Multicentre registry of brain-injured patients with disorder of consciousness: rationale and preliminary data.

Diagnostic accuracy and reliable estimation of clinical evolution are challenging issues in the management of patients with disorders of consciousness (DoC). Longitudinal systematic investigations conducted in large cohorts of patients with DoC could make it possible to identify reliable diagnostic and prognostic markers. On the basis of this consideration, we devised a multicentre prospective registry for patients with DoC admitted to ten intensive rehabilitation units.

Development and Validation of a Predictive Model for Functional Outcome After Stroke Rehabilitation: The Maugeri Model.

Background And Purpose: Prediction of outcome after stroke rehabilitation may help clinicians in decision-making and planning rehabilitation care. We developed and validated a predictive tool to estimate the probability of achieving improvement in physical functioning (model 1) and a level of independence requiring no more than supervision (model 2) after stroke rehabilitation.

Methods: The models were derived from 717 patients admitted for stroke rehabilitation.

Supplementation of essential amino acids may reduce the occurrence of infections in rehabilitation patients with brain injury.

Background: To investigate whether supplementation with oral essential amino acids (EAAs) may reduce the occurrence of nosocomial infection among patients with brain injury (BI: stroke, trauma, anoxic coma).

Methods: Patients (n = 125; 77 men, 48 women; mean age 63 ± 15 years) with stroke (68.8%), subarachnoid hemorrhage (17.

Urodynamic findings suggesting two-stage development of idiopathic detrusor underactivity in adult men.

Objectives: To assess the evolution of bladder voiding dynamics from the onset of symptoms to the final diagnosis of idiopathic detrusor underactivity (DUA) in men with storage and voiding lower urinary tract symptoms (LUTS) and otherwise normal clinical findings.

Methods: We retrospectively analyzed the urodynamic findings in two patient groups of 25 men each. Group A, with storage and voiding LUTS and otherwise normal clinical findings, had an inconclusive urodynamic test at time 1 and were re-assessed after a mean (+/- SD) of 17 +/- 5 months for worsened symptom severity (time 2).

In situ demonstration of improvement of liver mitochondria function by melatonin after cold ischemia.

In a previous investigation, reperfusion with a melatonin-containing medium was demonstrated to enhance bile production and tissue ATP levels in rat livers, cold-preserved with University of Wisconsin (UW) or Celsior solutions, with respect to melatonin-free reperfusion; lipid peroxidation products in the perfusate were not influenced by the indole. This was ascribed to an increased efficiency of the hepatocyte mitochondria induced by melatonin. Reactive oxygen species (ROS) normally leak from the electron transfer chain in mitochondria and excessive ROS production is presumed to mediate ischemia-reperfusion (I/R) damage.

Urgency of micturition and detrusor contractility in men with prostatic obstruction and overactive bladders.

Aims: In men with prostatic obstruction and detrusor overactivity (DO), to ascertain whether urgency of micturition affects bladder contractility.

Materials And Methods: We urodynamically assessed five groups of 20 men each who had bladder outflow obstruction (BOO) from benign prostatic enlargement-Groups 1 (with no DO and no urgency), 2 (with DO and no urgency), 3A (with DO and moderate urgency), 3B (with DO and severe urgency), and 4 (with DO, severe urgency and chronic ischemic cerebral lesions). Urgency was graded as moderate or severe by the ability to avert an urgent void at cystometry for > or =2 or <2 min, respectively.

Voiding urgency and detrusor contractility in women with overactive bladders.

Aims: To check whether the contractility of overactive bladders would be affected by voiding urgency.

Methods: We urodynamically studied 100 women: 20 normal controls (group 1), 60 patients with idiopathic detrusor overactivity (DO), and 20 with neurogenic DO from intracerebral lesions. The idiopathic DO groups 2A (n = 20), 2B (n = 20), and 3 (n = 20) had moderate, severe, and no voiding urgency, respectively.

Lexical and semantic factors influencing picture naming in aphasia.

Picture naming requires early visual analysis, accessing stored structural knowledge, semantic activation, and lexical retrieval. We tested the effect of perceptual, lexical, and semantic variables on the performance of aphasics in picture naming and assessed prevalence of natural categories vs artifact dissociations. Forty-nine aphasics were asked to name 60 pictures, from three natural (animals, fruits, and vegetables) and three artificial categories (tools, furniture, and vehicles).

Limitations of the computerized laryngeal analyzer (CLA) in the assessment of the swallowing mechanism.

This study was devised to assess the repeatability of measurements obtained from the Computerized Laryngeal Analyzer (CLA), a commercial system which monitors global laryngeal activity through a piezoelectric transducer positioned at the level of the thyroid cartilage. Twenty-two healthy subjects (37+/-7 yr) were asked to repeat three consecutive times the deglutition of three types of bolus: dry (saliva only), liquid (10 ml water) and solid (1 cm(3) biscuit). The whole recording session was repeated 4+/-3 days apart.

Syntactic comprehension deficits in agrammatism.

Eleven agrammatic and 16 fluent aphasic patients were given a comprehension task consisting of simple, active and passive reversible sentences. The purpose of the study is to reconsider the comprehension disorders in agrammatism, and particularly of passive reversible sentences, to test to what extent Grodzinsky's trace deletion hypothesis (TDH) is generalizable to other types of NP-movement, and finally to ascertain whether the pattern of impairment observed in agrammatism differs from that of fluent aphasic patients. The study confirms that trace analysis may be selectively impaired in agrammatism.

