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Biomedical subjects

R Agosti

Publications and source records attributed to R Agosti.

At least 19 recordsLinked to original sources
PubMed2006

Effectiveness of Petasites hybridus preparations in the prophylaxis of migraine: a systematic review.

The objective of this review was to evaluate the strength of evidence of effectiveness for Petasites hybridus in the prophylaxis of migraine. Several databases and other sources were searched to identify randomised-controlled trials investigating P. hybridus preparations. Two trials totalling 293 patients (60 and 233 patients) were included in this review. Both trials investigated the proprietary Petasites root extract Petadolex. The trials were described in narrative way, taking into consideration methodological quality scores. Pooling of data was not carried out due to the heterogeneity of the results. The extract at higher dose (150 mg) showed a greater decreased frequency of migraine attacks and a greater number of responders (improvement>50%) after treatment over 3-4 months than the extract at lower dose (100 mg) and placebo. Moderate evidence of effectiveness is, thus, available for a higher than the recommended dose of the proprietary Petasites root extract Petadolex in the prophylaxis of migraine. Further rigorous studies are required to confirm effectiveness and safety in long-term use before treatment with Petasites root extract can be recommended as an alternative option in the treatment schedule for the prophylaxis of migraine.

Humans↗
PubMed2006

[The undetected brain lesion in sports. Minor traumatic brain injury and its sequelae].

The minor traumatic brain injury (mTBI) in sports is often looked at as a bagatelle. The treating physician underestimates the severity of the injury suspecting that a mTBI is a nonstructural lesion with an overall excellent prognosis in the majority of the cases. This paper shows that the minor traumatic brain injury may be a structural brain lesion with potentially life-threatening dangers. The therapy should follow exactly defined guidelines, e.g., stepwise protocol of the Concussion in Sports (CIS-) Group. Return to sports activities should happen only when all physical but also cognitive symptoms have subsided. All mTBIs that have been sustained prior to the actual injury have to be recorded properly because repeated mTBIs may cause chronic degenerative brain damage. Neuropsychological testing will aid in the correct diagnosis of a mTBI and is a useful parameter in the course of the injury. In the future biochemical markers may serve as indicators of the severity of the brain injury and may also aid in predicting the outcome after TBI. Today biochemical markers do not serve as a substitute for neuroimaging.

Adolescent↗
PubMed2006

Headache patients in primary care and a tertiary care unit in Zürich, Switzerland.

The Headache and Pain Clinic (HPC) is a unit of the Zürich Neurology Department, established in 1966. In the present study demographic features, clinical characteristics and medical management of primary and tertiary care patients were compared in two groups of 181 patients each, seen by general practitioners (GPs) or the HPC, respectively, for primary headaches in 1998. There was a preponderance of women and the socially underprivileged in both samples. Chronic headache was overrepresented in the HPC (44.7%). Loss of work for >2 months was found exclusively in the HPC (9.9%). Of the GP patients, 40% were using triptans and 26.5% in the HPC. One-third of both groups had had complementary and alternative medical treatment. Differences in management strategies reflected differences in headache severity and chronicity. Results indicated that remaining shortcomings of diagnosis and treatment of headache in primary care could be minimized by involving GPs in similar non-commercial studies.

Demography↗
PubMed1999

Perfusion weighted imaging during migraine: spontaneous visual aura and headache.

Using perfusion weighted imaging, we studied 28 spontaneous migraine episodes; 7 during visual aura (n = 6), 7 during the headache phase following visual aura (n = 3), and 14 cases of migraine without aura (n = 13). The data were analyzed using a region-of-interest-based approach. During aura, relative cerebral blood flow (rCBF) was significantly decreased (27% +/- 0.07) in occipital cortex contralateral to the affected hemifield. rCBV was decreased (15% +/- 0.12) and mean transit time increased (32% +/- 0.3), persisting up to 2.5 h into the headache phase. Other brain regions did not show significant perfusion changes. During migraine without aura, no significant hemodynamic changes were observed. In one patient who experienced both migraine with and without aura, perfusion deficits were observed only during migraine with aura. These findings suggest that decremental blood flow changes in occipital lobe are most characteristic of migraine with aura.

Adult↗
PubMed1998

Weekend therapy for the treatment of Helicobacter pylori infection.

