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1.
Int J Soc Psychiatry ; 62(3): 252-61, 2016 May.
Article in English | MEDLINE | ID: mdl-26896027

ABSTRACT

AIMS: This article aims to (1) explore the levels of perceived insecurity in a sample of patients with mood or anxiety disorders and (2) assess whether living in 'big cities' can influence the levels of patients' perceived insecurity and social contacts compared to living in a non-urbanized context. METHODS: A total of 24 Italian mental health centers (MHCs) have been invited to participate. Twenty patients consecutively accessing the MHC have been recruited. All patients have been assessed using validated assessment tools. RESULTS: The sample consisted of 426 patients, mostly female, with a mean age of 45 years. Globally, 52.2% of patients had a diagnosis of mood disorders, and 37.8% had anxiety disorders. Half of the sample declared that the main feeling toward life is uncertainty; higher levels of pessimistic views toward life have been detected in patients living in urban areas. A positive association between negative attitudes toward life and higher levels of depressive and anxiety symptoms, poor social functioning and higher levels of perceived psychological distress has been found. CONCLUSION: Our findings confirm the presence of a common sense of perceived uncertainty among our sample. Such attitude toward life can have a detrimental impact on patients' psychological and physical well-being, contributing to high levels of distress.


Subject(s)
Anxiety Disorders/epidemiology , Mental Health , Mood Disorders/epidemiology , Uncertainty , Urbanization/trends , Adult , Female , Hospitals, Psychiatric , Humans , Italy/epidemiology , Male , Middle Aged , Perception , Psychiatric Status Rating Scales , Quality of Life/psychology , Surveys and Questionnaires , Urban Health
2.
Acta Neurol Scand ; 97(5): 324-7, 1998 May.
Article in English | MEDLINE | ID: mdl-9613563

ABSTRACT

OBJECTIVES: To identify possible inter-hemispheric sex-related cerebral hemodynamic differences at rest, in healthy subjects by transcranial Doppler (TCD). SUBJECTS AND METHODS: Mean flow velocity (MV) was recorded by TCD in 96 (48 males, 48 females) right-handed volunteers. Mean age was similar in males and females, distribution of age-groups by sex was similar, too. RESULTS: Examining by sex MV values in each basal artery, left middle cerebral artery (MCA) showed a statistically significant difference (53.5+/-8.2 cm x s(-1) in males versus 58.5+/-10.4 cm x s(-1) in females, P=0.005, one-way ANOVA). Multiple regression models show a significant correlation between age and MV on each side, while sex correlates with MV on the left side. CONCLUSION: A sex-dependent hemispheric difference in MV in the left MCA at rest (females>males) in the younger population subgroup was identified. These data support recent observations on anatomical differences between sexes, referring a proportionally larger Broca area in females compared to males.


Subject(s)
Cerebral Arteries/diagnostic imaging , Cerebrovascular Circulation/physiology , Sex Characteristics , Adolescent , Adult , Age Factors , Aged , Analysis of Variance , Dominance, Cerebral/physiology , Female , Humans , Linear Models , Male , Middle Aged , Ultrasonography, Doppler, Transcranial
3.
Am J Psychiatry ; 154(3): 378-83, 1997 Mar.
Article in English | MEDLINE | ID: mdl-9054786

ABSTRACT

OBJECTIVE: Autonomic dysregulation and cerebral blood flow (CBF) abnormalities have been reported in patients with anxiety disorders and, more recently, in panic disorder. Variations in the middle cerebral artery velocity (measured by transcranial Doppler technique), heart rate, and blood pressure during a tilting-table test were used as nonanxiogenic procedures to explore these abnormalities. METHOD: Mean flow velocity in the right middle cerebral artery, heart rate, and blood pressure were monitored at rest and during a 70 degrees tilting-table test. Three groups of patients were studied: 11 patients (eight women and three men; mean age = 31.1 years, SD = 8.0) with a diagnosis of panic disorder within 6 months of the onset of the disorder, nine asymptomatic patients (two men and seven women; mean age = 35.0, SD = 6.3) with a previous diagnosis of panic disorder who were in full remission of symptoms and had been drug free for at least 6 months, and 10 normal comparison subjects (two men and eight women; mean age = 31.1, SD = 5.2). RESULTS: Both patients with acute panic disorder and patients with remitted panic disorder showed a significant percent reduction of right middle cerebral artery mean flow velocity compared with normal subjects following tilting to the upright position. No significant differences were observed for blood pressure and heart rate. CONCLUSIONS: Patients with panic disorder, both during the acute phase of the illness and after clinical recovery, show an exaggerated drop in CBF during tilting. Since these findings are similar, although attenuated in intensity, to those which are observed in dysautonomic illnesses, one possible interpretation is that of panic disorder as a subclinical form of autonomic dysreactivity.


