ABSTRACT
BACKGROUND AND PURPOSES: Neurological involvement in systemic sclerosis is unusual despite the possible cerebral localization of vascular lesions. The aim of this study was to evaluate cognitive performances and cerebral vasoreactivity in young scleroderma patients without any signs or symptoms of nervous system involvement. METHODS: Sixteen scleroderma patients and 16 sex- and age-matched healthy subjects without vascular risk factors were included. A neuropsychological assessment for the evaluation of different areas of cognition was performed. For an assessment of cerebrovascular reactivity (CVR), each subject was submitted to hypercapnia with transcranial Doppler ultrasonography using the Breath-Holding Index (BHI). RESULTS: Patients had significantly lower adjusted mean levels of performance with respect to controls in the Modified Card Sorting Test (P < 0.001) and in the Trail Making Test Parts A and B (P < 0.001 and P < 0.05 respectively). Regarding CVR, BHI values were significantly lower in patients with respect to controls: 0.82 +/- 0.44 vs. 1.34 +/- 0.18, P < 0.0001. CONCLUSIONS: These findings show the presence of reduced performances of executive functions in scleroderma patients. The associated alteration of CVR in the absence of other apparent causes of cerebrovascular impairment suggests that cognitive problems may be related to an alteration in cerebral perfusion regulation specifically linked to the disease. Further studies are needed to evaluate whether cognitive changes may be positively influenced by treatments aimed to improve vessels functionality in scleroderma patients.
Subject(s)
Cerebrovascular Circulation/physiology , Cognition Disorders/etiology , Scleroderma, Systemic/complications , Adult , Cognition Disorders/epidemiology , Female , Humans , Male , Neuropsychological TestsABSTRACT
OBJECTIVE: The aim of this study was to investigate whether the presence of severe internal carotid artery stenosis may be associated with different cognitive performance in relation to the side of the stenosis and its hemodynamic consequences. METHODS: Eighty-three patients with asymptomatic severe unilateral internal carotid stenosis were included. A neuropsychological investigation including Verbal Fluency using phonemic and category access, Coloured Progressive Matrices, and Complex Figure Test Copy was performed. Each patient underwent an assessment of cerebrovascular reactivity (CVR) to hypercapnia with transcranial Doppler ultrasonography using the breath-holding index (BHI). Thirty healthy subjects comparable for demographic characteristics and vascular risk profile served as controls. Subjects with carotid stenosis were classified into two groups: preserved CVR (BHI > or =0.69), 48 patients (25 with left and 23 with right stenosis); and impaired CVR (BHI <0.69), 35 patients (19 with left and 16 with right stenosis). RESULTS: Subjects with left stenosis and reduced CVR had significantly lower performances at phonemic verbal fluency with respect to controls and the other groups of stenosis. In subjects with right stenosis and reduced CVR, scores obtained in Coloured Progressive Matrices and in Complex Figure Test Copy were significantly lower with respect to the other groups. CONCLUSIONS: These results suggest that an alteration of cerebrovascular reactivity may be responsible for reduction in some cognitive abilities involving the function of the hemisphere ipsilateral to carotid stenosis. Such findings may be of interest for providing a more comprehensive indication to surgical treatment in subgroups of subjects with asymptomatic carotid stenosis.
Subject(s)
Carotid Stenosis/physiopathology , Carotid Stenosis/psychology , Cerebrovascular Circulation/physiology , Cerebrovascular Disorders/physiopathology , Cerebrovascular Disorders/psychology , Cognition Disorders/diagnosis , Aged , Aged, 80 and over , Carotid Artery, Internal/diagnostic imaging , Carotid Artery, Internal/pathology , Carotid Artery, Internal/physiopathology , Carotid Stenosis/diagnostic imaging , Cerebral Cortex/blood supply , Cerebral Cortex/physiopathology , Cerebrovascular Disorders/etiology , Cognition Disorders/etiology , Disability Evaluation , Disease Progression , Early Diagnosis , Female , Functional Laterality/physiology , Humans , Language Disorders/diagnosis , Language Disorders/etiology , Male , Neuropsychological Tests , Predictive Value of Tests , Severity of Illness Index , Ultrasonography, Doppler, TranscranialABSTRACT
The purpose of this study was to evaluate the efficacy of topiramate in the treatment of chronic migraine. This was a double-blind, randomized, placebo controlled, parallel-group study. Patients suffering from chronic migraine with analgesic overuse were randomly assigned in a 1 : 1 ratio to receive topiramate or placebo. Following a baseline phase of eight weeks, the study drug was titrated in 25-mg increments over one week to 50 mg daily. Titration phase was followed by a 8-week maintenance phase. Number of days with headache during a 28-day period was the efficacy variable. At baseline, there was no difference in the number of days with headache between patients treated with topiramate and those treated with placebo (mean +/- SD: 20.9 +/- 3.2 and 20.8 +/- 3.2, respectively). During the last 4 week-maintenance phase, topiramate-treated patients experienced a significantly lower 28-day headache frequency in comparison to those treated with placebo (mean number of days with headache +/- SD: 8.1 +/- 8.1 vs. 20.6 +/- 3.4, P < 0.0007). Topiramate at low doses proved to be an effective therapeutic approach to reduce headache frequency in patients with chronic migraine and analgesic overuse.
Subject(s)
Fructose/analogs & derivatives , Fructose/therapeutic use , Migraine Disorders/drug therapy , Adult , Analgesics/adverse effects , Chi-Square Distribution , Chronic Disease , Confidence Intervals , Double-Blind Method , Female , Humans , Male , Middle Aged , Migraine Disorders/chemically induced , Multivariate Analysis , Odds Ratio , TopiramateABSTRACT
An effective diet that attends patient's needs is being study by researchers connected with enteral nutrition and dietetics. The aim of study is to develop formulations for enteral products based on digestic bovine, chicken and fish meat by bromelin
Subject(s)
Enteral Nutrition , Meat , Cattle , Chickens , Fishes , Food Chemistry , HospitalizationSubject(s)
Antioxidants/pharmacology , Helianthus , Oils , Seeds , Drug Stability , Food PreservativesABSTRACT
Studies on the enzymatic digestion of food proteins are being carried out "in vitro" in order to prepare protein hydrolysates to be added to specific diet. The digested product is lyophilized to preserve its solubility characteristics.
Subject(s)
Food Additives/analysis , Food Preservation/methods , Food-Processing Industry , Meat , Peptide Hydrolases/pharmacology , Enzyme Activation , Freeze Drying , Solubility , VegetablesABSTRACT
The A.A. report a work done on the influence of hypophysectomy on fluoride metabolism by the bones of rats. The results obtained indicate that hypophysectomy enhances F concentration in bones and teeth. The F retained is function of the growth of the animals and depends on the type of mineralization of the colagen matrix. All these effects seem related to the thyroid hypofunction subsequent to the pituitary removal.
Subject(s)
Fruit/analysis , Lipids/analysis , Sugar Acids/analysisABSTRACT
The influence of time of hydrolysis, pression of the process, ratio of mass of flour and volume and concentration of the acid solution was studied in the hydrolytic processes for Cassava flour. The aim was to obtain fermentable sugars, and the results were submitted to variance analysis.