OBJECTIVES: The aim of the present study was to evaluate the efficacy and the safety of a short-term regimen (weekend therapy) in the cure of Helicobacter pylori infection and to analyze the factors that may influence the success of the treatment. METHODS: Seventy-one patients with gastric colonization by a tinidazole sensitive H. pylori strain (34 duodenal ulcer and 37 nonulcer dyspepsia) received omeprazole 40 mg o.m. for 7 days (from Monday to Sunday) and bismuth 240 mg q.i.d. + amoxicillin 1000 mg/q.i.d. + tinidazole 500 mg q.i.d. for only 2 days (Saturday and Sunday). Endoscopy, histology, culture, urease test, and susceptibility studies were done at entry and 30 days after treatment. RESULTS: Successful eradication was obtained in 84% of patients. The percentage of eradication was higher in duodenal ulcer patients (94%) than in those with nonulcer dyspepsia (74%; p < 0.05), and in patients who received the treatment during hot weather (94%) than in those who received the treatment during cold weather (74%; p < 0.05). Side-effects were induced by the treatment in 17% of patients, and these were all not severe, self-limiting, short-lasting, and did not require specific treatment. CONCLUSIONS: These data suggested that weekend therapy with high doses of drugs represents an effective, safe, and inexpensive therapeutic approach for the treatment of H. pylori infection, particularly in patients with duodenal ulcer. Furthermore, they also confirm the relevant role that short-term treatments may play in the therapeutic approach to H. pylori infection, and highlight some important aspects influencing short-term schedules.

Adult↗
PubMed1998

A modified Casson equation to characterize blood rheology for hypertension.

A modified Casson equation was established, verified satisficatorily for real conditions and suggested for use in clinical hemorheology. It provides 5 Casson parameters, i.e., Casson yield stress, Casson viscosity, the first critical point of shear rate to cause rouleaux to be broken down into smaller units, the second critical point of shear rate to completely disaggregate into individual erythrocytes, the difference between the two critical points, and also gives two series of the 5 above-mentioned Casson parameters, respectively, under original hematocrit and the standardized hematocrit of 45%. This equation not only reveals the apparent abnormalities of hypertensive patients and normalities of the healthy persons, but also reveals hidden abnormalities for patients with either low or high hematocrit. For 20 cases of hypertensive patients with low hematocrit, the 5 Casson parameters have lower values than control, but the modified equation reveals their hidden higher values than control when their hematocrit is standardized to 45%. For 7 cases of polycythemia complicated with hypertension, the 5 Casson parameters are higher at their original hematocrit, and the modified equation reveals the higher parameters than control also when the hematocrit is standardized to 45%. For 8 cases of polycythemia without complications, the 5 Casson parameters are higher at their original hematocrit than control, while the modified equation still reveals their normalities when standardizing their hematocrit to 45%.

Adult↗
PubMed1994

Heautoscopy, epilepsy, and suicide.

Heautoscopy (the doppelgänger experience), epilepsy, and suicide is a triad primarily known from literary accounts. This paper reports a patient with complex partial seizures who tried to commit suicide during the experience of heautoscopy.

Adult↗
PubMed1993

Haemorheological changes in obese adolescents after short-term diet.

Along with other risk factors in coronary heart and cerebrovascular disease, obesity is frequently associated with the development of atherosclerosis, a disease in which the rheological characteristics of blood are important. We studied the influence of weight reduction on haemorheological parameters of 20 obese adolescents (10 female, 10 male; aged 12-17 years) without metabolic and/or cardiovascular diseases. The control group composed 39 health non-obese subjects (19 female, 20 male; aged 13-17 years). At the beginning of the study the mean (+/- s.d.) body mass indices (BMI) of the obese adolescents were 36.0 +/- 5.3 kg/m2 in males and 36.8 +/- 5.0 kg/m2 in females. This was significantly reduced (31.5 +/- 4.9 kg/m2 in males and 32.5 +/- 4.7 kg/m2 in females) after one month following a diet of 1000 kcal/day: 25% proteins, 26% lipids and 49% carbohydrates. Before dieting, plasma fibrinogen level, whole blood viscosity at low shear rates and plasma viscosity were significantly higher in obese patients than in normal subjects, while the microhaematocrit values of the two groups were not significantly different. After dieting, plasma viscosity, the plasma fibrinogen level and the mean erythrocyte aggregation index of the patients decreased significantly compared to basal values, while whole blood viscosity did not change. Our data seem to indicate that short-term diet improves the haemorheological pattern in obese adolescents, probably as a consequence of an important metabolic rearrangement.

Adolescent↗
PubMed1992

Small infarctions of cochlear, retinal, and encephalic tissue in young women.

