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Biomedical subjects

G Bernardi

Publications and source records attributed to G Bernardi.

At least 37 records · Page 2Linked to original sources

Are new technologies always reducing patient doses in cardiac procedures?

Dynamic digital flat-panel (FD) imaging technology is characterised by a higher sensitivity and image quality compared to image intensifier (II) technology. In this study, an angiography system based on II and one based on FD were compared with respect to system performance and impact of patient dose in interventional cardiology. When entrance surface air kerma rates are measured, the FD system requires a reduced dose rate, of up to 40%. For coronary angiography (CA), fluoroscopy time (FT) and dose-area product (DAP) were 4.3 +/- 5.0 min and 31.2 +/- 30.2 Gy cm2 on the II system and 4.4 +/- 3.8 min and 33.4 +/- 19.2 Gy cm2 with the FD system. For percutaneous transluminal coronary angiography, FT and DAP were 11.4 +/- 10.7 min and 52.1 +/- 45.0 Gy cm2 on II and 10.7 +/- 8.7 min and 66.9 +/- 54.4 Gy cm2 on DF. Data comparison suggests that reduced entrance dose rates do not automatically imply a reduction of patient dose in clinical practice.

Cardiology↗

Image quality criteria in cardiology.

Image quality evaluation plays a key role in the process of optimisation in radiological procedures. Image quality criteria for cardiac cine-angiography were recently agreed as part of a European Research Project, and a scoring system based on these criteria has been developed to allow an 'objective' measurement of the quality of cardiac angiograms. Two studies aimed at the evaluation of the methodology have been completed, demonstrating that the method can be applied to cardiac images and translated into a scoring system that yields reproducible data. Based on the results of these studies, quality criteria have been further reviewed by DIMOND III panel and the updated version is presented in this paper.

Cardiology↗

Patient skin dosimetry in haemodynamic and electrophysiology interventional cardiology.

With the increase in number and complexity of interventional cardiology (IC) procedures, it is important to monitor skin dose in order to decrease skin injuries. This study investigated radiation doses for patients undergoing IC procedures, compare results with the literature and define a local dose-area product trigger level for operators to identify situations likely to exceed the threshold for transient skin erythema of 2 Gy. Dosimetric data were collected for 77 haemodynamic and 90 electrophysiological procedures. Mean maximum local skin doses (MSDs) were 0.28 Gy for coronary angiography, 1.03 Gy for percutaneous transluminal coronary angioplasty (PTCA), 0.03 Gy for pacemaker insertion, 0.17 Gy for radiofrequency ablation for nodal tachycardia, 0.10 Gy for WPW and 0.22 Gy for atrial flutter. Since MSD values for the other procedures were well below the deterministic effect limit, a trigger level of 140 Gy cm2 was derived for PTCA procedures alone.

Angioplasty, Balloon, Coronary↗

Retrospective evaluation of occurrence of skin injuries in interventional cardiac procedures.

Interventional cardiology procedures can involve high doses to patients and, in particular, to patients' skin, the tissue at greatest risk of deterministic injuries. The evaluation of skin dose from interventional procedures is recommended, but difficult because of the amount of different X-ray fields and projections used in a procedure. For this reason, a retrospective follow-up study has been developed to identify skin injuries in patients submitted to one or more cardiac interventions in the Udine hospital between 1998 and 2002. Seventy-eight patients with a cumulative dose-area product >300 Gy cm2 were selected from 3332 patients, who underwent 5039 procedures. In this group the maximum skin dose was 6.7 Gy. The clinical follow-up, performed using the LENT-SOMA methodology, has not detected skin injuries and this result allows a frequency to be estimated for skin injuries in patients undergoing repeated cardiac procedures of <3 x 10(-4) in our centre.

Aged↗

Dose to cardiologists in haemodynamic and electrophysiology cardiac interventional procedures.

