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Biomedical subjects

R Pentore

Publications and source records attributed to R Pentore.

11 recordsLinked to original sources
PubMed1998

Pitfalls in using the ring finger test alone for the diagnosis of carpal tunnel syndrome.

Latency differences (>0.5 ms) of median and ulnar sensory action potentials (mSAP and uSAP) at the wrist evoked by ring finger stimulation are considered a sensitive and specific test for diagnosis of carpal tunnel syndrome (CTS). In this study, we aimed to assess the practical usefulness of the ring finger test (RFT) in routine electromyography (EMG) examinations. We investigated 2 series of patients: in the first prospective series we considered 300 hands affected by only mild CTS; in the second series we examined retrospectively the EMG charts of 961 hands affected only by CTS but not selected for severity or duration of symptoms. In the first series we found pathological RFT scores in 87% of cases, and pathological RFT or mSAP latency results in 92%. In the second series, pathological RFT scores were found only in 55% of cases, while in 20% where mSAP failed, a volume conducted uSAP had been erroneously interpreted as arising from the median nerve. RFT sensitivity tested in routine EMG examinations of unselected hands affected by CTS drops considerably. Fingers innervated by one only nerve, such as the index and the little fingers, must also be investigated to increase the diagnostic value of RFT.

Carpal Tunnel Syndrome↗
PubMed1998

Unilateral spatial neglect in the late stage of Alzheimer's disease.

We report two patients with presumptive diagnosis of dementia of the Alzheimer's type (AD) who manifested a clear unilateral neglect syndrome in the late stage of the disease. At onset, their cognitive profiles were broadly similar to the usual cases of degenerative dementia, but, as the disease progressed, neglect appeared, becoming gradually more severe. MRI showed more pronounced cerebral atrophy in the right hemisphere in both patients and larger ventricles on the right in one of them. These two longitudinal single case studies show that neglect can occur in AD despite the insidious and progressive nature of this disease, and in spite of the fact that the underlying pathology affects the brain bilaterally. The appearance of neglect in the late stages of the patients' illness is interpreted as resulting from both the asymmetry in the atrophy and the disruption of compensatory mechanisms caused by the progressively worsening of the atrophy in the left hemisphere.

Alzheimer Disease↗
PubMed1996

Accidental choke-cherry poisoning: early symptoms and neurological sequelae of an unusual case of cyanide intoxication.

We report the case of a 56-year-old woman who was accidentally poisoned when she ingested choke cherries whose pulp contained cyanide, and describe the acute clinical picture, the neurological sequelae and the neuroradiological findings. After recovery from coma, the patient showed signs of a parkinsonian syndrome, retrobulbar neuritis and sensory-motor neuropathy. MRI showed abnormal signal intensities involving the basal ganglia. Since no memory deficits were observed, we argue that the parkinsonian syndrome was caused by cyanide intoxication rather than by subcortical damage due to hypoxia.

Amygdalin↗
PubMed1993

Horizontal and vertical neglect dyslexia.

This case study concerns a 25-year-old right-handed male patient (G.G.) with post-traumatic lesions involving the right temporal and occipital lobe as well as the basal forebrain of the same side. G.G., who had a visual field defect almost limited to the upper left quadrant, showed both left horizontal and lower vertical neglect dyslexia, disproportionately severe when compared with left and lower visuo-spatial neglect. This is the first case report of a patient whose neglect dyslexia for vertical stimuli depended upon stimulus orientation, i.e., errors affected the final letters of top-down words and the initial letters of the bottom-up ones. This implies that neglect dyslexia can affect the internal letter shape map not only along the horizontal, but also along the vertical axis.

Adult↗
PubMed1993

Anarthria impairs subvocal counting.

We studied subvocal counting in two pure anarthric patients. Analysis showed that they performed definitively worse than normal subjects free to articulate subvocally and their scores were in the lower bounds of the performances of subjects suppressing articulation. These results suggest that subvocal counting is impaired after anarthria.

Adult↗
PubMed1990

Incidence and clinical significance of elevated fibrin(ogen) degradation product and/or D-dimer levels in liver cirrhosis patients.

Fibrin(ogen) degradation product (FDP) and D-dimer levels were evaluated in 168 liver cirrhosis (LC) patients without evidence of bleeding. Eighty-two (48%) had FDP higher than 10 micrograms/ml; only 43 of them had a concomitant increase of D-dimer. These alterations were more frequent in older and decompensated patients and correlated to the Child-Turcotte score. In the patients with elevated FDP and/or D-dimer levels the mean values of platelets, prothrombin activity and fibrinogen were not significantly different from those of the other patients and remained fairly stable over the period of the study. Finally, an increase of FDP is frequent in LC and this may suggest a diagnosis of disseminated intravascular coagulation (DIC), but a concomitant increase of D-dimer is rarely detectable, thus excluding this diagnosis. Moreover, even in the cases with increased levels of D-dimer the presence of clinical or laboratory evidence of a consumption coagulopathy, expression of a manifest DIC, seems to be unusual.