BACKGROUND AND PURPOSE: Recently, a rare syndrome that involves uniformly the brain, inner ear, and retina in previously healthy young women has been described. Brain biopsies and ophthalmologic examinations disclosed small infarcts as a pathoanatomical substrate of the disease. In previous reports, an autoimmune disorder or a coagulopathy have been suggested as possible etiologies. CASE DESCRIPTIONS: Both patients (aged 22 and 20 years) had brain involvement with neurological and neuropsychological deficits. Multifocal small hyperintensities were shown in magnetic resonance imaging of the brain. Findings of cerebrospinal fluid examination and electroencephalography were pathological in case 1 and of cerebral angiography in case 2. Both patients had a neurosensory hearing loss and multiple retinal branch arteriolar occlusions. Both women were on fenfluramine before onset of the disease. In case 1, attacks recurred during a follow-up of 34 months. At onset of the disease the 5-hydroxyindoleacetic acid and homovanillic acid levels of the cerebrospinal fluid were reduced; 13 months later the 5-hydroxyindoleacetic acid level was still reduced and the homovanillic acid level was low-normal. In case 2, with the longest follow-up of 13 years, the disease was active during only the initial 2 1/4 years. During this period a combination of oral anticoagulant and antiplatelet agents was ineffective. CONCLUSIONS: Our findings could not support current etiologic hypotheses. Whether changes in 5-hydroxyindoleacetic acid and homovanillic acid levels in the cerebrospinal fluid and/or fenfluramine intake play a role in the pathogenesis of the disease remains to be elucidated.

Adult↗
PubMed1992

Work capacity and cardiopulmonary adaptation of the obese subject during exercise testing.

Twelve obese patients (six male subjects) aged 17 to 42 years with a mean body mass index (BMI) of 40 kg/m2 and 12 normal subjects (six male subjects) aged 19 to 39 years with a mean BMI of 22 kg/m2 underwent a cycloergometric test until exhaustion to assess work capacity and cardiopulmonary adaptations of the two groups. Minute ventilation, expiratory gas concentrations, and heart rate, together with anaerobic threshold (AT) were determined in each subject during the test. The same subjects were then submitted to normocapnic hyperpnea at rest to assess the oxygen cost of breathing. We found that in the obese patients, the maximal sustainable work rate was not different from that of controls (120 vs 136 W) while AT was significantly lower (78 vs 110 W). Nevertheless, there was no difference in maximum VO2 and in VO2 at AT levels (expressed in milliliters per minute) indicating that cardiac, pulmonary, vascular, and muscle performance did not differ from obese to normal subjects. Greater muscular effort was needed by obese patients when moving their heavier legs and less when doing external work with a decreased gross mechanical efficiency and an identical net mechanical efficiency between the two groups.

Adaptation, Physiological↗
PubMed1990

Neuropathology of a human hippocampus following long-term treatment with vigabatrin: lack of microvacuoles.

Vigabatrin (gamma-vinyl-GABA), an irreversible inhibitor of gamma-aminobutyric acid transaminase, has been reported to be effective in the treatment of refractory epilepsies. Animal toxicology studies have shown that long-term application of vigabatrin induces intramyelinic edema and microvacuolation of the white matter in non-primate species. However, clinical and neuropathological studies of patients exposed to long-term vigabatrin treatment have, so far, provided no evidence for microvacuolation in the human brain. We report on the histopathological findings of selective amygdalohippocampectomy specimens from a 36-year-old female patient treated with vigabatrin for a period of 11.5 months, and from 2 control patients with chronic refractory temporal lobe seizures. All specimens showed changes associated with chronic epileptic seizures including focal neuronal loss and hippocampal gliosis. Microvacuoles, intramyelinic edema or other manifestations of neurotoxic damage were not observed in vigabatrin exposed tissue, supporting the view that this compound may not exert hippocampal neurotoxicity in humans.

Adult↗
PubMed1986

Partial restitution of lesion-induced deficits in the horizontal vestibulo-ocular reflex performance measured from the bilateral abducens motor output in frogs.

