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Biomedical subjects

R Bolzani

Publications and source records attributed to R Bolzani.

At least 19 recordsLinked to original sources

Intra-individual variability of saccadic velocity measured with the infrared reflection and magnetic scleral search coil methods.

BACKGROUND: The infrared (IR) and the magnetic scleral search coil (MSC) systems for eye tracking were studied with regard to the intra-individual variability in saccadic eye movement recordings. METHOD: Three healthy subjects performed similar saccadic eye movement tasks at five different occasions with both the IR (Orbit XY-1000) and the MSC (Skalar Medical) techniques. The maximum velocity (VMAX) and slope constant (C) of the main sequence plots were analyzed with regard to the coefficient of variation (CV) and the intraclass correlation coefficient (Ricc). In addition, the possible reasons for variability in the IR recordings, especially different causes for noise, were analyzed and discussed. RESULTS: The main sequence data showed intra-individual variation with both recording systems, but the coefficient of variation was higher for VMAX with the IR compared to the MSC method. Ricc analysis showed that 36% of the variance of VMAX and 49% of the variance of C resulted from intra-individual variability in recordings of the IR system. The corresponding results for the MSC recordings regarding VMAX and C were 48% and 88%. CONCLUSIONS: Saccadic eye movement recordings yielded a larger intra-individual variability with the IR system than with the MSC system. The effect that the MSC annulus may have on the ocular motor command signal and the possible low pass filter caused by the coil slipping on the surface of the eye may partly explain the relatively lower velocity in the MSC recordings. Also, noise in the IR recordings induces peaks of eye velocity, which can be reduced considerably by filtering. However, the variability in the recordings, which was larger in the IR than in the MSC recordings, did not seem to be decreased by filtering. The basic level of noise in the recordings was not clearly associated with the amount of reduction of VMAX when the IR recordings were filtered. We suggest that artefacts of the saccadic signal, which can be related to changes in the reflecting surface of the eyes and eyelids, are important factors for explaining the variability and high-velocity peaks in the IR recordings. Lighting conditions was confirmed as a cause for noise, but temperature and air humidity changes in the goggles were not suspected to influence data in the normal experimental setting. Although noise, shortcomings of the recording technique and procedure may offer explanations for the intra-individual variability, the calibration procedure and changes in attention and fatigue of the subject should also be considered.

Adult↗

A comparison between the magnetic scleral search coil and infrared reflection methods for saccadic eye movement analysis.

BACKGROUND: A non-invasive eye tracking system, based on pulsed infrared light (IR), was compared with the magnetic scleral search coil method (MSC) for saccadic eye movement recordings. METHODS: Ten normal subjects performed horizontal and vertical saccades recorded with both methods. Eight recordings were complete and analysed for maximum peak velocity (V(MAX)) and constant (C) of the main sequence curve. RESULTS: The IR recordings showed significantly higher peak velocity values than the MSC system and generally more inter-individual variability. No significant difference regarding peak velocity was detected between abducting and adducting saccades or between upward and downward saccades with either of the systems. Horizontal saccades had higher peak velocities with both techniques. CONCLUSIONS: Comparison of the main sequence plots of the IR and MSC eye tracking techniques reveals that the IR system yields higher values of maximum peak velocity and the constant, the differences being similar for eye movements in different directions. There are various possible explanations for the lower maximum velocity of the MSC recordings, e.g. slipping of the coil annulus on the surface of the eye and a change of the oculomotor command signal induced by wearing the coil. Also, artefacts associated with the IR recording system may cause over-estimations of the saccadic velocity and, furthermore, contribute to the higher variability of the IR recordings.

Adult↗

The validity of informant report for grading the severity of Alzheimer's dementia.

