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Wei Y, Cui Y, Pang X, Wang W. A systematic review and meta-analysis on abnormal posturing among brain injury patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-10. [PMID: 38653484 PMCID: PMC11039044 DOI: 10.1055/s-0044-1785689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/17/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Abnormal motor posturing (AMP), exhibiting as decorticate, decerebrate, or opisthotonos, is regularly noticed among children and adults. OBJECTIVE This systematic review and meta-analysis examined the risk factors and outcome of posturing among severe head and brain injury subjects. METHODS Based on the inclusion and exclusion criteria and using MeSH terms: "decerebrate posturing", "opisthotonic posturing", "brain injury", and/or "cerebral injury" articles were searched on Scopus, PubMed, Science Direct, and google scholar databases. Observational studies, case series, and case reports were included. RESULTS A total of 1953 studies were retrieved initially, and based on the selection criteria, 20 studies were finally selected for review and were analyzed for meta-analysis based on the mortality between the hematomas. The functional outcomes of this study are the risk factors, mortality rate and Glasgow Outcome Scale. Decerebrative patients were higher among the studies related to head injury surgeries. Males were mainly treated for decerebrate postures compared with the female subjects. Extradural hematoma and acute subdural hematoma with cerebral contusion were quite common in the surgical mass lesions. CONCLUSION The findings reported that the lesion types, the operative procedures, and the age of the decerebrating patients with brain injuries are the significant prognostic factors determining the survival outcomes.
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Affiliation(s)
- Yuyu Wei
- Hangzhou Red Cross Hospital, Department of Neurosurgery, Hangzhou, Zhejiang, People's Republic of China.
| | - Yan Cui
- Affiliated Hospital of North Sichuan Medical College, Department of Emergency, Shunqing, Sichuan, People's Republic of China.
| | - Xiaojun Pang
- Hangzhou Red Cross Hospital, Department of Neurosurgery, Hangzhou, Zhejiang, People's Republic of China.
| | - Weijie Wang
- Shandong University, The People's Hospital of Zhaoyuan City, Department of Neurosurgery, Zhaoyuan City, Shandong, People's Republic of China.
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Huerta de la Cruz S, Santiago-Castañeda C, Rodríguez-Palma EJ, Rocha L, Sancho M. Lateral fluid percussion injury: A rat model of experimental traumatic brain injury. Methods Cell Biol 2024; 185:197-224. [PMID: 38556449 DOI: 10.1016/bs.mcb.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Traumatic brain injury (TBI) represents one of the leading causes of disability and death worldwide. The annual economic impact of TBI-including direct and indirect costs-is high, particularly impacting low- and middle-income countries. Despite extensive research, a comprehensive understanding of the primary and secondary TBI pathophysiology, followed by the development of promising therapeutic approaches, remains limited. These fundamental caveats in knowledge have motivated the development of various experimental models to explore the molecular mechanisms underpinning the pathogenesis of TBI. In this context, the Lateral Fluid Percussion Injury (LFPI) model produces a brain injury that mimics most of the neurological and systemic aspects observed in human TBI. Moreover, its high reproducibility makes the LFPI model one of the most widely used rodent-based TBI models. In this chapter, we provide a detailed surgical protocol of the LFPI model used to induce TBI in adult Wistar rats. We further highlight the neuroscore test as a valuable tool for the evaluation of TBI-induced sensorimotor consequences and their severity in rats. Lastly, we briefly summarize the current knowledge on the pathological aspects and functional outcomes observed in the LFPI-induced TBI model in rodents.
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Affiliation(s)
- Saúl Huerta de la Cruz
- Department of Pharmacology, University of Vermont, Burlington, VT, United States; Departamento de Farmacobiología, Cinvestav Sede Sur, Ciudad de México, México.
