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Biomedical subjects

R Bergamaschi

Publications and source records attributed to R Bergamaschi.

At least 127 records · Page 7Linked to original sources
PubMed1993

Beta-endorphins during coronary angioplasty in patients with silent or symptomatic myocardial ischemia.

OBJECTIVES: The aims of this study were to correlate beta-endorphin plasma levels and anginal pain in patients with ischemia induced by percutaneous transluminal coronary angioplasty and to detect eventual endorphin variations during balloon occlusion. BACKGROUND: The opioid system appears involved in the absence of pain occurring in silent myocardial ischemia. METHODS: Beta-endorphin plasma levels were measured 24 h before, just before, during and after coronary angioplasty (performed on the left anterior descending artery) in 53 men with documented coronary artery disease and exercise-induced myocardial ischemia. RESULTS: Group 1 (33 patients) reported symptoms; group 2 (20 patients) was asymptomatic during angioplasty. In these patients, the prevalence of exercise-induced silent ischemia was 57%. The occurrence of angina during exercise or angioplasty was related to the frequency of angina during daily life when patients were subgrouped. The severity and distribution of coronary artery disease did not differ between the two groups. During angioplasty, the number of balloon inflations and the inflation time and pressure were similar in symptomatic and asymptomatic patients. In each group, no short-term variability of baseline beta-endorphin plasma levels was observed during 2 consecutive days. Corresponding beta-endorphin plasma levels (at baseline and during and after angioplasty) were significantly higher in Group 2. During balloon occlusion, the levels decreased significantly in the symptomatic group at the onset of angina but remained stable in the asymptomatic group. CONCLUSIONS: Methodologic variables and the severity of coronary artery disease did not influence the presence of symptoms during angioplasty-induced ischemia. Beta-endorphin plasma levels were higher and more stable in patients with silent ischemia during angioplasty, suggesting that opiate levels and their variation during ischemia are associated with individual attitude toward anginal pain.

Adult↗
PubMed1993

Accuracy of self-assessment of the minimal record of disability in patients with multiple sclerosis.

We tested the validity of a self-administered version of the minimal record of disability (MRD) for multiple sclerosis (MS) by measuring the agreement level between patients' self-assessment and neurologists' independent ratings. 96 MS patients and 4 neurologists took part in the experiment; the agreement level was measured in terms of the intraclass correlation coefficient (ICC). On the Kurtzke functional system (FS) the ICC ranged from 0.26 in the sensory to 0.69 in the pyramidal function; a high concordance (ICC = 0.84) was found on the expanded disability status scale (EDSS). The ICC values were above 0.70 for most of the incapacity status scale (ISS) and environmental status scale (ESS) items. A modified, self-administered version of the MRD may represent a reliable instrument for obtaining a comprehensive profile of patients' abilities.

Adolescent↗
PubMed1993

A clinically oriented approach to smooth pursuit eye movement quantitative evaluation.

The electrooculographic technique was used to record smooth pursuit eye movements in 71 healthy subjects homogeneously distributed within an age range between the 2nd and the 6th decades. The target moved at constant velocity (triangular ramps) and 9 different target velocities (V), from 10 deg/s to 50 deg/s were considered and presented according to pseudorandom sequence. Ad hoc software suppressed catch-up saccades so that a pursuit index (PI) value was computed for each ramp taking into account only the smooth pursuit tracking modality. It was demonstrated that the relationship between V and PI could be described by the linear model PI = a + b * V. Pursuit index was proved to be influenced by the age of subject (decade factor in the analysis of variance), since an almost linear increase in b values yields a reduction of pursuit index values. The method was tested in 22 multiple sclerosis patients and an association was found between the occurrence of cerebellar signs and the reduction of a value.

Adolescent↗
PubMed1993

Somatosensory evoked potentials by median nerve stimulation recorded with cephalic and non-cephalic references. I). Normative study.

