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Sangro B, Chan SL, Kelley RK, Lau G, Kudo M, Sukeepaisarnjaroen W, Yarchoan M, De Toni EN, Furuse J, Kang YK, Galle PR, Rimassa L, Heurgué A, Tam VC, Van Dao T, Thungappa SC, Breder V, Ostapenko Y, Reig M, Makowsky M, Paskow MJ, Gupta C, Kurland JF, Negro A, Abou-Alfa GK. Four-year overall survival update from the phase III HIMALAYA study of tremelimumab plus durvalumab in unresectable hepatocellular carcinoma. Ann Oncol 2024; 35:448-457. [PMID: 38382875 DOI: 10.1016/j.annonc.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND In the phase III HIMALAYA study (NCT03298451) in unresectable hepatocellular carcinoma (uHCC), STRIDE (Single Tremelimumab Regular Interval Durvalumab) significantly improved overall survival (OS) versus sorafenib; durvalumab monotherapy was noninferior to sorafenib for OS. Results reported herein are from a 4-year updated OS analysis of HIMALAYA. PATIENTS AND METHODS Participants with uHCC and no previous systemic treatment were randomized to STRIDE (n = 393), durvalumab (n = 389), or sorafenib (n = 389). The updated data cut-off was 23 January 2023. OS and serious adverse events (AEs) were assessed. Additionally, baseline characteristics and subsequent therapies were analyzed in long-term survivors (≥36 months beyond randomization). RESULTS For STRIDE, durvalumab, and sorafenib, median [95% confidence interval (CI)] follow-up was 49.12 months (46.95-50.17 months), 48.46 months (46.82-49.81 months), and 47.31 months (45.08-49.15 months), respectively. OS hazard ratio (95% CI) for STRIDE versus sorafenib was 0.78 (0.67-0.92). The 36-month OS rate for STRIDE was 30.7% versus 19.8% for sorafenib. The 48-month OS rate remained higher for STRIDE at 25.2%, versus 15.1% for sorafenib. The long-term OS benefit of STRIDE was observed across clinically relevant subgroups and was further improved in participants who achieved disease control. Long-term survivors with STRIDE (n = 103) included participants across clinically relevant subgroups, and 57.3% (59/103) had no reported subsequent anticancer therapy. No new serious treatment-related AEs occurred with STRIDE from the primary analysis (17.5%; 68/388). Durvalumab maintained OS noninferiority to sorafenib and no late-onset safety signals were identified. CONCLUSIONS These data represent the longest follow-up to date in phase III studies in uHCC. The unprecedented 3- and 4-year OS rates reinforce the sustained long-term OS benefit of STRIDE versus sorafenib. STRIDE maintained a tolerable yet differentiated safety profile from other current uHCC therapies. Results continue to support the long-term benefits of STRIDE in a diverse population, reflective of uHCC globally.
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MESH Headings
- Humans
- Carcinoma, Hepatocellular/drug therapy
- Carcinoma, Hepatocellular/mortality
- Carcinoma, Hepatocellular/pathology
- Liver Neoplasms/drug therapy
- Liver Neoplasms/mortality
- Liver Neoplasms/pathology
- Male
- Female
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Middle Aged
- Aged
- Sorafenib/administration & dosage
- Sorafenib/therapeutic use
- Sorafenib/adverse effects
- Survival Rate
- Adult
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Affiliation(s)
- B Sangro
- Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and CIBEREHD, Pamplona, Spain.
| | - S L Chan
- State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Sir Yue-Kong Pao Center for Cancer, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - R K Kelley
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, USA
| | - G Lau
- Humanity and Health Clinical Trial Center, Humanity and Health Medical Group, Hong Kong SAR, China
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - W Sukeepaisarnjaroen
- Department of Medicine, Songklanagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - M Yarchoan
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, USA
| | - E N De Toni
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
| | - J Furuse
- Kanagawa Cancer Center, Yokohama, Japan
| | - Y K Kang
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - P R Galle
- Department of Internal Medicine I, University Medical Center, Mainz, Germany
| | - L Rimassa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan; Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Heurgué
- Department of Hepato-Gastroenterology, Robert-Debré Hospital, Reims, France
| | - V C Tam
- Tom Baker Cancer Centre, Department of Oncology, University of Calgary, Calgary, Canada
| | - T Van Dao
- Cancer Research and Clinical Trials Center, Department of Optimal Therapy, National Cancer Hospital, Hanoi, Vietnam
| | - S C Thungappa
- Health Care Global Enterprises Ltd, Bangalore, India
| | - V Breder
- N. N. Blokhin Russian Cancer Research Center, Chemotherapy Unit, Moscow, Russia
| | - Y Ostapenko
- Department of Minimally Invasive and Endoscopic Surgery, Interventional Radiology, National Cancer Institute, Kyiv, Ukraine
| | - M Reig
- Barcelona Clinic Liver Cancer (BCLC), Liver Unit, Hospital Clinic de Barcelona, IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spain
| | - M Makowsky
- Oncology R&D, Late-Stage Development, AstraZeneca, Gaithersburg
| | - M J Paskow
- Global Medical Affairs, AstraZeneca, Gaithersburg
| | - C Gupta
- Oncology Biometrics, Late Oncology Statistics, AstraZeneca, Wilmington
| | - J F Kurland
- Oncology R&D, Late-Stage Development, AstraZeneca, Gaithersburg
| | - A Negro
- Oncology R&D, Late-Stage Development, AstraZeneca, Gaithersburg
| | - G K Abou-Alfa
- Department of Medicine, Memorial Sloan Kettering Cancer Center, Cornell University, New York; Weill Medical College, Cornell University, New York, USA; Trinity College Dublin, Dublin, Ireland
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Scutelnic A, van de Munckhof A, Miraclin AT, Aaron S, Hameed S, Wasay M, Grosu O, Krzywicka K, Sánchez van Kammen M, Lindgren E, Moreira T, Acampora R, Negro A, Karapanayiotides T, Yaghi S, Revert A, Cuadrado Godia E, Garcia-Madrona S, La Spina P, Grillo F, Giammello F, Nguyen TN, Abdalkader M, Buture A, Sofia Cotelli M, Raposo N, Tsivgoulis G, Candelaresi P, Ciacciarelli A, Mbroh J, Batenkova T, Scoppettuolo P, Zedde M, Pascarella R, Antonenko K, Kristoffersen ES, Kremer Hovinga JA, Jood K, Aguiar de Sousa D, Poli S, Tatlisumak T, Putaala J, Coutinho JM, Ferro JM, Arnold M, Heldner MR. Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19. Eur Stroke J 2024:23969873241241885. [PMID: 38572798 DOI: 10.1177/23969873241241885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Previous reports and meta-analyses derived from small case series reported a mortality rate of up to 40% in patients with coronavirus disease 2019 associated cerebral venous thrombosis (COVID-CVT). We assessed the clinical characteristics and outcomes in an international cohort of patients with COVID-CVT. PATIENTS AND METHODS This was a registry study of consecutive COVID-CVT patients diagnosed between March 2020 and March 2023. Data collected by the International Cerebral Venous Thrombosis Consortium from patients with CVT diagnosed between 2017 and 2018 served as a comparison. Outcome analyses were adjusted for age and sex. RESULTS We included 70 patients with COVID-CVT from 23 hospitals in 15 countries and 206 controls from 14 hospitals in 13 countries. The proportion of women was smaller in the COVID-CVT group (50% vs 68%, p < 0.01). A higher proportion of COVID-CVT patients presented with altered mental state (44% vs 25%, p < 0.01), the median thrombus load was higher in COVID-CVT patients (3 [IQR 2-4] vs 2 [1-3], p < 0.01) and the length of hospital stay was longer compared to controls (11 days [IQR 7-20] vs 8 [4-15], p = 0.02). In-hospital mortality did not differ (5/67 [7%, 95% CI 3-16] vs 7/206 [3%, 2-7], aOR 2.6 [95% CI 0.7-9]), nor did the frequency of functional independence after 6 months (modified Rankin Scale 0-2; 45/58 [78%, 95% CI 65-86] vs 161/185 [87%, 81-91], aOR 0.5 [95% CI 0.2-1.02]). CONCLUSION In contrast to previous studies, the in-hospital mortality rate and functional outcomes during follow-up did not differ between COVID-CVT patients and the pre-COVID-19 controls.