| | | | - Erick J Rodríguez-Palma
- Neurobiology of Pain Laboratory, Departamento de Farmacobiología, Cinvestav, Sede Sur, Mexico City, Mexico
| | - Luisa Rocha
- Departamento de Farmacobiología, Cinvestav Sede Sur, Ciudad de México, México
| | - Maria Sancho
- Department of Pharmacology, University of Vermont, Burlington, VT, United States; Department of Physiology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
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Liu X, Gu J, Wang C, Peng M, Zhou J, Fei X, Zhong Z, Li B. Ginsenoside Rg3 attenuates neuroinflammation and hippocampal neuronal damage after traumatic brain injury in mice by inactivating the NF-kB pathway via SIRT1 activation. Cell Cycle 2024; 23:662-681. [PMID: 38796716 PMCID: PMC11229723 DOI: 10.1080/15384101.2024.2355008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/07/2024] [Indexed: 05/28/2024] Open
Abstract
This investigation examined the potential of ginsenoside Rg3 in addressing traumatic brain injury (TBI). A TBI mouse model underwent treatment with ginsenoside Rg3 and nicotinamide (NAM). Neurological and motor functions were assessed using modified neurological severity score and rotarod tests. Brain water content in mice was detected. Primary mouse microglia were exposed to lipopolysaccharide (LPS), ginsenoside Rg3, and NAM. Nissl and immunofluorescence staining were utilized to investigate hippocampal damage, and localization of P65, Iba1 and INOS in microglia. Hippocampal neurons were grown in a culture medium derived from microglia. CCK-8 and TUNEL assays were employed to evaluate the viability and apoptosis of hippocampal neurons. Proinflammatory factors and proteins were tested using ELISA, western blot and immunofluorescence staining. As a result, ginsenoside Rg3 enhanced neurological and motor functions in mice post-TBI, reduced brain water content, alleviated hippocampal neuronal neuroinflammation and damage, activated SIRT1, and deactivated the NF-kB pathway. In LPS-stimulated microglia, ginsenoside Rg3 diminished inflammation, activated SIRT1, deactivated the NF-kB pathway, and facilitated nuclear localization of P65 and co-localization of Iba1 and INOS. The effects of ginsenoside Rg3 were countered by NAM in both TBI mice and LPS-stimulated microglia. Hippocampal neurons cultured in a medium containing LPS, ginsenoside Rg3, and NAM-treated microglia showed improved viability and reduced apoptosis compared to those cultured in a medium with LPS and ginsenoside Rg3-treated microglia alone. Ginsenoside Rg3 was effective in reducing neuroinflammation and damage in hippocampal neurons following TBI by modulating the SIRT1/NF-kB pathway, suggesting its potential as a therapeutic agent for TBI.
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Affiliation(s)
- Xi Liu
- Department of Neurosurgery, Changsha of Traditional Chinese Medicine Hospital, Changsha, Hunan, China
| | - Jia Gu
- Hunan International Scientific and Technological Cooperation Base of Brain Tumor Research, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Cheng Wang
- Department of Neurosurgery, Changsha of Traditional Chinese Medicine Hospital, Changsha, Hunan, China
| | - Min Peng
- Department of Neurosurgery, Changsha of Traditional Chinese Medicine Hospital, Changsha, Hunan, China
| | - Jilin Zhou
- Department of Neurosurgery, Changsha of Traditional Chinese Medicine Hospital, Changsha, Hunan, China
| | - Xiyun Fei
- Department of Neurosurgery, Changsha of Traditional Chinese Medicine Hospital, Changsha, Hunan, China
| | - Zhijun Zhong
- Department of Neurosurgery, Changsha of Traditional Chinese Medicine Hospital, Changsha, Hunan, China
| | - Bo Li
- Department of Thoracic Surgery, Changsha of Traditional Chinese Medicine Hospital, Changsha, Hunan, China
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Woo JE, Azariah A, Reed EA, Gut N. Medical, Neurologic, and Neuromusculoskeletal Complications. Phys Med Rehabil Clin N Am 2024; 35:127-144. [PMID: 37993183 DOI: 10.1016/j.pmr.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
For patients with disorders of consciousness (DoC), treating the medical, neurologic, and neuromuscular complications not only stabilizes their medical disturbances, but minimizes confounding factors that may obscure the ability to accurately identify the level of consciousness and increase the chance of patients' neurologic and functional recovery. Lack of reliable communication and low-level function of patients with DoC make it challenging to diagnose some of the complications. Skilled clinical observation will be imperative to appropriately care for the patients.
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Affiliation(s)
- Jean E Woo
- TIRR Memorial Hermann, 1333 Moursund Street, Houston, TX 77030, USA; H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, 7200 Cambridge Street, Houston, TX 77030, USA.