The validity of informant-based techniques has been established for the detection of dementia cases by non-pathological individuals, but is still controversial for the assessment of the severity of dementia. This study aimed at ascertaining whether informant-based evaluation (the so-called informant report) of the cognitive and behavioral impairment of a patient is valid for grading the severity of dementia, and consistent with objective assessment of the patient's cognitive and behavioral functioning. We enrolled 96 community-dwelling outpatients and 56 controls assessed at the Geriatric Evaluation Unit of the University of Modena, Italy. All patients scored lower than 27 on the MMSE, and met DSM-IV inclusion criteria for Alzheimer's dementia. Patients and controls were administered the CAMDEX interview, containing a section which collects participant (patient or control) and informant evaluations on dementia-related cognitive and behavioral deficits. The informant report resulted effective at MANOVA for grading the severity of dementia in 4 of its 5 measures (namely, memory, everyday activities, general mental functioning and depressed mood), and was correlated with the scores of several scales of the CAMDEX cognitive section (i.e., CAMCOG). Instead, the participant's (patient or control) report showed a lower capacity for grading dementia, and was poorly correlated with the psychometric outcomes of cognitive functioning. On the whole, the results corroborated the validity of the informant report in the diagnostic work-up for grading dementia, given its sensitivity to the severity of dementia, and its consistency with cognitive psychometric outcomes.

Aged↗

Active processing of declarative knowledge during REM-sleep dreaming.

The ability to process recently acquired knowledge is clearly maintained during sleep. Here we assess whether and how far the sleeper controls this processing (in a non-volitional and non-conscious manner). We posit that during sleep, the cognitive concerns of previous waking may guide access to, and processing of, items of declarative knowledge with which those concerns are associated. In a delayed recall task, before each of three sleep onsets in the same night, 12 subjects heard a different nonsense sentence. When awakened in rapid eye movement (REM) sleep, they were asked to report their dream experience and to recall the last sentence heard. Occurrences of incorporation into dream content were more frequent for this sentence than for the sentences heard before previous sleep onsets, and also more frequent than occurrences of similar contents in reports from a control night. However, the modalities of elaboration of dream contents did not vary. These findings indicate that cognitive concern can affect the accessing of recently acquired declarative knowledge during sleep, but not the modalities by which this is inserted into dream content. They also suggest that cognitive concern may help consolidate knowledge by increasing the likelihood of it being processed during sleep.

Adult↗

Autonomic reactivity during viewing of an unpleasant film.

The effect of an aversive, high-arousing film on heart rate, respiratory sinus arrhythmia, and electrogastrographic activity (EGG) was investigated. Previous studies have indicated a larger heart-rate deceleration for visual stimuli depicting surgery or blood compared to neutral content, and this phenomenon is similar to the bradycardia observed in animals in response to fear. The heart-rate deceleration is clearly parasympathetically driven, and it is considered a general index of attention. An accurate index of cardiac vagal tone can be obtained by means of quantification of the amplitude of respiratory sinus arrhythmia. The relationship between cardiac vagal tone and EGG is complex, but animal research has shown that suppressing vagal activity dampens gastric motility. We have investigated whether a movie depicting surgery is associated with greater heart-rate deceleration, larger increase in respiratory sinus arrhythmia, and greater increase in EGG activity compared to a neutral movie. In addition, if both respiratory sinus arrhythmia and EGG are indices of vagal tone, a positive correlation between these physiological responses was expected. Analysis indicated an effect of the surgery movie on heart rate and respiratory sinus arrhythmia, but not on EGG activity. Moreover, the expected correlation was not found. Implications for future studies are discussed.

Adult↗

Coupled plasma filtration-adsorption in a rabbit model of endotoxic shock.

OBJECTIVE: To test the hypothesis that nonselective adsorption by a hydrophobic resin of cytokines and other proinflammatory mediators could improve 72-hr survival in a rabbit model of endotoxic shock. DESIGN: Prospective, randomized, controlled animal trial. SETTING: Animal care facility at a research institution. SUBJECTS: A total of 109 New Zealand white male rabbits. INTERVENTIONS: Anesthetized rabbits were cannulated with indwelling femoral arterial and venous lines. Septic shock was induced by a single intravenous injection of Escherichia coli lipopolysaccharide. The dose was experimentally assessed in 40 rabbits receiving 1.0, 0.5, 0.1, and 0.05 mg/kg body weight to determine LD80 at 72 hrs. Extracorporeal circulation consisted of plasma filtration coupled with passage of the plasma filtrate through a hydrophobic sorbent and reinfusion into the venous line. The extracorporeal treatment lasted for 3 hrs. Rabbits injected with endotoxin (0.05 mg/kg) were submitted to plasma filtration with (19 rabbits) or without (20 rabbits) sorbent adsorption. As controls, rabbits injected with vehicle alone were treated with plasma filtration (ten rabbits) or without (ten rabbits) sorbent adsorption. Ten rabbits were monitored under anesthesia to determine basal survival. MEASUREMENTS AND MAIN RESULTS: Plasma concentrations of endotoxin, bioactive tumor necrosis factor, resin-adsorbed platelet-activating factor, mean arterial pressure, base excess, and white cell count were assessed and a global severity score was established. At 72 hrs, cumulative survival was significantly (p = .0041) improved in septic rabbits treated with coupled plasma filtration-adsorption. Circulating tumor necrosis factor bioactivity remained similar in control and treated rabbits. Biologically significant amounts of platelet activating factor were eluted from the sorbent during the entire treatment time. The severity score inversely correlated with survival (p < .001). CONCLUSIONS: Coupled plasma filtration-adsorption improved survival in a rabbit model of endotoxic shock. Coupled plasma filtration-adsorption may be an extracorporeal treatment capable of removing structurally different inflammatory mediators associated with sepsis.