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Affiliation(s)
- Adrian Scutelnic
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anita van de Munckhof
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Angel T Miraclin
- Department of Neurosciences, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Sanjith Aaron
- Department of Neurosciences, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | | | | | - Oxana Grosu
- Institute of Neurology and Neurosurgery "Diomid Gherman," Chisinau, Republic of Moldova
| | - Katarzyna Krzywicka
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Mayte Sánchez van Kammen
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Erik Lindgren
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Tiago Moreira
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Roberto Acampora
- Department of Neurology and Stroke Unit, Ospedale del Mare Hospital, Naples, Italy
| | - Alberto Negro
- Department of Neurology and Stroke Unit, Ospedale del Mare Hospital, Naples, Italy
| | - Theodoros Karapanayiotides
- 2nd Department of Neurology, Aristotle University of Thessaloniki, School of Medicine, AHEPA University Hospital, Greece
| | - Shadi Yaghi
- Department of Neurology, Brown University, Providence, RI, USA
| | - Anna Revert
- Hospital del Mar, Faculty of Medicine and Life Sciences, Pompeu Fabra University Barcelona, Spain
| | - Elisa Cuadrado Godia
- Hospital del Mar, Faculty of Medicine and Life Sciences, Pompeu Fabra University Barcelona, Spain
| | | | - Paolino La Spina
- Translational Molecular Medicine and Surgery 36th Cycle, Department of BIOMORF, Stroke Unit, Department of Clinical and Experimental Medicine, University Hospital G. Martino, Messina, Italy
| | - Francesco Grillo
- Translational Molecular Medicine and Surgery 36th Cycle, Department of BIOMORF, Stroke Unit, Department of Clinical and Experimental Medicine, University Hospital G. Martino, Messina, Italy
| | - Fabrizio Giammello
- Translational Molecular Medicine and Surgery 36th Cycle, Department of BIOMORF, Stroke Unit, Department of Clinical and Experimental Medicine, University Hospital G. Martino, Messina, Italy
| | - Thanh N Nguyen
- Neurology, Boston Medical Center, MA, USA
- Radiology, Boston Medical Center, MA, USA
| | | | - Alina Buture
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Nicolas Raposo
- Department of Neurology, University Hospital of Toulouse, Toulouse, France
| | - Georgios Tsivgoulis
- Second Department of Neurology, National & Kapodistrian University of Athens, School of Medicine, "Attikon University Hospital", Athens, Greece
| | | | - Antonio Ciacciarelli
- Neurology Division, Santa Maria Goretti Hospital, Latina, Italy
- Department of Translation and Precision Medicine, Sapienza University of Rome, Italy
| | - Joshua Mbroh
- Department of Neurology & Stroke, University Hospital Tuebingen, Eberhard-Karls University, Tuebingen, Germany
| | | | - Pasquale Scoppettuolo
- Neurology Department, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Marialuisa Zedde
- Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Rosario Pascarella
- Neuroradiology Unit, Azienda Unità Sanitaria-IRCCS di Reggio Emilia, Italy
| | - Kateryna Antonenko
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Johanna A Kremer Hovinga
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Katarina Jood
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Diana Aguiar de Sousa
- Lisbon Central University Hospital and Faculdade de Medicina da Universidade de Lisboa, Portugal
| | - Sven Poli
- Department of Neurology & Stroke, University Hospital Tuebingen, Eberhard-Karls University, Tuebingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tuebingen, Germany
| | - Turgut Tatlisumak
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Jukka Putaala
- Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jonathan M Coutinho
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - José M Ferro
- Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Marcel Arnold
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mirjam R Heldner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Negro A, Cesarani A, Cortellari M, Bionda A, Fresi P, Macciotta NPP, Grande S, Biffani S, Crepaldi P. A comparison of genetic and genomic breeding values in Saanen and Alpine goats. Animal 2024; 18:101118. [PMID: 38508133 DOI: 10.1016/j.animal.2024.101118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
Nowadays, several countries are developing or adopting genomic selection in the dairy goat sector. The most used method to estimate breeding values is Single-Step Genomic Best Linear Unbiased Prediction (ssGBLUP) which offers several advantages in terms of computational process and accuracy of the estimated breeding values (EBVs). Saanen and Alpine are the predominant dairy goat breeds in Italy, and both have similar breeding programs where EBVs for productive traits are currently calculated using BLUP. This work describes the implementation of genomic selection for these two breeds in Italy, aligning with the selection practices already carried out in the international landscape. The available dataset included 3 611 genotyped animals, 11 470 lactation records, five traits (milk, protein and fat yields, and fat and protein percentages), and three-generation pedigrees. EBVs were estimated using BLUP, GBLUP, and ssGBLUP both with single and multiple trait approaches. The methods were compared in terms of correlation between EBVs and genetic trends. Results were also validated with the linear regression method excluding part of the phenotypic data. In both breeds, EBVs and GEBVs were strongly correlated and the trend of each trait was similar comparing the three methods. The average increase in accuracy across traits and methods amounted to +13 and +10% from BLUP to ssGBLUP for Alpine and Saanen breeds, respectively. Results indicated higher prediction accuracy and correlation for GBLUP and ssGBLUP compared to BLUP, implying that the use of genotypes increases the accuracy of EBVs, particularly in the absence of phenotypic data. Therefore, ssGBLUP is likely to be the most effective method to enhance genetic gain in Italian Saanen and Alpine goats.
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Affiliation(s)
- A Negro
- Ufficio Studi, Associazione Nazionale della Pastorizia, 00187 Rome, Italy; Dipartimento di Scienze Agrarie e alimentari, Università degli studi di Milano, 20133 Milan, Italy
| | - A Cesarani
- Dipartimento di Scienze Agrarie, Università degli Studi di Sassari, 07100 Sassari, Italy; Department of Animal and Dairy Science, University of Georgia, Athens, GA, USA
| | - M Cortellari
- Dipartimento di Scienze Agrarie e alimentari, Università degli studi di Milano, 20133 Milan, Italy
| | - A Bionda
- Dipartimento di Scienze Agrarie e alimentari, Università degli studi di Milano, 20133 Milan, Italy.
