 patients, the mean incidence per year for the period from 1967 through 1987 was 10.01/100,000. The incidence rate of Parkinson's disease among cases with early onset was found to be statistically higher in rural areas as compared with urban ones (6.32/100,000 vs 3.11/100,000). Moreover, the study revealed a significantly higher incidence rate among agricultural workers (20.6/100,000). These results would seem to give further support to the hypothesis of a possible causal role of environmental factors that are mainly linked to agriculture, most likely due to the continual exposure to toxic agents in this area. However, further studies, which are not exclusively epidemiological, are necessary before any conclusions may be drawn, because many confounding variables may account for the results from surveys of this type.

Adult↗

High-density lipoprotein composition in obesity: interrelationships with plasma insulin levels and body weight.

Hyperinsulinism may play a role in the development of atherosclerosis. In this study we analyzed the interrelationships between plasma glucose, insulin, body weight and high-density lipoproteins (HDL) in a group of obese women and faced the question of what is the effect of obesity on insulin, glucose and HDL relationships. HDL cholesterol was significantly lower, while HDL triglycerides resulted significantly higher in the obese women than in the controls. The two groups did not show any difference in the serum concentration of HDL apoprotein A-I and apoprotein A-II. There was an inverse correlation between fasting plasma glucose and summated means of glucose and insulin levels after an oral glucose tolerance test and HDL cholesterol in the two groups; on the contrary a positive relationship between the same parameters and HDL triglyceride occurred. HDL cholesterol was inversely related also to the weight index, while HDL triglyceride concentration was directly correlated with this parameter in the two groups. Partial correlation analysis demonstrates that, when exposed to similar plasma insulin and glucose levels, HDL cholesterol and triglyceride concentrations were no longer correlated with the weight index, and therefore that the significant correlations between these variables are likely to be due to the significant correlations of each of them with plasma glucose and insulin levels. Further studies clarifying the role of glucose and insulin in determining HDL composition would appear important.

Adult↗

Phonological dyslexia, lexical analogy, and functional models of oral reading: a critique of Bradley and Thomson.

We discuss some of the interesting features of the investigation of a phonological dyslexic patient's ability to read aloud nonwords embedded in words reported by Bradley and Thomson (1984, Brain and Language, 22, 292-302). We highlight some problems of their interpretation, tentatively suggest an alternative explanation in terms of lexical analogy, and conclude by suggesting some prescriptive conditions for the legitimacy of extending models of normal functioning to account for cognitive neuropsychological data.

Dyslexia, Acquired↗

Alexia without agraphia: a study of a case of verbal alexia without accompanying colour-naming defect.

A 47-year-old man developed a persistent form of alexia without agraphia as the result of a haemorrhagic intracerebral lesion in the left inferior temporo-occipital region, due to the rupture of an arteriovenous malformation. Surgical evacuation of the haematoma and excision of the malformation did not produce any modification of the reading deficit, which remained unchanged during a 4-year follow-up. The reading deficit was restricted to words and the patient was able to read only letter-by-letter, so that the whole words were reconstructed from the auditory names of the letters. So far, the disconnection explanation is the standard explanation of alexia without agraphia and the present case of verbal alexia may be regarded as being within this overall category. However, this explanation meets with unanswered questions that suggest more flexible interpretations. Neurolinguistic studies have questioned the unique character of alexia without agraphia as a clinical entity and, in contrast to the disconnection hypothesis, support the notion that the different varieties of alexia that are traditionally described represent distinctive syndromes, each with its own clinical features and pathophysiological basis. In this context, the reading properties in this case seem fully compatible with a deficit of the visual word-form system postulated by Warrington and Shallice, that is, the relatively early stage of the reading process through which a word-form or equivalent unit is attained. This system might be lateralized to the left hemisphere, as suggested by the fact that this case, like other cases of verbal alexia, had sustained damage to the left hemisphere and did not show any differential preservation of the reading of concrete words.

Brain↗

Pure "aphasic" agraphia due to damage of the left superior parietal lobule.

A case of pure agraphia, due to an ischaemic lesion of the left superior parietal lobule, is reported. The neuropsychological analysis of writing performances suggests an aphasic nature of this patient's pure agraphia. The authors discuss the role played by diffuse and/or localized brain lesions in writing function, emphasizing that the left superior parietal lobule in man may be crucial for the sensorimotor linguistic integration needed for writing.

Aged↗

Cognitive function and regular dialysis treatment.

