P Meineri

Università degli Studi di Torino, Torino, Piedmont, Italy

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Publications (14)40.41 Total impact

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    ABSTRACT: Objective: To determine the incidence of ALS in two regions of Northwestern Italy, utilizing a prospective design. Methods: The study was performed in Piemonte and Valle d'Aosta (4,418,503 inhabitants) during the period 1995 to 1996. All neurologic departments in the two regions were involved in the study and prospectively collected and followed up ALS cases. Other secondary sources of information were used in order to ensure complete case ascertainment. ALS diagnosis was based on El Escorial criteria. Although all patients with motor neuron disease were enrolled in the follow-up, only probable and definite cases are included in the study. Results: During the study period, 221 cases of ALS were found (120 men and 101 women), corresponding to a mean annual crude incidence rate of 2.5/100,000 population (95% CI 2.2 to 2.9). The rate was higher for men (2.9) than for women (2.3), and increased with age to a peak in the 75 to 79 age group among men and to the 70 to 74 age group among women. Conclusions: Comparing these data to those of epidemiologic studies with a similar prospective design, the incidence rates are similar, despite the large differences in terms of genetics, environment, and socioeconomic background. This finding points to diffuse environmental or genetic factors rather than to a specific exogenous toxin in the pathogenesis of ALS.
    No preview · Article · Jan 2001 · Neurology
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    ABSTRACT: Cerebral venous thrombosis (CVT) is the main venous cerebral pathology. Its incidence is not exactly known, due to diagnostic difficulty and to rare autoptic reports. We present clinical, instrumental, therapeutic and etiopathogenetic aspects concerning 10 CVT cases (8 females) to our department from 1995 to 1999. In 9 patients Magnetic Resonance Imaging and angio MRI were diagnostic. Only in 2 cases a cerebral angiography was necessary to detect CVT and one case was detected by cerebral Computed Tomography and angiography. All the subjects were screened for thrombophilia. In 2 cases omocisteine titer was high, one patient had high antiphospholipids antibody titer, one case was HIV positive in antiretroviral treatment. Four cases assumed oral contraceptives and two of them were smokers. We discuss clinical, instrumental, etiopathogenetic and therapeutic data.
    No preview · Article · Jan 2000
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    ABSTRACT: Percutaneous endoscopic gastrostomy (PEG) has been proposed as symptomatic treatment of dysphagia in patients with ALS. Safety and factors related to survival after PEG were analyzed in 50 consecutive ALS patients. No major acute or long-term complications were observed. Stabilization or increase in weight were observed after PEG. Median survival after PEG was 185 days, with a worse outcome in patients with weight loss > or =10% healthy body weight and forced vital capacity <65%. PEG may be a useful option in the symptomatic treatment of dysphagia in ALS.
    No preview · Article · Oct 1999 · Neurology
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    ABSTRACT: Background Studies on risk factors for epileptic seizures are mostly based on heterogeneous groups of patients: incident and prevalent cases, first seizures and epilepsies, idiopathic and symptomatic seizures, children and adults, hospital and population series. Different types of seizures are pooled together and methods of exposure ascertainment differ among studies. Confounding has never been considered. Objective To evaluate with a case-control study risk factors for a first "symptomatic" epileptic seizure. Methods This is a multicenter case-control study, involving 18 neurological departments from January 1995 through April 1998. Cases are adult patients (age > 15 years) with a first seizure, symptomatic (either acute or remote) of stroke, intracranial tumor or head trauma. Controls are patients without seizures, matched to the cases for center, sex, age, and underlying pathology (stroke, intracranial tumor or head trauma). Cases and controls are interviewed with a questionnaire, already validated, on risk factors for epilepsy, including familial, pre-, peri- and post-natal risk factors. Results We included 290 cases (5 to 41 per center), 125 women and 165 men, with a mean age of 61.4 years. The underlying pathology was stroke in 169 cases, intracranial tumor in 90 and head trauma in 31. We included 211 cases with acute and 79 with remote symptomatic seizures. The recruitment of controls is still ongoing; we have now recruited 344 controls. Preliminary results (odds ratio, 95% confidence limits) are: family history for seizures, 1.9 (0.8-4.6); complications of pregnancy, 1.0 (0.6-1.4); low gestational age, 0.8 (0.5-1.4); low birthweight, 1.5 (1.2-1.8); febrile seizures, 1.3 (0.6-2.9); sleep deprivation, 1.2 (0.91.5); hypertension 0.9 (0.8-1.1); alcohol use 26-50 g/day, 1.3 (0.7-2.4); alcohol use more than 51 g/day, 1.5 (0.8-2.8). Conclusions In presence of an insult to CNS (either acute or remote), other risk factors for seizures have only a minor role.