| | - P Fresi
- Ufficio Studi, Associazione Nazionale della Pastorizia, 00187 Rome, Italy
| | - N P P Macciotta
- Dipartimento di Scienze Agrarie, Università degli Studi di Sassari, 07100 Sassari, Italy
| | - S Grande
- Ufficio Studi, Associazione Nazionale della Pastorizia, 00187 Rome, Italy
| | - S Biffani
- Istituto di Biologia e Biotecnologia, Consiglio Nazionale delle Ricerche, 20133 Milan, Italy
| | - P Crepaldi
- Dipartimento di Scienze Agrarie e alimentari, Università degli studi di Milano, 20133 Milan, Italy
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Somma F, Negro A, Tortora M, Gemini L, Pace G, Fasano F, Piscitelli V, Sicignano C, Prudente M, Falco AD, Villa A, Lugarà M, Pezzullo G, D'Agostino V, Gatta G. Sex life and low back pain: The impact of intradiscal ozone therapy in patients with herniated lumbar disc. Interv Neuroradiol 2023:15910199231183108. [PMID: 37321647 DOI: 10.1177/15910199231183108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES To assess the improvement of sexual impairment after percutaneous intradiscal ozone therapy in patients complaining of low back pain (LBP) due to lumbar disc herniation. METHODS Between January 2018 and June 2021, 157 consecutive imaging-guided percutaneous intradiscal ozone therapies were performed on 122 patients with LBP and/or sciatic pain due to lumbar disc herniation. Oswestry Disability Index (ODI) was administered before the treatment and at 1-month and 3-month follow-ups and the ODI Section 8 (ODI-8/sex life) values were retrospectively reviewed to evaluate the improvement of sexual impairment and disability. RESULTS Mean age of patients was 54.63 ± 12.40. Technical success was achieved in all cases (157/157). Clinical success was registered in 61.97% (88/142) of patients at 1-month follow-up and in 82.69% (116/142) at 3-month follow-up. The mean ODI-8/sex life was 3.73 ± 1.29 before the procedure, 1.71 ± 1.37 at 1-month follow up and 0.44 ± 0.63 at 3-month follow-up. Compared to older patients, subjects under 50 years showed a significantly slower recovery of sexual impairment (p = 0.003). The treated levels were L3-L4, L4-L5, and L5-S1 in 4, 116, and 37 patients, respectively. Patients with L3-L4 disc herniation showed less sexual disability at presentation, with a significantly faster improvement of sexual life (p = 0.03). CONCLUSIONS Percutaneous intradiscal ozone therapy is highly effective in reducing sexual impairment due to lumbar disc herniation, and the improvement is faster in older patients and in the case of L3-L4 disc involvement.
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Affiliation(s)
- Francesco Somma
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Alberto Negro
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Mario Tortora
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italia
| | - Laura Gemini
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italia
| | - Gianvito Pace
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Fabrizio Fasano
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Valeria Piscitelli
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Carmine Sicignano
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Mariaevelina Prudente
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Arturo De Falco
- Neurology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Alessandro Villa
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Marina Lugarà
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Giovanna Pezzullo
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Vincenzo D'Agostino
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Gianluca Gatta
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Caserta, Italia
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Gemini L, Tortora M, Giordano P, Prudente ME, Villa A, Vargas O, Giugliano MF, Somma F, Marchello G, Chiaramonte C, Gaetano M, Frio F, Di Giorgio E, D'Avino A, Tortora F, D'Agostino V, Negro A. Vasari Scoring System in Discerning between Different Degrees of Glioma and IDH Status Prediction: A Possible Machine Learning Application? J Imaging 2023; 9:jimaging9040075. [PMID: 37103226 PMCID: PMC10143099 DOI: 10.3390/jimaging9040075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/04/2023] [Accepted: 03/21/2023] [Indexed: 04/28/2023] Open
Abstract
(1) The aim of our study is to evaluate the capacity of the Visually AcceSAble Rembrandt Images (VASARI) scoring system in discerning between the different degrees of glioma and Isocitrate Dehydrogenase (IDH) status predictions, with a possible application in machine learning. (2) A retrospective study was conducted on 126 patients with gliomas (M/F = 75/51; mean age: 55.30), from which we obtained their histological grade and molecular status. Each patient was analyzed with all 25 features of VASARI, blinded by two residents and three neuroradiologists. The interobserver agreement was assessed. A statistical analysis was conducted to evaluate the distribution of the observations using a box plot and a bar plot. We then performed univariate and multivariate logistic regressions and a Wald test. We also calculated the odds ratios and confidence intervals for each variable and the evaluation matrices with receiver operating characteristic (ROC) curves in order to identify cut-off values that are predictive of a diagnosis. Finally, we did the Pearson correlation test to see if the variables grade and IDH were correlated. (3) An excellent ICC estimate was obtained. For the grade and IDH status prediction, there were statistically significant results by evaluation of the degree of post-contrast impregnation (F4) and the percentage of impregnated area (F5), not impregnated area (F6), and necrotic (F7) tissue. These models showed good performances according to the area under the curve (AUC) values (>70%). (4) Specific MRI features can be used to predict the grade and IDH status of gliomas, with important prognostic implications. The standardization and improvement of these data (aim: AUC > 80%) can be used for programming machine learning software.
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Affiliation(s)
- Laura Gemini
- Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 80131 Naples, Italy
| | - Mario Tortora
- Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 80131 Naples, Italy
| | - Pasqualina Giordano
- Oncology Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Maria Evelina Prudente
- Neuroradiology Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Alessandro Villa
- Neurosurgery Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Ottavia Vargas
- Neuroradiology Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | | | - Francesco Somma
- Neuroradiology Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Giulia Marchello
- CNRS, Laboratoire J.A. Dieudonné, Inria, Universitè Côte d'Azur, Avenue Valrose, 06108 Nice, France
| | - Carmela Chiaramonte
- Neurosurgery Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Marcella Gaetano
- Radiotherapy Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Federico Frio
- Neurosurgery Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Eugenio Di Giorgio
- Nuclear Medicine Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Alfredo D'Avino
- Pathological Anatomy Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Fabio Tortora
- Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 80131 Naples, Italy
| | - Vincenzo D'Agostino
- Neuroradiology Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
| | - Alberto Negro
- Neuroradiology Unit, Ospedale del Mare ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
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Capasso R, Negro A, Russo C, Zeccolini F, Muto G, Caranci F, Pinto A. Conventional and advanced MRI techniques in the evaluation of primary CNS lymphoma. Semin Ultrasound CT MR 2023; 44:126-135. [DOI: 10.1053/j.sult.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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Altamura C, Ornello R, Ahmed F, Negro A, Miscio AM, Santoro A, Alpuente A, Russo A, Silvestro M, Cevoli S, Brunelli N, Grazzi L, Baraldi C, Guerzoni S, Andreou AP, Lambru G, Frattale I, Kamm K, Ruscheweyh R, Russo M, Torelli P, Filatova E, Latysheva N, Gryglas-Dworak A, Straburzynski M, Butera C, Colombo B, Filippi M, Pozo-Rosich P, Martelletti P, Sacco S, Vernieri F. OnabotulinumtoxinA in elderly patients with chronic migraine: insights from a real-life European multicenter study. J Neurol 2023; 270:986-994. [PMID: 36326890 DOI: 10.1007/s00415-022-11457-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Although migraine prevalence decreases with aging, some older patients still suffer from chronic migraine (CM). This study aimed to investigate the outcome of OnabotulinumtoxinA (OBT-A) as preventative therapy in elderly CM patients. METHODS This is a post hoc analysis of real-life prospectively collected data at 16 European headache centers on CM patients treated with OBT-A over the first three treatment cycles (i.e., Cy1-3). We defined: OLD patients aged ≥ 65 years and nonOLD those < 65-year-old. The primary endpoint was the changes in monthly headache days (MHDs) from baseline to Cy 1-3 in OLD compared with nonOLD participants. The secondary endpoints were the responder rate (RR) ≥ 50%, conversion to episodic migraine (EM) and the changes in days with acute medication use (DAMs). RESULTS In a cohort of 2831 CM patients, 235 were OLD (8.3%, 73.2% females, 69.6 years SD 4.7). MHDs decreased from baseline (24.8 SD 6.2) to Cy-1 (17.5 SD 9.1, p < 0.000001), from Cy-1 to Cy-2 (14.8 SD 9.2, p < 0.0001), and from Cy-2 to Cy-3 (11.9 SD 7.9, p = 0.001). DAMs progressively reduced from baseline (19.2 SD 9.8) to Cy-1 (11.9 SD 8.8, p < 0.00001), to Cy-2 (10.9 SD 8.6, p = 0.012), to Cy-3 (9.6 SD 7.4, p = 0.049). The 50%RR increased from 30.7% (Cy-1) to 34.5% (Cy-2), to 38.7% (Cy-3). The above outcome measures did not differ in OLD compared with nonOLD patients. CONCLUSION In a population of elderly CM patients with a long history of migraine OBT-A provided a significant benefit, over the first three treatment cycles, as good as in non-old patients.
