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1.
Rhinology ; 61(1): 32-38, 2023 Feb 01.
Article in English | MEDLINE | ID: mdl-36272169

ABSTRACT

BACKGROUND: The purpose of this study was to compare the prevalence of olfactory dysfunction (OD) at different stages of the COVID-19 pandemic by evaluating subjects diagnosed with SARS-CoV-2 infection during the Omicron wave with psychophysical tests and comparing the results with those obtained from patients infected during the D614G, Alpha and Delta waves and with those of a control group. METHODOLOGY: The study included adult patients diagnosed with SARS-CoV-2 infection. Depending on the time of diagnosis, the subjects were divided into four study groups: D614G; Alpha, Delta and Omicron variant groups. A group of uninfected individuals was used as control. All subjects underwent psychophysical evaluation of the olfactory function with the Connecticut Chemosensory Clinical Research Center olfactory test (D614G and Alpha groups) or the extended version of the Sniffin'Sticks test (Delta, Omicron and control groups). RESULTS: 372 cases (134 D614G group, 118 Alpha group, 32 in Delta group and 88 Omicron group) were recruited and evaluated within 10 days of infection, alongside 80 controls. Patients self-reported olfactory loss in 72.4% of cases in the D614G group, in 75.4% of cases in the Alpha group, in 65.6% of cases in the Delta group and in 18.1% in the Omicron group. Psychophysical evaluation revealed a prevalence of OD: 80.6%, 83.0%, 65.6% and 36.3% in the D614G, Alpha, Delta and Omicron group respectively. The differences between the D614G, Alpha and Delta groups were not statistically significant. The Omicron group demonstrated a significantly lower prevalence of OD than the other variants but still significantly higher than the controls. CONCLUSIONS: During the Omicron wave OD was less prevalent than during the D614G, Alpha and Delta periods. One-third of patients have reduced olfactory function on psychophysical evaluation during the Omicron wave. Our results should be considered with caution as the VOC has not been determined with certainty.


Subject(s)
COVID-19 , Olfaction Disorders , SARS-CoV-2 , Adult , Humans , Case-Control Studies , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/virology , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/virology , Pandemics , Prevalence
2.
J Laryngol Otol ; 135(8): 723-728, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34184623

ABSTRACT

OBJECTIVE: To analyse the correlations between olfactory psychophysical scores and the serum levels of D-dimer, C-reactive protein, ferritin, lactate dehydrogenase, procalcitonin and neutrophil-to-lymphocyte ratio in coronavirus disease 2019 patients. METHODS: Patients underwent psychophysical olfactory assessment with the Connecticut Chemosensory Clinical Research Center test, and determination of blood serum levels of the inflammatory markers D-dimer, C-reactive protein, ferritin, lactate dehydrogenase, procalcitonin and neutrophil-to-lymphocyte ratio within 10 days of the clinical onset of coronavirus disease 2019 and 60 days after. RESULTS: Seventy-seven patients were included in this study. D-dimer, procalcitonin, ferritin and neutrophil-to-lymphocyte ratio correlated significantly with severe coronavirus disease 2019. No significant correlations were found between baseline and 60-day Connecticut Chemosensory Clinical Research Center test scores and the inflammatory markers assessed. CONCLUSION: Olfactory disturbances appear to have little prognostic value in predicting the severity of coronavirus disease 2019 compared to D-dimer, ferritin, procalcitonin and neutrophil-to-lymphocyte ratio. The lack of correlation between the severity and duration of olfactory disturbances and serum levels of inflammatory markers seems to further suggest that the pathogenetic mechanisms underlying the loss of smell in coronavirus disease 2019 patients are related to local rather than systemic inflammatory factors.