Somatosensory evoked potentials by median nerve stimulation were obtained in 50 healthy subjects (aged 15-70 years) with cephalic and non cephalic references. Most parameters were influenced by one or more independent variables (sex, age, arm lengths). The coefficients of the appropriate linear models are reported to compute correct individual normal limits.

Adolescent↗
PubMed1993

Somatosensory evoked potentials by median nerve stimulation recorded with cephalic and non-cephalic references. II). Reliability study.

Reliabilities of parameters of median nerve short-latency somatosensory, evoked potential obtained using both cephalic and non-cephalic references was measured in 20 healthy volunteers (aged 20-50 years) who repeated the recording session after one week. All latency measures and peak-to-peak times were highly reliable; amplitudes were less reliable. Upper normal test-retest variability limits of all the analyzed parameters were also computed.

Adolescent↗
PubMed1993

Clinical trials in multiple sclerosis: a critical review (1970-1990).

The present study is a critical review of 100 papers concerning clinical trials in Multiple Sclerosis (MS), published between 1970-1990. We analyzed 20 validity criteria (internal 12, and external 8) and codified each item as "adequate" or "not adequate", so that the validity of each report was quantified. In addition, we used a statistical method of automatic classification (cluster analysis) to subdivide all the papers in 4 groups with growing validity. Only 52 reports had a fairly good or good validity, therefore more efforts are suggested to correctly plan clinical trials in MS and lead to reliable results.

Evaluation Studies as Topic↗
PubMed1993

One-week test-retest reliability of spinal and cortical somatosensory evoked potentials by tibial nerve stimulation.

Spinal (Th12) and cortical somatosensory evoked potentials by right and left posterior tibial nerve stimulation at the ankle were performed in 20 healthy volunteers (10 females and 10 males) aged 23-50 years. The procedure was repeated after one week to assess the reliability of the parameters and to establish upper normal variability limits. Reliability was measured by the intraclass correlation coefficient and was excellent for all absolute latencies and at least good for amplitudes and for the spinal-cortical conduction time. Upper variability limits were calculated using a method based on the within-subject mean square, which can be also applied in the case of more than two repetitions.

Adult↗
PubMed1993

Coelioscopic cholecystectomy: experience with 201 initial patients.

Over a 20-month period, 201 patients underwent laparoscopic cholecystectomy, including 159 women and 42 men (mean age, 44.2 years). Indications included symptomatic cholelithiasis (181 cases), acute cholecystitis (15 cases), gallstone pancreatitis (two cases), and cholangitis (three cases). Mean operating time was 78 min. Overall conversion rate was 5.4% (11 cases). Conversion to open procedure was elective in nine patients and enforced in two because of uncontrollable bleeding from the cystic artery. Three of the former nine patients who were converted subsequently had acute cholecystitis. One case of cellulitis at the umbilical stab wound and one case of bile leak, which drained spontaneously, occurred in patients operated on for acute cholecystitis. Laparotomy was performed on the 7th postoperative day for a liver bed hemorrhage in a patient presenting with cholecystitis. One common bile duct injury occurred in a patient with cholecystitis necessitating a biliary reconstruction. No perioperative deaths occurred. Mean hospital stay was 3.4 days. Despite several advantages, laparoscopic cholecystectomy must be performed by surgeons experienced in biliary tract surgery.

Acute Disease↗
PubMed1993

Migration and slipping of metal clips after celioscopic cholecystectomy.

Most surgeons performing in laparoscopic cholecystectomy have opted for the use of metal clips to secure the cystic duct before division. Accordingly, we have been using double proximal clipping of the cystic duct for our patients. Certain disadvantages of clips are well known, among them, their ability to slip. We report one case of clip migration into the common bile duct, which led to obstructive jaundice. The clip was recovered after endoscopic sphincterotomy. Slipping of the second metal clip lead to biliary peritonitis necessitating surgical drainage. The case presented raises the question of whether suture ligation of the proximal end of the cystic duct should be preferred to clipping.

