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Hussain S, Akhmedov A, Mohammad S, Gkolfos C, Costantino S, Paneni F, Caidahl K, Cosentino F. P4478Cardiac specific overexpression of activated protein-1 transcription factor JunD protects against oxidative stress and left ventricular dysfunction in the diabetic heart. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Costantino S, Bonzanni M, Legchenko E, Paneni F, Mitchell K, Berrino L, Schwarzwald C, Volpe M, Luscher TF, Cosentino F, Napoli A, Landi S, Bucchi A, Vernillo G, Baruscotti M, La Torre A, Difrancesco D, Barbuti A, Kueffner R, Hansmann G. Epigenetics in Cardiac Health and Disease225miR-218 and mi-R34a drive persistent myocardial oxidative stress by targeting chromatin remodelers DNMT3b and SIRT1: new mechanistic insights in diabetic cardiomyopathy226Effects of miRNAs modulated by endurance training on cardiomyocyte excitability227Differential transcriptome and microRNA expression signatures in the healthy heart (RV vs. LV) and the failing, pressure-overloaded right ventricle (SuHx model). Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Forte M, Abbate G, Badalamenti P, Costantino S, Lunesu D, Rusconi R. Validation of a method for measuring (226)Ra in drinking waters by LSC. Appl Radiat Isot 2015; 103:143-50. [PMID: 26093366 DOI: 10.1016/j.apradiso.2015.05.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 04/27/2015] [Accepted: 05/28/2015] [Indexed: 11/17/2022]
Abstract
A simple method for measuring (226)Ra in drinking waters has been validated and validation parameters are provided. It is based on the measurement by LSC of (222)Rn, at equilibrium with (226)Ra, which is absorbed into a water immiscible scintillation cocktail (Ultima Gold F) inside the counting vial. The validated application field ranges between the detection limit (2·10(-3) Bq/kg) to 150 Bq/kg. The method has proven to be reliable, effective and suitable for wide-range measuring campaigns. A summary of results obtained in recent years is also given.
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Beaton L, Mazzaferri J, Lalonde F, Hidalgo-Aguirre M, Descovich D, Lesk MR, Costantino S. Non-invasive measurement of choroidal volume change and ocular rigidity through automated segmentation of high-speed OCT imaging. BIOMEDICAL OPTICS EXPRESS 2015; 6:1694-706. [PMID: 26137373 PMCID: PMC4467714 DOI: 10.1364/boe.6.001694] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 03/17/2015] [Accepted: 03/18/2015] [Indexed: 05/26/2023]
Abstract
We have developed a novel optical approach to determine pulsatile ocular volume changes using automated segmentation of the choroid, which, together with Dynamic Contour Tonometry (DCT) measurements of intraocular pressure (IOP), allows estimation of the ocular rigidity (OR) coefficient. Spectral Domain Optical Coherence Tomography (OCT) videos were acquired with Enhanced Depth Imaging (EDI) at 7Hz during ~50 seconds at the fundus. A novel segmentation algorithm based on graph search with an edge-probability weighting scheme was developed to measure choroidal thickness (CT) at each frame. Global ocular volume fluctuations were derived from frame-to-frame CT variations using an approximate eye model. Immediately after imaging, IOP and ocular pulse amplitude (OPA) were measured using DCT. OR was calculated from these peak pressure and volume changes. Our automated segmentation algorithm provides the first non-invasive method for determining ocular volume change due to pulsatile choroidal filling, and the estimation of the OR constant. Future applications of this method offer an important avenue to understanding the biomechanical basis of ocular pathophysiology.
