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Biomedical subjects

A Fiorentini

Publications and source records attributed to A Fiorentini.

At least 19 recordsLinked to original sources

Sleep's quality disorders in patients with hypertension and type 2 diabetes mellitus.

Sleep is one of the most important factors contributing to health. Although same studies examining the relationship between sleep duration and mortality, has not been fully discussed. We consecutively studied two hundred and fifty Caucasian subjects, normoweight, who were referred for ambulatory blood pressure monitoring (APM). Quality of sleep was evaluated through the Pittsburgh Sleep Quality Index (PSQI). PSQI assessed subjective sleep quality of the past 4 weeks and was administered during the personal interview. A global PSQI > or =5 has a diagnostic sensitivity of 89.6 and specificity of 86.5 in distinguishing "poor sleepers"(PSQI > or =5) from "good sleepers" (PSQI <5) subjects. Hypertension, type 2 diabetes mellitus and sleep's quality disorders were reported respectively in 53.4%, 12.5% and 35.2% of the total population examined. The prevalence of hypertension was 87.1% in "poor sleepers" subjects versus 35.1% in "good sleepers" subjects (p<0.0001). Our results permit to conclude that, as the sleep-disordered breathing, also the sleep's quality disorders, evaluated by PSQI, are associated with significant comorbidities, as hypertension and diabetes mellitus. We hypothesize that the valuation of the quality of sleep through the Pittsburgh Sleep Quality Index (PSQI) could be considered in screening for cardiovascular risk.

Diabetes Mellitus, Type 2↗

Circadian rhythm of autonomic activity in non diabetic offsprings of type 2 diabetic patients.

UNLABELLED: The aim of the present study was to evaluate, by heart rate variability (HRV) with 24-hours ECG Holter (HRV), the circadian autonomic activity in offspring of type 2 diabetic subjects and the relation with insulin-resistance. METHODS: 50 Caucasian offsprings of type 2 diabetic subjects were divided in two groups: insulin-resistant offsprings (IR) and non insulin-resistant offsprings (NIR). Autonomic nervous activity was studied by HRV. Time domain and spectral analysis (low frequency, LF, and high frequency, HF, provide markers of sympathetic and parasympathetic modulation when assessed in normalized units) were evaluated. RESULTS: Time domain showed a reduction of total SDNN in IR (p < 0.001) and NIR (p 0.047) versus controls. Spectral analysis showed a total and night LF higher in IR and NIR than in control group (all p < 0.001). CONCLUSION: In frequency domain, the analysis of sympathetic (LF) and parasympathetic (HF) component evidenced an association between the offspring of type 2 diabetic subjects and a sympathetic overactivity. A global reduction and alteration of circadian rhythm of autonomic activity are present in offspring of type 2 diabetic patients with and without insulin resistance. The data of our study suggested that an autonomic impairment is associated with the familiarity for type 2 diabetes independently to insulin resistance and that an impairment of autonomic system activity could precede the insulin resistance.

Adult↗

Clinical outcome and olanzapine plasma levels in acute schizophrenia.

PURPOSE: This open label study was performed to evaluate the relationship between the plasma concentration of olanzapine and the response in acute schizophrenic inpatients. MATERIAL AND METHODS: A total of 54 inpatients, 38 males and 16 females, age ranging from 18 to 75 years, affected by Schizophrenia (DSM IV criteria) during an exacerbation phase were included in the study. Olanzapine (OLZ) was started at a dose of 5-20 mg/day and was increased to a mean dose of 15.27 mg +/-5.53 S.D. Patients were evaluated at baseline, and after 2 weeks, by using BPRS, PANNS, HRS-D, EPSE, and ACS. RESULTS: BPRS and total PANSS showed a statistically significant improvement at the end of the study. Olanzapine plasma levels (PL) ranged from 5 to 120 ng/ml (mean 33.15 ng/ml +/- 28.28 S.D.) and showed a positive correlation with OLZ dosage. A significant curvilinear correlation between OLZ PL and clinical improvement (BPRS, PANSS and HRS-D percent of amelioration) was observed. CONCLUSION: Olanzapine plasma level determination seems to be a useful tool in optimizing acute treatment particularly for more problematic cases.

Acute Disease↗

Lack of cortical contrast gain control in human photosensitive epilepsy.