Interventional cardiac procedures can be complex and involve extensive use of low dose rate fluoroscopy and high dose rate in image acquisition mode; hence, staff may receive significant radiation exposure. Radiation exposure to operators was assessed in 173 procedures. Fluoroscopy time, number of acquired images and dose-area product were recorded and occupational dose assessed with thermoluminescence dosemeters. The effective dose to the operator was compared with relevant literature data: values found were generally lower than those reported for other interventional cardiology laboratories. This is probably because of the strict radiation protection policy in our centre. Higher effective doses were found for defibrillator implantation and percutaneous transluminal coronary angiography procedures; for other cardiac procedures, effective dose was lower. Yearly extrapolated occupational doses to cardiologists are lower than the regulatory dose limit and in the lower band of doses reported in the literature.

Algorithms↗

Search for the Higgs boson in H --> WW(*) decays in pp collisions at square root of 1.96 TeV.

We present a search for the standard model Higgs boson in H --> WW(*) decays with e+e-, e+/-mu-/+, and mu+mu- final states in pp collisions at a center-of-mass energy of square root of s = 1.96 TeV. The data, collected from April 2002 to June 2004 with the D0 detector, correspond to an integrated luminosity of 300-325 pb(-1), depending on the final state. The number of events observed is consistent with the expectation from backgrounds. Limits from the combination of all three channels on the Higgs boson production cross section times branching ratio sigma x BR(H --> WW(*) are presented.

Journal Article↗

Deep brain stimulation in Parkinson's disease patients: biochemical evidence.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson's disease (PD) patients augments STN-driven excitation of the internal globus pallidus (GPi). However, other DBS-induced changes are largely unknown. Here we report the biochemical effects of STN-DBS in two basal ganglia stations (putamen--PUT--and GPi) and in a thalamic relay nucleus, the anteroventral thalamus (VA). In six advanced PD patients undergoing surgery, microdialysis samples were collected from GPi, PUT and VA before, during and after one hour of STN-DBS. cGMP was measured in the GPi and PUT as an index of glutamatergic transmission, whereas GABA was measured in the VA. During clinically effective STN-DBS, we found a significant decrease in GABA extracellular concentrations in the VA (-25%). Simultaneously, cGMP extracellular concentrations were enhanced in the PUT (+200%) and GPi (+481%). DBS differentially affects fibers crossing the STN area: it activates the STN-GPi pathway while inhibiting the GPi-VA one. These findings support a thalamic dis-inhibition, as the main responsible for the clinical effect of STN-DBS. This, in turn, re-establishes a more physiological level of PUT activity.

Aged↗

High plasma creatine kinase: review of the literature and proposal for a diagnostic algorithm.

The condition of persistently high plasma CK levels is frequently encountered in asymptomatic patients with normal neurological examination. This condition may be the unique manifestation of several neuromuscular disorders, whose diagnosis is now possible using new diagnostic techniques. However, even if these patients are intensely investigated, specific diagnoses are not always forthcoming. Because of the lack of a widely accepted diagnostic protocol, hyperCKaemia in asymptomatic subjects is a potentially difficult clinical problem. In this paper we review the literature on conditions associated with variations in plasma CK levels and the literature on investigations carried out in asymptomatic persons with high CK to identify neuromuscular diseases. In the light of these data, and the deliberations of a working group of the Italian Association of Myology, we propose a diagnostic algorithm to guide the diagnostic work-up of persons presenting with persistently high levels of plasma CK. This algorithm has been discussed and approved by the Committee of the Italian Association of Myology.

Algorithms↗

Measurement of semileptonic branching fractions of B mesons to narrow D** states.

