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Biomedical subjects

T Rosolacci

Publications and source records attributed to T Rosolacci.

10 recordsLinked to original sources
PubMed2005

[Discharge prescription for ischemic stroke patients].

Stroke is a major public health issue: it affects 120 000 people in France each year. The yearly recurrence rate is thought to reach 8 percent. Secondary prevention of stroke is thus crucial and focuses on controlling vascular risk factors most often associated with antiplatelet agents. Therapeutic objectives are set depending on the individual's global cardiovascular risk. The PROGRESS study has shown the relevance of systematic blood pressure lowering using an angiotensin-converting-enzyme inhibitor (perindopril) in combination with a diuretic (indapamide) in secondary prevention of stroke, including in normotensive patients. If possible, blood pressure should be below 130/85 mmHg. Statins are indicated in stroke patients with hypercholesterolemia, coronary heart disease, diabetes mellitus or carotid stenosis, the target LDL-cholesterol level being below 1 g/L (2.58 mmol/L). There is a wide consensus on treating patients with symptomatic carotid stenoses > or = 70 percent by thrombo-endarterectomy and stroke associated with atrial fibrillation by anticoagulants. Management should be global and include changes in dietary behavior, tobacco and/or alcohol withdrawal, and regular exercising. Patient-specific therapeutic education should be offered in order to improve compliance.

Atrial Fibrillation↗
PubMed1999

Clomethiazole acute stroke study (CLASS): results of a randomized, controlled trial of clomethiazole versus placebo in 1360 acute stroke patients.

BACKGROUND AND PURPOSE: The efficacy and safety of the neuroprotective drug clomethiazole was tested in a double blind placebo controlled trial in patients with a clinical diagnosis of acute hemispheric stroke. METHODS: Patients with symptom onset of </=12 hours before the start of treatment were included in the study. Clomethiazole (75 mg/kg) or placebo was given as an intravenous infusion over a 24-hour period. Patients were followed up for 90 days. The primary efficacy variable was the proportion of patients reaching relative functional independence (>/=60 points on the Barthel Index) at 90 days. RESULTS: A total of 1360 patients were included. In the main efficacy analysis (n=1353), 56.1% of patients taking clomethiazole and 54.8% of placebo patients reached relative functional independence. The difference was not statistically significant. An analysis of the effect of time since onset of symptoms showed no difference between the treatment groups. Clomethiazole was generally well tolerated and appeared safe in the population studied. Sedation was the most common adverse event, leading to treatment withdrawal that occurred in 15.6% of clomethiazole-treated patients compared with 4.2% of placebo-treated patients. In a subgroup classified before randomization as having total anterior circulation syndrome (TACS) (n=545, or 40% of all randomized patients), the percentage of those reaching relative functional independence was 40.8% on clomethiazole and 29.8% on placebo, a difference of approximately 11 percentage units. TACS patients have clinical symptoms suggesting a "large" stroke. CONCLUSIONS: Clomethiazole had no adverse or beneficial effect on long-term outcome for all patients but produced sedation. The hypothesis that clomethiazole is effective in patients with large strokes will be tested in a further study.

Acute Disease↗
PubMed1993

[Cerebral infarction, cardiac myxoma and lentiginosis].

Occlusion of the middle cerebral artery in a 16-year old woman revealed a left atrial myxoma associated with a mucocutaneous lentiginosis. Two-dimensional transthoracic or transesophageal echocardiography should be performed in all patients with stroke and lentiginosis to look for cardiac myxoma. After treatment of the cardiac tumor, echocardiography should be repeated at regular intervals to detect a recurrence of the myxoma. As this cardio-cutaneous syndrome is a familial disorder with autosomal dominant inheritance, examination of all family members by echocardiography is recommended.

Cerebral Infarction↗
PubMed1992

[Idiopathic peripheral facial paralysis. Prognostic value of the combined study of the blink reflex with stimulation of the facial nerve. 91 cases].

The blink reflex and stimulodetection of the facial nerve was studied during the first ten days, the 30th and 60th day and at the end of the sixth month in 91 patients with Bell's palsy. In patients with present R1 during the first ten days, there was a remarkable tendency towards a satisfactory recovery without complications. On the contrary using this single test, it is impossible to determine with 100% accuracy, which Bell's palsy will have an unsatisfactory recovery with severe dysfunction. The blink reflex seems to be a useful test for predicting the prognosis in an early stage of the paralysis. The association of the blink reflex and stimulodetection of the facial nerve allows to evaluate the risk of sequelae by the means of different electrophysiological patterns.

Blinking↗
PubMed1991

[Significance of the blink reflex in the Wallenberg syndrome].

The blink reflex was studied in 38 cases with lateral medullary lesions (Wallenberg syndrome). Twenty-one blink reflexes were abnormal. The most common abnormality is an afferent delay in the late reflex on the side of the lesion with a normal early reflex. This abnormality is not pathognomonic of the Wallenberg syndrome. The physiopathogeny is discussed.

Adult↗
PubMedDate not supplied

Event-related auditory evoked potentials and multiple sclerosis.

Long latency event-related auditory evoked potentials, particularly the P300 wave, constitute an objective electrophysiological index of cognitive function. For this reason, these potentials have been studied in a series of 101 patients with multiple sclerosis (MS), classified according to McAlpine's criteria into definite, probable and possible cases. The patients were also classified as depressed or non-depressed according to the DSM-III and Research Diagnostic Criteria. They were also subjected to a battery of psychometric tests. In the patient population the N200 and P300 latencies were increased, as were the P200 latencies, when compared with a control population. This electrophysiological pattern had previously been observed in other conditions characterised by subcortical lesions. Partial correlations (at constant disease duration) between the disability score and the cognitive deficit were found to be significant. Patients with an increased P300 latency had a greater disability and the P300 latency was significantly correlated with the duration of the illness. The N200 and P300 latencies were increased in depressed MS subjects, but this increase did not reach the level of significance. Depression was more frequent in the more severely handicapped patients. This suggests that the origin of the depression seen in multiple sclerosis is only partly organic, and that it is one of the factors contributing to the subcortical cognitive deficit in multiple sclerosis. Progressive forms of the disease exhibited the most profound cognitive deficit, and the most marked increase in P300 latency.

Acoustic Stimulation↗
PubMedDate not supplied

[Late recurrence of Miller-Fischer syndrome. Physiopathogenic reflections about a case].

The physiopathology of the syndrome of ophtalmoplegia-ataxia-areflexia-hyperproteinorachia, firstly described by FISHER in 1956, remains a matter of controversy among neurologists. We report a new case of recurrence of a MILLER-FISHER's syndrome. The involvement of peripheral and central structures is discussed according to recent knowledges about the immunopathology of inflammatory polyneuropathies.

Cerebellar Ataxia↗