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Affiliation(s)
- Claudia Altamura
- Unit of Headache and Neurosonology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
| | - R Ornello
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio 1 Coppito, 67100, L'Aquila, Italy
| | - F Ahmed
- Department of Neurosciences, Hull University Teaching Hospitals, Hull, UK
| | - A Negro
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, 00189, Rome, RM, Italy
| | - A M Miscio
- Unit of Neurology, Headache Center, Fondazione IRCCS "Casa Sollievo Della Sofferenza", San Giovanni Rotondo, FG, Italy
| | - A Santoro
- Unit of Neurology, Headache Center, Fondazione IRCCS "Casa Sollievo Della Sofferenza", San Giovanni Rotondo, FG, Italy
| | - A Alpuente
- Headache Unit, Department of Neurology, Vall d'Hebron University, Barcelona, Spain
- Headache and Neurological Pain Research Group, Department of Medicine, Vall d'Hebron Institute of Research (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - A Russo
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences, Headache Center, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M Silvestro
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences, Headache Center, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - S Cevoli
- IRCCS Istituto delle scienze Neurologiche di Bologna, Bologna, Italy
| | - N Brunelli
- Unit of Headache and Neurosonology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - L Grazzi
- Neurology Department, Headache Center, IRCCS Foundation "Carlo Besta" Neurological Institute, Via Celoria,11, 20133, Milan, Italy
| | - C Baraldi
- Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology-Headache Center and Drug Abuse, Laboratory of Clinical Pharmacology and Pharmacogenomics, Department of Specialist Medicines, AOU Policlinico Di Modena, Modena, Italy
| | - S Guerzoni
- Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology-Headache Center and Drug Abuse, Laboratory of Clinical Pharmacology and Pharmacogenomics, Department of Specialist Medicines, AOU Policlinico Di Modena, Modena, Italy
| | - A P Andreou
- Headache Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - G Lambru
- Headache Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - I Frattale
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio 1 Coppito, 67100, L'Aquila, Italy
| | - K Kamm
- Department of Neurology, Ludwig Maximilians University München, Munich, Germany
| | - R Ruscheweyh
- Department of Neurology, Ludwig Maximilians University München, Munich, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany
| | - M Russo
- Neurology Unit, Neuromotor and Rehabilitation Department, Headache Center, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - P Torelli
- Headache Center, University of Parma, Parma, Italy
| | - E Filatova
- Department of Neurology, Institute for Postgraduate Education, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | | | - M Straburzynski
- Headache Clinic, Terapia Neurologiczna Samodzielni, Maurycego Mochnackiego 10, 02-042, Warsaw, Poland
| | - C Butera
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - B Colombo
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Filippi
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - P Pozo-Rosich
- Headache Unit, Department of Neurology, Vall d'Hebron University, Barcelona, Spain
- Headache and Neurological Pain Research Group, Department of Medicine, Vall d'Hebron Institute of Research (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - P Martelletti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, 00189, Rome, RM, Italy
| | - S Sacco
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio 1 Coppito, 67100, L'Aquila, Italy
| | - F Vernieri
- Unit of Headache and Neurosonology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
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Negro A, Tortora M, Gemini L, de Falco A, Somma F, d’Agostino V. Neurological manifestations of COVID-19: a retrospective observational study based on 1060 patients with a narrative review. Acta Radiol 2022; 64:1950-1957. [PMID: 36451533 PMCID: PMC9720471 DOI: 10.1177/02841851221138557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background In the past two decades, three coronavirus epidemics have been reported. Coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome (SARS)-like coronavirus (SARS-CoV-2). In most patients, the disease is characterized by interstitial pneumonia, but features can affect other organs. Purpose To document the radiological features of the patients and to perform a narrative review of the literature. Material and Methods We conducted a retrospective, single-center study on 1060 consecutive hospitalized patients with COVID-19 at our institution. According to the inclusion criteria, we selected patients to be studied in more radiological detail. All images were obtained as per standard of care protocols. We performed a statistic analysis to describe radiological features. We then presented a systematic review of the main and conventional neuroimaging findings in COVID-19. Results Of 1060 patients hospitalized for COVID-19 disease, 15% (159) met the eligibility criteria. Of these, 16 (10%) did not undergo radiological examinations for various reasons, while 143 (90%) were examined. Of these 143 patients, 48 (33.6%) had positive neuroimaging. We found that the most frequent pathology was acute ischemic stroke (n=16, 33.3%). Much less frequent were Guillain–Barre syndrome (n=9, 18.8%), cerebral venous thrombosis (n=7, 14.6%), encephalitis or myelitis (n=6, 12.5%), intracranial hemorrhage and posterior hemorrhagic encephalopathy syndrome (n=4, 8.3%), exacerbation of multiple sclerosis (n=4, 8.3%), and Miller–Fisher syndrome (n=2, 4.2%). Conclusion Our data are coherent with the published literature. Knowledge of these patterns will make clinicians consider COVID-19 infection when unexplained neurological findings are encountered.
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Affiliation(s)
- Alberto Negro
- Department of Neuroradiology, Ospedale del Mare, Naples, Italy
| | - Mario Tortora
- Department of Advanced Biomedical Sciences, University “Federico II,” Naples, Italy
| | - Laura Gemini
- Department of Advanced Biomedical Sciences, University “Federico II,” Naples, Italy
| | | | - Francesco Somma
- Department of Neuroradiology, Ospedale del Mare, Naples, Italy
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Chan S, Kudo M, Sangro B, Kelley R, Furuse J, Park JW, Sunpaweravong P, Fasolo A, Yau T, Kawaoka T, Cheng AL, Azevedo S, Reig Monzon M, Assenat E, Yarchoan M, He A, Makowsky M, Gupta C, Negro A, Abou-Alfa G. 67O Outcomes in the Asian subgroup of the phase III HIMALAYA study of tremelimumab (T) plus durvalumab (D) in unresectable hepatocellular carcinoma (uHCC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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10
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Vogel A, Chan S, Furuse J, Tak W, Masi G, Varela M, Kim J, Tanasanvimon S, Reig Monzon M, Dayyani F, Makowsky M, Marcovitz M, Negro A, Abou-Alfa G. 79P Outcomes by baseline liver function in patients with unresectable hepatocellular carcinoma treated with tremelimumab and durvalumab in the phase III HIMALAYA study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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11
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Govoni E, La Porta F, Negro A, Valpiani G, Caselli S, Bassi E, Pecoraro V, Lullini G, Tedesco D, Rolli M. Evaluation of fall risk factors for among hospitalized patients: systematic review and meta-analysis. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hospitals falls are an important challenge for healthcare systems. An early identification of patients at risk is critical, but no assessing tool has proven to be sufficiently predictive. This review aims at identifying factors associated with an increased risk of falls in hospitalized adults and at mapping them according to main international classification systems.