The responses of the bilateral abducens nerves to small table velocity steps in the dark were measured in four groups of animals: One group was intact prior to recording (controls), one group was hemi-labyrinthectomized the day before the recordings (acute HL), the horizontal canal nerve was sectioned the day before the recordings (acute HCN) in another and the last group was hemi-labyrinthectomized between 60 and 90 days prior to recording (chronic HL). In controls (N = 6) the slopes of the change in discharge rate to increasingly larger velocity steps increased maximally with about 200 imp/s per 1 degree/s and decreased maximally with about -60 imp/s per 1 degree/s. This difference is explained by low resting rates and by recruitment of spontaneously inactive vestibular afferent, central vestibular and abducens neurons. Results obtained from acute HL (N = 4) and acute HCN (N = 4) animals were practically identical. In neither case was a spontaneous nystagmic activity pattern observed. Results differed from those obtained in controls due to an asymmetric reduction in responsiveness. Comparison of the slopes of the evoked increases and decreases in discharge rates of abducens nerves to increasingly larger velocity steps with those in controls show that normal abducens responses are predominantly controlled by crossed excitation and by uncrossed inhibition. Disinhibition and disfacilitation play minor roles. In chronic HL animals (N = 6) that had posturally recovered to a similar degree, responses evoked by steps towards the intact side at larger velocity steps were slightly reduced with respect to those in acute HL or HCN animals. Responses evoked by steps towards the lesioned side differed between individuals. They were either similar to those in controls (N = 1), to those in acute animals (N = 2) or lay between these two extremes (N = 3). The improvement in response to velocity steps towards the lesioned side in 4 of 6 animals is explained by an increase in activity released by disinhibition. This inhibition in turn is controlled by horizontal canal-dependent input from the intact side. Plugging of this canal abolished all direction-specific responses in this plane in the dark, suggesting that the partial restitution of function of horizontal reflex performance depends exclusively on signals derived from receptors of this canal.

Abducens Nerve↗
PubMed1985

[Comparison of methods for determining erythrocyte deformability].

We have studied the erythrocyte deformability by means of the filtration technique proposed by Reid et al. and with the new technique proposed by Schmid-Schönbein et al. using a Filtrometer MF4. We have studied 50 healthy subjects (24 females and 26 males) aged 25-61 (mean age 34 years). Our results show that slope 80% (SL80) and minimal value (MV) represent the more reliable indexes given by Filtrometer MF4. This instrument gives an exhaustive and automated analysis of erythrocyte deformability. Its results allow us a more extensive knowledge of hemorheological behavior of red blood cells in very low flow conditions.

Adult↗
PubMed1981

Effects of isovolumetric venesection on blood viscosity, on red cell deformability, and on arterial flow velocity in chronic respiratory failure with secondary polycythemia.

Normovolemic hemodilution produced by isovolumetric venesection was done in 8 patients with polycythemia and respiratory failure secondary to chronic obstructive pulmonary disease. The 'deformability index' was studied by means of a filtration technique. The blood flow velocity in ascending aorta and right pulmonary artery was also studied by means of ultrasonic Echo-Doppler technique. The procedure showed in all patients an increase of oxygen tension and a decrease of carbonic gas tension in arterial blood. At the same time it was possible to demonstrate an improvement of red cell deformability and an increase of arterial flow velocity. Isovolumetric venesection is an important procedure in the management of patients with polycythemia secondary to respiratory failure.

Arteries↗
PubMed1980

Effect of hematocrit on the blood viscosity of patients with chronic respiratory failure and secondary polycythemia.

The blood of patients with chronic global respiratory failure and polycythemia exhibits higher viscosity than that of normal subjects. Plasma changes have been excluded as causal factors. The viscosity of whole blood, plasma and blood after correction of hematocrit (Ht; 45%) with autologous plasma, has been determined. The results indicate that in such patients the increase in Ht is not the most important factor affecting the rheological properties (increased viscosity) of blood. A high Ht value may be only pat of the mechanism that increases the blood viscosity of patients with chronic obstructive pulmonary disease. There is evidence that other factors are responsible for increased blood viscosity in chronic respiratory failure.

Blood Viscosity↗
PubMedDate not supplied

Malignant sarcomatoid mesothelioma of the pleura: a histological and immunohistological study of a case.

The authors describe the case of a 70 year-old asymptomatic female, who showed nodular pleural growths at an occasional chest roentgenogram. Histological examinations and laboratory findings excluded the possibility of an inflammatory granulomatous process, but they did not allow differentiation between malignant sarcomatoid pleural mesothelioma and malignant fibrous histiocytoma. Only at immunohistochemistry was the differential diagnosis made. In fact, the co-expression of vimentin and cytokeratins by neoplastic cells, along with their negativity for macrophage markers strongly supported the hypothesis that the neoplastic growth originated from subpleural mesenchymal stem cells.

Aged↗