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Biomedical subjects

M Azzolini

Publications and source records attributed to M Azzolini.

15 recordsLinked to original sources

Quantitative study of spontaneous eye blinks and eye tics in Gilles de la Tourette's syndrome.

Spontaneous eye blink rate and frequency of eye tics were studied in nine Tourette patients during periods of rest, conversation, and video watching. In comparison with controls, the Tourette patients showed a significantly higher blink rate during rest and video watching. Conversation induced a significant increase in blink rate in the control group, but not in the Tourette patients, whereas video watching significantly increased blink rate in both groups. The frequency of eye tics showed a significant decrease during conversation and increased significantly during video watching in Tourette patients. In five patients, a significant positive correlation between blink rate and eye tic frequency was found, whereas one patient showed a significant negative correlation. Our results show that, even though some of our patients were on neuroleptic treatment, blink rate was about twofold to threefold increased versus healthy controls, suggesting increased central dopaminergic activity. Furthermore, these first quantitative data illustrate task specific effects on eye tic frequency and the complexity of their relation with eye blinks.

Adult↗

Radial and staggered treatment patterns to correct hyperopia using noncontact holmium:YAG laser thermal keratoplasty.

PURPOSE: To compare the effects of two treatment patterns in the correction of hyperopia by noncontact holmium:YAG laser thermal keratoplasty (LTK). SETTING: Divisione Oculistica, Ospedale S. Gerardo, Monza, Italy. METHODS: Using two treatment patterns, we performed noncontact LTK in one session in 16 eyes of 8 patients with isometropic hyperopic refractive errors; mean preoperative subjective cycloplegic refraction was +4.90 diopters (D) +/- 1.17 (SD). The treatment consisted of 24 spots in three concentric rings of eight spots each; ring diameters were 6.0, 7.0, and 8.0 mm, respectively. Each spot received seven pulses of laser energy at 30 mJ/pulse. We treated one eye of each patient with a radial pattern (the spots of the three rings aligned on the eight semimeridians) and the fellow eye with a staggered pattern (the spots of the contiguous rings at 22.5 degrees from each other). Follow-up at 1, 15, 30, 90, 180, and 360 days included subjective cycloplegic refraction, uncorrected (UCVA) and spectacle-corrected visual acuity (SCVA), computerized videokeratography (CVK), and Scheimpflug camera examination. RESULTS: One year postoperatively, the mean subjective cycloplegic refraction was +2.75 +/- 1.6 D in the eyes treated with the radial pattern and +3.40 +/- 1.6 D in those treated with the staggered pattern; the mean change in subjective cycloplegic refraction was 2.15 and 1.50 D, respectively. Mean UCVA improved by five lines in the radial group and by four lines in the staggered group. Mean SCVA returned to preoperative levels by day 15 in the radial group and at 1 year in the staggered group; at 1 year, SCVA improved by one line in the radial group and remained unchanged in the staggered group. No eye lost one or more lines of SCVA. Refractive astigmatism was essentially unchanged in both groups. Scheimpflug photography and CVK indicated larger and more uniform corrected zones in the radial group. CONCLUSIONS: Radial and staggered patterns effectively corrected low hyperopia, although both were subject to a certain amount of regression. The radial pattern produced faster postoperative recovery of SCVA and demonstrated greater refractive stability.

Adult↗

Long-term results of photorefractive keratectomy for hyperopia and hyperopic astigmatism.

PURPOSE: This study was conducted to determine the safety and efficacy of using the Nidek EC-5000 excimer laser for photorefractive keratectomy to correct hyperopia and hyperopic astigmatism. METHODS: We treated 67 eyes of 44 patients for hyperopia and hyperopic astigmatism with the Nidek EC-5000 excimer laser. The algorithm provided an ablation zone of 5.5 mm diameter with the addition of a tapered transition zone of 3.5 mm diameter, for a total ablation of 9 mm diameter. RESULTS: Uncorrected visual acuity (geometrical mean) changed from 0.16 to 0.37 at 12 months; corrected visual acuity (geometrical mean) changed from 0.8 to 0.89; mean sphere decreased by 2.08 D from 3.76 to 1.40 D (range, 1.70 to 1.68 D) and cylinder by 1.40 D from 2.20 to 1.00 D. Refractive results for < or = 3.00 D were reasonably accurate and stable, but for > +3.00 D, undercorrection and regression over l year were the rule. CONCLUSION: Hyperopic PRK proved to be a safe technique in regard to the risk of loss of visual acuity with no central corneal opacities and with a generally rapid recovery of baseline spectacle-corrected visual acuity, but the predictability of correction greater than +3.00 needs improvement.

