Severity of obstructive sleep apnoea/hypopnoea syndrome and subsequent waking EEG spectral power.

It is well known that most patients with obstructive sleep apnoea/hypopnoea syndrome (OSAHS) suffer sleepiness, although the underlying mechanisms of this relationship remain unclear. The present study examined the relationship between nocturnal variables and the subsequent waking electroencephalogram (EEG), in order to determine if sleepiness was related to OSAHS severity and due to sleep fragmentation or to nocturnal hypoxaemia. In total, 12 moderate-to-severe OSAHS patients underwent a total sleep night followed by a 24-h period of sustained wakefulness where the waking EEG was measured every hour. The results showed that alpha (7.9-12.6 Hz) and beta (12.7-29.2 Hz) activities were strongly related to OSAHS severity, mainly reflected by the apnoea index. Moreover, spectral power in most of the waking EEG components was significantly correlated with nocturnal hypoxaemia indices, namely alpha and beta activity when hypoxaemia becomes severe. However, no correlation was found between the waking EEG and sleep fragmentation parameters. In conclusion, the present results suggest that the difficulty in maintaining an optimal level of alertness, reflected by a higher activity in awake alpha and beta bands (7.9-29.2 Hz) in obstructive sleep apnoea/hypopnoea syndrome, was better explained by: 1) the apnoea as opposed to the hypopnoea index; and 2) nocturnal hypoxaemia as opposed to sleep fragmentation.

EEG spectral power and sleepiness during 24 h of sustained wakefulness in patients with obstructive sleep apnea syndrome.

OBJECTIVE: This study investigated if obstructive sleep apnea syndrome (OSAS) may be associated with higher activity in different frequency bands of the EEG during a sustained wakefulness paradigm. METHODS: Twelve OSA patients and 8 healthy controls were studied with the Karolinska Drowsiness Test (KDT) and subjective ratings of sleepiness (VAS and KSS) conducted every hour during 24 h of sustained wakefulness. RESULTS: The waking EEG activity, mainly in the low (0.5-7.8 Hz) and fast (12.7-29.2 Hz) frequency band, increased as time awake progressed in both groups but more obviously in OSA patients. A similar pattern was observed for rated sleepiness in both groups. Moreover, VAS ratings of alertness were closely related to the awake theta, fast alpha and beta bands in controls but not in OSA patients. CONCLUSIONS: OSAS was associated with a wake-dependent increase in low (0.5-7.8 Hz) and fast (12.7-29.2 Hz) frequency range activity. Variations in behavioural sleepiness measured by VAS ratings closely reflect most of the waking EEG parameters in controls but not in OSA patients. SIGNIFICANCE: In a sustained wakefulness paradigm, higher activity in delta, theta and beta bands associated with OSAS indicates that OSA patients show marked signs of higher sleepiness and stronger efforts than controls to stay awake, even though they tend to underestimate their sleepiness.

Are OSAS patients impaired in their driving ability on a circuit with medium traffic density?

OBJECTIVES: Many studies have demonstrated that patients with Obstructive Sleep Apnea Syndrome (OSAS), a very common sleep-related breathing disorder, are usually impaired in their driving ability because of decreased sleep quality. However, most of the simulation procedures in laboratories are designed to create monotonic conditions with low traffic density, if any, thereby leading to a dramatic decrease in performance in OSAS patients because of the lack of stimulation. The aim of this study was therefore to evaluate driving abilities in OSAS patients involved in a driving simulation task with medium traffic density, in order to replicate as far as possible real world conditions. The behavioral and physiological attributes likely to predict driving performance in these patients were also investigated. METHODS: After a normal night of sleep, 12 OSAS patients and 8 healthy controls performed 6 driving sessions during a 24-h period of sustained wakefulness. Driving performances (speed, lateral position, distances...) were measured and correlated to sleep parameters and to a waking EEG recorded during the task. RESULTS: Compared to controls, patients showed difficulties in speed adjustment. However, they maintained longer inter-vehicle distances, including during overtaking. Their waking EEG, while driving, showed increased spectral power in theta (3.9-7.8Hz) but also in beta (12.7-29.2Hz) activity, alpha power (7.9-12.6Hz) being increased in both groups due to sustained wakefulness. Poor sleep indices were correlated to increased theta and beta activities, as well as to more cautious behavior. DISCUSSION: In medium traffic density conditions, driving performance in OSAS patients remained at near normal levels, but with more cautious behavior than controls. This could be the result of a bigger effort to stay awake, as suggested by an increased beta activity in these patients.

