Quality of vision with presbyopic contact lens correction: subjective and light sensitivity rating.

PURPOSE: To quantify the quality of vision achieved with multifocal and bifocal contact lenses. METHODS: We analyzed differential light sensitivity by computerized automatic perimetry in 21 patients wearing monofocal soft contact lenses (group 1, controls) and multifocal and bifocal contact lenses (groups 2 and 3, respectively). Seven patients each were fitted with multifocal or bifocal contact lenses; seven patients were without contact lenses (without correction for testing the visual periphery and with near-vision correction using monofocal contact lens for testing the central 30 degrees of vision). The type of correction was randomly changed in a crossover fashion so that each eye was examined at different times with different corrections. Humphrey 640 VFA computerized automated perimetry was used to test visual fields at baseline, 45 days, and 3, 4.5, and 6 months. RESULTS: A statistically significant difference was found between the global sensitivities (GS) of the central visual field in patients with near-vision monofocal contact lenses and with bifocal contact lenses (P=0.0273) and between the GS of the central visual fields with multifocal contact lenses and with bifocal contact lenses (P=0.0261). In both cases, the GS were significantly reduced with bifocal contact lenses (total GS: group 1, 11256 dB (Decibels); group 2, 11154 dB; group 3, 10679 dB). CONCLUSIONS: The results indicate that there is reduced differential light sensitivity in the central 30 deg of the visual field with bifocal contact lenses compared with multifocal contact lenses and monofocal contact lenses (controls).

The anterior tilt of the acromion: radiographic evaluation and correlation with shoulder diseases.

The aim of this study was to test whether the anterior tilt of the acromion can be objectively evaluated on lateral radiographs, and whether there is a relation between this anatomical feature and the most common shoulder diseases. Lateral radiographs of 15 dried scapulas were performed in neutral position and with 5 degrees of caudal, cranial, anterior and posterior angulations. Two hundred and forty-three shoulders, both asymptomatic and affected by chronic and post-traumatic impingement, calcific tendinitis and instability, were examined by conventional radiography. The presence of rotator-cuff tears was investigated by sonography. A method was elaborated to obtain reproducible lateral radiographs and to determine the acromial tilt angle. Inter- and intraobserver and inter- and intraoperator variations in measurements were evaluated. Variations in tube angulation produced changes in tilt-angle values on dried scapulas. The average tilt angle for the chronic impingement and the instability groups were significantly different from the post-traumatic, calcific tendinitis and control groups. Rotator-cuff tears were significantly more frequent in the chronic impingement group and related to a more acute tilt angle. The inter- and intraobserver variability coefficients were 0.95 and 0.98, whereas the inter- and intraoperator variability coefficients were 0.94 and 0.96, respectively. Conventional radiography using fluoroscopy for positioning is a well-reproducible method for the evaluation of acromial tilt. There is a significant difference in tilt-angle values between some groups of subjects examined, but the lack of specificity limits the clinical importance of such measurement.

Reductive surgery and ovarian function in the human--can reductive ovarian surgery in reproductive age negatively influence fertility and age at onset of menopause?

A statistical study was carried out on a cohort of 165 women, menopausal for at least 2 years, who had undergone reductive ovarian surgery in fertile age, against nonoperated controls. The purpose of the study was to examine possible interference caused by surgery on fertility performance and age at which the natural menopause starts. It was found that fertility in the operated women was reduced when compared to the controls, although the difference was not of statistical significance. However, the difference between the two groups in mean age at menopause onset was significant (P < .001). The study sample was divided into two sub-groups according to age at operation (<30/>30) and a significant difference between them was found for age at menopause onset, the under-thirty group starting earlier. In particular, the onset of menopause was even earlier in women who had undergone bilateral wedge biopsy for polycystic ovarian syndrome (PCO). The anatomical state of the ovary at operation was also found to be relevant: ovariectomized women with intrinsic ovarian pathology (cysts, tumors or PCO) started the menopause earlier than those without intrinsic diseases (i.e., ectopic pregnancy), suggesting that such intrinsic pathology may cause a primary depletion of the follicles.

[Eating behavior and energy expenditure]. / Comportamento alimentare e spese energetiche.