Adult↗

Effect of decreasing surface and interface irregularities after photorefractive keratectomy and laser in situ keratomileusis on optical and functional outcomes.

PURPOSE: To assess a new method for decreasing corneal ablated surface irregularities after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) by performing a final smoothing immediately after the treatment. METHODS: One hundred forty-seven eyes with ablation irregularities after PRK or LASIK using the Nidek ED-5000 excimer laser and examined with the Nidek EAS 1000, were randomized into two groups: 74 eyes had final smoothing and 73 eyes were patched immediately. Preoperative mean refraction for the smoothing group was -7.55 +/- 2.50 D and for the patched group, it was -7.30 +/- 1.90 D, (p = 0.04). RESULTS: AT 12 months after treatment, mean haze was 0.5 +/- 0.3 in the smoothing group and 1.2 +/- 0.4 in the patched group (p = 0.006); mean spectacle-corrected visual acuity was 1.1 +/- 0.25 in the smoothing group and 0.95 +/- 0.18 in the patched group (p = 0.02); the percentages of eyes within 1.00 D of the planned correction was 68% in the smoothing group and 33% in the patched group. CONCLUSION: Performing a final smoothing immediately after PRK or LASIK improves refractive and optical outcomes.

Adult↗

A method for examining surface and interface irregularities after photorefractive keratectomy and laser in situ keratomileusis: predictor of optical and functional outcomes.

PURPOSE: To develop a system for the examination of the ablated surface after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and to correlate the surface regularity to the functional outcome. METHODS: A Nidek Eas-1000 Anterior Eye Segment Analysis System was used to examine the ablated surface or the interface regularity immediately after PRK and LASIK. Eighty eyes were evaluated and divided into three study groups; group 1; regularity (18 eyes), group 2; mild irregularity (32 eyes) group 3; severe irregularity (30 eyes). RESULTS: At 12 months postoperatively, group 1 (regularity) showed the best percentage of eyes with 0 haze (100%) and with a refraction +/- 1.00 D of plano (89%); group 2 (mild irregularity) 84% had 0 haze and 62% were +/- 1.00 D of plano; group 3 (severe irregularity) 27% had 0 haze and 47% were +/- 1.00 D of plano. CONCLUSION: The patients with no postoperative irregularity had a sharply lower incidence of haze and a better refractive outcome with respect to plano, confirming the influence of ablation regularity on the results and the importance of this analysis in clinical practice.

Cornea↗

Zonal photorefractive keratectomy for presbyopia.

PURPOSE: We performed zonal excimer laser photorefractive keratectomy in three eyes of three presbyopic patients using a specially designed mask, with a minimum follow-up of 24-months. METHODS: Two females (ages 59 and 48) and one male (age 55) were included in the study. The procedure was performed with a mask designed by one of the authors (GMN), applied to the Aesculap-Meditec Mel 60 excimer laser. The mask consists of a mobile diaphragm formed by two blunt blades. The aim in all the eyes was a presbyopic correction of 3.00 D. RESULTS: After an initial regression of 1.00 D, the presbyopic correction remained stable during the 36-month follow-up. The patients read at least J3 at normal reading distance without correction. Since the ablated zone was only about 15% of the total area of a 3.0 mm pupil, all three patients were also able to read with their preoperative presbyopic correction (using the untreated 85% of the pupillary area). CONCLUSION: Although only three eyes were treated with the zonal presbyopia mask presented here, the visual and refractive outcome appears promising in view of the relatively long follow-up time.

Contrast Sensitivity↗

[Monitoring of cuff pressure in double-lumen endotracheal tubes during anesthesia for thoracic surgery].