    No preview · Article · Jan 1999
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    ABSTRACT: To assess the prognosis of the Guillain-Barre syndrome and identify the main prognostic indicators, 297 patients with Guillain-Barre syndrome recruited through a network of Italian centres were followed up for 24 months or until clinical recovery, whichever was earliest. For each patient the time to plateau, improvement, clinical recovery, or death was calculated, and prognostic indicators (age, sex, antecedent events, disability at admission and nadir electrophysiological patterns) and treatments were noted. The mean duration of follow-up was 309 days. During this period, 212 patients (71%) recovered, 48 (16%) had residua and 33 (11%) died. The mean times to nadir improvement and clinical recovery were 12, 28 and 200 days. Using life-tables and survival curves, the cumulative probability of achieving the plateau of symptoms was 73% by 1 week and 98% by 4 weeks. Improvement started during the first week in 36% of cases and within 4 weeks in 85%. The rates of clinical recovery at 1 and 4 weeks, 6, 12 and 24 months were 4, 24, 57, 70 and 82%, respectively. The chance of recovery was significantly affected by age, antecedent gastroenteritis, disability, electrophysiological signs of axonopathy, latency to nadir and duration of active disease. The main treatments did not seem to affect the chance of recovery.
    Full-text · Article · Dec 1996 · Brain
  • A Chió · P Meineri · A Tribolo · D Schiffer
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    ABSTRACT: A case-control study of risk factors in 512 cases of motor neuron disease (MND) and 512 controls, affected by other neurological diseases, was performed. Clinical history showed a significant increase in gastric ulcer and mechanical injuries among MND cases, whereas the frequencies of operations, poliomyelitis, malignancies and autoimmune diseases were similar for cases and controls. The women affected by MND had a later menarche and an earlier menopause; therefore, the reproductive period was significantly shorter, supporting a possible role of sexual hormones in the pathogenesis of MND. The analysis of occupations showed an increased number of farmers and also of subjects exposed to chemical products among MND cases.
    No preview · Article · Feb 1991 · Neuroepidemiology
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    ABSTRACT: Incidence and prevalence rates of motor neuron disease in two Italian provinces (Asti and Cuneo, Piedmont region) in the period 1971 through 1985 were estimated. The data were homogeneous in the investigated area, but an increasing incidence of the disease during the period studied was found, particularly in older age groups and in females. An increasing trend in mean age of onset of symptoms was also found.Copyright © 1989 S. Karger AG, Basel
    No preview · Article · Jan 1989 · Neuroepidemiology
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    ABSTRACT: Leukocyte glutamate dehydrogenase (GDH) was studied in 29 patients affected by progressive cerebellar ataxia (PCA) and in 20 healthy controls. Eight GDH-deficient patients, with GDH activity 2 SD below mean value of controls, were identified. GDH deficiency did not identify a subgroup of PCA by characteristic pattern of inheritance and/or age of onset of disease. However, the GDH-deficient patients presented more neurological signs than non-GDH-deficient patients. A significant correlation was observed between GDH deficiency and the presence of extrapyramidal signs, supranuclear palsy, absence of osteotendineal reflexes and neurogenic electromyographical findings.
