An analysis of symptoms in patients with permanent ventricular pacemakers.

The prevalence and severity of symptoms of the "pacemaker syndrome" were investigated in 64 patients with VVI pacemakers and compared, in the same patients, to a series of control symptoms, unrelated to pacemaker function. Symptoms were also compared in patient groups unlikely to have the "pacemaker syndrome" (atrial fibrillation), most likely to have such symptoms (retrograde atrial activation) and in an intermediate group (competitive paced and sinus rhythms). There was a linear relationship between the frequency and severity of "pacemaker" symptoms and control questions in all groups and no preponderance of "pacemaker" symptoms in any group. The study provides an estimate of the number and severity of symptoms in patients with VVI pacemakers, demonstrates the non-specificity of the "pacemaker syndrome" and shows no evidence of a sub-clinical "pacemaker syndrome" in the patients observed.

Informed consent for research. Effects of readability, patient age, and education.

Comprehension of informed consent materials from a study of psychological variables associated with chest pain was evaluated as a function of age (27 to 69 years), education (5 to 20 years), and readability of information [low (college level) versus high (7th grade)]. The potentially confounding effect of memory was eliminated by allowing patients to use the written information sheets to find answers to the multiple choice test. Feedback and a repeat test were provided if any answers were incorrect. The findings indicated that comprehension varied inversely with age and directly with education. It is suggested that while ensuring informed consent may be difficult for all volunteers, it may be a critical problem for elderly patients with low education. The effects of readability were not consistent, suggesting that simplifying informed consent materials by shortening words and sentences may not, by itself, be sufficient to improve comprehension.

Temporal summation functions for detection of sine-wave gratings in young and older adults.

Temporal summation functions for 0.416 and 7.5 c/deg sinusoidal gratings were measured in young and old observers in order to test the hypothesis of a shift in sensitivity from "transient" to "sustained" channels in the aging visual system. Results failed to support the transient-shift hypothesis. Additional tests showed no age-related changes in temporal summation even within a single channel. When all observers were refracted for the test distance and matched for retinal illuminance, no age-related differences in contrast sensitivity were found.

Psychophysical evidence for losses in rod sensitivity in the aging visual system.

Rod sensitivity was measured with a criterion-free psychophysical method at 10 deg in the horizontal meridian of the nasal field of the left eye on 26 young (mean age, 24.1 yr) and 14 older (mean age 72.6 yr) observers in good ocular health. A 1 deg, 90 msec stimulus was delivered by means of a free-viewing optical system under computer control. Stimulus wavelengths were chosen to have either significant (406 nm) or minimal (560 nm) absorption by the older lens. After correction for senile miosis and lens density, 0.39 log unit higher thresholds for the older observers remained and are interpreted as being due to neural factors.

Photophobia in patients with traumatic brain injury: Uses of light-filtering lenses to enhance contrast sensitivity and reading rate.

Patients who have sustained traumatic brain injury (TBI) often experience a new, intense and chronic photophobia. Photophobia, an intolerance to light, is an incompletely understood, subjective symptom, which has been divided into ocular and central types. Various commercial sources of light-filtering lenses have been developed, which have proven to be successful in diminishing visual symptoms expressed by patients who are photophobic. However, despite the many subjective reports of improved visual performance and comfort with use of these filters, there has been little documentation of actual enhanced visual sensitivity/efficiency. Letter contrast sensitivity (CS) and reading rate were measured in patients with TBI, who, despite good ocular health, experienced significant light intolerance. These patients exhibited up to two fold increases (0.3 log units) in binocular letter contrast sensitivity, as measured with the Pelli-Robson Letter CS Chart, in the presence of selected Corning Photochromic Filters (CPF), as compared to performance in the absence of CPF filters, or to that of similarly treated normal observers. These same patients demonstrated reading rates enhanced up to 39% above that measured in the presence of nearpoint optical correction alone. Reading performance of normal observers was unaffected by similar light filtration. These data provide objective evidence for improvement of visual function provided by light-filtering lenses in patients who become photophobic after TBI. Contrast sensitivity testing and assessment of reading rate add objective criteria for the clinical selection of light-filtering lenses in the treatment of TBI-induced photophobia.

Visual information processing speed in hypnotized and nonhypnotized subjects.

Using a backward-masking paradigm with a bias-free and ceiling-free psychophysical task, we tested hypnotized and control subjects for speed of visual information processing. Approximately half of each group received visual imagery suggestions in an attempt to influence attention. Imagery produced no significant differential effect. Although an absence of a hypnotizability-performance relationship was in keeping with findings of a previous study, those subjects in the present study who performed under hypnosis were, as a group, significantly superior to the other subjects in speed of information processing.