The purpose of this investigation was to assess the intellectual function of patients on regular dialysis treatment by using neuropsychological tests such as the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Memory Scale (WMS). Studies were performed on 54 patients; 21 patients were retested after at least 12 months. We found no relationship between the neuropsychological scores and the blood levels of small molecules, the hemoglobin concentrations, the serum aluminium levels, and the levels of formal education. We found, however, an impairment of neuropsychological performance, mainly for memory function, related to the duration of dialysis and, possibly, to parathormone levels. We conclude that standard hemodialysis strategies are not able to prevent the development of intellectual impairment in uremic patients and that the WMS could be used as a sensitive objective measure of the comparative adequacy of various long-term dialysis treatments.

Adult↗

Clinical and audiological findings in a case of auditory agnosia.

A case is reported of severe agnosia for verbal and non-verbal sounds without associated aphasic disorder. A CT scan revealed bilateral, temporal lobe lesions from two ischaemic accidents that had occurred 9 months apart. The search for subtle deficits in the patient showed normal sensitivity to changes in the intensity and frequency of simple sounds; in contrast, his ability to discriminate sound duration and musical note sequences was severely impaired. The simultaneous recording of the whole auditory-evoked response pattern revealed no abnormality in the early components, which reflect the activation of the auditory nuclei and pathways of the brain stem. However, the middle and late components were delayed and slowed. These results and others in the literature suggest that the neocortex in man, as in other mammals, plays an essential role in the temporal aspects of hearing. Also, the two main ingredients commonly recognized in auditory agnosia, i.e. word deafness and the inability to interpret non-verbal sounds, are caused by the disruption of elementary, bilaterally represented cortical functions which start the processing of every kind of auditory information.

Agnosia↗

Uremic neuropathy: correlations between electroneurographic parameters and serum levels of parathyroid hormone and aluminum.

An electrophysiological investigation on 29 dialysis patients was performed with the aim of verifying whether serum parathyroid hormone (PTH) and aluminum (Al) levels may play a role in the pathogenesis of uremic neuropathy. All patients except 1 showed electrophysiological abnormalities. Both PTH and Al levels were found to be significantly correlated with the time on dialysis. On the contrary, the values of each single electroneurographic parameter did not show any correlation with the duration of dialysis, PTH levels and Al levels. The authors conclude that PTH and Al does not seem to play a role in the etiology of uremic neuropathy.

Adult↗

[Tactile recognition and cognitive tasks. Preliminary results].

In a basic experiment, a tactual recognition task was given to 28 normal blindfolded subjects. The subject were asked to explore the stimuli with the left or the right hand, and to choose out of 4 cavities the target form. Two cognitive concurrent tasks varied in terms of their verbal (left hemisphere) and non-verbal (right hemisphere) attributes were then given to other two groups of subjects (both of 24 Ss) performing the basic task. A consistent right hemisphere advantage was obtained in experiment I. For the non-verbal condition left hand performance was disrupted as well as for the concurrent verbal task condition. These findings were interpreted in terms of brain lateralisation of cognitive functions. For the "verbal" condition the results suggests that in case of a different task difficulties the normal mode of operation of the hemispheres is one of cooperative interaction, affecting, in this case, the hemisphere doing the processing.

Female↗

Multiple sclerosis in northern Italy. Prevalence in the province of Ferrara in 1978.

Most available Italian studies indicate that the prevalence of multiple sclerosis (MS) in Italy is lower than 20 per 100,000. Much higher prevalence figures, however, have been recently found in small communities in Sicily. On this basis, it has been suggested that the frequency the MS in Italy has been seriously underestimated and that the true prevalence for MS is probably similar to that established for northern European countries. This paper reports the results of a survey of MS in the various public health districts of the province of Ferrara. The public health districts are homogeneous medical units serving small populations and therefore represent ideal areas for epidemiological purposes. The total prevalence rate of probable MS for the whole province has been found to be at least 26.9 per 100,000. This result supports the view that the frequency of MS in Italy is higher than that indicated by most published studies, but not that Italy is an area of high risk for MS.

Adolescent↗

Oral aluminum and neuropsychological functioning. A study of dialysis patients receiving aluminum hydroxide gels.

Nine dialysis patients with significantly increased serum-aluminum levels due to chronic ingestion of aluminum hydroxide gels and eleven dialysis patients with normal serum-aluminum levels were tested neuropsychologically for generalized functions (intelligence, reasoning, memory) and for more specific abilities (visual memory, verbal and reading fluency, manual dexterity). All tests did not reveal any significant difference in neurophyscholigical functioning between the two groups. This finding seems to indicate that oral aluminum is not neurotoxic for man, even under circumstances of renal failure. This contradicts the idea that oral aluminum plays a role in etiology of dialysis dementia. However, the possibility cannot be excluded that aluminum overload in the present sample was not sufficient to induce changes in CNS functioning. Thus, until the importance of oral aluminum has been decided, it seems wise to keep all sorces of aluminum overload as low as possible.

Aluminum↗