Television and video games may be powerful triggers for visually induced epileptic seizures. To better understand the triggering elements of visual stimuli and cortical mechanisms of hyperexcitability, we examined eleven patients with idiopathic photosensitive epilepsy by recording visually evoked potentials (VEPs) in response to temporally modulated patterns of different contrast. For stimuli of low-medium, but not high, temporal frequency, the contrast dependence of VEP amplitude and latency is remarkably abnormal for luminance contrast (black-white), but not so for chromatic contrast (equiluminant red-green) stimuli. We conclude that cortical mechanisms of contrast gain control for pattern stimuli of relatively low temporal frequency and high luminance contrast are lacking or severely impaired in photosensitive subjects.

Adolescent↗

A cortical area that responds specifically to optic flow, revealed by fMRI.

The continuously changing optic flow on the retina provides information about direction of heading and about the three-dimensional structure of the environment. Here we use functional magnetic resonance imaging (fMRI) to demonstrate that an area in human cortex responds selectively to components of optic flow, such as circular and radial motion. This area is within the region commonly referrred to as V5/MT complex, but is distinct from the part of this region that responds to translation. The functional properties of these two areas of the V5/MT complex are also different; the response to optic flow was obtained only with changing flow stimuli, whereas response to translation occurred during exposure to continuous motion.

Adult↗

Developmental changes in optokinetic mechanisms in the absence of unilateral cortical control.

Animal models suggest that the asymmetry of monocular optokinetic nystagmus (OKN) in young infants can be explained by a direct pathway from retina to the midbrain nucleus of the optic tract. However, earlier studies with hemispherectomized infants showed no evidence for OKN responses towards the damaged cortex that could be ascribed to this subcortical pathway. In longitudinal testing of two infants with very extensive unilateral cortical damage, we have now shown that OKN responses in both directions do occur before 10 months of age. OKN towards the damaged cortex, indicating functioning of the direct pathways in the absence of cortical control, drops out in the later development. The neural circuitry responsible for OKN in humans appears to undergo a plastic reorganization.

Brain↗

Irritable bowel syndrome in patients with Blastocystis hominis infection.

The prevalence of Blastocystis hominis in stool specimens of individuals with gastrointestinal symptoms was evaluated to study a possible link between the protozoan and the irritable bowel syndrome. According to the Rome diagnostic criteria, 388 patients were evaluated. Altogether, 81 patients were classified as affected by irritable bowel syndrome. Blastocystis hominis was recovered from the stools of 38 subjects, 15 of whom belonged to the group with irritable bowel syndrome (P = 0.006). In addition, patients with irritable bowel syndrome were significantly more likely to have five or more Blastocystis hominis organisms per field (P = 0.031). In conclusion, there was a set of patients with irritable bowel syndrome in whom the presence of Blastocystis hominis may not be incidental.

Adolescent↗

Behavioural visual acuity of wild type and bcl2 transgenic mouse.

Since the advent of gene manipulating techniques, it has become increasingly important to study the neural functional properties of the mouse. The bcl2 gene has a powerful inhibitory action on naturally occurring cell death. As a consequence the brain of bcl2 overexpressing mouse is 1.5 times bigger than the brain of a wild type animal and the retina has more than twice the ganglion cells than normal (Martinou, Dubois-Dauphin, Staple, Rodriguez, Frankowski, Missotten, Albertini, Talabot, Catsicas, Pietra, & Huarte (1994). Neuron, 13: 1017-1030). Since in most mammals the upper limit of behavioural visual acuity is imposed by ganglion cells density, the visual acuity should be higher in bcl2 mice than in wild type mice. We measured behavioural visual acuity in wild type and transgenic mice and, contrary to the expectation, we found it to be of the same order (0.5-0.6 c/deg) in the two groups of animals, indicating that an increase in ganglion cells density is not effective in improving visual resolution.

Animals↗

The effects of ageing on reaction times to motion onset.

We have measured reaction time (RT) to motion onset in two groups of subjects (average ages: 70 and 29 years), for horizontal gratings of 1 c deg-1, modulated in either luminance or colour (equiluminant red-green), for various contrasts and speeds. For both old and young subjects, RTs depended on both speed and contrast, being faster at high speeds and high contrasts, and showed a stronger contrast dependency for chromatic gratings. The older subjects were systematically slower than the younger subjects. The difference between old and young RTs varied with condition, being 30-40 ms more at the slow than at the fast speed. The relative difference in RTs in different stimulus conditions shows that at least some of the increase in response time with age has a sensory origin. The results relate well to previous work on visual evoked potentials.