Subject(s)
COVID-19/pathology , Olfaction Disorders/etiology , Aged , Biomarkers/blood , C-Reactive Protein/analysis , COVID-19/blood , COVID-19/complications , Female , Ferritins/blood , Fibrin Fibrinogen Degradation Products/analysis , Humans , Inflammation/blood , L-Lactate Dehydrogenase/blood , Lymphocyte Count , Male , Middle Aged , Olfaction Disorders/blood , Olfaction Disorders/pathology , Procalcitonin/blood , Severity of Illness Index
3.
Ann Ig ; 32(4): 357-367, 2020.
Article in English | MEDLINE | ID: mdl-32744294

ABSTRACT

BACKGROUND: Prevalence surveys can be helpful to assess Health-care Associated Infections and antimicrobial use in healthcare settings, as well as infection control interventions. The aim of this study was to estimate the prevalence of both Health-care Associated Infections and antimicrobial use in acute care wards in the University Hospital of Sassari according to the European Centre for Disease Prevention and Control light protocol. METHODS: According to the case-finding algorithm, information was collected only if the patient had received at least one antimicrobial at the time of the survey or if the patient had an active infection associated with an acute care hospital stay. Data were collected over a span of a week, on a single day for every ward. RESULTS: The survey included 588 patients. A total number of 49 Health-care Associated Infections were observed on 43 patients with an overall prevalence of 7.3%. Urinary tract infections were the most common Health-care Associated Infection. The antimicrobial use prevalence was 44.6%. Results for microbiological investigation were available for 27 Health-care Associated Infections (55.1%) with 36 identified microorganisms. A total of 343 antimicrobials were administered, mainly for the treatment of an infection (57.4%). Combinations of penicillins, including beta-lactamase inhibitors, were the most frequently prescribed (35.0%). CONCLUSIONS: To our best knowledge, this is the first prevalence study carried out in Italy following the light protocol. This study suggests that the prevalence of patients with Health-care Associated Infections in our hospital is slightly higher than the one observed by the European Centre for Disease Prevention and Control point prevalence survey of 2011, and lower than the one observed in the last national survey of 2016. The European Centre for Disease Prevention and Control light protocol proved applicable in acute-care hospitals with high complexity of structures and particular distribution of wards in order to perform a point prevalence study more quickly, without decreasing its value and its comparability to other similar studies.


Subject(s)
Anti-Infective Agents/administration & dosage , Cross Infection/drug therapy , Urinary Tract Infections/drug therapy , Adult , Aged , Aged, 80 and over , Cross Infection/epidemiology , Female , Hospitals, University , Humans , Italy/epidemiology , Male , Middle Aged , Prevalence , Surveys and Questionnaires , Urinary Tract Infections/epidemiology
4.
Eur J Neurol ; 25(8): 1076-e84, 2018 08.
Article in English | MEDLINE | ID: mdl-29603839

ABSTRACT

BACKGROUND AND PURPOSE: Human endogenous retroviruses (HERV) K/W seem to play a role in fostering and exacerbation of some neurological diseases, including amyotrophic lateral sclerosis (ALS). Given these findings, the immunity response against HERV-K and HERV-W envelope surface (env-su) glycoprotein antigens in serum and cerebrospinal fluid (CSF) was investigated for ALS, multiple sclerosis (MS) and Alzheimer's disease patients and in healthy controls. METHODS: Four antigenic peptides derived respectively from HERV-K and HERV-W env-su proteins were studied in 21 definite or probable ALS patients, 26 possible or definite relapsing-remitting MS patients, 18 patients with Alzheimer's disease and 39 healthy controls. An indirect enzyme-linked immunosorbent assay was set up to detect specific antibodies (Abs) against env-su peptides. RESULTS: Amongst the measured levels of Abs against the four different HERV-K peptide fragments, only HERV-K env-su19-37 was significantly elevated in ALS compared to other groups, both in serum and CSF. Instead, amongst the Abs levels directed against the four different HERV-W peptide fragments, only HERV-W env-su93-108 and HERV-W env-su248-262 were significantly elevated, in the serum and CSF of the MS group compared to other groups. In ALS patients, the HERV-K env-su19-37 Abs levels were significantly correlated with clinical measures of disease severity, both in serum and CSF. CONCLUSIONS: Increased circulating levels of Abs directed against the HERV-W env-su93-108 and HERV-W env-su248-262 peptide fragments could serve as possible biomarkers in patients with MS. Similarly, increased circulating levels of Abs directed against the HERV-K env-su19-37 peptide fragment could serve as a possible early novel biomarker in patients with ALS.