Subject(s)
Cerebrovascular Circulation/physiology , Hemodynamics/physiology , Panic Disorder/diagnosis , Posture/physiology , Acute Disease , Adult , Autonomic Nervous System Diseases/physiopathology , Blood Flow Velocity/physiology , Blood Pressure/physiology , Cerebral Arteries/diagnostic imaging , Diagnosis, Differential , Female , Heart Rate/physiology , Humans , Male , Panic Disorder/physiopathology , Ultrasonography, Doppler, Transcranial
4.
Ultrasound Med Biol ; 23(8): 1275-7, 1997.
Article in English | MEDLINE | ID: mdl-9372576

ABSTRACT

Transcranial Doppler (TCD) is a technique that evaluates blood flow velocity in intracranial vessels. It uses a 2-MHz probe and a Doppler signal analyzer. Absence of an acoustic window is a considerable problem for clinical utilization of TCD because cerebrovascular patients are frequently elderly. Previous reports suggest a higher prevalence of inadequate temporal acoustic window (TAW) in aged subjects and in females. A consecutive series of 624 subjects (376 males and 248 females, age range 2-86 y) were evaluated by standard TCD examination, to assess the contemporary absence of any signal corresponding to insonated basal arteries, defined as inadequate acoustic window. The rate of inadequate TAW was 8.2%, that of inadequate occipital acoustic window (OAW) was 9.0%. Prevalence of inadequate TAW was higher in females than in males, and OAW was higher in males than in females. Influence of aging on the presence of inadequate acoustic window is confirmed for temporal, but not for the occipital window. Different anatomical characteristics of the 2 regions could explain the different prevalence of TAW and OAW.


Subject(s)
Cerebrovascular Disorders/diagnostic imaging , Ultrasonography, Doppler, Transcranial , Aged , Aged, 80 and over , Aging , Blood Flow Velocity , Cerebrovascular Circulation , Female , Humans , Male , Middle Aged , Skull/diagnostic imaging
5.
Echocardiography ; 8(5): 541-5, 1991 Sep.
Article in English | MEDLINE | ID: mdl-10149270

ABSTRACT

To assess the value of transcranial Doppler examination for the early prognosis of ischemic stroke, we examined 24 patients (15 males and 9 females, mean age 66.8 +/- 9.3 years) with hemispheric cerebral infarction, within 6 hours of stroke onset. Of these 24 patients, 22 were evaluated on the Canadian Neurological Scale, the Toronto Stroke Scale, and the Barthel Index on days 60 and 120. Mean flow velocity in the middle cerebral artery on the lesion side was measured and values outside the range 30 to 80 cm/sec were rated abnormal. Two of nine patients with normal flow velocity died compared to five of the 13 patients with abnormal values. Four of the seven remaining patients in the former group made a full recovery compared with none of the remaining eight patients in the latter group (P less than 0.05). Neurological and functional status measured on the scales used on days 60 and 120 were also significantly better in the group with normal flow velocity. Early transcranial Doppler may prove useful in predicting the outcome of hemispheric infarction in the acute phase of cerebral ischemia.


Subject(s)
Cerebrovascular Disorders/diagnostic imaging , Aged , Blood Flow Velocity , Cerebral Arteries/diagnostic imaging , Cerebrovascular Circulation/physiology , Cerebrovascular Disorders/physiopathology , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Prognosis , Severity of Illness Index , Ultrasonography/methods
6.
Acta Neurol Scand ; 83(4): 214-20, 1991 Apr.
Article in English | MEDLINE | ID: mdl-2048394

ABSTRACT

A case-control study was based on "unselected" transient ischemic attacks (TIAs) in a middle-aged Italian population. The identified cases included 52 prevalent and 25 incident TIAs. There was an incidence rate ratio (female/male) of 1.8 for definite cases. Comparison with the whole population for medical history of hypertension, diabetes and heart attack showed age/sex-adjusted odds ratios of 4.3, 2.1, 7.9 for incident cases. The results were similar when a more detailed investigation of risk factors was performed with all the cases and a random sample of the controls. Moreover, female sex had an odds ratio for incident cases of 3.3 (95% confidence interval 1.0-11.3) after adjustment for age and presence of all the main risk factors. The presence of at least one cardiopathy showed an odds ratio of 8.3 for incident cases (95% confidence interval 2.4-28.4).


