PubMed HealthSearch

Biomedical subjects

R Manni

Publications and source records attributed to R Manni.

At least 37 records · Page 2Linked to original sources

Breathing patterns and HbSaO2 changes during nocturnal sleep in patients with Duchenne muscular dystrophy.

A night-time polygraphic sleep recording with continuous HbSaO2 monitoring was performed in 11 chair-bound Duchenne muscular dystrophy patients with severe restrictive lung disease but with blood gas values within normal limits when awake. No abnormalities of sleep pattern were detected. Nocturnal sleep did not have significant adverse effects on respiration. However, in 6 patients, infrequent central apnoeas or hypopnoeas occurred which were associated with falls in HbSaO2 greater than those that have been reported to be in normal subjects. The magnitude of HbSaO2 falls appeared to be significantly correlated with functional residual capacity values. Overall, the findings revealed a relatively preserved, although unstable, blood O2 balance during nocturnal NREM and REM sleep in patients with Duchenne muscular dystrophy, even in an advanced stage of their illness.

Adolescent

Time-dependent pharmacodynamic effects of phenobarbital in humans.

The relationship between the serum concentration of phenobarbital and its pharmacodynamic effects was assessed in a double-blind controlled study in eight normal volunteers who were given single oral doses of phenobarbital (200 mg) and placebo according to a randomized cross-over design. Compared with the placebo session, phenobarbital was found to induced CNS-depressing effects as assessed by visual analogue rating scales (VARS) and critical flicker fusion tests (CFF), whereas no significant effects were detected on choice reaction times, tappings, and digit symbol substitutions. There was a clear-cut dissociation between the time course of serum phenobarbital levels, which remained at a plateau throughout most of the period of observation (up to 72 h) and its subjective (VARS) and objective (CFF) effects, which could be documented only for up to 9 h after administration. These data suggest that pharmacodynamic tolerance develops rapidly even after a single oral dose of the drug. Multiple Sleep Latency Tests (MSLTs) were also performed in the same subjects and showed that phenobarbital increases diurnal drowsiness and attenuates the circadian variation in drowsy state that is seen under control conditions. MLSTs appeared to be superior to other tests in documenting the sedative effects of the barbiturate.

Adult

Effects of vigabatrin on evoked potentials in epileptic patients.

1. Somatosensory (SEP) brainstem auditory (BAEP) and visual (VEP) evoked potentials were determined before and after add-on administration of vigabatrin (GVG) in patients with epilepsy. 2. At pre-treatment assessment SEP and BAEP parameters were usually found to be within normal limits, while P100 latencies of the VEP were abnormally prolonged in a considerable proportion of patients. 3. In a double-blind, placebo-controlled trial in 22 patients GVG (1-3 g day-1 stratified according to body weight) given for 7 weeks did not modify any of the evoked potential parameters evaluated. 4. Eighteen patients were evaluated prospectively at regular intervals during long-term GVG (2-4 g day-1) therapy with a mean follow up of 24 months (range 13-42 months). SEP, BAEP and especially VEP parameters showed some interindividual variability, but the within patient variation was relatively small. No consistent important changes were seen in association with GVG, although a possible trend towards a shortening of BAEP latencies and P100 latencies was observed. 5. The relevance of these findings with respect to GVG safety is discussed.

Adolescent

Vigabatrin in the treatment of epilepsy: a long-term follow-up study.

Twenty-five adult epileptic patients who had shown a satisfactory clinical response to add-on vigabatrin under placebo-controlled conditions continued on long-term treatment for up to 47 months (median 22 months). The initially favourable therapeutic response was generally maintained throughout the observation period with an overall good clinical tolerance. No evidence of neurotoxicity was detected by multimodal evoked potentials monitoring.

Adult

Effect of vigabatrin (gamma-vinyl-GABA) on visual, brainstem auditory and somatosensory evoked potentials in epileptic patients.

Visual (V), somatosensory (S) and brainstem auditory (BA) evoked potentials (EPs) were determined in 22 epileptic patients, mostly with partial seizures, who received add-on treatment with vigabatrin (1-3 g/day, stratified according to body weight) and placebo, each given for 7 weeks according to a double-blind, randomized cross-over design. At pretreatment assessment, BAEPs and SEPs were found to be within normal limits in most of the patients tested, while for VEPs several abnormal responses were found, including a marked prolongation of P100 latency values in the majority of cases. None of the EP parameters examined was significantly influenced by vigabatrin treatment. These results support the evidence that enhancement of GABA-ergic transmission does not substantially affect the functional state of afferent sensory pathways as assessed by EP analysis. The significance of these findings with respect to the safety of vigabatrin therapy is discussed.

Adolescent

Sleep and oxyhemoglobin desaturation patterns in chronic obstructive pulmonary diseases.

A polysomnographic study with noninvasive oxyhemoglobin saturation (HbSaO2) monitoring has been conducted in 11 consecutive male nonobese subjects with chronic obstructive pulmonary disease (COPD). The patients with a high arterial CO2 level and markedly reduced functional residual capacity appeared to be more prone to undergo HbSaO2 desaturation during sleep compared to patients with less severe functional and clinical respiratory impairment. The HbSaO2 desaturations were mostly linked to REM sleep and appeared to be concomitant to the inhibition of the tone of the intercostal muscles. Regarding sleep architecture, the patients with less severe COPD and scarce or absent tendency to HbSaO2 desaturation during sleep showed light and fragmented sleep with a marked tendency to arousals and awakenings.