Animals↗

Story-like organization of dream experience in different periods of REM sleep.

Four dream reports, collected from each of 16 subjects in an experimental night, were analysed using the criteria of Mandler and Johnson's story grammar. The experimental night was the first of the four nights where subjects had spontaneously given a dream report after each of the four awakenings planned in REM sleep. A multivariate analysis of covariance, taking the order of the nights where the experimental night occurred and the order of reports as factors, the number of stories per report as covariate and the number of statements in the setting, the number of statements in the event structure and number of episodes per story as dependent variables, showed that the greater length and complexity of reports collected in the second half of the night depends on a greater effectiveness of the dream production system rather than on a greater accuracy of recall. This increase concerns the organization of individual stories rather than the number of stories developed in a given time. These findings raise the issue of how dream production is re-triggered during REM sleep. To cast light on this issue, it seems important to establish whether and how the themes of the various stories developed in a given dream experience are interrelated.

Adult↗

Four diopters prism test recording in small angle esotropia: a quantitative study using a magnetic search coil.

PURPOSE: To determine the vergence response, if any, in a homogenous group of patients suffering from strabismus and submitted to environmental induction of retinal disparity with respect to a control group of subjects. MATERIALS AND METHODS: A series of 13 subjects was included in the present study (5 normal subjects and 8 patients suffering from small angle esotropia). The patients were evaluated in an illuminated environment where they were told to stare at a target which subtended a visual angle of 20 degrees and, successively, in the dark using a luminous stimulus which subtended a visual angle of 3.5 minutes. The vergence movements were evaluated using a four diopter base-out prism; eye movements were recorded under conditions of both binocular and monocular vision. Ocular movements were recorded by means of a magnetic search coil; the amplitude and peak velocity of the vergence movements were evaluated by computer analysis. Statistical analysis was performed using the Multiple Anova test for repeated measures. RESULTS: The data obtained in the present study demonstrate that: 1) there is a significant difference between binocular and monocular vision in both groups of subjects; however, the ocular response in the patients affected by strabismus was significantly different from that in the control group of subjects; 2) during monocular vision in the dark, the response of the strabismic patients was highly variable; 3) for both groups of subjects no significant differences were observed in the vergence response when a large-angle stimulus was employed in light conditions nor when a small-angle stimulus was utilized in a dark environment.

Journal Article↗

Acetate-free biofiltration versus bicarbonate haemodialysis in the treatment of patients with diabetic nephropathy: a cross-over multicentric study.