Methods
We carried out a systematic literature review and metanalysis to detect risk factors positively associated with the increase of falls in hospitals, searching litterature from January 2015 to March 2022. We included studies investigating falling risk factors in patients older than 16 years. Researchers independently assessed records’ eligibility and the methodological quality of included studies was assessed. When possible, data was processed using a random effects model and odds ratio (OR) with 95% confidence interval to quantify the effect. Risk factors were than classified according to ICF, ICD, and ATC classifications.
Results
We included 40 observational studies, enrolling 3,495,552 patients. Considering ICF-factors, mental and sensory functions-pain have a strong association with falls (OR = 3.311 and 2.149, respectively). ICD-factors associated with falls were mental and behavioural disorders (OR = 2.219), diseases of the nervous system (OR = 2.974), and symptoms, signs, and abnormal clinical and laboratory findings (OR = 2.665). Considering ATC-related factors, medications for alimentary tract and metabolism (OR = 1.978), and nervous system (OR = 1.779), showed a strong association with falls. Other factors were also associated with a moderately increased risk.
Conclusions
The comprehensive evidence-based assessment achieved with this meta-analysis alongside with the classification according to ICF, ICD and ATC systems provides a new standardized identification of the risk factors associated with an increase of falls in hospital.
Key messages
• Falls occurring in hospital are an important challenge for health care systems. Therefore the identification of risk factors associated to patients increased risk of fall is fundamental.
• The comprehensive evidence-based assessment achieved with this meta-analysis provides a new standardized identification of the risk factors associated with an increase of falls for hospital.
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Affiliation(s)
- E Govoni
- Hospital Care Sector, General Management for People Care , Health, Bologna, Italy
| | - F La Porta
- Neurorehabilitation Unit, IRCCS Neurological Sciences Insitute , Bologna, Italy
| | - A Negro
- Regional Agency for Health and Social Care, Emilia Romagna Region , Bologna, Italy
| | - G Valpiani
- Research and Innovation Office, S. Anna University Hospital , Ferrara, Italy
| | - S Caselli
- Rehabilitation Unit, Baggiovara Hospital, AOU Modena , Modena, Italy
| | - E Bassi
- Department of Translational Medicine, University of Eastern Piedmont , Novara, Italy
| | - V Pecoraro
- Department of Laboratory Medicine, AUSL Modena , Modena, Italy
| | - G Lullini
- Neurorehabilitation Unit, IRCCS Neurological Sciences Insitute , Bologna, Italy
| | - D Tedesco
- Hospital Care Sector, General Management for People Care , Health, Bologna, Italy
| | - M Rolli
- Hospital Care Sector, General Management for People Care , Health, Bologna, Italy
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12
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Chan L, Kudo M, Sangro B, Kelley R, Furuse J, Park JW, Sunpaweravong P, Fasolo A, Yau T, Kawaoka T, Cheng AL, Azevedo S, Reig Monzon M, Assenat E, Yarchoan M, He A, Makowsky M, Ran D, Negro A, Abou-Alfa G. 714P Impact of viral aetiology in the phase III HIMALAYA study of tremelimumab (T) plus durvalumab (D) in unresectable hepatocellular carcinoma (uHCC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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13
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Lugarà M, Tamburrini S, Coppola MG, Oliva G, Fiorini V, Catalano M, Carbone R, Saturnino PP, Rosano N, Pesce A, Galiero R, Ferrara R, Iannuzzi M, Vincenzo D, Negro A, Somma F, Fasano F, Perrella A, Vitiello G, Sasso FC, Soldati G, Rinaldi L. The Role of Lung Ultrasound in SARS-CoV-19 Pneumonia Management. Diagnostics (Basel) 2022; 12:diagnostics12081856. [PMID: 36010207 PMCID: PMC9406504 DOI: 10.3390/diagnostics12081856] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 12/22/2022] Open
Abstract
Purpose: We aimed to assess the role of lung ultrasound (LUS) in the diagnosis and prognosis of SARS-CoV-2 pneumonia, by comparing it with High Resolution Computed Tomography (HRCT). Patients and methods: All consecutive patients with laboratory-confirmed SARS-CoV-2 infection and hospitalized in COVID Centers were enrolled. LUS and HRCT were carried out on all patients by expert operators within 48−72 h of admission. A four-level scoring system computed in 12 regions of the chest was used to categorize the ultrasound imaging, from 0 (absence of visible alterations with ultrasound) to 3 (large consolidation and cobbled pleural line). Likewise, a semi-quantitative scoring system was used for HRCT to estimate pulmonary involvement, from 0 (no involvement) to 5 (>75% involvement for each lobe). The total CT score was the sum of the individual lobar scores and ranged from 0 to 25. LUS scans were evaluated according to a dedicated scoring system. CT scans were assessed for typical findings of COVID-19 pneumonia (bilateral, multi-lobar lung infiltration, posterior peripheral ground glass opacities). Oxygen requirement and mortality were also recorded. Results: Ninety-nine patients were included in the study (male 68.7%, median age 71). 40.4% of patients required a Venturi mask and 25.3% required non-invasive ventilation (C-PAP/Bi-level). The overall mortality rate was 21.2% (median hospitalization 30 days). The median ultrasound thoracic score was 28 (IQR 20−36). For the CT evaluation, the mean score was 12.63 (SD 5.72), with most of the patients having LUS scores of 2 (59.6%). The bivariate correlation analysis displayed statistically significant and high positive correlations between both the CT and composite LUS scores and ventilation, lactates, COVID-19 phenotype, tachycardia, dyspnea, and mortality. Moreover, the most relevant and clinically important inverse proportionality in terms of P/F, i.e., a decrease in P/F levels, was indicative of higher LUS/CT scores. Inverse proportionality P/F levels and LUS and TC scores were evaluated by univariate analysis, with a P/F−TC score correlation coefficient of −0.762, p < 0.001, and a P/F−LUS score correlation coefficient of −0.689, p < 0.001. Conclusions: LUS and HRCT show a synergistic role in the diagnosis and disease severity evaluation of COVID-19.
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Affiliation(s)
- Marina Lugarà
- U.O.C. Internal Medicine, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (M.G.C.); (G.O.)
- Correspondence:
| | - Stefania Tamburrini
- U.O.C. Radiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (S.T.); (V.F.); (M.C.); (R.C.); (P.P.S.); (N.R.); (A.P.)
| | - Maria Gabriella Coppola
- U.O.C. Internal Medicine, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (M.G.C.); (G.O.)
| | - Gabriella Oliva
- U.O.C. Internal Medicine, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (M.G.C.); (G.O.)
| | - Valeria Fiorini
- U.O.C. Radiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (S.T.); (V.F.); (M.C.); (R.C.); (P.P.S.); (N.R.); (A.P.)
| | - Marco Catalano
- U.O.C. Radiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (S.T.); (V.F.); (M.C.); (R.C.); (P.P.S.); (N.R.); (A.P.)
| | - Roberto Carbone
- U.O.C. Radiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (S.T.); (V.F.); (M.C.); (R.C.); (P.P.S.); (N.R.); (A.P.)
| | - Pietro Paolo Saturnino
- U.O.C. Radiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (S.T.); (V.F.); (M.C.); (R.C.); (P.P.S.); (N.R.); (A.P.)
| | - Nicola Rosano
- U.O.C. Radiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (S.T.); (V.F.); (M.C.); (R.C.); (P.P.S.); (N.R.); (A.P.)
| | - Antonella Pesce
- U.O.C. Radiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (S.T.); (V.F.); (M.C.); (R.C.); (P.P.S.); (N.R.); (A.P.)
| | - Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80121 Naples, Italy; (R.G.); (R.F.); (F.C.S.); (L.R.)
| | - Roberta Ferrara
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80121 Naples, Italy; (R.G.); (R.F.); (F.C.S.); (L.R.)