Aged

A clinical, EEG and CT study in 21 cases of chronic respiratory failure.

A clinical, EEG and CT study was carried out on 21 patients with chronic stable respiratory failure. The neurological disturbances and mental deterioration observed were of a mild degree, and no severe alterations were detected at EEG. CT showed cerebral atrophy, but the type and prevalence did not differ substantially between patients studied and normal sex- and age-matched control subjects. The data gave evidence that in chronic stable respiratory failure cerebral function is only slightly affected.

Aged

Luteinizing hormone pulsatile secretion and pituitary response to gonadotropin releasing hormone and to thyrotropin releasing hormone in male epileptic subjects on chronic phenobarbital treatment.

Endocrine changes have been reported in treated epileptic subjects, who often exhibit sexual dysfunctions, but the endocrine effects of single antiepileptic drugs have not been completely elucidated. In this study we have investigated the influence of phenobarbital (PB) on adenopituitary function and on peripheral sexual steroid pattern in 8 epileptic males. Chronic PB treatment does not modify luteinizing hormone (LH) pulsatile secretion. In the same subjects, LH and follicle stimulating hormone (FSH) response to Gonadotropin Releasing Hormone was blunted with respect to healthy controls both in terms of absolute values and of secretion areas. No difference was found in prolactin (PRL) response to Thyrotropin Releasing Hormone. In the epileptic group a significant increase in the levels of sex hormone binding globulin and a consequent decrease of the percent free testosterone have been observed. PB treatment also significantly lowers 17-beta-estradiol mean levels. These data suggest that PB independently affects both gonadotropin secretion and peripheral steroid pattern.

Adult

The importance of gastric emptying in reflux esophagitis: an experimental research on pigs.

A study was conducted on pigs to evaluate the importance of gastric emptying rate in reflux esophagitis development. Gastric emptying was previously measured in 25 pigs. Then, the following operative procedures were carried out: Heller's cardiomyotomy, common bile duct ligature, cholecysto-gastric anastomosis, and extramucosal duodenal myotomy on 10 animals (group A); the same procedures except extramucosal duodenal myotomy on another 10 animals (group B); common bile duct ligature and cholecysto-gastric anastomosis on the last 5 animals (group C). Six months later, gastric emptying was measured again; whereas in group A a significant shortening of gastric emptying was found, the other 2 groups remained unchanged. Then, all the animals were sacrificed and the lower third of the esophagus was removed for histologic examination. In all the pigs undergoing cardiomyotomy (groups A and B) appearance of esophagitis was found. No signs of esophagitis were found in group C. The conclusions reached are cardiomyotomy is in all cases responsible for reflux esophagitis development; extramucosal duodenal myotomy is capable of shortening gastric emptying, but this does not affect reflux esophagitis development.

Animals

Carbamazepine poisoning: a case report.

In a case of acute intoxication produced by carbamazepine overdose ataxia and cyclic coma were the salient features. The mechanisms underlying these symptoms are discussed. Some peculiarities such as breathing irregularities and microhematuria are also described.

Adolescent

Polygraphic sleep patterns in heredoataxia: a study of nine cases.

A clinical and polygraphic sleep study was carried out in nine patients affected by heredoataxia (three by sporadic olivopontocerebellar ataxia (SOPCA), three by early onset cerebellar ataxia (EOCA) and three by Friedreich's ataxia). None of the patients complained about subjective sleep complaints. Polysomnographic findings showed a decrease in REM time in all the patients considered and a lower REM density in SOPCA and EOCA. A pattern of obstructive sleep-apnea was found in one case of SOPCA.

Cerebellar Ataxia

Diagnostic value of spontaneous afternoon sleep in epilepsy: polysomnographic study of 96 epileptic patients.

An early afternoon polysomnographic recording was performed in 112 epileptic patients in order to better define their epileptic disease. 96 subjects (85.7%) slept spontaneously and sleep EEG tracing resulted in diagnostically useful data in 47.8% of cases, a significantly higher percentage than that obtained from tests performed in basal conditions. EEG activation, mostly linked to light NREM sleep stages, was greater in infanto-juvenile subjects than in adults.

Adolescent

Femoral neuropathy from iliac muscle hematoma complicating anticoagulant therapy: a surgical emergency. Report of a case.

A case of femoral neuropathy from iliac muscle hematoma occurring during heparin administration, successfully treated by early surgical decompression is reported. Following the evaluation of anatomy, possible pathogenesis and CT scanning findings, the role of early diagnosis is emphasized in the assessment of prognosis and for successful operative decompression.

Emergencies

Sodium valproate "encephalopathy": report of three cases with generalised epilepsy.

A report of 3 cases of sodium valproate "encephalopathy". The addition of valproate to the treatment in 3 subjects, two adults and one child, all with generalised epilepsy, induced a worsening of the clinical and EEG pattern and in one case disturbances of vigilance as well. The occurrence of this complication in generalised epilepsy and the possibility that EEG alterations are its only manifestation are emphasised.

Adult