Subject(s)
Amyotrophic Lateral Sclerosis/diagnosis , Amyotrophic Lateral Sclerosis/immunology , Endogenous Retroviruses/immunology , Immunity, Humoral/immunology , Nervous System Diseases/diagnosis , Nervous System Diseases/immunology , Retroviridae Infections/immunology , Diagnosis, Differential , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male
5.
Neurochirurgie ; 61(2-3): 113-22, 2015.
Article in English | MEDLINE | ID: mdl-25676911

ABSTRACT

Pineal tumors are rare and include a large variety of entities. Germ cell tumors are relatively frequent and often secreting lesions. Pineal parenchymal tumors include pineocytomas, pineal parenchymal tumor of intermediate differentiation, pineoblastomas and papillary tumors of the pineal region. Other lesions including astrocytomas and meningiomas as well as congenital malformations i.e. benign cysts, lipomas, epidermoid and dermoid cysts, which can also arise from the pineal region. Imagery is often non-specific but detailed analysis of the images compared with the hormone profile can narrow the spectrum of possible diagnosis.


Subject(s)
Astrocytoma/pathology , Brain Neoplasms/pathology , Neoplasms, Germ Cell and Embryonal/pathology , Pineal Gland/pathology , Pinealoma/pathology , Astrocytoma/diagnosis , Brain Neoplasms/diagnosis , Humans , Meningioma/diagnosis , Meningioma/pathology , Pinealoma/diagnosis
8.
Ann Phys Rehabil Med ; 57(6-7): 436-51, 2014.
Article in English | MEDLINE | ID: mdl-25127063

ABSTRACT

INTRODUCTION: The purpose of this monocentric study was to assess the long-term outcome of a group of severe traumatic brain-injured patients and explore the prognostic values of some clinical and paraclinical parameters available at the initial stage. METHODOLOGY: The patients included were victims of severe traumatic brain injuries in 2007 or 2008. A standardized assessment was performed for each patient including clinical, radiological, and electrophysiological data collected at the initial stage, The outcomes were assessed at least 2 years after injury. Depending on the patients' availability and ability to communicate, the assessments included measures of dependency for activities of daily living (ADL), cognitive functions, behaviour, mood, and quality of life. RESULTS: Eighteen patients were included, of whom ten were autonomous for ADL at the time of assessment. Memory complaints, attentional deficits, anxiety, and irritability were the main long-term impairments observed. A correlation analysis showed significant correlations between the dependency level (as rated by the Functional Independence Measure) and each of length of coma, length of the post-traumatic amnesia, and the N100 auditory evoked potentials. DISCUSSION: These results confirm the uniqueness of each patient regarding the long-term consequences of a traumatic brain injury and the multi-determined nature of each prognosis.


Subject(s)
Brain Injuries/psychology , Survivors/psychology , Activities of Daily Living , Adolescent , Adult , Affect , Aged , Anxiety/psychology , Attention , Cognition , Dependency, Psychological , Evoked Potentials , Female , Glasgow Coma Scale , Humans , Male , Memory Disorders/psychology , Middle Aged , Neuropsychological Tests , Prognosis , Quality of Life , Retrospective Studies , Time Factors , Young Adult
9.
Rev Neurol (Paris) ; 170(8-9): 536-40, 2014.
Article in French | MEDLINE | ID: mdl-24856610

ABSTRACT

Amusia is defined as an auditory agnosia, specifically related to music, resulting from a cerebral lesion or being of congenital origin. Amusia is rarely associated to musical anhedonia. We report the case of a 43-year-old patient who suffered in January 2012 from a right ischemic lesion affecting the superior temporal cortex, in particular lateral Heschl Gyrus and the posterior part of the Superior Temporal Gyrus (Brodmann areas 21 and 22). Neuropsychological tests revealed an amusia combined to musical anhedonia. The specificity of this case is based on the combination of both syndromes highlighting the relation between neural networks involved in the processing of musical information in both its perceptual and emotional components.


