Nocturnal sleep in multisystem atrophy with autonomic failure: polygraphic findings in ten patients.
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Biomedical subjects
Publications and source records attributed to R Morini.
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A multiparametric investigation of daytime sleepiness was carried out in 10 patients with a generalized epilepsy treated by phenobarbital, 10 with a cryptogenic partial epilepsy treated by carbamazepine and 10 healthy controls. After a standard ambulatory night-time polysomnography, an objective and subjective estimate of daytime sleepiness was made in each subject by means of the Multiple Sleep Latency Test (MSLT) and visual analogue rating scale (VARS), respectively. Furthermore, a parallel assessment of mood and cognitive tasks involving attention and psychomotor speed was also carried out. The data show that patients on chronic treatment with phenobarbital have a greater daytime sleep tendency and they show a worse score at the digit symbol substitution test, than patients on carbamazepine and healthy controls.
Twenty-five patients with epilepsy (mostly with partial seizures) who had responded favourably to a short-term trial of add-on vigabatrin entered maintenance treatment. After 52 to 78 months, 15 patients continue to take the drug with good therapeutic response. Median monthly seizure frequency during the last 2 months on vigabatrin in all patients, including drop-outs, was 3.5 (range 0-74) as compared with 10 (range 3-98) during an initial placebo period (p < 0.01). Drop-outs were caused by adverse events in 2 cases (ataxia and psychotic symptoms respectively), seizure breakthrough in 4 cases and reasons unrelated to treatment in 4 patients. In most patients, side effects were absent or mild, the most frequent complaint being weight gain. It is concluded that the antiepileptic efficacy and good clinical tolerability of vigabatrin are generally maintained during long-term treatment for up to 6 years.
The relationships between blood rheology and peripheral arterial disease are reviewed. The connections between abnormal blood rheology and peripheral arterial disease are discussed considering the opinions of the enthusiastic and skeptic rheologists. A prospective for future investigations is also proposed.
The results from 398 consecutive measurements of blood viscosity, plasma viscosity and hematocrit were submitted to a statistical analysis. Hematocrit appeared to be the main determinant of blood viscosity, even though its influence was not so strong as illustrated in previous investigations. The correlation between blood viscosity and hematocrit appeared strictly connected with the red cell amount of the blood sample, being higher when the latter exceeded its physiological range; this correlation disappeared when red blood cell amount was strongly reduced, while the correlation between plasma viscosity and blood viscosity had an opposite behaviour. From these results we can conclude that correlations between hematocrit and plasma viscosity with blood viscosity have opposite trends and that a reciprocal interference is often present.
By means of the filterability test of Reid et al., the influence of a subpopulation of rigid erythrocytes (5% and 2.5%, respectively) was studied using Nucleopore polycarbonate membranes with pore size of 5 mu and diameter of 13 mm. The addition of 5% and 2.5% of rigid red cells delays the erythrocyte filtration times and alters the red cell deformability index. The meaning of the obtained data is discussed.
The findings of 300 consecutive measurements of erythrocyte filterability, whole blood viscosity, plasma viscosity, hematocrit, mean corpuscular volume and white blood cell count have been statistically analyzed in order to find a possible correlation between these parameters. No correlation between erythrocyte filterability, whole blood viscosity, plasma viscosity, hematocrit, mean corpuscular volume and white blood cell count was found. Some hypotheses are enunciated to explain such absence of correlation. The meaning of erythrocyte filtration test is still unclear.
The influence of an acute physical exercise on hemorheological parameters in insulin-dependent diabetes mellitus in not actually known. We have examined the behavior of hemorheological parameters and other laboratory findings such as blood glucose, blood lactic acid, O2 and CO2 venous pressure and venous pH before and after a submaximal physical exercise standardized by ECG monitoring and by means of an 'oxygen consumption computer'. The work load was significantly lower in diabetic patients than in normal control subjects. On the other hand, changes in hemorheological parameters were more evident in diabetic patients. The significance of these findings is also discussed.
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