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Costantino S, Paneni F, Berrino L, Volpe M, Luscher TF, Cosentino F. Hyperglycemia-induced myocardial oxidative stress and inflammation persist despite optimal glycemic control: role of mitochondrial adaptor p66shc. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Paneni F, Costantino S, Battista R, Capretti G, Castello L, Chiandotto S, Volpe M, Luscher TF, Cosentino F. Prolyl-isomerase-1 (pin1) mediates hyperglycemia-induced oxidative stress, endothelial function and vascular inflammation: insights in patients with type 2 diabetes. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Paneni F, Capretti G, Costantino S, Chiandotto S, Akhmedov A, Di Stasio E, Rocca B, Luscher TF, Volpe M, Cosentino F. The lifespan determinant p66shc drives obesity-induced oxidative stress, mitochondrial dysfunction and vascular inflammation. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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33
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Paneni F, Costantino S, Krankel N, Cosentino F, Luscher TF. Aging and longevity genes p66shc and junD mediate age-related dysfunction of angiogenic early outgrowth cells: mechanistic insights into vascular repair. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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34
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Costantino S, Paneni F, Battista R, Castello L, Capretti G, Chiandotto S, Volpe M, Luscher TF, Cosentino F. Acetyltransferase gene non-derepressible 5 mediates hyperglycemia-induced endothelial oxidative stressin patients with type 2 diabetes. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Paneni F, Costantino S, Castello L, Battista R, Capretti G, Chiandotto S, Luscher TF, Lanza G, Volpe M, Cosentino F. Adverse epigenetic remodelling of p66shc gene correlates with persistent endothelial dysfunction and oxidative stress in type 2 diabetics with optimal glycemic control. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht311.5927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Iori I, Gussoni G, Blasi F, Bulfoni A, Costantino S, Legnani D, FASTCAP Study Group OBOT. Guidelines and management of hospitalized patients with community-acquired pneumonia: the Italian experience of the FASTCAP study. ITALIAN JOURNAL OF MEDICINE 2013. [DOI: 10.4081/itjm.2008.1.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Nowadays few data are available addressing the validation of guidelines concerning diagnosis and treatment of Community-Acquired Pneumonia (CAP) in clinical practice. AIM OF THE STUDY To evaluate the impact of compliance to the recommendations issued by the Italian Federation of Internal Medicine (FADOI) in 2002 on the management of hospitalised CAP. METHODS National, multicentre, interventional, “before-after” survey, performed in 31 hospitals in Italy. All patients with CAP of Fine class IV or V (excluding those who were directly admitted to intensive care units) were included. The study was composed of three consecutive periods: 1) a retrospective phase (RP); 2) guideline implementation; 3) a prospective phase (PP). Results were expressed as Odds Ratios (OR) with 95% confidence intervals (95% CI) adjusted for risk factors and corrected for multiple comparisons in subgroups. RESULTS A significant increase in use of combinations was observed in the PP (p = 0.006). Moreover, a shift of prescription from β-lactams to fluoroquinolones as initial monotherapy was recorded. Therapies adherent to FADOI recommendations increased by 10.9% in the PP (p < 0.001). Therapeutic success improved after implementation of recommendations (73.9 vs 71.5%; OR = 0.83; 95% CI = 0.69-1.00; p = 0.049). The difference was particularly evident in Fine class V (58.0 vs 52.5%; OR = 0.71; 95% CI = 0.51-0.98; p = 0.036), where a trend towards a lower mortality occurred (23.1 vs 26.3%; OR = 0.71; 95% CI = 0.48-1.05; p = 0.090). Therapies compliant with FADOI recommendations showed a higher success rate in both study phases (76.6% vs 70.3%; OR = 0.74; 95% CI = 0.60-0.90; p = 0.004). Levofloxacin was the most clinically effective first-cycle therapy with 79.1% of success, the least effective being an antipneumococcal cephalosporin alone with 68.6% (OR = 0.72; 95% CI = 0.51-1.01; p = 0.053). Etiologic diagnosis was obtained in less than 12% of patients in both study phases. Mean lengths of hospital stay were 12.2 and 11.9 days in the RP and PP, respectively. CONCLUSIONS Implementation of FADOI therapeutic recommendations led to a significantly better outcome in terms of clinical success, especially in more severe cases of CAP. Possibly, more “aggressive” approaches towards implementation may result in further improvement in the overall management of CAP.
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Roy S, Meunier J, Marian AM, Vidal F, Brunette I, Costantino S. Automatic 3D reconstruction of quasi-planar stereo Scanning Electron Microscopy (SEM) images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:4361-4. [PMID: 23366893 DOI: 10.1109/embc.2012.6346932] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Scanning Electron Microscopy (SEM) is widely used in science to characterize the surface roughness of materials. Three-dimensional information can be obtained with SEM based on stereovision techniques. A stereo pair is typically obtained by tilting the sample by a few degrees. In this paper we present a fully automated method for 3D reconstruction from a SEM stereo pair without any particular constraint. Results are presented for corneal stromal surfaces.
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Costantino S, Lord H. 47 How are we doing? Clinical audit of patient survival and toxicities following adjuvant chemotherapy for non-small cell lung cancer in NHS Tayside 2005–2010. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70047-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mazzaferri J, Kunik D, Belisle JM, Singh K, Lefrançois S, Costantino S. Analyzing speckle contrast for HiLo microscopy optimization. OPTICS EXPRESS 2011; 19:14508-14517. [PMID: 21934814 DOI: 10.1364/oe.19.014508] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
HiLo microscopy is a recently developed technique that provides both optical sectioning and fast imaging with a simple implementation and at a very low cost. The methodology combines widefield and speckled illumination images to obtain one optically sectioned image. Hence, the characteristics of such speckle illumination ultimately determine the quality of HiLo images and the overall performance of the method. In this work, we study how speckle contrast influence local variations of fluorescence intensity and brightness profiles of thick samples. We present this article as a guide to adjust the parameters of the system for optimizing the capabilities of this novel technology.