Subject(s)
Agnosia/etiology , Anhedonia , Brain Ischemia/complications , Music , Stroke/complications , Adult , Agnosia/diagnosis , Humans , Male
10.
Rev Neurol (Paris) ; 170(4): 277-9, 2014 Apr.
Article in French | MEDLINE | ID: mdl-24726038

ABSTRACT

Bilateral medial medullary infarction is exceptional. Initial symptoms can be misleading, even for a trained neurologist. We report two patients who presented progressive quadriplegia, anarthia and dysphagia. Sequential MRI showed progressive constitution of the characteristic "heart appearance" sign.


Subject(s)
Lateral Medullary Syndrome/pathology , Medulla Oblongata/pathology , Aged , Deglutition Disorders/etiology , Deglutition Disorders/pathology , Diabetes Mellitus, Type 2/complications , Humans , Lateral Medullary Syndrome/complications , Magnetic Resonance Imaging , Male , Middle Aged , Quadriplegia/etiology , Quadriplegia/pathology
11.
Eur J Neurol ; 10(2): 165-8, 2003 Mar.
Article in English | MEDLINE | ID: mdl-12603292

ABSTRACT

Neurological syndromes caused by Mycoplasma pneumoniae (MP) infection are occasionally reported in adults, usually in the post-infectious period, and three computed tomography documented cases have recently appeared in this journal. Here we present the cases of three young women with recent respiratory tract infection caused by MP some weeks prior to neurological complication documented by magnetic resonance imaging. Two cases suffered from demyelinating disorders of the central nervous system (CNS). The other case had a middle cerebral artery thrombosis, a rare complication of MP infection. Another potential risk factor for stroke in the latter case was the use of oral contraceptives. Recent infection with MP is discussed as a risk factor for cerebrovascular disorders and CNS demyelinating diseases.


Subject(s)
Encephalomyelitis, Acute Disseminated/diagnostic imaging , Encephalomyelitis, Acute Disseminated/etiology , Infarction, Middle Cerebral Artery/diagnostic imaging , Infarction, Middle Cerebral Artery/etiology , Pneumonia, Mycoplasma/complications , Adolescent , Adult , Female , Humans , Magnetic Resonance Imaging , Mycoplasma pneumoniae , Radiography , Risk Factors
12.
Mult Scler ; 7(6): 371-4, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11795458

ABSTRACT

Chlamydia pneumoniae infection is a common event in neurological patients and recovery of C. pneumoniae DNA in the cerebrospinal fluids (CSF) of multiple sclerosis (MS) patients could represent an epiphenomenon. We assessed the relevance of C. pneumoniae infection in 62 CSF samples from 32 MS patients and 30 neurological controls by means of PCR, immunofluorescence microscopy, enzyme-linked fluorescence and antibody detection. Multiple sclerosis (9.3%) and neurological controls (13.3) had similar percentage of anti-C. pneumoniae antibodies. However, C. pneumoniae DNA was only detectable in MS patients' CSF (9.3%). Our data support the hypothesis that C. pneumoniae persistence in some MS patients may be the result of an impaired clearance within the central nervous system.


Subject(s)
Cerebrospinal Fluid/microbiology , Chlamydophila pneumoniae/isolation & purification , Multiple Sclerosis/cerebrospinal fluid , Multiple Sclerosis/microbiology , Nervous System Diseases/cerebrospinal fluid , Nervous System Diseases/microbiology , Adult , Antibodies, Bacterial/analysis , Chlamydophila pneumoniae/genetics , Chlamydophila pneumoniae/immunology , DNA, Bacterial/analysis , Female , Humans , Male
14.
Article in English | MEDLINE | ID: mdl-11041543

ABSTRACT

1. Conflicting reports are available regarding the sensitivity of patients with Dementia with Lewy bodies (DLB) to risperidone. 2. The authors studied a rare familial case of probable DLB, who developed a documented episode of neuroleptic malignant syndrome (NMS) following the exposure to risperidone. Previously, the patient had had an episode of NMS on trifluoperazine. 3. The discontinuance of risperidone, in combination with a mild increase of dopaminergic therapy, led to a complete recovery in few days. 4. In patients with DLB, a continued vigilance for extrapyramidal side effects, including NMS, would be advisable during the use of risperidone.