BACKGROUND: Morbidity and mortality rates in diabetic patients on regular dialysis treatment (RDT) are higher than in non-diabetic-subjects on RDT. Moreover, diabetic patients experience an intradialitic morbidity unacceptably higher than in patients with other causes of terminal renal failure. The aim of the present investigation was to compare standard bicarbonate haemodialysis (BHD) with acetate-free biofiltration (AFB) in a group of 41 diabetic patients stable on dialysis treatment for 25 +/- 22 months. METHODS: Twenty-four type II and 17 type I diabetic patients, all requiring insulin therapy, were included and were followed for 1 year in a 6-month cross-over randomized study for both methods. The analysis was carried out on dialysis symptoms, interdialysis symptoms, and nutritional status, and the multivariate analysis of variance for repeated measures on the same subjects in the two techniques was used. RESULTS: AFB significantly reduced dialytic and extradialytic symptoms (P=0.003 and 0.001 respectively). Cardiovascular collapses decreased by 43%, and other dialysis symptoms showed a similar trend (-35%). The interdialysis symptoms decreased by 28% and were accompanied by an increase in subjective wellbeing (39%) when patients were switched from traditional haemodialysis to AFB. Acid base control was better with AFB (P=0.01), both at the beginning and during the session. Slightly significant differences were also obtained for Kt/V (AFB 1.48 +/- 0.29 vs BHD 1.38 +/- 0.30), while no significant difference was noted with respect to sodium mass balance, nutritional status, calorie-protein intake, nPCR, blood glucose profile, and insulin requirements. The number of hospital admissions and the mortality rate, which were much lower during the AFB than the BHD period, were not analysed statistically. CONCLUSIONS: AFB allows better control of some metabolic aspects, reduces intra- and extradialysis symptoms, and improves patient quality of life. Whether the long-term prognosis can be improved by AFB remains to be established with further studies.

Acetates↗

Assessing behavioural and cognitive impairment in dementia using an informant's report: evidence from the CAMDEX interview.

The consistency of measures from informants' report and from objective testing, both incorporated into the CAMDEX interview, was tested for elderly persons with mild dementia (n = 46), with moderate dementia (n = 41), and without cognitive impairment (controls, n = 56). Informants' reports permitted grading severity of dementia and provided measures of memory and mental functioning in everyday activities highly related to indices derived from objective testing.

Activities of Daily Living↗

Binocular vertical perceptual adaptation in essential infantile esotropia.

This study assessed whether dissociated vertical deviation, corresponding to an occasional elevation of the deviated eye, is accompanied by a binocular vertical perceptual adaptation. Dissociated vertical deviation was elicited by means of neutral filters in 16 patients, 8 who had undergone operations for the disorder of essential infantile esotropia and 8 who had not. Neutral filters elicited dissociation vertical deviation, which was accompanied by binocular vertical perceptual adaptation. This effect was significantly greater for patients who had operations and was enhanced by the filter density. Surgical elimination of inhibitory mechanisms for dissociated vertical deviation in patients with essential infantile esotropia appears to facilitate a loose sensory adaptation, which permits a binocular vertical perceptual adaptation.

Adolescent↗

Modifications of electrogastrographic activity during the viewing of brief film sequences.

The experiment assessed the effects of two film sequences, a pleasant documentary and a distressful scene, on electrogastrographic (EGG), electromyographic (EMG), and heart-rate responses during digestion by 30 healthy students. The physiological measures were recorded before and during the projection of each film sequence. At the end of each viewing period, subjects completed a self-rating questionnaire on the emotional experience. Analysis yielded a significant increase in heart-rate and EMG values during the viewing of the film sequences and a significant decrease in amplitude of the 3 cycles per minute (cpm) wave of EGG during the unpleasant film. The type of film sequence had also a statistically significant effect on the self-ratings of emotional states.

Adult↗

Effect of citicoline on visual acuity in amblyopia: preliminary results.

BACKGROUND: Citicoline has been used to improve consciousness levels in cerebral trauma and as a complement for levodopa in Parkinson's disease. It has also been shown that severe glaucomatous visual field deficits improve for at least 4 months with the use of citicoline. In this paper, preliminary results are presented of an open and a double-blind study on the effect of citicoline in amblyopia. METHODS: The open study was started in 1991. Fifty patients with amblyopia were treated with citicoline (1000 mg i.m. daily for 15 days). They were selected from an age group beyond the plastic period of the visual system. Occlusion or other types of anti-amblyopic treatment were never used at the same time as citicoline. A double-blind study was conducted on 10 more patients, randomly assigned to a treatment or placebo group and followed for 6 months. A statistical test for repeated measures was performed on all the results. RESULTS: A statistically significant improvement in visual acuity was found both for the amblyopic and the sound eye in 46 of the 50 patients (92%). The behaviour was different for normal and amblyopic eyes. The improvement remained stable for at least 4 months. These results have been substantiated by the double-blind study. No side effects were observed. CONCLUSION: Citicoline improves visual acuity, at least temporarily, in amblyopic patients beyond the plastic period of the visual system. Our results suggest that trials of citicoline as a medical treatment of amblyopia are warranted.