Using the data accumulated in 2002-2004 with the D0 detector in proton-antiproton collisions at the Fermilab Tevatron collider with a center-of-mass energy of 1.96 TeV, the branching fractions of the decays B --> D0(1)(2420)mu+ vmuX and B --> D2(*0)(2460)mu+ vmuX and their ratio have been measured: B(b --> B) x B(B --> D0(1)mu+ vmuX) x B(D0(*0) --> D*- pi+) = [0.087 +/- 0.007(stat) +/- 0.014(syst)]%; B(b --> B) x B(B --> D2(*0) mu+ vmuX) x B(D2(*0) --> D*- pi+) = [0.035 +/- 0.007(stat) +/- 0.008(syst)]% and [B(B --> D2(*0)mu+ vmuX) x B(D2(*0) --> D*- pi+)]/[B(B --> D0(1)mu+ vmuX) x B(D0(1) --> D*- pi+)] = 0.39 +/- 0.09(stat) +/- 0.12 (syst), where the charge conjugated states are always implied.

Journal Article↗

Measurement of the lifetime difference in the B0(s) system.

We present a study of the decay B0(s) --> J/psiphi. We obtain the CP-odd fraction in the final state at time zero, Rperpendicular = 0.16 +/- 0.10(stat) +/- 0.02 (syst), the average lifetime of the (B0(s), B0(s)) system, tau(B0(s)) = 1.39(+0.13)(-0.16)(stat)(+0.01)(-0.02)(syst) ps, and the relative width difference between the heavy and light mass eigenstates, DeltaGamma/Gamma tripple bond (GammaL - GammaH)/Gamma = 0.24(+0.28)(-0.38)(stat)(+0.03)(-0.04)(syst). With the additional constraint from the world average of the lifetime measurements using semileptonic decays, we find tau(B0(s)) = 1.39 +/- 0.06 ps and DeltaGamma/Gamma = 0.25(+0.14)(-0.15). For the ratio of the B0(s) and B0 lifetimes we obtain tau(B0(s))/tau(B0) = 0.91 +/- 0.09(stat) +/- 0.003(syst).

Journal Article↗

Search for large extra spatial dimensions in dimuon production with the d0 detector.

We present the results of a search for the effects of large extra spatial dimensions in pp collisions at sqrt[s] = 1.96 TeV in events containing a pair of energetic muons. The data correspond to 246 pb(-1) of integrated luminosity collected by the D0 experiment at the Fermilab Tevatron Collider. Good agreement with the expected background was found, yielding no evidence for large extra dimensions. We set 95% C.L. lower limits on the fundamental Planck scale between 0.85 and 1.27 TeV within several formalisms. These are the most stringent limits achieved in the dimuon channel to date.

Journal Article↗

Search for supersymmetry via associated production of charginos and neutralinos in final states with three leptons.

A search for associated production of charginos and neutralinos is performed using data recorded with the D0 detector at a pp center-of-mass energy of 1.96 TeV at the Fermilab Tevatron Collider. This analysis considers final states with missing transverse energy and three charged leptons, of which at least two are electrons or muons. No evidence for supersymmetry is found in a data set corresponding to an integrated luminosity of 320 pb-1. Limits on the product of the production cross section and leptonic branching fraction are set. For the minimal supergravity model, a chargino lower mass limit of 117 GeV at the 95% C.L. is derived in regions of parameter space with enhanced leptonic branching fractions.

Journal Article↗

Search for neutral supersymmetric Higgs Bosons in multijet events at sqrt[s]=1.96 TeV.

We have performed a search for neutral Higgs bosons produced in association with bottom quarks in pp collisions, using 260 pb-1 of data collected with the D0 detector in Run II of the Fermilab Tevatron Collider. The cross sections for these processes are enhanced in many extensions of the standard model (SM), such as in its minimal supersymmetric extension at large tanbeta. The results of our analysis agree with expectations from the SM, and we use our measurements to set upper limits on the production of neutral Higgs bosons in the mass range of 90 to 150 GeV.

Journal Article↗

Production of WZ events in pp collisions at square root(s) = 1.96 TeV and limits on anomalous WWZ couplings.

