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Biomedical subjects

P L Ghilardi

Publications and source records attributed to P L Ghilardi.

At least 19 recordsLinked to original sources

Acute peripheral vertigo: involvement of the hemostatic system.

Viral infection is the most frequent cause of unilateral acute peripheral vestibulopathy (APV). Another possible cause is a vascular disorder in the labyrinth area associated with alterations in hemostasis. In a group of 45 patients with APV and in a series of 25 patients with Ménière's disease (control group), we evaluated blood parameters, including total cholesterol, triglycerides, apolipoprotein A and B, lipoprotein (a), homocysteine, folate, prothrombin time, activated partial thromboplastin time. D-dimer, fibrinogen, antithrombin III, protein C, protein S, activated protein C resistance, and anticardiolipin antibodies. In the acute phase of their disease, the patients with APV exhibited increased plasma levels of fibrinogen (341.5 +/- 136.8 standard deviation [SD] versus 268.1 +/- 72.6 SD mg/dl; p = .05); increased plasma levels of D-dimer (305 +/- 158 SD versus 201 +/- 106 SD ng/dl; p = .008); enhanced plasma levels of lipoprotein (a) (42.6 +/- 38.5 SD versus 16.9 +/- 17.7 SD mg/dl; F = 5.67, p = .02); high leukocyte count (9.2 +/- 2.7 SD versus 6.4 +/- 1.2 SD x 10(3)/microliter; F = 8.42, p < .006); and low serum folate concentration (5.1 +/- 1.7 SD versus 7.2 +/- 2.6 SD ng/ml; F = 4.34, p = .04). During follow-up, the prothrombin time was prolonged (p = .04), and leukocyte count was decreased (p < .019) in the patients with APV, whereas fibrinogen, D-dimer, lipoprotein (a), and folate were unchanged. In this study, we demonstrated that patients with APV exhibit significant involvement of the hemostatic system.

Adult↗

Vestibular disorders in primary thrombocytosis.

OBJECTIVE: Balance disturbances are some of the most common symptoms among the clinical manifestations of chronic myeloproliferative disorders (MPDs) with a high platelet count, such as essential thrombocythaemia (ET) and polycythaemia vera (PV). In this study, we evaluated the vestibulo-oculomotor and vestibulospinal reflexes in a group of patients suffering from these diseases. DESIGN: Evaluation of balance disturbances. SETTING: Department of Neurosciences, ENT Unit, University of Pisa, Italy. METHOD: In this study, we evaluated 43 patients suffering from ET and PV who underwent otoneurologic examination, based on a study of the vestibulo-oculomotor and vestibulospinal reflexes. RESULTS: There was exclusive central vestibular involvement in 26 cases (60.4%), peripheral and central signs were associated in 8 cases (18.6%), and the involvement was purely peripheral in 1 patient. In six patients (14%), the otoneurologic examination revealed no alterations. CONCLUSIONS: The high percentage of balance disorders in cases of ET and PV probably depends upon disorders of the microcirculation due to platelet dysfunction. We also postulate a full explanation of the involvement of the central vestibular system on the basis of a greater availability of central activated serotonin acting as neuromediator.

Adult↗

Electrophoretic pattern of physiological human nasal secretions.

Various proteins have been detected in human nasal mucus, but their electrophoretic pattern has not been extensively investigated. Therefore, we have studied this pattern in nasal mucus samples from a group of 40 healthy subjects (20 males and 20 females). The electrophoretic separations have been performed under both native and denaturing conditions. The electrophoretic pattern of nasal mucus obtained under denaturing conditions and stained with Coomassie brilliant blue R-250, reveals 17 distinguishable areas into which protein bands are divided, with no significant variations from one individual to another. Eight of these areas contain high concentrations of nasal mucus proteins, whereas lower concentrations are seen in the other nine areas. The electrophoretic patterns of nasal mucus differs from that of eye mucus. The method used for sampling is rapid, simple, requires no local anaesthetic, and supplies an adequate quantity of proteins for laboratory testing. Electrophoresis under denaturing conditions proves to be the better of the two techniques, since it permits good separation of proteins. Among the protein bands revealed in our study there are some already known proteins (i.a. pre-albumim, albumin, lysozymne), but the presence of other proteins which have yet to be identified cannot be excluded. Hence, a study is underway for the purification and identification, by amino-acid sequencing, of the various proteins which make up each band. A through definition of the protein pattern of nasal mucus might prove useful for detecting anomalies in its composition, for example, in cases of olfactory disorders.

Adult↗

Menière's disease: role of antibodies against basement membrane antigens.