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Singh K, Dion C, Lesk MR, Ozaki T, Costantino S. Spectral-domain phase microscopy with improved sensitivity using two-dimensional detector arrays. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2011; 82:023706. [PMID: 21361600 DOI: 10.1063/1.3556787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In this work we demonstrate the use of two-dimensional detectors to improve the signal-to-noise ratio (SNR) and sensitivity in spectral-domain phase microscopy for subnanometer accuracy measurements. We show that an increase in SNR can be obtained, from 82 dB to 105 dB, using 150 pixel lines of a low-cost CCD camera as compared to a single line, to compute an averaged axial scan. In optimal mechanical conditions, phase stability as small as 92 μrad, corresponding to 6 pm displacement accuracy, could be obtained. We also experimentally demonstrate the benefit of spatial-averaging in terms of the reduction of signal fading due to an axially moving sample. The applications of the improved system are illustrated by imaging live cells in culture.
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Singh K, Dion C, Costantino S, Wajszilber M, Lesk M, Ozaki T. Development of a novel instrument to measure the pulsatile movement of ocular tissues. Exp Eye Res 2010; 91:63-8. [DOI: 10.1016/j.exer.2010.03.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Revised: 02/24/2010] [Accepted: 03/25/2010] [Indexed: 11/30/2022]
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Tappero C, Barbero S, Costantino S, Bergui M, Ropolo R, Bradac G, Gandini G. Patient and operator exposure during percutaneous vertebroplasty. Radiol Med 2009; 114:595-607. [PMID: 19444592 DOI: 10.1007/s11547-009-0385-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 06/27/2008] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study was to compare exposure of patient and operator to ionising radiation during percutaneous vertebroplasty performed under combined computed tomography (CT) and fluoroscopic guidance or fluoroscopic guidance alone. MATERIALS AND METHODS With the collaboration of our physics department, we measured exposure on ten patients undergoing vertebroplasty with combined CT and fluoroscopic guidance and on ten undergoing vertebroplasty with fluoroscopic guidance alone. RESULTS Mean operator dose was approximately 0.8 microSv during vertebroplasty done with combined CT and fluoroscopic guidance and 5.8 microSv in procedures with fluoroscopic guidance alone. Mean patient dose was approximately 6 mSv for combined guidance and 8 mSv for fluoroscopic guidance, a difference that was not found to be statistically significant. CONCLUSIONS Although combined CT and fluoroscopic guidance is normally preferred for difficult areas such as the cervical and upper thoracic vertebrae, to ensure operator radiation protection, the technique should also be considered for areas normally treated under fluoroscopic guidance alone. However, a larger patient series is needed to correctly evaluate the real contribution of low-dose CT to patient exposure.
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Canavese F, Valfrè L, Vinardi S, Cortese MG, Costantino S, Macchieraldo R, Bianco E. [A rare case of esophageal atresia type I]. Minerva Pediatr 2009; 61:111-114. [PMID: 19180007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
An extremely rare case of type A esophageal atresia is reported. The baby girl patient born spontaneously after a 38-week pregnancy, was diagnosed prenatally with suspected type A esophageal atresia. Diagnosis was confirmed at birth by chest and abdominal X-ray. As per protocol, a naso-esophageal tube was positioned in aspiration and a Stamm gastrostomy made for nutritional purposes. Evaluation of the distance between blind pouches at one month of life showed they were overlapping. At intervention the pouches were found to be united by a fibrous bridge about 1.5 cm long. Anastomosis was carried out with ease. The postoperative course was trouble-free. On the X day the baby girl was being fed completely per os. Histolo-gical examination of the fibrous residue excluded the presence of a mucosa-lined lumen. X-ray examination of the esophageal-gastric passage, one month after the operation, showed the smooth transit of the contrast medium and an adequate anastomotic lumen. At follow-up, at the age of 9 months, the baby was growing normally and being fed per os with a diet appropriate for her age; no oesophageal dilatation was necessary. Type A oesophageal atresias are long-gap forms: they are treated with direct anastomosis after the blind pouches come together spontaneously in the first four months of life. Stress is laid on the rarity of the case. According to Kluth's classification of 1976, this form was described by Mason in 1855 and Jlott in 1905 on the basis of autopsy findings. A review of the literature did not show any similar clinical cases.