    No preview · Article · Dec 1988 · Acta Neurologica Scandinavica
  • A Chiò · F Brignolio · P Meineri · M G Rosso · A Tribolo · D Schiffer
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    ABSTRACT: Eight cases of malignancies with concurrent motor neuron disease (MND), derived from an unselected population representing all cases of MND diagnosed during a 15-year period in two Italian provinces, were studied to verify the existence of paraneoplastic forms of the disease. No statistically significant association between the two diseases was found. Therefore, from our findings the occurrence of a neoplasm in a patient affected by MND can be considered a chance association.
    No preview · Article · Aug 1988 · Journal of Neurology
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    ABSTRACT: 60 cases of chronic spinal muscular atrophy (CSMA) were followed-up for a period varying from 5 to 40 years. The neuromuscular impairment was evaluated by Norris' ALS score, both at the time of last examination and retrospectively at the time of diagnosis. Age at onset of symptoms was the most important factor in the progression of the neuromuscular damage. Monomelic or asymmetric location of symptoms at the time of diagnosis and duration of the disease were not significantly correlated to the worsening of ALS score.
    No preview · Article · Mar 1988 · The Italian Journal of Neurological Sciences
  • P Meineri · F Brignolio · A Chiò · D Mittino · A Tribolo · D Schiffer
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    ABSTRACT: Eighteen cases of post-poliomyelitic motor neuron disease (PPMND) were found in a series of 869 subjects affected by motor neuron disease (MND). The mean age of onset of acute anterior poliomyelitis (AAP) was 43.6 months. The mean age of onset of MND was 45.9 years. No case had a bulbar onset and hyperreflexia was found in only 2 subjects, one of them having also bilateral extensor plantar response. The survival curve showed a better course of these cases, compared to typical MND (TMND). The present study seems to indicate that PPMND and TMND are different diseases.
    No preview · Article · Feb 1988 · European Neurology
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    ABSTRACT: A clinical, genetic and epidemiological study of hereditary motor and sensory neuropathies (HMSN) was performed in the province of Turin, Italy. The patients were allocated to 5 groups, according to genetic and electroneurographic features. The high proportion of males among recessive and sporadic cases in the present series may suggest the existence of a recessive X-linked form of the disease. The crude prevalence rate was 3.18 (+/- 0.72)/100.000 population for all cases. The slow progression rate and the frequently mild symptoms of the disease, already suggested in literature, are confirmed by the analysis of the survival curves of the cases.
    No preview · Article · Sep 1987 · The Italian Journal of Neurological Sciences
  • A Chio · F Brignolio · P Meineri · D Schiffer
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    ABSTRACT: Twenty-seven cases of hereditary amyotrophic lateral sclerosis (ALS), belonging to 8 families, are reported. The analysis of the pedigrees suggests an autosomal dominant transmission, apparently with incomplete penetration. The mean age at onset of symptoms was 50.3 (SD 12.4) years. The mean duration of the disease was 31.2 (SD 20.4) months, ranging from 9 to 86. The median survival time was 24 months. The degree of variation of some quantitative characters, both within and among families, was statistically analyzed. The results support the hypothesis of a phenotypic and genetic heterogeneity of autosomal dominant transmitted ALS.
    No preview · Article · May 1987 · Acta Neurologica Scandinavica
  • F Brignolio · M Leone · A Tribolo · M G Rosso · P Meineri · D Schiffer
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    ABSTRACT: A descriptive epidemiological survey of hereditary ataxias and spastic paraplegias was conducted in the province of Torino, Italy (2,327 996 inhabitants). On prevalence day (31 December 1982) 142 patients were alive. Total prevalence was 6.1 cases/100,000 inhabitants (95% confidence limits = 5.1-7.0). The prevalence rate was 2.6 for recessive or sporadic juvenile ataxias, 1.3 for spastic paraplegias, 1.2 for autosomal dominant cerebellar ataxias, and 1.1 for late onset cerebellar ataxias. The prevalence of hereditary ataxias is similar in our province to that recorded in other populations, but hereditary spastic paraplegias are less frequent than in other populations.
    No preview · Article · Sep 1986 · The Italian Journal of Neurological Sciences