| | - Abana Azariah
- TIRR Memorial Hermann, 1333 Moursund Street, Houston, TX 77030, USA; Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, 1333 Moursund Street, Houston, TX 77030, USA
| | - Eboni A Reed
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, 7200 Cambridge Street, Houston, TX 77030, USA
| | - Nicholas Gut
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, 1333 Moursund Street, Houston, TX 77030, USA
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Barak S, Brezner A, Yissar T, Eisenstein E, Ackerman-Laufer S, Landa J. Gross motor proficiency deficits among children and adolescents post posterior fossa brain tumor removal vs. traumatic brain injury in the chronic phase of recovery: a cross-sectional study. Front Sports Act Living 2024; 6:1284421. [PMID: 38318486 PMCID: PMC10839087 DOI: 10.3389/fspor.2024.1284421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/02/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction Acquired brain injury (ABI) is a prevalent diagnosis in pediatric rehabilitation. Gross motor skills are often affected by ABI and limit the ability to participate in various physical activities. However, as ABI injury location is diverse, children and adolescents (youth) with localized ABI, such as ABI in the posterior fossa (ABI-PF) may present unique and different motor disabilities than youth with ABI on account of traumatic brain injury (TBI). Aims The aims of the study were: (1) to compare gross motor deficits in youth with TBI vs. ABI-PF; and (2) to compare two methods on scoring BOT2 to determine which is better for identifying motor deficits. Methods Participated in this study youth with TBI (N = 50) and ABI-PF (N = 30). Participants were tested on Bruininks-Oseretsky Test of Motor Proficiency-2nd Edition (BOT2) Upper-Limb Coordination, Balance, Strength, Running Speed and Agility, and Bilateral-Coordination subtests. Motor performance deficits were established using two-standard deviations (2SD) and age-equivalent methods. Between-group differences were assessed via independent t-tests and receiver operating characteristic curves (ROC). Results According to the 2SD method, motor deficits in the ABI-PF group ranged from 20% to 66.66%, whereas in the TBI group 8%-16%. According to the age-equivalent method, in the TBI and ABI-PF groups 40%-66.0% and 46.66%-76.66% of the youth presented motor deficits, respectively. Moreover, ROC analysis showed that motor performance deficits of both groups in all sub-scales except for Bilateral Coordination differed enough to result in medium area under the curve. Conclusions Motor deficits post-pediatric ABI are prevalent. In comparison to the TBI group, deficits are greater in the ABI-PF group. Moreover, compared to the 2SD method, the extent of motor deficiency is greater in the age-equivalent method. Therefore, using the later might provide a more valid classification of deficits in gross motor proficiency for youth post-ABI.
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Affiliation(s)
- Sharon Barak
- Department of Nursing, Faculty of Health Science, Ariel University, Ariel, Israel
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
| | - Amichai Brezner
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
| | - Tamar Yissar
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
| | - Etzyona Eisenstein
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
| | - Shirley Ackerman-Laufer
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
| | - Jana Landa
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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Garcia Ruiz PJ, Feliz LD, Feliz CE, Sanchez IL, Fernandez AA, Kelly FB, Tiebas MJT, del Val J, Vinagre IN. The enduring enigma of sporadic chorea: A single center case series. Tremor Other Hyperkinet Mov (N Y) 2023; 13:33. [PMID: 37692071 PMCID: PMC10487123 DOI: 10.5334/tohm.800] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023] Open
Abstract
Chorea can have a wide variety of causes including neurodegenerative, pharmacological, structural, metabolic, infectious, immunologic and paraneoplastic processes. We reviewed the clinical records of patients with apparently sporadic choreic movements and no relevant family history, who presented to our neurology department (Hospital Fundación Jimenez Diaz) between 1991 and 2022. We detected 38 cases of apparent sporadic chorea (ASC); Our analysis revealed 5 cases of genetic chorea (including 3 cases with Huntington's disease) while 6 cases were autoimmune/hematological; 6 drug-related chorea, 5 metabolic-vascular, 5 due to miscellaneous conditions and 4 were of mixed etiology. No clear etiology was identified in 8 cases. The differential diagnosis of ASC is extensive and challenging. Highlights Chorea can have a wide variety of genetic and sporadic causesWe reviewed the clinical records of patients with apparently sporadic chorea (ASC), who presented to our neurology department over the last 30 yearsWe detected 38 cases of apparent ASC; Our analysis revealed a wide array of different sporadic conditions and 5 cases of genetic choreaThe differential diagnosis of ASC is extensive and challenging.