Adult↗
PubMed1990

[Doppler flowmetry in the study of portal hypertension in patients with liver cirrhosis. Qualitative and quantitative analyses].

The recent development of the duplex-Doppler technique, which combined real-time US with pulsed Doppler flowmetry, has allowed the flowmetric hemodynamic study of large abdominal vessels. As yet, however, both accuracy and possible applications of this method in the study of portal hypertension have not been fully investigated. This study was aimed at assessing whether or not the combined use of Doppler flowmetry and bidimensional US is able to detect portal hypertension in patients with liver cirrhosis (LC), and could therefore represent a valid alternative to endoscopic, angiographic, and direct pressure measurement techniques. Twenty-six patients with LC and 25 control patients were studied with a strictly standardized method; portal hypertension was detected in the patients with LC by EGDS and laparoscopy. The results demonstrated pulsed duplex-Doppler US to be able to detect portal hypertension in 92.4% of LC patients, with 2 false negatives only (7.6%). The difference in the flowmetric data of normal and LC patients was highly significant (p less than 0.001 Student's t test). In conclusion, duplex-Doppler US can be considered as a valid technique to detect portal hypertension in LC patients, and can thus be used as an alternative to more invasive techniques of general use in clinics.

Adult↗
PubMed1990

[A proposed method for the laboratory diagnosis of disseminated intravascular coagulation in liver cirrhosis].

Laboratory diagnosis of disseminated intravascular coagulation (DIC) in liver cirrhosis (LC) could be complicated by the presence of the usual decrement of the hemocoagulative parameters and of an increase of the fibrinogen/fibrin degradation products (FDP). The D-dimer test, more sensible than the one for FDP and specific for the cross-linked fibrin degradation products is now available. A significant difference between the two tests, assayed simultaneously has been demonstrated in 217 LC patients, without any recent or present hemorrhagic signs. The D-dimer was increased in only 60 of the 108 patients with high values of FDP; therefore this test has a screening value higher than FDP. If only the D-dimer is elevated, the FDP assay is indicated: if FDP are normal a thrombosis may be present and, finally, if the FDP are also increased with a concomitant decrement of fibrinogenemia, the laboratory diagnosis of DIC is reasonably certain.

Adult↗
PubMed1989

[Role of combined etiology (alcohol and B virus) in the development of hepatocarcinoma in subjects with liver cirrhosis].

107 (8.2%) of 1297 patients with liver cirrhosis admitted to our Clinic between 1980 and 1987 had hepatocellular carcinoma (HCC). This disorder was more frequent in patients with liver cirrhosis of dual etiology, alcoholic and post-hepatitic (9.9%), than in those with liver cirrhosis of unknown (7.82%), alcoholic (9.35%) or post-hepatitic (5.16%) etiology. The mean age of the patients with HCC of dual etiology (51.2 years) was significantly lower than that of the other three groups (61.0, 62.0 and 64.5 years, respectively; p less than 0.001). The conclusion is that in patients with liver cirrhosis of dual etiology the onset of HCC is frequent and precocious. This fact must be considered in epidemiological studies, in the prognosis and in the clinical management of the patient since early diagnosis is of importance in deciding therapy.

Aged↗
PubMedDate not supplied

Fructosamine and glycated hemoglobin as indices of glycemic control in patients with liver cirrhosis.

Glucose intolerance often occurs in liver cirrhosis; therefore a long-term control of plasma glucose levels appears to be important. For this purpose glycated hemoglobin A (HbA1c) determination is proposed as a suitable method, while no data are available on fructosamine test. In 98 cirrhotic patients serum fructosamine and HbA1c levels were compared with those of normal controls and among cirrhotic patients grouped in non glucose-intolerant and with non insulin-dependent (NIDDM) or insulin-dependent diabetes mellitus (IDDM). The mean HbA1c values of cirrhotic patients with normal glycemic control were significantly lower than normal, and only a few IDDM and NIDDM cirrhotic patients showed high values of HbA1c, indicating that HbA1c is often underestimated in these patients. On the contrary, serum fructosamine levels were on the average higher than normal in nondiabetic patients, but they were significantly higher in IDDM and NIDDM patients than in nondiabetics, and the 72% of NIDDM and 85% of IDDM patients had fructosamine levels higher than the upper normal value. In conclusion, in diabetic patients with liver cirrhosis fructosamine seems to be a more suitable test than HbA1c for monitoring blood glucose levels.

Aged↗