We present results from a search for WZ production with subsequent decay to l nu l' l' (l and l' = e or mu) using 0.30 fb(-1) of data collected by the D0 experiment between 2002 and 2004 at the Fermilab Tevatron. Three events with WZ decay characteristics are observed. With an estimated background of 0.71 +/- 0.08 events, we measure the WZ production cross section to be 4.5(-2.6)(+3.8) pb, with a 95% C.L. upper limit of 13.3 pb. The 95% C.L. limits for anomalous WWZ couplings are found to be -2.0 < delta kappaZ < 2.4 for form factor scale lambda = 1 TeV, and -0.48 < lambdaZ < 0.48 and -0.49 < delta g(1)(Z) < 0.66 for lambda = 1.5 TeV.

Journal Article↗

Search for Randall-Sundrum gravitons in dilepton and diphoton final states.

We report the first direct search for the Kaluza-Klein (KK) modes of Randall-Sundrum gravitons using dielectron, dimuon, and diphoton events observed with the D0 detector operating at the Fermilab Tevatron pp(-) Collider at sqrt[s]=1.96 TeV. No evidence for resonant production of gravitons has been found in the data corresponding to an integrated luminosity of approximately equal to 260 pb(-1). Lower limits on the mass of the first KK mode at the 95% C.L. have been set between 250 and 785 GeV, depending on its coupling to standard model particles.

Journal Article↗

Partial resistance of ataxin-2-containing olivary and pontine neurons to axotomy-induced degeneration.

Spinocerebellar ataxia type 2 (SCA2) is caused by the expansion of a polyglutamine tract in ataxin-2, the SCA2 gene product. In spite of the identification of the genetic defect and the coded protein, the function of wild-type ataxin-2 has not been clarified. In order to identify the possible resistance of ataxin-2-containing neurons to degeneration, we investigated in this study the distribution and the characteristics of cell reaction to axotomy in ataxin-2-positive olivary and pontine neurons in a model of cerebellar damage represented by hemicerebellectomy. We also performed double immunofluorescence studies of ataxin-2 and purinergic receptors to characterize ataxin-2-positive surviving neurons. The present data demonstrated that after axotomy olivary and pontine ataxin-2-expressing neurons survived longer than the ataxin-2-negative cell population. Cell counting performed in the different olivary subdivisions failed to reveal any topographical prevalence in the distribution of ataxin-2-positive neurons. Therefore, the relative resistance to axotomy appears to be an intrinsic property of the ataxin-2 cell population. In addition, the capacity to modify the pattern of purinergic receptor expression in response to damage was present in only one subset of ataxin-2-positive surviving neurons. These data suggest that ataxin-2 is involved in resistance to degeneration phenomena which may be lost after mutation.

Animals↗

Sildenafil increases cerebrovascular reactivity: a transcranial Doppler study.

The authors performed a double-blind, placebo-controlled study in 28 patients to evaluate the effects of sildenafil on cerebral hemodynamics. A significant improvement of cerebrovascular reactivity, without any modification of other variables, was recorded 1 hour after the administration of 50 mg sildenafil. Further investigations are needed to evaluate whether cerebrovascular reactivity improvement could contribute to triggering sildenafil-induced migraine.

Aged↗

Study of Zgamma events and limits on anomalous ZZgamma and Zgammagamma couplings in pp collisions at square root s = 1.96 TeV.

We present a measurement of the Zgamma production cross section and limits on anomalous ZZgamma and Zgammagamma couplings for form-factor scales of lambda = 750 and 1000 GeV. The measurement is based on 138 (152) candidates in the eegamma (mumugamma) final state using 320(290) pb(-1) of pp(-1) collisions at square root of s = 1.96 TeV. The 95% C.L. limits on real and imaginary parts of individual anomalous couplings are /h(10,30)Z/ < 0.23, /h(20,40)Z/ < 0.020, /h(10,30)gamma/ < 0.23, and /h(20,40)gamma/ < 0.019 for lambda = 1000 GeV.

Journal Article↗