Adolescent↗

Technique of simultaneous recording of EMG from various extraocular muscles under EOG control.

With this technique simultaneous recording of EMG is shown from various extra-ocular muscles. Electrodes are applied in the muscles during surgical procedures and recordings are performed without discomfort in the following days. The electrical signals are acquired at large bandwidth, and various off-line elaborations are possible. Preliminary results as well as technical details are presented.

Electrodes↗

Regulation of base balance in bicarbonate hemofiltration.

The purpose of this study was to investigate the feasibility of bicarbonate as a substitute for acetate or lactate in hemofiltration solutions using a new bag for the bicarbonate substitution fluid. We analysed 24 hemofiltration sessions with different HCO3- concentrations (30, 35 and 40 mEq/L) in the substitution fluid. The increase in the HCO3- concentration in the substitution fluid resulted in a more positive HCO3- balance. The Net Base Gains (NBG) were, respectively, 73.7 +/- 92 with 30, 138.2 +/- 97 with 35 (p < 0.05 vs 30) and finally 201 +/- 65.9 with 40 mEq/L (p < 0.001 vs 30). The physical separation between the base losses and gains could facilitate the modelling approach in hemofiltration. By means of a stepwise regression analysis, we studied a series of variables that could influence end-treatment HCO3-, which was significantly and directly dependent (F = 6.003, r = 0.747, p = 0.0027) on the HCO3- concentration in the substitution fluid and the apparent HCO3- space. HCO3- values predicted by the statistical model correlated well with those actually measured (r = 0.757; p < 0.001). This mathematical modelling approach allowed us to predict the quantities and concentrations of HCO3- to be infused in order to obtain an ideal acidosis correction, tailored to individual patient needs.

Acid-Base Equilibrium↗

Bizarreness effect in dream recall.

This study aimed to ascertain a) whether morning reports of dream experience more frequently reproduce bizarre contents of night reports than nonbizarre ones and b) whether this effect depends on the rarity of bizarre contents in the dream or on their richer encoding in memory. Ten subjects were awakened in rapid eye movement (REM) sleep three times per night for 4 nonconsecutive nights and asked to report their previous dream experiences. In the morning they were asked to re-report those dreams. Two separate pairs of judges scored the reports: the former identified the parts in each report with bizarre events, characters or feelings and the latter parsed each report into content units using transformational grammar criteria. By combining the data of the two analyses, content units were classified as bizarre or nonbizarre and, according to whether present in both the night and corresponding morning reports, as semantically equivalent or nonequivalent. The proportion of bizarre contents common to night and morning reports was about twice that of nonbizarre contents and was positively correlated to the quantity of bizarre contents present in the night report. These findings support the view that bizarreness enhances recall of dream contents and that this memory advantage is determined by a richer encoding at the moment of dream generation. Such a view would seem to explain why dreams in everyday life, which are typically remembered after a rather long interval, appear more markedly bizarre than those recalled in the sleep laboratory.

Adult↗

Analysis of the factors influencing bicarbonate balance during acetate-free biofiltration.

In acetate-free biofiltration (AFB), the physical separation between the base losses and the gains could facilitate the modeling of intradialytic bicarbonate (HCO3) balance. In order to verify this hypothesis, we analyzed in a multicenter study, 126 AFB sessions in which differing parameters were evaluated (dialysis time, blood flow, ultrafiltration, infused HCO3, pre- and post-dialytic HCO3, hematocrit and body wt). Statistical analysis performed with multiple linear regression showed that the post-dialysis HCO3 was significantly dependent (F = 21.68, d.f. 5.95, P < 0.001) directly on the amount of infused HCO3, the level of pre-dialysis HCO3 and the final body weight, and inversely on the dialysis time and the blood flow. HCO3 values predicted by the statistical model correlated well with the observed ones (r = 0.788, P < 0.0001) with a mean absolute difference of 2.138 mEq/liter. This modeling approach allowed us to predict, with a computer-aided procedure, the quantities of HCO3 to be infused to obtain a desired and personalized acidosis correction.

Acetates↗