Subject(s)
Ischemic Attack, Transient/epidemiology , Adult , Aged , Case-Control Studies , Female , Humans , Incidence , Ischemic Attack, Transient/etiology , Italy/epidemiology , Male , Middle Aged , Odds Ratio , Prevalence , Regression Analysis , Risk Factors , Surveys and Questionnaires
7.
Neuroepidemiology ; 10(5-6): 282-7, 1991.
Article in English | MEDLINE | ID: mdl-1798431

ABSTRACT

Testing the reliability and usefulness of disability scales in Parkinson's disease has been the object of a study carried out by 4 neurologists on 48 patients using 2 rating scales--Hoehn and Yahr staging and Columbia University Rating Scale--and 2 disability scales--Northwestern University Disability Scale and Extensive Disability Scale, a new scale conceived for this purpose, which is more accurate in examining in a different way the physical incapacity and handicap of parkinsonian patients in their daily living. The examiners worked in pairs and did not discuss their rating scores before the end of the study. As far as interobserver agreement is concerned, the results of the disability scales are better than those of the rating scales. The Northwestern Disability Scale and the new scale are similar in reliability and consistency; however, the Extensive Disability Scale has proved to be a better indicator of the functional status. We suggest a more extensive employment of disability scales in clinical studies.


Subject(s)
Disability Evaluation , Parkinson Disease/physiopathology , Activities of Daily Living , Aged , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Walking
8.
Neuroepidemiology ; 8(2): 87-96, 1989.
Article in English | MEDLINE | ID: mdl-2922102

ABSTRACT

A simple self-administered questionnaire was mailed to a population sample of 8,626 (40-65 years old) to identify transient ischemic attacks (TIAs) that occurred in the previous 12 months. This study was conducted in a well-defined, medically controlled geographic area. 75.4% of the questionnaires were returned. The procedure identified 52 TIA cases (43 definite and 9 uncertain). The 12-month period prevalence for TIAs was 6.6 per 1,000 (95% confidence limits of 4.8-8.9) among the respondents. The annual incidence rate for first TIAs was 3.1 per 1,000 (95% confidence limits of 1.9-4.7). Our results differ from those reported in hospital series or in population surveys based on clinical records, with higher incidence and prevalence rates, female preponderance and higher frequency of vertebrobasilar attacks.


Subject(s)
Ischemic Attack, Transient/epidemiology , Adult , Age Factors , Aged , Cerebrovascular Disorders/etiology , Health Surveys , Humans , Interviews as Topic , Ischemic Attack, Transient/complications , Ischemic Attack, Transient/physiopathology , Italy , Middle Aged , Sex Factors , Surveys and Questionnaires , Time Factors , Vertebrobasilar Insufficiency/epidemiology
9.
Riv Neurol ; 58(5): 210-5, 1988.
Article in Italian | MEDLINE | ID: mdl-3231990

ABSTRACT

To study the possible damage of oculomotor structures we have studied 10 patients affected by idiopathic Parkinson's disease with a clear on-off phenomena. All the patients were subjected to an electro-oculographic examination observing qualitative and quantitative parameters in both on and off phases. The two exams were carried out in the same morning. We observed the well known electro-oculographic pattern of parkinsonian syndrome: multiple steps saccades, pursuit alterations, absence of spontaneous or evoked nystagmus. Moreover the most relevant finding consisted in an improvement of some electro-oculographic features during the off phase, contrary to clinical evidence. Such results seem to suggest that oculomotor system is functionally separate from that which controls arm movements.


Subject(s)
Electrooculography , Eye Movements , Parkinson Disease/physiopathology , Saccades , Aged , Female , Humans , Male , Middle Aged , Reflex, Vestibulo-Ocular
10.
G Ital Cardiol ; 18(7): 592-5, 1988 Jul.
Article in Italian | MEDLINE | ID: mdl-3234658

ABSTRACT

Cardiac sources of emboli have been frequently described in patients with Transitory Ischemic Attacks (TIAs). The aim of our study was to assess the value of two-dimensional echocardiography (2D-E) in the investigation for possible cardiac aetiology of TIAs. As an offshoot of a larger epidemiologic study which aimed at determining the period prevalence of TIAs in 6.504 subject(s) of the general population aged between 40-65, fifty subjects with TIA (group A) and 66 controls (group B) were studied. A heart disease was found in 20/50 s. (40%) in group A (coronary artery disease: 5; hypertensive heart disease: 4; mitral valve prolapse: 5; left ventricular aneurysms: 2; aortic valve disease: 2; aortic valve prosthesis: 1; atrial fibrillation: 1) and in 5/66 s. (7.5%) in group B (p less than 0.01) (coronary disease: 2; hypertensive heart disease: 1; mitral valve prolapse: 2). A potential source of emboli was present in 11 s. in group A (22%) and in 2 s. in group B (3%) (p less than 0.01). In 4/50 s. in group A and in 1/66 in group B the diagnosis was obtained by means of 2D-E only, because other clinical signs and ECG data were negative. 2D-E could only confirm the diagnosis in the remaining cases, with no additional information (i.e., no intracavitary masses were seen). In conclusion there is a high prevalence of heart disease in patients with TIA over 40 years of age. A cardiac source of emboli may be suspected in a substantial number of cases. Nevertheless the value of routine 2D-E in disclosing an otherwise undetected source of emboli is rather low.