| | - Michele Iannuzzi
- Department of Anesthesia and Intensive care Medicine, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy;
| | - D’Agostino Vincenzo
- U.O.C. Neurodiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (D.V.); (A.N.); (F.S.); (F.F.)
| | - Alberto Negro
- U.O.C. Neurodiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (D.V.); (A.N.); (F.S.); (F.F.)
| | - Francesco Somma
- U.O.C. Neurodiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (D.V.); (A.N.); (F.S.); (F.F.)
| | - Fabrizio Fasano
- U.O.C. Neurodiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy; (D.V.); (A.N.); (F.S.); (F.F.)
| | - Alessandro Perrella
- Infectious Diseases at Health Direction, AORN A. Cardarelli, 80131 Naples, Italy;
| | - Giuseppe Vitiello
- Healt Direction, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy;
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80121 Naples, Italy; (R.G.); (R.F.); (F.C.S.); (L.R.)
| | - Gino Soldati
- Diagnostic and Interventional Ultrasound Unit, Valle del Serchio General Hospital, Castelnuovo Garfagnana, 55032 Lucca, Italy;
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80121 Naples, Italy; (R.G.); (R.F.); (F.C.S.); (L.R.)
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Scutelnic A, Krzywicka K, Mbroh J, van de Munckhof A, van Kammen MS, de Sousa DA, Lindgren E, Jood K, Günther A, Hiltunen S, Putaala J, Tiede A, Maier F, Kern R, Bartsch T, Althaus K, Ciccone A, Wiedmann M, Skjelland M, Medina A, Cuadrado-Godia E, Cox T, Aujayeb A, Raposo N, Garambois K, Payen JF, Vuillier F, Franchineau G, Timsit S, Bougon D, Dubois MC, Tawa A, Tracol C, De Maistre E, Bonneville F, Vayne C, Mengel A, Michalski D, Pelz J, Wittstock M, Bode F, Zimmermann J, Schouten J, Buture A, Murphy S, Palma V, Negro A, Gutschalk A, Nagel S, Schoenenberger S, Frisullo G, Zanferrari C, Grillo F, Giammello F, Martin MM, Cervera A, Burrow J, Esperon CG, Chew BLA, Kleinig TJ, Soriano C, Zimatore DS, Petruzzellis M, Elkady A, Miranda MS, Fernandes J, Vogel ÅH, Johansson E, Philip AP, Coutts SB, Bal S, Buck B, Legault C, Blacquiere D, Katzberg HD, Field TS, Dizonno V, Gattringer T, Jacobi C, Devroye A, Lemmens R, Kristoffersen ES, di Poggio MB, Ghiasian M, Karapanayiotides T, Chatterton S, Wronski M, Ng K, Kahnis R, Geeraerts T, Reiner P, Cordonnier C, Middeldorp S, Levi M, van Gorp ECM, van de Beek D, Brodard J, Kremer Hovinga JA, Kruip MJHA, Tatlisumak T, Ferro JM, Coutinho JM, Arnold M, Poli S, Heldner MR. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination. Ann Neurol 2022; 92:562-573. [PMID: 35689346 PMCID: PMC9349982 DOI: 10.1002/ana.26431] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/21/2022] [Accepted: 05/27/2022] [Indexed: 01/01/2023]
Abstract
Objective Cerebral venous thrombosis (CVT) caused by vaccine‐induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus‐based severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non‐heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods We used data from an international prospective registry of patients with CVT after the adenovirus‐based SARS‐CoV‐2 vaccination. We analyzed possible, probable, or definite VITT‐CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results Ninety‐nine patients with VITT‐CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in‐line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non‐heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions In patients with VITT‐CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT‐CVT. ANN NEUROL 2022;92:562–573
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Affiliation(s)
- Adrian Scutelnic
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Katarzyna Krzywicka
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Joshua Mbroh
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tuebingen, Germany.,Department of Neurology & Stroke, Eberhard-Karls University, Tuebingen, Germany
| | - Anita van de Munckhof
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Mayte Sánchez van Kammen
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Diana Aguiar de Sousa
- CEEM and Institute of Anatomy, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Erik Lindgren
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Gothenburg, Sweden
| | - Katarina Jood
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Gothenburg, Sweden
| | - Albrecht Günther
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Sini Hiltunen
- Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Jukka Putaala
- Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Andreas Tiede
- Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Frank Maier
- Department of Neurology, Caritas Hospital Saarbrücken, Saarbrücken, Germany
| | - Rolf Kern
- Department of Neurology, Kempten Hospital, Kempten, Germany
| | - Thorsten Bartsch
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | | | - Alfonso Ciccone
- Department of Neurology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale di Mantova, Mantua, Italy
| | - Markus Wiedmann
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Mona Skjelland
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Antonio Medina
- Department of Neurology, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | | | - Thomas Cox
- Department of Neurology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, Cramlington, UK
| | - Nicolas Raposo
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - Katia Garambois
- Stroke Unit, University Hospital of Grenoble, Grenoble, France
| | | | | | - Guillaume Franchineau
- Department of Intensive Care, Centre Hospitalier Intercommunal de Poissy Saint Germain en Laye, Poissy, France
| | - Serge Timsit
- Neurology and Stroke Unit, Centre Hospitalier Universitaire de Brest, CHU Brest, Brest, France
| | - David Bougon
- Department of Critical Care, Annecy Genevois Hospital, Annecy, France
| | - Marie-Cécile Dubois
- Department of Anesthesia and Intensive Care, University Hospital of Poitiers, Poitiers, France
| | - Audrey Tawa
- Department of Anesthesia and Intensive Care, University Hospital of Rennes, Rennes, France
| | | | | | - Fabrice Bonneville
- Department of Neuroradiology, Toulouse University Hospital, Toulouse, France
| | - Caroline Vayne
- Department of Hematology and Hemostasis, Tours University Hospital, Tours, France
| | - Annerose Mengel
- Department of Neurology and Stroke, Eberhard-Karls University, Tuebingen, Germany
| | - Dominik Michalski
- Department of Neurology, Leipzig University Hospital, Leipzig, Germany
| | - Johann Pelz
- Department of Neurology, Leipzig University Hospital, Leipzig, Germany
| | | | - Felix Bode
- Department of Neurology, Universitätsklinikum Bonn, Bonn, Germany
| | | | - Judith Schouten
- Department of Neurology, Rijnstate Hospital Arnhem, Arnhem, The Netherlands
| | - Alina Buture
- Acute Stroke Service, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Sean Murphy
- Acute Stroke Service, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Vincenzo Palma
- Department of Neuroradiology, Ospedale del Mare, Naples, Italy
| | - Alberto Negro
- Department of Neuroradiology, Ospedale del Mare, Naples, Italy
| | - Alexander Gutschalk
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Simon Nagel
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Giovanni Frisullo
- Department of Neurology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Carla Zanferrari
- Department of Neurology, Azienda Ospedaliera di Melegnano e della Martesana, Melegnano, Italy
| | - Francesco Grillo
- Stroke Unit, Department of Clinical and Experimental Medicine, University Hospital G. Martino, Messina, Italy
| | - Fabrizio Giammello
- Translational Molecular Medicine and Surgery, XXXV Cycle, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Mar Morin Martin
- Department of Neurology, Hospital Complex of Toledo, Toledo, Spain
| | - Alvaro Cervera
- Department of Neurology, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Jim Burrow
- Department of Neurology, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Carlos Garcia Esperon
- Department of Neurology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Beng Lim Alvin Chew
- Department of Neurology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Timothy J Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Cristina Soriano
- Department of Neurology, Hospital General de Castellón, Castelló, Spain
| | | | - Marco Petruzzellis
- Department of Neurology, AOU Consorziale Policlinico di Bari, Bari, Italy
| | - Ahmed Elkady
- Department of Neurology, Saudi German Hospital, Jeddah, Saudi Arabia
| | - Miguel S Miranda
- Department of Neurology, Hospital de Cascais Dr José de Almeida, Cascais, Portugal
| | - João Fernandes
- Department of Neurology, Norra Älvsborgs Länssjukhus, Trollhattan, Sweden
| | | | - Elias Johansson
- Clinical Science, Neurosciences, Umeå University, Umeå, Sweden.,Wallenberg Centre for Molecular Medicine, Umeå, Sweden
| | | | - Shelagh B Coutts
- Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Simerpreet Bal
- Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Brian Buck
- Division of Neurology, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Catherine Legault
- Department of Neurology and Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dylan Blacquiere
- Division of Neurology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Hans D Katzberg
- Department of Neuromuscular Medicine, Toronto General Hospital, Toronto, Ontario, Canada
| | - Thalia S Field
- Division of Neurology, University of British Columbia, Vancouver Stroke Program, Vancouver, British Columbia, Canada
| | - Vanessa Dizonno
- Division of Neurology, University of British Columbia, Vancouver Stroke Program, Vancouver, British Columbia, Canada
| | | | - Christian Jacobi
- Department of Neurology, Nordwest Hospital, Frankfurt am Main, Germany
| | - Annemie Devroye
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Robin Lemmens
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Masoud Ghiasian
- Department of Neurology, Sina Hospital, Hamadan University of Medical Science, Hamadan, Iran
| | | | - Sophie Chatterton
- Department of Neurology, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Miriam Wronski
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Karl Ng
- Department of Neurology and Clinical Neurophysiology, Royal North Shore Hospital and The University of Sydney, Sydney, New South Wales, Australia
| | - Robert Kahnis
- Department of Neurology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Thomas Geeraerts
- Department of Anaesthesiology and Critical Care, University Toulouse 3-Paul-Sabatier, University Hospital of Toulouse, Hôpital Pierre-Paul Riquet, CHU Toulouse-Purpan, Toulouse, France
| | - Peggy Reiner
- Service de neurologie, hôpital Lariboisière Université Paris-7, AP-HP, Paris Cedex 10, France
| | - Charlotte Cordonnier
- University of Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
| | - Saskia Middeldorp
- Department of Internal Medicine & Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel Levi
- National Institute for Health Research University College London Hospitals (UCLH) Biomedical Research Centre, London, UK.,Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Eric C M van Gorp
- Department of Viroscience, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Diederik van de Beek
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Justine Brodard
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Johanna A Kremer Hovinga
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Turgut Tatlisumak
- Department of Neurology & Stroke, Eberhard-Karls University, Tuebingen, Germany
| | - José M Ferro
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Jonathan M Coutinho
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Marcel Arnold
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sven Poli
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tuebingen, Germany.,Department of Neurology & Stroke, Eberhard-Karls University, Tuebingen, Germany
| | - Mirjam R Heldner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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15
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Vogel A, Chan S, Furuse J, Tak W, Masi G, Varela M, Kim J, Tanasanvimon S, Reig M, Dayyani F, Makowsky M, Marcovitz M, Negro A, Abou-Alfa G. O-5 Outcomes by baseline liver function in patients with unresectable hepatocellular carcinoma treated with tremelimumab and durvalumab in the phase 3 HIMALAYA study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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16
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Somma F, Negro A, D’Agostino V, Piscitelli V, Pace G, Tortora M, Tortora F, Gatta G, Caranci F. COVID-19 and low back pain: previous infections lengthen recovery time after intradiscal ozone therapy in patients with herniated lumbar disc. Radiol Med 2022; 127:673-680. [PMID: 35536526 PMCID: PMC9088142 DOI: 10.1007/s11547-022-01500-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/27/2022] [Indexed: 11/25/2022]
Abstract
Purpose To assess and compare the clinical effectiveness of percutaneous intradiscal ozone therapy in patients affected by lumbar disc herniation, with and without history of COVID-19 infection. Materials and Methods After the rising of COVID-19 pandemics in Italy, 47 consecutive percutaneous intradiscal ozone therapies were performed on patients with low back pain and/or sciatic pain due to lumbar disc herniation. Among these, 19 had suffered from COVID-19 and successively recovered with no residual symptoms, while the remaining 28 had not previously been affected by COVID-19 and were not convalescent. Oswestry Disability Index (ODI) was administered before the treatment and at 1-month and 3-month follow-up in order to assess the clinical outcome. Results The two groups were similar in terms of patient age (p-value 0.54), treated levels (p-value 0.26) and pre-procedure ODI (p-value 0.33). Technical success was achieved in all cases. In patients previously affected by COVID-19, mean ODI decrease was 11.58 ± 9.51 (35.72%) at 1-month follow-up and 20.63 ± 9.87 (63.63%) at 3-month follow-up. In patients never affected by COVID-19, mean ODI decrease was 20.93 ± 10.53 (58.73%) at 1-month follow-up and 22.07 ± 11.36 (61.92%) at 3-month follow-up. Eventually, clinical success was registered in 84.21% (16/19) of patients with history of COVID-19 infection and in 85.71% (24/28) of patients with no history of COVID-19 infection. No major complication was registered. Conclusions In case of lumbar disc herniation treated with percutaneous intradiscal ozone therapy, patients previously affected by COVID-19 showed a significantly longer recovery time.
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Affiliation(s)
- Francesco Somma
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Alberto Negro
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Vincenzo D’Agostino
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Valeria Piscitelli
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Gianvito Pace
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Mario Tortora
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli Federico II, 80131 Naples, Italy
| | - Fabio Tortora
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli Federico II, 80131 Naples, Italy
| | - Gianluca Gatta
- Dipartimento di Medicina di Precisione, Università Vanvitelli, Via de Crecchio, 80138 Naples, Italy
| | - Ferdinando Caranci
- Dipartimento di Medicina di Precisione, Università Vanvitelli, Via de Crecchio, 80138 Naples, Italy
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17
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Somma F, D’Agostino V, Negro A, Piscitelli V, Tamburrini S, Sicignano C, Fasano F, Peluso S, Villa A, Pace G, Sarti G, La Tessa GME, Pezzullo G, Gatta G, Caranci F. Radiation exposure and clinical outcome in patients undergoing percutaneous intradiscal ozone therapy for disc herniation: Fluoroscopic versus conventional CT guidance. PLoS One 2022; 17:e0264767. [PMID: 35290390 PMCID: PMC8923460 DOI: 10.1371/journal.pone.0264767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/16/2022] [Indexed: 12/19/2022] Open
Abstract
Purpose To compare technical success, clinical success, complications and radiation dose for percutaneous intradiscal ozone therapy in patients with lumbar disc herniation using fluoroscopic guidance versus conventional computed tomography (CT) guidance. Materials and methods Between March 2018and March 2021, 124consecutive percutaneous intradiscal ozone therapies wereperformedon111 patients with low back pain (LBP) and/or sciatic pain due to lumbar disc herniation, using fluoroscopic or conventional CT guidance, respectively in 53 and 58 herniated lumbar discs, with at least 1-month follow up. Dose area product (DAP) and dose length product (DLP) were recorded respectively for fluoroscopy and CT, and converted to effective dose (ED). Results Fluoroscopic and CT groups were similar in terms of patient age (p-value 0.39), patient weight (p-value 0.49) and pre-procedure Oswestry Disability Index (ODI, p-value 0.94). Technical success was achieved in all cases. Clinical success was obtained in 83.02% (44/53) patients in fluoroscopic group and 79.31% (46/58) in CT group. Mean DAP was 11.63Gy*cm2 (range 5.42–21.61). Mean DLP was 632.49mGy-cm (range 151.51–1699). ED was significantly lower in the fluoroscopic group compared toCT group (0.34 vs. 5.53mSv, p = 0.0119). No major complication was registered. Minor complications were observed in 4 cases (2 in fluoroscopic group; 2 in CT group). Conclusions Compared to conventional CT guidance, fluoroscopic guidance for percutaneous intradiscal ozone therapy in patients with lumbar disc herniation shows similar technical and clinical success rates, with lower radiation dose. This technique helps sparing dose exposure to patients.