Seroprevalence and isolation of Toxoplasma gondii from free-range chickens in Ghana, Indonesia, Italy, Poland, and Vietnam.

The prevalence of Toxoplasma gondii in free-ranging chickens (Gallus domesticus) is a good indicator of the prevalence of the parasite's oocysts in soil because chicken feed from the ground. The prevalence of T. gondii in free-range chickens from Ghana, Indonesia, Italy, Poland, and Vietnam was determined using the modified agglutination test (MAT). Antibodies to T. gondii were found in 41 (64%) of 64 chickens from Ghana, 24 (24.4%) of 98 chickens from Indonesia, 10 (12.5%) of 80 chickens from Italy, 6 (30%) of 20 chickens from Poland, and 81 (24.2%) of 330 chickens from Vietnam. Hearts and brains of chickens were bioassayed for T. gondii. Viable T. gondii was isolated from 2 chickens from Ghana, 1 chicken from Indonesia, 3 chickens from Italy, 2 chickens from Poland, and 1 chicken from Vietnam. Toxoplasma gondii isolates from 9 chickens were genotyped using 10 PCR-RFLP markers including SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico. A total of 7 genotypes was identified; the 3 isolates from chickens from Italy were clonal type II, and the others were nonclonal. This is the first report of genetic characterization of T. gondii isolates from animals from these countries.

Toxoplasma gondii infection in horses. A review.

This review updates those written by Dubey and Beattie in 1988 (1988a) and by Tenter et al in 2000, on pathological and epidemiological aspects of Toxoplasma infection in horses. Under natural conditions, seroprevalence may variate from 0% up to 90%. This wide variation may be due to the sensitivity of the serological methods, to the age of animals, to the geographical area, and even to the hygienic condition of the farms and farm management. With few exceptions, horses are considered one of the less sensitive specie to the pathogenic effect of Toxoplasma gondii. In fact, neither under experimental nor under natural condition a genuine pathologic picture related to the toxoplasmic infection has been described. In one occasion the organism has been isolated from an eye condition and in others a connection between a higher frequency of unspecified pathological conditions and a positive response to serological test for Toxoplasma has been speculated. Diaplacental transmission and the following abortion have been only occasionally reported, and at least in one case in a quite trustworthy way, therefore it must be considered possible, though rare. Although infection of humans due to the consumption of horse meat has never been reported, the existence of a possible risk arouses by the demonstration of the presence of parasite stages in either naturally or experimentally infected horses, which resulted to be infective for mice and/or cats.

Defining the states of consciousness.

Consciousness remains an elusive concept due to the difficulty to define what has been regarded for many years as a subjective experience, therefore irrelevant for scientific study. Recent development in this field of research has allowed to provide some new insight to a possible way to define consciousness. Going through the extensive literature in this domain, several perspectives are proposed to define this concept. (1) Consciousness and Attention may not reflect the same process. (2) Consciousness during wake and sleep may not involve the same mechanisms. (3) Besides physiological states of consciousness, human beings can experience modified states of consciousness either by self-training (transcendental meditation, hypnosis, etc.) or by drug intake (hallucinogens, anaesthetics, etc.). Altogether, we address the question of a more precise terminology, given the theoretical weight words can convey. To this respect, we propose different definitions for concepts like consciousness, vigilance, arousal and alertness as candidates to separate functional entities.

Tick-borne diseases (TBDs) of dairy cows in a Mediterranean environment: a clinical, serological, and hematological study.

A longitudinal study of tick-borne diseases (TBDs) in Southern Italy was carried out by monitoring two dairy farms (A and B) located in the Apulia Region. On each farm ten calves and ten heifers were observed monthly from May 1999 to February 2001 for clinical signs and blood parameters; antibodies against Babesia bigemina and Anaplasma marginale using an ELISA test were also monitored for the first eight months of the study. Totals of 28 and 14 cases of TBDs were observed in the complete herds of Farms A and B, respectively. Timing of disease appearance, categories of animals affected and changes in blood parameters are discussed.

Implementation of napping in industry and the problem of sleep inertia.