It is well known that cuff overinflation in endotracheal tubes may cause serious damage to the tracheal mucosa. Cuff overinflation is also related to the diffusion of nitrous oxide across the cuff membrane, thus giving way to a progressive volume/pressure increase up to overcoming, critical capillaric perfusion pressure. The kinetics of hi-lo cuff-pressure in single-lumen endotracheal tubes during general anesthesia using nitrous oxide has been well documented. The authors have investigated the cuff-pressure modifications in 40 left double-lumen tubes (DLTs), monitoring the inflation pressure for both the endotracheal and endobronchial cuffs at the sealing of the airways and at different phases of the anesthetic procedures performed using nitrous oxide, in 40 male patients undergoing thoracic surgery. In ten of these case, special equipment was used in order to keep the cuff-pressures steady and at the lowest sealing level. The pressure shows the same trend in both cuffs but, depending on the medium calibre of the main left bronchus and the volume/pressure relations of the endobronchial cuffs, the pressure in the latter increases faster. The investigation was performed using an original equipment developed by the authors; such equipment is able not only to monitor the cuff-pressures, but also to maintain them at steady controlled levels (below 20 cm water seal), by means of counterregulating all the volume variations due either to anesthetic requirements, or to the diffusion of nitrous oxide.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗

Photorefractive keratectomy to correct myopic or hyperopic astigmatism with a cross-cylinder ablation.

PURPOSE: To assess the efficacy and safety of a combined ablation of the steep and flat meridian to correct astigmatism with the excimer laser. METHODS: Twenty-two eyes with myopic, mixed, or hyperopic astigmatism (mean preoperative spherical equivalent refraction -4.30 +/- 4.70 D [range, -12.50 to +1.50 D] and mean preoperative cylinder magnitude -3.40 +/- 1.40 D [range, -1.50 to -6.00 D]) underwent PRK with the Nidek EC-5000 excimer laser. The surgical strategy involved ablating half the amount of the cylinder (in diopters) along steepest meridian, the other half in a subsequent step along the flattest meridian; thereafter, the spherical equivalent was corrected. RESULTS: Six months postoperatively, mean spherical equivalent refraction was -0.07 +/- 0.87 D and mean cylinder was -0.44 +/- 0.36 D. Mean spectacle-corrected visual acuity was 0.86 +/- 0.13 compared to 0.75 +/- 0.22 preoperatively. Mean corneal haze was 0.67 +/- 0.31. No patient lost 2 or more lines of spectacle-corrected visual acuity and there were no complaints about night halos or glare. CONCLUSIONS: Unlike other ablation strategies, the cross-cylinder method creates a smooth transition (low dioptric gradient) between the treated and untreated cornea. This is achieved by first treating the cylinder and making the corneal surface spherical and then ablating the spherical component of the refractive error.

Adult↗

Algorithm to correct hyperopic astigmatism with the Nidek EC-5000 excimer laser.

BACKGROUND: The efficacy of a new ablation algorithm for the correction of hyperopic astigmatism with the Nidek EC-5000 excimer laser was evaluated. METHODS: Twenty-five eyes with mean preoperative hyperopia of +3.76 +/- 1.70 D and a mean hyperopic cylinder of 2.20 +/- 0.80 D underwent photorefractive keratectomy (PRK) using a new algorithm with the Nidek EC-5000 excimer laser (software version 3.0). The new algorithm differed from previous algorithms in that less tissue was removed for the same amount of diopters, and there was less of a dioptric gradient between the optical zone and the transition zone. Mean preoperative spectacle-corrected visual acuity was 0.8 +/- 0.09. Minimum follow-up was 6 months. RESULTS: Mean postoperative spectacle corrected visual acuity (geometric mean) increased significantly to 0.89 +/- 0.1. The mean sphere decreased by 3.08 D and the mean cylinder by 1.60 D. CONCLUSION: Hyperopic PRK using the Nidek EC-5000 excimer laser with this new algorithm for hyperopic astigmatism appears to be safe and effective.

Adult↗

[Idiopathic long QT-syndrome. Changes in the duration of the QTC during anesthesia with propofol].

A prolonged electrocardiographic QTc interval may be unsafe during general anesthesia; thus successful anesthetic management in patients affected by congenital long QT syndrome include avoidance of any event that increases sympathetic activity and drugs that prolong QT interval. Propofol seems to have less effect on the QTc interval than tiopentone in normal subjects. This report suggest that propofol administration and infusion in clinical doses in a patient with Jerwell Lange-Nielsen syndrome may be safe and without increase of duration of QTc interval. The most marked changes in HR and QTc followed tracheal intubation and awakening suggesting a specific effect of cathecolamines.

Adolescent↗