Subject(s)
Echocardiography , Embolism/complications , Heart Diseases/diagnosis , Ischemic Attack, Transient/etiology , Aged , Diagnosis, Differential , Evaluation Studies as Topic , Female , Heart Diseases/complications , Humans , Male , Middle Aged
11.
Acta Neurol Scand ; 77(1): 6-11, 1988 Jan.
Article in English | MEDLINE | ID: mdl-3258461

ABSTRACT

The authors studied a group of 36 patients with idiopathic Parkinson's disease by electro-oculographic examination in order to evaluate the most frequent vestibular and oculomotor findings. Vestibular alterations were detected mainly in caloric nystagmus (82.9%). Hyperreflectivity was the most frequent evidence, but it does not necessarily represent the sign of a lesion. The occurrence of spontaneous and evoked nystagmus was not significant. Oculomotor findings were more interesting, as they were altered in two-thirds of the cases. Particularly, saccadic eye movements presented a "multiple step" morphology in 58.3% of the series. This saccadic disarrangement was scarcely found in neurological patients with brainstem and/or cerebellum pathology (7.7%). Moreover, in Parkinson's disease patients no other saccadic alterations typical of brainstem or cerebellum involvement were found. Such observations suggest a possible non-cerebellar origin of "multiple step". Vestibular and oculomotor findings were not significantly correlated with the clinical features of the patients.


Subject(s)
Electrooculography , Parkinson Disease, Secondary/diagnosis , Vestibule, Labyrinth/physiopathology , Adult , Age Factors , Aged , Caloric Tests , Humans , Middle Aged , Parkinson Disease, Secondary/physiopathology , Saccades , Tremor/physiopathology
12.
Neuroepidemiology ; 7(1): 38-41, 1988.
Article in English | MEDLINE | ID: mdl-3340268

ABSTRACT

We studied the three most commonly used rating scales in Parkinson's Disease (Hoehn and Yahr Clinical Staging, Webster Rating Scale, Columbia University Rating Scale) in order to examine the agreement between observers. Six neurologists, experts at using such scales, evaluated 48 patients suffering from the idiopathic form of Parkinson's Disease. Reliability using the K index was moderate, although a slight superiority was found with the Columbia University Rating Scale. Analysis of the various items used has suggested that scales of disability could be a valid alternative to those examined.


Subject(s)
Disability Evaluation , Parkinson Disease/physiopathology , Adult , Aged , Aged, 80 and over , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Parkinson Disease/diagnosis
13.
Ital J Neurol Sci ; 8(4): 351-5, 1987 Aug.
Article in English | MEDLINE | ID: mdl-3679785

ABSTRACT

Lisuride was investigated for therapeutic effects in 19 patients with advanced Parkinson disease, no longer satisfactorily responding to routine L-Dopa therapy. The patients were treated with oral Lisuride (0.6-2.5 mg/die) and L-Dopa. The follow-up was at least 6 months. We noted a significant improvement on the Webster Rating Scale at 1st, 3rd and 6th months. Disability and on-off phenomen were reduced. Side effects were few. Lisuride is a valuable tool in this type of patient.


Subject(s)
Ergolines/therapeutic use , Lisuride/therapeutic use , Parkinson Disease/drug therapy , Adult , Aged , Dose-Response Relationship, Drug , Drug Therapy, Combination , Follow-Up Studies , Humans , Levodopa/therapeutic use , Middle Aged
14.
Neurosci Lett ; 50(1-3): 301-5, 1984 Sep 07.
Article in English | MEDLINE | ID: mdl-6493633

ABSTRACT

Choline acetyltransferase (ChAT) activity was measured in the first temporal gyrus (Brodmann area 22) and in the gyrus precentrale (Brodmann area 4) of both hemispheres in post-mortem human fetus and adult brains. In fetal brains the ChAT values were higher in the right first temporal gyrus in comparison to the left one (P less than 0.05). Conversely in adult brains ChAT activity was higher in the left first temporal gyrus than in the controlateral one (P less than 0.05). Absolute values of ChAT were similar in the right first temporal gyrus of fetus and adult brains. No asymmetry was found in the fetal and adult gyrus precentrale. These findings could be interpreted in terms of differential rates of development of cholinergic synapses in left and right human temporal lobes.


Subject(s)
Brain/enzymology , Choline O-Acetyltransferase/metabolism , Dominance, Cerebral , Aged , Brain/embryology , Cerebral Cortex/enzymology , Humans , Middle Aged
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