It seems reasonable to believe that in specific situations napping at the work place would be possible and used if authorized and encouraged. Very short naps could have very positive long-term effects on biological functions. Training someone to sleep for short periods appears feasible if there is a high motivation to do so. Sleep inertia can be considered as one of the main limiting factors in napping strategy. Sleep inertia depends on different factors such as sleep stage preceding the awakening, temporal placement of the nap, duration of nap and wakefulness preceding it, etc. The effects of sleep inertia might be different depending on the type of task, and a reactivation technique applied immediately after awakening may remove it. Despite the fact that its implementation in industry raises some practical issues, napping can be considered as a possible strategy to increase the vigilance level of night workers.

Diurnal rhythmicity for visual sensitivity in humans?

Visual sensitivity rhythm has been assessed by several authors in animals. It shows an intrinsic circadian rhythm of some retinal mechanisms that could account for fluctuating sensitivity to light during the day in these species. However, very little is known concerning a possible circadian rhythm of visual sensitivity in humans. The present experiment was designed to assess a diurnal rhythm of visual sensitivity using psychophysical methods. Two different detection threshold measures (adaptive and constant methods) were applied on 7 highly entrained subjects. The results show a strongly increased visual detection threshold in the morning (8:00 h) in 4 of 7 subjects, followed by an important improvement at 10:00 h, after which time it remains almost constant whatever the method used. But 3 subjects had constant thresholds throughout the day. A "first session" effect as well as a "chronotype" effect were ruled out. The results are discussed in terms of a possible effect of sleep inertia, suggesting a long-lasting effect probably dependent on the type of task.

Visual resolution in humans fluctuates over the 24h period.

The present experiment was designed to assess daily fluctuations of visual discriminability, a function reflecting the resolution power of the visual sensitivity by measure of a differential threshold. Sixteen subjects underwent a visual discrimination threshold task (using the constant method) in a protocol allowing one point every 2h over the 24h period. The results show that the visual discrimination threshold is low in the morning and increases progressively over the day, reaching a first peak at 22:00. During the night, the same pattern occurs, with low threshold levels at the beginning of the night and high levels at the end. This profile is quite different from that of detection threshold variations, suggesting that the two visual functions are under the control of different underlying mechanisms. Two interpretations could account for this discrepancy. The first relates to different oscillators in the eye for detection and discrimination. The second refers to a possible linkage of visual discriminability with the sleep-wake cycle since threshold measures were systematically low (i.e., high resolution power) after long sleep periods.

Variation of visual detection over the 24-hour period in humans.

A circadian rhythm for visual sensitivity has been intensively assessed in animals. This rhythm may be due to the existence of a circadian clock in the mammalian eye, which could account for fluctuating sensitivity to light over the day in certain species. However, very few studies have been devoted to the human visual system. The present experiment was designed to assess a possible rhythm of visual sensitivity using a psychophysical method over the whole 24h period. Twelve subjects underwent visual detection threshold measures in a protocol that allowed one point every 2h. The results show that the visual detection threshold changes over the 24h period, with high thresholds in the morning, a progressive decrease over the day and the early night, and an increase during the last part of the night. These data suggest that a circadian rhythm influences visual sensitivity to mesopic luminance in humans.

Piperacillin versus cefotetan as single-dose prophylaxis in abdominal hysterectomy: a prospective, randomized, multicenter study.

Five hundred and sixty-six women, consecutively admitted to nine different hospitals for elective abdominal hysterectomy, were randomized to receive a single 2 g i.v. dose of either cefotetan or piperacillin at induction of anesthesia. Five patients were excluded and 561 (287 given cefotetan and 274 given piperacillin) could be evaluated. In 10 patients (5 for each drug) the concentrations of either cefotetan or piperacillin in serum and subcutaneous tissue at the beginning and at the end of surgery and in uterus, salpinx and ovary samples, were microbiologically assessed. No significant differences could be found between cefotetan and piperacillin groups for any of the considered infectious complications (bacteremia, wound or vaginal cuff infection, pelvic cellulitis and febrile morbidity) nor for the pooled data (cefotetan group: 4.9%, piperacillin group: 5.8%, p:NS). As for the concentrations of prophylactic drugs, serum levels throughout surgery were found to be adequate.

Disposition of antimony and aminosidine in dogs after administration separately and together: implications for therapy of leishmaniasis.

