Showing papers by "Lino Nobili published in 2000"

Morning increase of whole blood viscosity in obstructive sleep apnea syndrome.

Abstract: Objective: Patients affected by obstructive sleep apnea syndrome (OSAS) have an increased risk of cardiovascular diseases such as stroke and myocardial infarction. The pathophysiological mechanisms leading to increased vascular risk are still matter of debate. A relative morning hyperviscosity could be one of the leading mechanisms of cardiovascular morbidity which is actually known to be especially high in the morning hours. Methods: Whole blood viscosity (WBV) at seven shear rates, ranging from 0.47 to 118 sec -1 , haematocrit (Hct), and plasma fibrinogen (F) concentration, were measured on venous blood samples in 12 patients with OSAS and in 8 healthy controls at 8-9 p.m. and at 7-8 a.m. the morning after. WBV values were normalized on Hct by the computation of the standardised normal deviate z on the normal database of the laboratory. Results: No changes were observed in controls. Hct, F and normalized WBV (independently from Hct changes) significantly increased in the morning hours in OSAS patients. Conclusions: Viscosity of whole blood increases in the morning in OSAS patients but not in healthy controls. This condition may be related to the increased susceptibility to cerebral ischemia in patients affected by OSAS, particularly evident in the early morning.

Spindles-Inducing Mechanism Modulates Sleep Activation of Interictal Epileptiform Discharges in the Landau—Kleffner Syndrome

Abstract: Summary: Purpose: Landau-Kleffner syndrome (LKS) is characterized by a marked increase of interictal epileptiform discharges (IEDs) during sleep. During nonrapid eye movement (NREM) sleep, neuronal membrane potential oscillations lead to the appearance of spindles and delta waves in the surface EEG and might develop into paroxysmal synchronization. Spectral analysis allows the quantitative description of the dynamics of delta (slow-wave activity, SWA, 0.5-4.5 Hz) and sigma activity (SA, 12.0-16.0 Hz) and can be used to assess the relation between SA, SWA, and IEDs during sleep. Methods: We performed six overnight continuous EEGpolysomnographic studies in three patients with LKS. The temporal series of SWA and SA were obtained from a spike-free derivation lead. The IEDs count was performed on the most active lead. Relations between sigma and SWA and time series of IEDs were tested by means of correlation techniques after data normalization. Results: Our results revealed a significantly higher correlation between IEDs and SA with respect to SWA in all the subjects, in total sleep time. The same analysis limited to NREM sleep highlights the better correlation between SA and IEDs. Conclusions: Our data suggest that neural mechanisms involved in the generation of sleep spindles facilitate IEDs production in LKS. Key Words: Landau-Kleffner syndromeSleep-Spindles-Slow-wave activity-Interictal epileptic discharges.

Combined treatment with haloperidol and trazodone in patients with tic disorders.

Abstract: The combination of haloperidol and trazodone was evaluated in an open-label trial in 10 patients with chronic tic and Tourette's syndrome. We found a mean reduction of symptoms of 58.9% on the Yale Global Tic Severity Scale, with a statistically significant difference (p < 0.001) between the baseline and endpoint treatment conditions. This approach significantly reduces clinical symptoms, with the advantage of a lower dose of haloperidol than usual, with no side effects reported by the patients.

[Sleepiness and road accidents among policemen on shif-work on Italian highways: study of the national highway network in the period of 1993-1997].

Abstract: Sleep disorders and daytime sleepiness are the most frequent disturbances reported by shift-workers. Sleepiness and fatigue can increase the risk of human errors and accidents especially during night work. In order to evaluate the time distribution and the possible role of sleepiness on road accidents in policemen on shift-work on highway patrols over 24 hours, we analyzed 1218 car accidents that occurred on the Italian highway network in the period 1993-1997. Accidents occurring during day shifts were significantly correlated with traffic density while accidents occurring during night shifts were not. During the 19:00-01:00 h shift the number of accidents showed a progressively increasing trend with two significant peaks around 23:00 and 01:00 h. Accidents occurring during the 01:00-07:00 h shift did not show significant trends. Information about sleep habits before starting night shifts were obtained by means of telephone interviews. While 85% of the subjects usually took a nap (30-90 min) before the 01:00-07:00 h shift only 15% took a short nap ( Language: it