Adult↗

Reaction time to motion onset of luminance and chromatic gratings is determined by perceived speed.

We measured reaction times for detecting motion onset for sinusoidal gratings whose contrast was modulated in either luminance or chromaticity, for various drift rates and contrasts. In general, reaction times to chromatic gratings were slower than to luminance gratings of matched cone contrast, but the difference in response depended critically on both contrast and speed. At high image speeds there was virtually no difference, whereas at low speeds, the difference was pronounced, especially at low contrasts. At high image speeds there was little dependence of reaction times on contrast (for either luminance or colour), whereas at low speeds the dependence was greater, particularly for chromatic stimuli. This pattern of results is reminiscent of those found for apparent speed of drifting luminance and chromatic gratings. We verified the effects of contrast on perceived speed, and went on to show that the effects of contrast on reaction times are totally predictable by the perceived speed of the stimuli, as if it were perceived rather than physical speed that determined reaction times. Our results support that idea of separate systems for fast and slow motion (with separate channels for luminance and colour at slower speeds), and further suggest that apparent speed and reaction times may be determined at a similar stage of motion analysis.

Adult↗

Cyclosporiasis in a traveler returning from South America.

Cyclospora is a coccidian, previously referred to as a cyanobacterium-like body, with an epidemiology similar to that of Cryptosporidium parvum. In recent years, several studies have shown that Cyclospora is not a rare opportunistic pathogen but rather is the cause of common, worldwide intestinal infections in healthy adults and children. Previous reports of diarrhea resulting from Cyclospora sp. have been linked to travelers and immunocompromised patients. The species has a worldwide distribution. Although Cyclospora infection has been reported from Southeast Asia, Papua New Guinea, Indonesia, India, Pakistan, Nepal, the Middle East, North Africa, the United Kingdom, the Caribbean, the United States, Central America, and South America, the true prevalence of this parasite in any population is unknown. The parasite is associated with prolonged self-limiting and relapsing watery diarrhea, anorexia, fatigue, and sometimes myalgia. Fever is infrequent.

Adult↗

Responses to chromatic and luminance contrast in glaucoma: a psychophysical and electrophysiological study.

Increasing anatomical evidence indicates that large retinal ganglion cells (M-cells) are preferentially damaged in primary open angle glaucoma (OAG), while the smaller ganglion cells (P-cells) are relatively spared. In 13 patients with defined OAG and modest visual field defects, we evaluated the responses to stimuli that are expected to involve primarily the function of the P-pathway and compared them with those of control subjects. The psychophysical contrast sensitivity (CS), the PERG and the VEPs were measured for red-green gratings of pure chromatic contrast, as well as yellow-black gratings of pure luminance contrast. As compared with controls, OAG patients had reduced CS for both luminance and chromatic contrast stimuli by about 6 dB. PERGs and VEPs to luminance stimuli were little affected, whereas those to chromatic stimuli were both reduced in amplitude and delayed. These results indicate that visual dysfunction in glaucoma is not selective for the M-pathway, and that responses to equiluminant colour-contrast stimuli may be of diagnostic value.

Aged↗

Visual perceptual learning: a sign of neural plasticity at early stages of visual processing.

Examples of perceptual learning in various visual tasks are briefly reviewed. In spite of the variety of the tasks and stimuli, in most of these examples the effects of learning are specific for stimulus parameters and retinal location and transfer interoccularly. Enduring practice effects can be acquired within a single experimental session and/or progressively from one session to the next one, often continuing to improve until thousands of trials have been performed. The consolidation of learning effects from one session to the next one may occur in the waking state as well as during a normal night sleep, but is strongly dependent on the type of sleep. Improvement in performance does not require that the subject is informed of the correctness of his/her responses, but needs attention to the task: learning does not take place for the stimulus attributes that are not attended to. All this suggests that visual perceptual learning involves plastic changes at early neural processing levels, which are dependent for their induction and consolidation on the general behavioural state of the subject, such as attentiveness and type of sleep.

Discrimination Learning↗

Visual ageing: unspecific decline of the responses to luminance and colour.