The pharmacokinetic behaviour of aminosidine (15 mg kg-1) and antimony (25.65 mg kg-1 as N-methylglucamine antimoniate), administered subcutaneously either separately or together was studied on four dogs. The results demonstrated that antimony (Sb) did not significantly modify the kinetics of aminosidine (AM) but that the kinetic behaviour of the metal was markedly influenced by the antibiotic, as shown by the differences in mean residence time (MRT), elimination rate constant (Kel) and area under the curve (AUC) with and without the antibiotic (MRT[Sb] = 243.8 +/- 29.5 minutes, MRT[Sb+AM] = 1067.9 +/- 199.2 minutes; Kel[Sb] = 0.008 +/- 0.001 min-1, Kel[Sb+AM] = 0.0015 +/- 0.0003 min-1; AUC[Sb] = 21,024.6 +/- 4448.5 micrograms min ml-1, AUC[Sb+AM] = 130,478.5 +/- 30,481.7 micrograms min ml-1). The persistence of high serum concentrations of antimony when it was administered with aminosidine suggests that the therapeutic doses commonly used should be reduced and that the interval between administration should be increased to avoid the metal reaching toxic concentrations.

Pharmacokinetics of N-methylglucamine antimoniate after intravenous, intramuscular and subcutaneous administration in the dog.

The pharmacokinetic profile of antimony in dogs was defined by administering it intravenously, intramuscularly and subcutaneously as N-methylglucamine antimoniate at a dose of about 25.65 mg of antimony kg-1 bodyweight. The results showed a different half-life for the three routes of administration: 20.5, 42.1 and 121.6 minutes for the intravenous, intramuscular and subcutaneous routes, respectively; peak time values (Tmax) were also different for the intramuscular (90 to 120 minutes) and subcutaneous (210 to 240 minutes) injection. The apparent bioavailability of antimony was > 100 per cent for the intramuscular and 100 per cent for the subcutaneous routes. The data obtained showed a relevant difference in the behaviour of the drug in the dog in comparison to that in humans.

[Research on intestinal parasitic diseases in dogs of the city of Rome]. / Ricerche sulle parassitosi intestinali dei cani della città di Roma.

A survey on the diffusion of intestinal parasites of dogs in the town of Rome. The results of a survey on the diffusion of cestodes and nematodes in a hundred dogs in Rome are reported. The dogs were subjected to fecal examinations --- using both the flottation method and the McMaster method -- and to the post-mortem examination of the intestine. At post-mortem examination 25 dogs were found parasitized by one or more species of nematodes, 19 by one or more species of cestodes and 12 both by cestodes and nematodes for a total of 56 animals parasitized. The parasites were identifed with the following frequency: Dipylidium caninum 28 per cent, Toxocara canis 17 per cent, Uncinaria stenocephala 15 per cent, Trichuris vulpis 10 per cent, Toxascaris leonina 9 per cent, Taenia pisiformis 4 per cent, Echinococcus granulosus 2 per cent, Ancylostoma caninum, T. hydatigena and Mesocestoides lineatus 1 per cent each. The most frequent parasite found in stray dogs was U. stenocephala (33.3 per cent) while among the dogs with owners the most frequent one was D. caninum (31.8 per cent) which was also identified most frequently in dogs over a year of age (31.1 per cent). The dogs under one year of age were more often affected by T. canis (43.7 per cent). In the paper a review of similar Italian surveys is also given.

Ivermectin against larval stages of Dirofilaria repens in dogs.

The prophylactic efficacy of ivermectin against Dirofilaria repens infections in dogs was investigated. A first trial was carried out on 15 dogs exposed to four inoculations of L3 larvae at 15-day intervals and treated, in groups of five, with 0, 6 or 12 micrograms/kg body weight of ivermectin given per os 30 and 60 days after the first inoculation. Necropsy, performed about 9 months later, revealed that worm burdens were reduced by 86.6 and 92.8% for the 6 and 12 micrograms/kg dose levels, respectively. In a second trial with an otherwise identical protocol, a dose rate of 24 micrograms/kg of ivermectin was tested in 12 dogs. Only one of the six treated dogs was found worm free at necropsy. The worm burden was reduced by 87.9% in treated animals as opposed to controls. A lengthening of the prepatent periods, which might be considered dose related, was apparent in all treated groups. Ivermectin was not completely effective in preventing establishment of experimental infections with D. repens in dogs.

Infection by the warble fly Przhevalskiana silenus Brauer, 1858, in the Italian goats. An update up to 1988.