Subject(s)
Antipsychotic Agents/adverse effects , Lewy Body Disease/drug therapy , Neuroleptic Malignant Syndrome/physiopathology , Risperidone/adverse effects , Antipsychotic Agents/therapeutic use , Female , Humans , Lewy Body Disease/genetics , Middle Aged , Neuroleptic Malignant Syndrome/etiology , Risperidone/therapeutic use
15.
Prog Urol ; 10(2): 298-9, 2000 Apr.
Article in French | MEDLINE | ID: mdl-10857152

ABSTRACT

The lithotomy position is widely used in urological surgery to obtain adequate exposure of the perineal plane. It is used, for instance, for stenosis of the posterior urethra. Fortunately, it rarely gives rise to complications although if the operation takes a long time the patient may suffer various adverse reactions; these range from simple peroneal nerve distress to thromboembolism [1, 2] and the much more serious "compartmental syndrome" [2, 3, 4]. There is still debate about the best therapeutic approach to a lesion caused by prolonged muscle compression. Some suggest immediate fasciotomy, whether others hold out for conservative treatment. We report here a case of compartmental syndrome arising in a patient who had to remain the the lithotomy position for a long time, which responded well to conservative treatment.


Subject(s)
Compartment Syndromes/etiology , Posture , Adult , Humans , Male , Time Factors
16.
Arch Ital Urol Androl ; 71(4): 241-4, 1999 Sep.
Article in Italian | MEDLINE | ID: mdl-10592539

ABSTRACT

Retrograde ejaculation is a frequent and permanent complication after bilateral retroperitoneal lymphadenectomy (RPLND). Seminal emission and ejaculation are primarily under sympathetic control. Several studies after RPLND in patients with nonseminomatous testis cancer proved the role of preservation of the efferent fibers originating from the lumbar sympathetic ganglia. Based on the results of anatomical studies, a modified unilateral operative technique and nerve-sparing approach permit to preserve normal anterograde ejaculation without reduction of long-term survival.


Subject(s)
Ejaculation , Erectile Dysfunction/etiology , Germinoma/surgery , Lymph Node Excision/adverse effects , Testicular Neoplasms/surgery , Ejaculation/physiology , Erectile Dysfunction/prevention & control , Ganglia, Sympathetic/physiology , Humans , Lymph Node Excision/methods , Male , Retroperitoneal Space , Time Factors
17.
Brain Res ; 764(1-2): 230-6, 1997 Aug 01.
Article in English | MEDLINE | ID: mdl-9295215

ABSTRACT

Effects of pentylenetetrazole (PTZ)-induced convulsive status epilepticus on free amino acids changes in venous blood, CSF and interstitial fluid (IF) of the brain were examined in dogs. A volume of brain IF sufficient for analysis was obtained by chronically implanted tissue cages. The onset of PTZ-induced convulsive seizures seemed mainly related to a marked increase of glutamate, aspartate, taurine, glycine and phosphoserine while, the maintenance and frequency of seizures seemed related to a marked increase of serine and glycine, in combination with a moderate rise of glutamate. L-alpha-Aminoadipate was recovered in moderate amount in epileptic brain IF, while, in controls, this compound was present in minimal amount. The observed complex temporal variation of the amino acidic pattern may play a role in PTZ-induced seizures and, possibly, in pharmacological kindling and brain structural alterations induced by PTZ.