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Affiliation(s)
| | - Lola Diaz Feliz
- Department of Neurology, Fundacion Jimenez Diaz, Madrid, Spain
| | - Cici E. Feliz
- Department of Neurology, Fundacion Jimenez Diaz, Madrid, Spain
| | | | | | | | | | - Javier del Val
- Department of Neurology, Fundacion Jimenez Diaz, Madrid, Spain
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Fanning A, Kuo SH. Clinical Heterogeneity of Essential Tremor: Understanding Neural Substrates of Action Tremor Subtypes. CEREBELLUM (LONDON, ENGLAND) 2023:10.1007/s12311-023-01551-3. [PMID: 37022657 PMCID: PMC10556200 DOI: 10.1007/s12311-023-01551-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/07/2023]
Abstract
Essential tremor (ET) is a common movement disorder affecting millions of people. Studies of ET patients and perturbations in animal models have provided a foundation for the neural networks involved in its pathophysiology. However, ET encompasses a wide variability of phenotypic expression, and this may be the consequence of dysfunction in distinct subcircuits in the brain. The cerebello-thalamo-cortical circuit is a common substrate for the multiple subtypes of action tremor. Within the cerebellum, three sets of cerebellar cortex-deep cerebellar nuclei connections are important for tremor. The lateral hemispheres and dentate nuclei may be involved in intention, postural and isometric tremor. The intermediate zone and interposed nuclei could be involved in intention tremor. The vermis and fastigial nuclei could be involved in head and proximal upper extremity tremor. Studying distinct cerebellar circuitry will provide important framework for understanding the clinical heterogeneity of ET.
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Affiliation(s)
- Alexander Fanning
- Department of Neurology, Columbia University, New York, NY, 10032, USA
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, 10032, USA
| | - Sheng-Han Kuo
- Department of Neurology, Columbia University, New York, NY, 10032, USA.
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, 10032, USA.
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Cacciatore M, Magnani FG, Ippoliti C, Barbadoro F, Anversa P, Portincaso L, Visani E, Navarro J, Devalle G, Lanfranchi M, Pingue V, Marelli S, Ferini Strambi L, Lunardini F, Ferrante S, Tremolati M, Leonardi M, Rossi Sebastiano D, Sattin D. Non-Functional Jaw Muscular Activity in Patients with Disorders of Consciousness Revealed by A Long-Lasting Polygraphy. Diagnostics (Basel) 2023; 13:1053. [PMID: 36980361 PMCID: PMC10046974 DOI: 10.3390/diagnostics13061053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
The presence of involuntary, non-functional jaw muscle activity (NFJMA) has not yet been assessed in patients with disorders of consciousness (DOC), although the presence of bruxism and other forms of movement disorders involving facial muscles is probably more frequent than believed. In this work, we evaluated twenty-two prolonged or chronic DOC patients with a long-lasting polygraphic recording to verify NFJMA occurrence and assess its neurophysiological patterns in this group of patients. A total of 5 out of 22 patients showed the presence of significant NFJMA with electromyographic patterns similar to what can be observed in non-DOC patients with bruxism, thus suggesting a disinhibition of masticatory motor nuclei from the cortical control. On the other hand, in two DOC patients, electromyographic patterns advised for the presence of myorhythmia, thus suggesting a brainstem/diencephalic involvement. Functional, non-invasive tools such as long-lasting polygraphic recordings should be extended to a larger sample of patients, since they are increasingly important in revealing disorders potentially severe and impacting the quality of life of DOC patients.
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Affiliation(s)
- Martina Cacciatore
- SC Neurologia, Salute Pubblica, Disabilità—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (M.C.)
| | - Francesca Giulia Magnani
- SC Neurologia, Salute Pubblica, Disabilità—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (M.C.)
| | - Camilla Ippoliti
- SC Neurologia, Salute Pubblica, Disabilità—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (M.C.)
| | - Filippo Barbadoro
- SC Neurologia, Salute Pubblica, Disabilità—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (M.C.)
| | - Paola Anversa
- SC Neurofisiopatologia—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | | | - Elisa Visani
- SC Epilettologia Clinica e Sperimentale—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Jorge Navarro
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
| | - Guya Devalle
- Vegetative State Unit—IRCCS Don Gnocchi Foundation, 20149 Milan, Italy
| | | | - Valeria Pingue
- Neurorehabilitation and Spinal Unit of Pavia Institute—Istituti Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Sara Marelli
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Centre—IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Luigi Ferini Strambi
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Centre—IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Sleep Disorders Center, Division of Neuroscience, Vita-Salute” San Raffaele University, 2013 Milan, Italy
| | - Francesca Lunardini
- Dipartimento di Neuroscienze Pediatriche—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Simona Ferrante
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Marco Tremolati
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Institute of Geriatric Rehabilitation, Pio Albergo Trivulzio, 20146 Milan, Italy
| | - Matilde Leonardi
- SC Neurologia, Salute Pubblica, Disabilità—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (M.C.)
| | - Davide Rossi Sebastiano
- SC Neurofisiopatologia—Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Davide Sattin
- Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Italy;
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