Peripheral plasma amino acid abnormalities in rehabilitation patients with severe brain injury.

Objective: Acute severe brain injury causes an increased mobilization of amino acids from tissue. The plasma amino acid profile of patients undergoing rehabilitation after brain injury is unknown. This study was aimed at delineating the plasma amino acid profile of rehabilitation patients with brain injury.

[The evaluation of aphasic deficits for the definition of a targetted logotherapeutic treatment].

The Aachener Aphasie Test (AAT) is the major German test for the diagnosis of aphasic disorders. The test is easy to use and is valid and reliable for the diagnosis of aphasia and its severity and to evaluate the recovery of the aphasic disorder after language rehabilitation. The AAT is, however, not sufficient to define cognitively sound logotherapeutic treatment.

[A computerized endurance test: efficacy of pelvic floor rehabilitation treatment in patients with stress incontinence].

In the present study the authors wanted to transfer rigorous methods of study, already in use in other sectors (sports, medicine, isokinetic work, etc.) of the validity of interventions made and their effectiveness, into an "emerging" field, that of perineal rehabilitation. 15 female patients, aged between 35 and 45, affected by stress incontinence underwent a baseline clinico-instrumental evaluation of the perineal floor including a computerized test of endurance.

Imitating gesture learning in apraxic patients.

The authors studied a group of patients with ideomotor apraxia (IMA) to verify if these patients had some difficulties in gesture learning task in respect to non-apraxic patients and normal control subjects. The results show that learning difficulties are present in patients with IMA. Apraxic patients are not able to perform the gestures in the testing situation and non in everyday life; this fact would demonstrate that the motor pattern still exists in these patients but is inaccessible unless elicited by a strong stimulation.

[Deep cerebral lesions: neuro-rehabilitative aspects].

All 21 patients under rehabilitative care, who were followed by the authors, suffered from language and motor deficits, the latter being part of a deficient hemi-syndrome caused by deep vascular cerebral lesions, in both thalamic (8 patients) and basal ganglia (13 patients) sites. All subjects, on entry and 3 months after treatment, underwent a language test, routine tests, De Renzi-Vignolo's Token test and neuromotor evaluation, to study muscle tone, the presence of pathological synergies, sensitivity, active motility and functionality. On entry, patients with thalamic lesions had fewer problems than those with lesions of the basal ganglia at both symbolic and neuromotor levels.

Effects of intravenous high dose co-dergocrine mesylate ('Hydergine') in elderly patients with severe multi-infarct dementia: a double-blind, placebo-controlled trial.

A double-blind, placebo-controlled trial was carried out in 40 patients affected by multi-infarct dementia to see if a daily intravenous infusion of 3 mg co-dergocrine mesylate ('Hydergine') over 14 days would improve severely deteriorated elderly patients and shorten the latent period (3 months) which is observed when the drug is given orally. All the patients had severe mental impairment, psychological deficit or altered consciousness. A Hachinski score of 7 or more, and a cumulative score of at least 12 points on SCAG scale Items 1, 2 and 4 (anxiety/depression) and/or Items 5, 6 and 8 (alertness/confusion) were required for admission.

Pathological brain ageing: evaluation of the efficacy of a pharmacological aid.

The efficacy of a molecule active at metabolic, neurotransmitter and membrane levels was evaluated in a group of 20 patients with typical involutional symptoms, who came under the care of the rehabilitation therapist for their concomitant decrease of motor activities. All subjects were treated with 1.5 g/day L-acetylcarnitine per os for 6 months, and subjected to the evaluation of cognitive ability (MMS), depression (HDRS), and behavioral and self-sufficiency performances (SCAG), at baseline (t0), after 90 days (t1), and after 180 days (t2).

[Visual feedback on the maximal momentum of the voluntary tibio-tarsal dorsal flexion in hemiplegic patients].

In both sides (healthy and plegic) of an hemiplegic group the evaluation of tibio-tarsic isometric torque (with and without the aid of a visual feed-back) was carried out. No significative differences in the "total biological work" during a series of ten contractions, in the two cases were found. A marked increase of the pin-point single contraction in the hemiplegic side was noted.

Evaluation of the effect of vincamine teprosilate on behavioural performances of patients affected with chronic cerebrovascular disease.

With a view to determining the efficacy of Teproside versus placebo in patients affected with cerebrovascular disease, 30 subjects, selected at the Montescano Medical Rehabilitation Centre, were randomly divided into two groups of 15 subjects each. After a two-week wash-out period, the first group was treated with placebo and the second with vincamine teprosilate (Teproside) at 120 mg daily, both for a period of 90 days. The assessment of each patient took place in two stages, one at the beginning and one at the end of treatment.

[Electroanalgesia by transcutaneous stimulation (TNS). Response to the naloxone test].

The authors, after a review of the literature about TNS, suggest the comparison between three different TNS techniques from two points of view: A) Pain relief estimate; B) Response to Naloxone Test. To this purpose a impulse generator delivered a biphasic square-wave stimulus with duration of 0.40 msec and amplitude (peak to peak) to 130 mVolt, was used.