Cholecystectomy, Laparoscopic↗
PubMed1993

[Cholecystectomy by celioscopy. Apropos of 126 cases].

One hundred twenty-six cases who underwent laparoscopic cholecystectomy were included in the study: 28 males and 98 females with a mean age of 44.2 years. Laparoscopic cholecystectomy was performed for uncomplicated cholelithiasis (111 cases), acute cholecystitis (10 cases), biliary pancreatitis (2 cases) and cholangitis (3 cases). The mean operative time was 78 minutes. In 7 cases, a transformation into open surgery was necessary (5.5%). There were no deaths and one major complication was reported: an iatrogenic injury to the bile duct requiring secondary laparotomy. The mean hospital stay was 3.4 days. However, despite several advantages, this new technique must be performed by a surgeon with experience of biliary tract surgery.

Acute Disease↗
PubMed1993

High-dose methylprednisolone infusions in relapsing and in chronic progressive multiple sclerosis patients. One year follow-up.

Sixty Multiple Sclerosis patients hospitalized either in relapse (28) or in chronic progressive (32) phase of the disease were treated with high-dose methylprednisolone infusions (1 g/daily for 6 days). Clinical examinations, scored by Kurtzke's functional systems (FSs) and expanded disability status scale (EDSS), were performed before treatment, immediately after, and thereafter at 1,3,6 and 12 month intervals. In relapsing cases, 22 patients (78.6%) improved and EDSS mean value decreased by 1.39 points after the treatment; 8 patients had a new bout within one year. In chronic progressive cases, 18 patients (56.2%) improved and EDSS mean value decreased by 0.56 points after the treatment; 13 patients showed a new worsening throughout the follow-up period. The treatment proved to be safe and effective both in relapsing and in chronic progressive patients, determining rapid clinical improvement in most of the cases, and a slowing down of progression in some chronic patients.

Adolescent↗
PubMed1993

Quantitative evaluation of saccadic and smooth pursuit eye movements. Is it reliable?

PURPOSE: The authors evaluated the reliability of the coefficients of the (1) amplitude/duration and (2) amplitude/peak velocity relationships of the mean precision values and the mean latency values (saccadic eye movements) and the coefficients of the target velocity/gain relationship (smooth pursuit eye movements). They computed test-retest maximum variability limits for these parameters. METHODS: After a 1-week interval, saccadic and smooth pursuit eye movements were recorded twice from 20 healthy subjects; 12 of these subjects underwent a third recording session. The estimate of the intraclass coefficient of reliability, R, was adopted to evaluate the reliability of eye movement quantitative analysis. RESULTS: The data demonstrated that the reliability was fairly good for the amplitude/peak velocity relationship, was good for the precision, and was excellent for the amplitude/duration, the target velocity/gain relationships, and the latency. CONCLUSIONS: Quantitative analysis of both saccadic and smooth pursuit eye movements is reliable. One statistic used to estimate reliability, ie, the within-subjects mean square value, also enables the determination of test-retest normal variability values for both the variances and the differences of measurements.

Adult↗
PubMed1992

Multimodal evoked potentials in myotonic dystrophy (MyD).

By means of multimodal evoked potentials (EPs), we evaluated the central nervous system (CNS) involvement in 25 subjects suffering from myotonic dystrophy: brainstem auditory evoked potentials (BAEPs), middle-latency auditory evoked potentials (MLAEPs) and somatosensory evoked potentials (SEPs) from the upper limb were performed on all subjects, whereas only the 19 patients, whose clinical ocular abnormalities were slight, underwent pattern-electretinograms (PERGs) and pattern visual-evoked potentials (VEPs) in order to identify the site of lesion among visual pathways (retinal and/or retroretinal). PERGs were abnormal in 8/19 subjects, VEPs in 8/19 subjects (the two techniques were simultaneously abnormal in 8 eyes), BAEPs in 7/25 subjects, MLAEPs in 4/25 subjects (in one subject both BAEps and MLAEPs were abnormal) and SEPs were abnormal in 1/25 subjects. 13/25 of our subjects showed at least one EP that revealed a CNS involvement. The electrophysiological alterations were not correlated either with subject age or with disease duration. Multimodal EPs enabled us to demonstrate that CNS involvement in myotonic dystrophy is important and mainly affects the visual and auditory system.