We have investigated whether ageing affects selectively the responses to equiluminant patterns of pure colour contrast. In two groups of subjects (mean ages 29 and 72 yr) contrast thresholds were measured psychophysically for the detection and for the discrimination of the direction of motion of drifting gratings. The gratings were modulated either in pure luminance contrast (and uniform colour), or pure chromatic contrast (red-green equiluminant gratings). In subjects of the same age groups, visual evoked potentials (VEP) were recorded in response to gratings with either pure luminance contrast or pure colour contrast sinusoidally reversed in contrast at various temporal frequencies. It was shown that psychophysical contrast sensitivity for equiluminant patterns deteriorates significantly with age, and VEP latency increases. However, these effects of ageing on the responses to patterns of pure colour contrast are substantially the same as those observed in the same subjects for stimuli with pure luminance contrast. The results suggest that ageing causes a small and unspecific decline of the response of the visual system to luminance and colour contrast.

Adult↗

Development of the temporal properties of visual evoked potentials to luminance and colour contrast in infants.

We have studied the development of the temporal characteristics of the pattern visual evoked potentials (P-VEPs) in response to contrast reversal of patterns of low spatial frequency (0.1 c/deg) of either pure luminance contrast (yellow-black plaid patterns) or pure colour contrast (equiluminant red-green plaid patterns) in 15 infants between 6 and 30 weeks of age. High contrast patterns were modulated temporally either sinusoidally at various temporal frequencies to elicit steady-state responses, or abruptly at a low temporal frequency to elicit transient responses. Analysis of both the transient and steady-state responses suggests the existence of three different mechanisms contributing to the infant and adult P-VEP responses at low, medium and high temporal frequencies. The responses at the three different temporal frequency ranges have different time constants, and develop at different rates. The low frequency response predominates at 8 weeks, where it spans the range 1-6 Hz with an apparent latency of about 230 msec, for both colour and luminance stimulation. This response increases in bandwidth and decreases in latency progressively with age, at a similar rate for luminance and colour contrast, up to 14 weeks. After 14 weeks, the luminance response undergoes major changes, with the emergence of a new response with a shorter latency (about 100 msec) and a peak activity near 10 Hz. This mid-frequency response matures further with age, until it dominates the whole response of the adult P-VEP to luminance contrast. It also makes a contribution to the chromatic response at frequencies above 10 Hz, generating the characteristic double-peaked amplitude response in adults. However, its contribution is very limited below 10 Hz, where the response latency is 140 msec in adults, as it was at 14 weeks of age. A third component is evident at very high temporal frequencies of the luminance response as early as 6 weeks, extending up to 15 Hz in 8-week-olds and up to 25 Hz for older infants. It remains apparent up to 18 weeks, thereafter being swamped by the major mid-frequency response. The apparent latency of response over this frequency range is about 70 msec at all ages. The development of transient P-VEPs paralleled that of the steady-state P-VEPs. At all ages there was an early negative component (N70) at about 70 msec, corresponding to the fast steady-state response at high frequencies for luminance contrast. Before 14 weeks, the luminance and chromatic transient response had the same morphology, with a single major peak of similar latency to the apparent latency of the low temporal frequency response. After this age, the morphology of the luminance response changed, particularly in the first 100 msec, consistent with the emergence of the mid-frequency response. We discuss whether the high-frequency component may represent pre- or early post-synaptic cortical activity, already mature by 8 weeks, and how the different maturation rates of the mid and high-frequency components may reflect different intra-cortical circuitry for colour and luminance.

Adult↗

The pattern electroretinogram in response to colour contrast in man and monkey.

Steady-state pattern-reversal electroretinograms (PERG) were recorded from both monkeys and humans in response to tartan patterns modulated in both space and time in either luminance contrast or chromatic contrast. In both species, all types of patterns cause a strong modulation of the second-harmonic of the PERG. There was no measurable dependency of the PERG on the colour of the stimulus per se: both in humans and monkeys, stimuli with green-black, red-black or yellow-black modulation of the same mean luminance and of the same contrast, produced identical results. However, chromatic stimuli with modulation between equiluminant red and green produced a qualitatively different PERG: the amplitude was lower, particularly at high temporal frequencies, and there was a clear phase lag corresponding to a difference in processing time of about 20 ms.

Animals↗