The relationships between the resting energy expenditure (REE), measured by indirect calorimetry, and eating behavior, assessed by the "Three Factor Eating Questionnaire" were evaluated. The study was carried out in a group of healthy never-obese subjects and in two groups of formerly obese people, who have maintained a normal weight for more than two years. The subjects of the first formerly obese group had brought their body weight to normal by dieting. The second one comprised subjects following biliopancreatic diversion for obesity (BPD) in the long term, who maintain a normal weight because of the intestinal malabsorption due to the operation regardless of food consumption. In comparison with the other subjects, significantly higher cognitive restraint score values were observed in the post-diet subjects. Furthermore, a negative significant correlation between cognitive restraint and REE was found in the non operated subjects, while such correlation was not present in the BPD subjects. Therefore, in normal people cognitive restraint has to be considered to be related to behavioral-cognitive factors rather than biologically driven by energy requirements.

Changes in fibronectin production in rat liver during cirrhotic evolution due to treatment with CCl4 and steroid hormones: correlation with plasmatic fibronectin.

Previous our studies showed that some steroid hormones, as pure crystalline Progesterone (pPc) and 17-alpha-hydroxyprogesterone capronate (17 alpha HPC) heightened the cirrhogenic action produced in rat liver by carbon tetrachloride. Medroxyprogesterone (MPA), however, did not appear to promote cirrhosis, but increased just steatosis. In the present paper, we have studied the above mentioned steroid hormones for their possible capability of inducing changes in plasma fibronectin concentration. For this purpose, the soluble plasma fibronectin level was measured in female rats 45 days after CCl4-induced cirrhosis, and it was compared with the insoluble fibronectin of liver (detected by immunostaining) and the collagen content in the organ. The results obtained show that, after treatment with CCl4 and MPA, both plasma and liver fibronectin content strongly increases, whereas liver collagen content lowers. However, after treatment with CCl4 alone or in association with the other two steroid hormones, any changes in fibronectin content is not observable, but, on the contrary, is evident a heightened collagen production associated with a cirrhotic change of liver.

Ouham-Pendé: a new endemic goiter area in the Centroafrican Republic (CAR): epidemiological survey on 7621 subjects.

The authors report epidemiological observations about a new endemic goiter area in the North western region of the Centro-African Republic (CAR). The research was carried out in 7 quarters of the chief-town (Bocaranga) and in 8 rural villages; 7621 people were examined by the same three of the present Authors who filled in a sample individual form (proposed by WHO) with the generalities and the goiter grading. The data were analyzed according to sex, age and place of residence by means of the common position parameters and the cumulative frequencies, taking into account the goiter grading of each group. The goiter prevalences observed in the rural areas varied from 70.9% (males) to 82.6% (females), whereas in the chief-town they varied from 29.3% (males) to 57.9% (females). Neurological and myxedematous cretins were seen to constitute 3.4% of the visited population. The M/F goitrous ratio was near unity under the age of 6; above this age, females are more widely and severely affected than males. An important fall in goiter prevalence was observed in adult males after the age of 16. The gradings observed in the rural villages, in both females and males of different ages (0-5; 6-15; 16-45; greater than 45 ys.) were significantly more severe than those observed in the chief town (P less than 0.01). The results obtained confirm those of a preliminary survey which the Authors previously carried out on a sample of school children living in the same region of CAR.

[Normotest in the early neonatal period]. / Ii normotest nel periodo neonatale precoce.

The aim of this study is the behavior of Normotest (NT) values in newborns in the first 4 days of life. The study has been carried out between January, 1982, and December, 1984, at the Department of Child Health and Neonatal Medicine - School of Medicine - University of Genoa. The number of infants tested was 1320. 694 were males and 626 females, 529 preterm (G.A. less than 37 weeks) and 791 full term babies. Infants have been tested from one to five times in the first four days of life, with the first evaluation within 12 hours of life. 1215 newborns (92%) presented NT values greater than 20%, 105 babies (8%) had NT below 20% in at least one evaluation, and received Vitamin K1 (0.5 mg/kg i.m.) as prophylaxis, being thereafter excluded from this study. Among the neonate with NT greater than 20%, 426 babies have been considered, who had, at least, three evaluations in the first four days of life. 288 (68%) of the 426 newborns, had not important disease, while 138 (32%) were sick neonates; of these babies 88 (64%) had respiratory distress syndrome and 50 (36%) had an infectious condition. The mean of NT values of the 426 newborns decreased from the first (33.84%) to the 2nd day (32.72%), with a following increment in 3rd (35.29%) and 4th day of life (39.01%). Newborns with gestational age (G.A.) less than 34 weeks showed significantly lower values than newborns with G.A. between 34-37 weeks and those with G.A. greater than 37 weeks. No newborn with NT values greater than 20% either received vitamin K or showed symptoms of haemorrhagic disease in early or later neonatal period.