Adult↗
PubMed1992

Neuropsychological assessment in MS: clinical, neurophysiological and neuroradiological relationships.

We assessed cognitive performance and its relationship with clinical and anatomic disease severity in MS with mild to moderate handicap; 34 definite MS and 18 healthy subjects matched for age and education were submitted to a neuropsychological test battery. Both groups were examined for anxiety. MS patients underwent magnetic resonance imaging examination. MS performed worse than controls on all WAIS-P subtests and had learning, short- and long-term verbal memory impairment. Cognitive deficits were not related to abnormal emotional states, but were found to be associated with attentional process and information-processing speed impairment. Cognitive impairment did not correlate with severity of physical disability. The most severe memory deficits were found in patients with extensive periventricular damage.

Adult↗
PubMed1992

Spinal and cortical potentials evoked by tibial nerve stimulation in humans: effects of sex, age and height.

Somatosensory evoked potentials by posterior tibial nerve stimulation at the ankle were performed in 74 healthy volunteers (36 females and 38 males) aged 14-76 years. Cortical potentials were obtained in all subjects and spinal potentials (N22) in 71 subjects. All parameters were related to subject's age, height and sex. Sex influenced only P40-N50 amplitude, which was greater in females. All latencies of spinal and cortical components increased in a similar manner with subject's height (about 0.16-0.18 ms per cm), whereas the N22-P40 interpeak latency was independent from height, but related to T12-Cz distance. Absolute latencies of the spinal and of most cortical components, but not interpeak latencies, increased with subject's age (about 0.06-0.09 ms per year). The parameters to compute normative data (according to univariate or bivariate regression models) are furnished. Limits of right-left differences are reported.

Adolescent↗
PubMed1992

A one-week test-retest reliability study of Brainstem Auditory Evoked Potentials.

Brainstem Auditory Evoked Potentials (BAEPs) are increasingly used in longitudinal evaluation of brainstem function. The reliability of the neurophysiological parameters and definition of the normal test-retest variability are required for such investigations. In the present study we submitted 20 healthy volunteers (10 males and 10 females; mean age 35.1 years, range 24-49) to BAEPs in two sessions separated by seven days. The reliability of the parameters was estimated by means of intraclass correlation coefficient (R). All BAEP parameters showed excellent R values (above 0.75). In addition, the confidence interval lower limits of all R coefficients had good to excellent values. Finally we computed the upper normal limits of the test-retest variability of each parameter, with alpha = 0.01, using the within-subjects mean square. The confirmed good reliability of the analyzed parameters enables us to employ BAEPs as useful monitoring instruments in longitudinal studies.

Adult↗
PubMed1992

The reliability of eye movement quantitative evaluation. I. Saccadic eye movements.

We adopted the estimate of the intraclass coefficient of reliability, R, to evaluate the reliability of saccadic eye movements quantitative analysis. At a one-week interval we recorded refixative saccadic eye movements twice from fifteen healthy subjects by means of the binocular electrooculographic technique. R was computed for the constants and the slopes of the amplitude/duration and the amplitude/peak velocity relationships, for the mean precision values and for the mean latency values adjusted for subject's age. Our data demonstrated that the reliability of saccade parameters is fairly good for the amplitude/peak velocity relationship, good for the precision and very good for the amplitude/duration relationship. Finally, we believe that the normal variability values we obtained can be usefully employed in neurophysiological longitudinal studies not only in normal subjects, but also in pathological condition provided the more reliable parameters and the more adequate strategies to compute normal variability values are chosen.

Adult↗