Recently, high levels of anti-collagen II (CII) antibodies have been found in a significant percentage of patients with Menière's disease (MD). An immune response against other collagens (C) present in the basal membranes has also been suggested by the presence of anti-CIV and anti-laminin antibodies in a number of instances of progressive systemic sclerosis (PSS) and Raynaud's phenomenon (RP). The aim of the present study was to measure the levels and frequency of anti-CI, -CII, -CIV, -CV, and anti-laminin antibodies by enzyme-linked immunosorbent assay (ELISA) in 45 patients affected by MD, 24 patients with PSS, 24 patients with RP, and 25 normal subjects. Immunoglobulin G (IgG) anti-CII antibodies were detected in 15.5% of MD sera, and 6.6% of MD sera were positive on CV, 11.1% were positive on laminin, 4.4% were positive on CI, and 4.4% were positive on CIV. A low incidence of anti-CI, -CII, -CIV, -CV, and antilaminin antibodies was found. Positive sera did not react on immunoblot with peptides obtained by cyanogen bromide (CNBr) digestion of CII. These results contrast with those of Yoo, et al.; differences in the washing procedure used and in the ethnic background of the patients may explain this divergence. Our results would seem to indicate that autoimmune responses do not play a role in the pathogenesis of MD.

Adult↗

[Immunological aspects of Menière's disease].

Among the various aetiopathogenetic hypotheses regarding Ménière's disease, the immunologic one has recently received a considerable amount of interest. Several studies have been performed using specific inner ear antigens (cell-mediated immunity) or by the evolution of circulating autoantibodies (i.e. against type II collagen or immune complex, etc...). We studied the immunological condition of 40 patients suffering from Ménière's disease, through the analysis of the following immunological blood tests: IgG, IgA, IgM, C3c, C4 and C-haemolytic complement level; circulating immune complexes, autoantibodies screening (Rheumatoid and antinuclear factors, mitochondrial smooth muscle and type II collagen antigens), cryoglobulins; T3, T4, T4/T8 monoclonal antibodies. Our results showed a rise in IgG levels in 6 patients (15%) and in IgA level, in 4 patients (10%). IgM blood level were abnormal in only one patient. Complement blood tests showed pathological results in 9 patients. All the patients had normal immunological tests regards to the autoantibody screening and T3, T4, T4/T8 monoclonal antibodies. The immunological results obtained in the patients suffering from Ménière's disease were compared with those of the control group (subjects suffering from vertigo by other causes than Ménière's disease); no significant difference was assessed between the two groups. The abnormal immunological pattern found in a few Ménière patients seems to be due to an aspecific response of the immune system, as the consequence of an alteration of the normal inner ear homeostasis.

Adult↗

Leiomyoma of the nose. A case report.

A case of leiomyoma of the nose is reported. The nose is a very rare site for tumours of myogenic origin. Up to date, only seven cases have been published. Anatomopathological considerations and etiopathogenetic hypotheses are discussed.

Adult↗

[Comparative studies of the results of caloric vestibular tests and classical torsion swing tests].

Vestibular Paresis (PL) and Directional Preponderance (PD) are the measurements found on caloric testing described by Fitzgerald and Hallpike (1942); frequency nystagmogram is the typical result of the torsion swing test of the French school. The differences between the two methods stimulated us to make a comparison of the results. Seventy-eight patients affected by unilateral peripheral vestibulopathy in various degree of compensation were submitted to both tests. Frequency nystagmogram was transformed, for calculation purposes, into normalized percentual difference (SSP). SSP and PD were found highly significantly correlated and were considered as equivalent from the statistical point of view. SSP and PL were completely independent at slow velocity stimulation. Using high velocities of stimulation a correlation was demonstrated between SSP and PL; unfortunately to the elevation of SSP corresponds a so minimal increasing of PL that the correlation is scarcely useful from the clinical point of view.

Caloric Tests↗

Treatment of ear, nose and throat infections with clofoctol.

Fifty-two adult patients affected by infectious otorhinolaryngological diseases were treated rectally with clofoctol, a new chemotherapeutic phenol derivative. The clinical diagnoses included tonsillitis, paranasal sinus infections, nose and nasopharyngeal infections, external ear canal and middle ear infections. Evaluation of the results was based on clinical and bacteriological data; the effectiveness of the drug was also confirmed by statistical reference to a control group consisting of 52 adult patients affected by otorhinolaryngological infections treated only with topical agents or not treated at all. In the patients treated with clofoctol, good therapeutic results were obtained in over 90% of cases. Only four patients showed mild adverse reactions. On the whole, results demonstrated that clofoctol is very valuable for the management of most of the infectious diseases common in ENT practice.

Adolescent↗

[The occurrence of nystagmus in sustained sinusoidal stimulation].

Twenty normal subjects have been submitted to a set of vestibular sinusoidal stimulations, the maximal acceleration per hemiperiod being constant. However the nystagmic response (number of beats per hemiperiod) was not constant, but increased during every single trial. The clinical consequences of this observation are discussed. In particular authors suggest that the classical damped sinusoidal stimulation test should be considered a semi-quantitative test.

Adolescent↗