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Blasi F, Iori I, Bulfoni A, Corrao S, Costantino S, Legnani D. Can CAP guideline adherence improve patient outcome in internal medicine departments? Eur Respir J 2008; 32:902-10. [PMID: 18508826 DOI: 10.1183/09031936.00092607] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The impact of compliance with Italian guidelines on the outcome of hospitalised community-acquired pneumonia (CAP) in internal medicine departments was evaluated. All Fine class IV or V CAP patients were included in this multicentre, interventional, before-and-after study, composed of three phases: 1) a retrospective phase (RP; 1,443 patients); 2) a guideline implementation phase; and 3) a prospective phase (PP; 1,404 patients). Antibiotic prescription according to the guidelines increased significantly in the PP. The risk of failure at the end of the firstline therapy was significantly lower in the PP versus the RP (odds ratio (OR) 0.83, 95% confidence interval (CI) 0.69-1.00), particularly in Fine class V patients (OR 0.71, 95% CI 0.51-0.98). Analysis of outcome in the overall population (2,847 patients) showed a statistically significant advantage for compliant versus noncompliant therapies in terms of failure rate (OR 0.74, 95% CI 0.60-0.90) and an advantage in terms of mortality (OR 0.77, 95% CI 0.58-1.04). Antipneumococcal cephalosporin monotherapy was associated with a low success rate (68.6%) and the highest mortality (16.2%); levofloxacin alone and the combination of cephalosporin and macrolide resulted in higher success rates (79.1 and 76.7%, respectively) and significantly lower mortalities (9.1 and 5.7%, respectively). Overall, a low compliance with guidelines in the prospective phase (44%) was obtained, indicating the need for future more aggressive and proactive approaches.
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Mortellaro C, Pucci A, Palmeri A, Lucchina AG, Berta M, Celeste A, Costantino S, Del Prever AB, Forni M. Oral Manifestations of Langerhans Cell Histiocytosis in a Pediatric Population. J Craniofac Surg 2006; 17:552-6. [PMID: 16770197 DOI: 10.1097/00001665-200605000-00028] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Langerhans Cell Histiocytosis is a rare and protean disease of unknown etiology, clinically characterized by single or multiple osteolytic and/or soft tissue lesions. Oral involvement may predate systemic manifestations or mimic infectious/inflammatory disorders. In the present series, oral involvement characterized eight cases of pediatric Langerhans Cell Histiocytosis and oral symptoms represented a very early sign of this disease in four patients. A careful clinical investigation and a proper histologic analysis were required for achieving a definite diagnosis and for confirming clinical suspicion of disease relapse. Immunohistochemistry, that nowadays represents a reliable and accessible ancillary histological technique, allowed the definite diagnosis in all cases of our series.
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Curcio B, Cuttone R, Costantino S. [Polycythemia vera]. LA CLINICA TERAPEUTICA 2005; 156:33-4. [PMID: 16080658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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Costantino S, Milanetti F, Sgambato E, Campanale ER, Cuttone R, Curcio B. [Osteoarthrosis]. LA CLINICA TERAPEUTICA 2004; 155:553-6. [PMID: 15861971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Spoto S, Sgambato E, Costantino S. [Epilepsy]. LA CLINICA TERAPEUTICA 2004; 155:477-9. [PMID: 15702662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Campanale R, Milanetti F, De Galasso L, Costantino S. [Pulse]. LA CLINICA TERAPEUTICA 2004; 155:481-2. [PMID: 15702663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Salvinelli F, Firrisi L, Casale M, Trivelli M, D'Ascanio L, Lamanna F, Greco F, Costantino S. Benign paroxysmal positional vertigo: diagnosis and treatment. LA CLINICA TERAPEUTICA 2004; 155:395-400. [PMID: 15700633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Benign paroxysmal positional vertigo (BPPV) has been recognized as the most common vestibular disorder; it is a term coined in 1952 by Dix and Hallpike, and it is most commonly used to describe a disease with a characteristic clinical presentation believed to be caused by free-floating particles leaving the macula and entering one of the semicircular canals, usually the posterior one, more rarely the horizontal or superior ones. A lot of studies showed as the prevalence is higher in females than in males with a ratio of 2:1; furthermore, prevalence increases with the age: the mean age at onset is 54 years, with a range of 11 to 84 years. The most important clinical manifestations of BPPV are: vertigo, lightheadedness, dysequilibrium and sometimes nausea, vomiting, pallor and sweating. The diagnosis of BPPV is very simple through the Dix-Hallpike test or the diagnostic Semont's maneuver; the increasing information about the BPPV's pathogenesis has led most authors to consider the rehabilitative therapy, and in particular the so-called Semont's "liberatory" maneuver, as the first choice treatment of BPPV, in relation to its quickness and efficacy. In this treatment the debris are moved from the posterior semicircular canal to another location within the vestibular labyrinth. In our review we consider the possible pathogenesis of this disease and the best therapies, like repositioning maneuvers, in a patient affected by BPPV.
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