This paper is a review of the work done at the University of Bari on the goat warble fly Przhevalskiana silenus Brauer, 1858. It reports data concerning taxonomy, biology, and epidemiology of the goat warble fly, as well as therapy against the infection. Grunin in 1962, and later Madel in 1969, were the first researchers to reach the conclusion that the three species of Przhevalskiana up to then recognized--namely P. silenus, P. aegagri, and P. crossii--should be unified in just one--Przhevalskiana silenus. The genetical studies conducted by us on the third instar larvae with the use of 9 gene-enzyme systems confirmed the assumption that P. silenus is the only species which parasitizes goats. Studies were conducted on the external life-cycle of the parasite with the purpose of elucidating the relationship existing among time of dropping, length of time needed for adults to emerge from pupae, and temperature of the environment. Both total sum of temperature and length of time seem to play an important role in determining the duration of the pupal stage. Epidemiological data derived from a two-year survey carried out in six infected groups of goats are also reported. The interrelationship existing among prevalence, mean intensity, variance, variance/mean rate, and parameter K of the negative binomial are presented. It appears that age, parameter K, and variance of infection intensity are closely related. A trial experiment was also carried out to evaluate the efficacy of ivermectin against a natural infection with P. silenus larvae. A single subcutaneous injection of 1% ivermectin was given, at doses of 50, 100 or 200 micrograms/kg b.w. The drug was found to be fully effective at all three doses.

The efficacy of ivermectin against Strongyloides papillosus in cattle.

The efficacy of ivermectin was evaluated against Strongyloides papillosus in four controlled trials in cattle. Thirty-four animals were inoculated subcutaneously with S. papillosus 3rd stage larvae 14-24 days before treatment. At 7-14 days after treatment, calves were slaughtered and the number of adult S. papillosus present in the small intestine counted. Faecal egg counts were carried out before and after treatment. Seventeen control animals received a single subcutaneous injection of vehicle solution at a dose volume of 1 ml/50 kg body weight, and 17 calves were treated once with ivermectin at 200 mcg/kg b.w. using a 1% injectable solution (IVOMEC Injection Merck & Co., Inc.), subcutaneously. The control animals had a mean burden of 5,913 worms, while ivermectin significantly (p less than 0.01) reduced the number of adults S. papillosus by more than 99%. There was a greater than 99% reduction in the faecal egg count of treated animals at the last faecal examination compared with that pre-treatment.

Identification of Theileria buffeli/orientalis and Babesia bigemina in Apulian cattle using molecular techniques and study of changes in blood parameters.

Recently several cases of theileriosis due to the haemoprotozoan Theileria buffeli/orientalis have been recorded in the Apulian region, Italy. In this area other tick-borne pathogens were usually identified such as Anaplasma marginale and Babesia bigemina. Outbreaks were recorded showing that these pathogens can be observed separately or in mixed infections. Sub-clinical cases and carrier animals were also previously identified. A lack of specific techniques could not rule out the presence of other haemoparasites such as T. annulata, B. divergens, B. bovis, Ehrlichia phagocytophila and E. bovis. Moreover little is known about the tick species involved in the dissemination of these diseases. Therefore more powerful techniques to specifically identify Theileria or Babesia species have been recently developed. A PCR technique and reverse line blotting (RLB) system to specifically identify six Theileria species and three Babesia species were used. T. buffeli/orientalis and B. bigemina were the only pathogens observed in the targeted animals. The authors also present some changes in blood parameters for the animals followed during this study.

[Echinococcus granulosus infection in urban areas]. / Infezione urbana da Echinococcus granulosus.

In a previous survey, carried out in 100 dogs in Rome by Tassi and Widenhorn (1977), two animals, which always lived in the urban area, were found infected by Echinococcus granulosus. An urban infection was therefore hypothized. During a following experiment 6 three-month old Beagle dogs were fed for nine months with raw meat sold in the butcheries of Rome as "food for pets". Two dogs of the same breed and origin were fed for the same period with canned food and were kept as control animals. At the end of the experiment three of the six dogs were found infected by E. granulosus, while the renmant three and the two controls resulted negative. An additional similar trial was carried out in Bologna. Three dogs were fed for seven months with the same kind of raw meat sold in three butcheries of Bologna, and a fourth dog was kept as control. At the end of the seven months also one of the three dogs was found infected by E. granulosus. These results seem to confirm the hypothesis of an urban infection by E. granulosus in dogs. Various possibilities of contamination of raw meat sold in butcheries as food for animals are discussed.