Subject(s)
Amino Acids/metabolism , Brain Chemistry/physiology , Status Epilepticus/metabolism , Amino Acids/cerebrospinal fluid , Animals , Body Fluids/metabolism , Convulsants , Dogs , Female , Male , Microdialysis , Pentylenetetrazole , Status Epilepticus/cerebrospinal fluid , Status Epilepticus/chemically induced , Time Factors
18.
Article in English | MEDLINE | ID: mdl-8938817

ABSTRACT

1. Several studies have demonstrated a deficiency in reduced glutathione (GSH) in the nigra of patients with Parkinson's Disease (PD). In particular, the magnitude of reduction in GSH seems to parallel the severity of the disease. This finding may indicate a means by which the nigra cells could be therapeutically supported. 2. The authors studied the effects of GSH in nine patients with early, untreated PD. GSH was administered intravenous, 600 mg twice daily, for 30 days, in an open label fashion. Then, the drug was discontinued and a follow-up examination carried-out at 1-month interval for 2-4 months. Thereafter, the patients were treated with carbidopa-levodopa. 3. The clinical disability was assessed by using two different rating scale and the Webster Step-Second Test at baseline and at 1-month interval for 4-6 months. All patients improved significantly after GSH therapy, with a 42% decline in disability. Once GSH was stopped the therapeutic effect lasted for 2-4 months. 4. Our data indicate that in untreated PD patients GSH has symptomatic efficacy and possibly retards the progression of the disease.


Subject(s)
Glutathione/therapeutic use , Parkinson Disease/drug therapy , Aged , Disease Progression , Female , Glutathione/administration & dosage , Glutathione/adverse effects , Humans , Injections, Intravenous , Male , Middle Aged , Neuropsychological Tests , Parkinson Disease/diagnosis , Tremor/drug therapy
19.
Article in English | MEDLINE | ID: mdl-8771607

ABSTRACT

1. The neuroleptic malignant syndrome (NMS) may occur, occasionally, in Parkinson's disease (PD) after withdrawal of antiparkinsonian drugs. However, the circumstances in which the NMS occurs and the pathophysiologic mechanisms remain uncertain. 2. The authors studied a woman with PD, who developed hyperthermia, increased muscular tone, tremor, signs of autonomic dysfunction and stupor as symptoms of acute hyponatremia due to gastrointestinal loss of sodium in excess of water. 3. The correction of hyponatremia led to a complete recovery after about 6 hours. During this period the antiparkinsonian therapy was not modified. 4. An acute imbalance of sodium in the central nervous system may play a role in the pathophysiology of NMS.


Subject(s)
Epilepsy, Complex Partial/physiopathology , Hyponatremia/complications , Neuroleptic Malignant Syndrome/complications , Parkinson Disease/physiopathology , Aged , Blood Pressure/physiology , Body Temperature/physiology , Female , Humans , Time Factors
20.
Article in English | MEDLINE | ID: mdl-8539426

ABSTRACT

1. The regional cerebral blood flow was studied by SPECT in patients with partial epilepsy before and after 30 days of monotherapy with carbamazepine (CBZ). 2. Both a qualitative visual interpretation and a semiquantitative analysis of SPECT was performed. All patients underwent EEG, CT scan, and MRI studies. The CBZ serum concentrations were assayed. 3. After therapy, in three patients with focal epilepsy, both a crossed cerebral and cerebellar diaschisis were observed, with respect to the side of the epileptic focus in the opposite hemisphere. No morphologic changes were detected at MRI in the cerebral or cerebellar remote hypometabolic areas found at SPECT. 4. CBZ may have a depressant action on the corticopontocerebellar pathways and on the corticocallosal connections.


Subject(s)
Blood Flow Velocity , Brain Damage, Chronic/chemically induced , Carbamazepine/adverse effects , Carbamazepine/therapeutic use , Cerebrovascular Circulation/drug effects , Epilepsy, Complex Partial/drug therapy , Adolescent , Adult , Female , Humans , Male , Tomography, Emission-Computed, Single-Photon
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