Biomedical subjects

P Tiraboschi

Publications and source records attributed to P Tiraboschi.

6 recordsLinked to original sources

PubMed1991

Long-term acetyl-L-carnitine treatment in Alzheimer's disease.

In a double-blind, placebo-controlled, parallel-group, randomized clinical trial, we studied the efficacy of long-term (1-year) oral treatment with acetyl-L-carnitine in 130 patients with a clinical diagnosis of Alzheimer's disease. We employed 14 outcome measures to assess functional and cognitive impairment. After 1 year, both the treated and placebo groups worsened, but the treated group showed a slower rate of deterioration in 13 of the 14 outcome measures, reaching statistical significance for the Blessed Dementia Scale, logical intelligence, ideomotor and buccofacial apraxia, and selective attention. Adjusting for initial scores with analysis of covariance, the treated group showed better scores on all outcome measures, reaching statistical significance for the Blessed Dementia Scale, logical intelligence, verbal critical abilities, long-term verbal memory, and selective attention. The analysis for patients with good treatment compliance showed a greater drug benefit than for the overall sample. Reported adverse events were relatively mild, and there was no significant difference between the treated and placebo groups either in incidence or severity.

Acetylcarnitine↗

PubMed1989

An example of a clinical trial in patients with Alzheimer's disease: some methodological issues.

UNLABELLED: In ten Italian centers--hospitals and geriatric institutions--130 outpatients and inpatients with a diagnosis of Alzheimer's disease were recruited for a randomized, double blind, placebo controlled clinical trial with 1-acetylcarnitine. In planning the trial, we had to deal with some important and largely open issues. DIAGNOSIS: we decided not to use neuropsychological tests (NPT) in the diagnostic process, both for the unknown risk of false positive and false negative rate and to improve the feasibility of the trial. FOLLOW-UP: it must be representative of the disease and consequently we chose to follow the patients for one year (assessment at baseline, 3rd, 6th and 12th month) in spite of a possible high rate of drop-outs. ASSESSMENT: to assess the patients' outcome we used NPT and behavioural scales. However, the validity, reliability and feasibility of these instruments are rarely discussed and their usefulness as indicators of the relevant aspects of the disease needs a careful evaluation. STATISTICAL ANALYSIS: in this type of trial there is both a high risk of alpha-error, in view of the high number of NPT and behavioural scales used to assess the drug efficacy, and a high risk of beta-error connected with the usually small sample size. Thus, the role of small trials in defining the risk/benefit ratio of a treatment needs to be discussed.

Acetylcarnitine↗

PubMed1988

Atypical features and prognosis of Wallenberg syndrome: longitudinal study.

The lessons of a retrospective study of 24 consecutive cases of Wallenberg syndrome observed during a 6-year span are described: the high frequency of signs and symptoms not considered typical, such as headache, diplopia, supranuclear homolateral facial paresis and homolateral brachiocrural hemiparesis; the unfavorable short term course in a high percentage of cases, and the risk of sudden respiratory arrest.

Aged↗

PubMed1986

[Diagnostic problems in spontaneous bacterial peritonitis].

In spontaneous bacterial peritonitis (SBP) the ascitic fluid culture (certain criterion of diagnosis) may be negative despite an evident clinical and biochemical picture. Therefore the diagnosis may be sometimes more "probable" than "certain". The authors performed a comparative analytical study--from a clinical, biochemical and prognostic point of view--between a group of 10 "probable" SBP (10 cirrhotic pts.) and 9 "certain" SBP (9 cirrhotic pts.). 115 "normal ascitic fluids" (negative culture in absence of any SBP-symptoms), collected from 82 cirrhotic pts., were used as control group. The ascitic concentration of white blood cells (WBC)/mmc and polymorphonuclear cells (PMN)/mmc was significantly different between the SBP and control group (p less than 0.001) and between the "certain" and "probable" SBP (p less than 0.02). The latter have a mean WBC and PMN/mmc count that is lower than the "certain" SBP and on the contrary a significantly higher ascitic glucose content (p less than 0.05). Probably that means a lower ascitic bacterial inoculum, which is below the threshold of detectability by current culture techniques. Serum laboratory tests showed no differences between the "probable" and the "certain" SBP groups, although, however they were worse than the control group. The symptoms and the prognosis resulted nearly the same in both groups. In spite of a high rate of recovery (57.9%) the global survival at the follow-up (10 +/- 5.2 months, range 6-19) was only 26.3%. The wide clinical, biochemical and prognostic overlap of the two groups leads us to consider as "certain" all the cases of "probable" SBP. Owing to the fact that only an early recognition and therapy are known to affect the prognosis significantly, the obvious conclusion is that in the SBP the suspicion is more important that the diagnostic certainty. Furthermore--in agreement with previous studies--the cutoff limit of 250 PMN/mmc has shown the best statistical diagnostic value for a rapid diagnosis (sensibility 100%, diagnostic accuracy 92.5%, negative predictive value 100%, likelihood ratio 1.9).

Adult↗

PubMedDate not supplied

[Fluoxetine].

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Depressive Disorder↗

PubMedDate not supplied

[Mianserin].

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Adjustment Disorders↗