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Affiliation(s)
- Francesco Somma
- UOC Neuroradiologia, Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy
- * E-mail:
| | | | - Alberto Negro
- UOC Neuroradiologia, Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy
| | | | | | - Carmine Sicignano
- UOC Neuroradiologia, Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy
| | - Fabrizio Fasano
- UOC Neuroradiologia, Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy
| | - Silvio Peluso
- UOC Neurologia, Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy
| | - Alessandro Villa
- UOC Neurochirurgia, Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy
| | - Gianvito Pace
- UOC Neuroradiologia, Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy
| | - Giuseppe Sarti
- UOC Radiologia, Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy
| | | | - Giovanna Pezzullo
- Dipartimento Medicina di Precisione, Università “Vanvitelli”, Napoli, Italy
| | - Gianluca Gatta
- Dipartimento Medicina di Precisione, Università “Vanvitelli”, Napoli, Italy
| | - Ferdinando Caranci
- Dipartimento Medicina di Precisione, Università “Vanvitelli”, Napoli, Italy
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Diez M, Abajo J, Negro A, Escalante SM, Fernández MT. Study on the influence of seating orientation during frontal impacts by child occupant human body model response analysis. Traffic Inj Prev 2022; 23:135-139. [PMID: 35191806 DOI: 10.1080/15389588.2022.2026936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 11/29/2021] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Autonomous driving cars must be developed to ensure that children will have the highest level of protection in case of collision. Changes to the vehicle cabin design (different seat orientations, fully reclining seats, etc.) may significantly impact child occupant safety. Understanding child occupant responses under these new conditions is necessary to decrease risk and enhance child safety. In this study, child occupant response in different seating orientations exposed to frontal impacts with a focus on the head injuries and kinematics was analyzed. METHODS Finite elements simulations were performed using the PIPER 6-year-old human body model (HBM). All simulations were carried out in a generic full vehicle environment. The child model was positioned in an adequate generic car restraint system (CRS) in the left rear vehicle seat in 4 seating orientations: 0° (forward-facing position), 30°, 60°, and 90° (living room position). Two scenarios were evaluated for all seating orientations according to the left front seat backrest position: reclined position nominal upright and rest position (55°). All seat configurations were subjected to the mobile progressive deformable barrier frontal impact (European New Car Assessment Programme [Euro NCAP] frontal impact testing protocol). A total of 8 scenarios were simulated in LS-DYNA. RESULTS Based on the Euro NCAP injury risk rate, 90° seating orientation (living room position) was the safest among all selected scenarios independent of the left front seat backrest position. The worst case was found in 60° seat rotation. The highest values for Head Injury Criterion (HIC) and head acceleration (Acc 3 ms) were noted for this case. Higher Brain Injury Criterion (BrIC) values were observed at higher seat rotation angles. Hence, a 90° seating orientation showed the highest BrIC value. Attending to the skull stress, greater head injuries were caused principally by contact with the vehicle interior (seat headrest). Maximum stress values were reached at 30° and 60° seating orientations with the front seat in rest position. In 90° seating orientation, high stress values were also identified. CONCLUSIONS These results show that attending to these new seating orientations, current child safety standards are not sufficient to ensure children the highest level of protection. Other additional criteria such as BrIC or skull stress that offer a way to capture brain injuries should be used.
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Affiliation(s)
- Mónica Diez
- CIDAUT Foundation (Investigación y Desarrollo en Transporte y Energía), Boecillo, Valladolid, Spain
| | - Julio Abajo
- CIDAUT Foundation (Investigación y Desarrollo en Transporte y Energía), Boecillo, Valladolid, Spain
| | - Alberto Negro
- CIDAUT Foundation (Investigación y Desarrollo en Transporte y Energía), Boecillo, Valladolid, Spain
| | - Susana M Escalante
- CIDAUT Foundation (Investigación y Desarrollo en Transporte y Energía), Boecillo, Valladolid, Spain
| | - M Teresa Fernández
- CIDAUT Foundation (Investigación y Desarrollo en Transporte y Energía), Boecillo, Valladolid, Spain
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Negro A, Somma F, Piscitelli V, La Tessa GME, Sicignano C, Fasano F, Tamburrini S, Vargas O, Pace G, Iannuzzi M, Villa A, Della Gatta L, Chiaramonte C, Caranci F, Tortora F, D’Agostino V. Intracranial Hemorrhage from Dural Arteriovenous Fistulas: What Can We Find with CT Angiography? Tomography 2021; 7:804-814. [PMID: 34941640 PMCID: PMC8703900 DOI: 10.3390/tomography7040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022] Open
Abstract
(1) Background: Dural arteriovenous fistulas (DAVF) represent a rare acquired intracranial vascular malformation, with a variety of clinical signs and symptoms, which make their diagnosis difficult. Intracranial hemorrhage is one of the most serious clinical manifestations. In this paper the authors’ goal was to verify the accuracy and utility of contrast-enhanced brain CT angiography (CTA) for the identification and the characterization of dural arteriovenous fistulas (DAVFs) in patients who presented with brain hemorrhage compared to 3D digital subtraction angiography (3D DSA); (2) a retrospective study of 26 patients with DAVFs who presented with intracranial hemorrhage to our institution was performed. The information reviewed included clinical presentation, location and size of hemorrhage, brain CTA and 3D DSA findings; (3) results: 61% (16/26) of DAVFs were identified by CTA. The vast majority of patients were male (69%, 18/26) and the most common presenting symptom was sudden onset headache. All DAVFs had cortical venous drainage and about one-third were associated with a venous varix. The most common location was tentorial (73%, 19/26); (4) conclusions: CTA can represent a valid alternative diagnostic method to 3D DSA for the study of DAVF in the initial and preliminary diagnostic approach, especially in emergency situations. In fact, it represents a fast, inexpensive, non-invasive and above all, easily accessible and available diagnostic technique, unlike DSA or MRI, allowing to provide information necessary for the identification, classification and treatment planning of DAVFs.
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Affiliation(s)
- Alberto Negro
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
- Correspondence:
| | - Francesco Somma
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
| | - Valeria Piscitelli
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
| | - Giuseppe Maria Ernesto La Tessa
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
| | - Carmine Sicignano
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
| | - Fabrizio Fasano
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
| | - Stefania Tamburrini
- Department of Radiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy;
| | - Ottavia Vargas
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
| | - Gianvito Pace
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
| | - Michele Iannuzzi
- Department of Anesthesia and Intensive Care, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy;
| | - Alessandro Villa
- Department of Neurorsurgery, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (A.V.); (C.C.)
| | - Luigi Della Gatta
- Department of Neuoradiology, AORN A.Cardarelli, via Antonio Cardarelli, 80131 Naples, Italy;
| | - Carmela Chiaramonte
- Department of Neurorsurgery, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (A.V.); (C.C.)
| | - Ferdinando Caranci
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via de Crecchio, 80138 Naples, Italy;
| | - Fabio Tortora
- Department of Advanced Biomedical Sciences, Federico II University Naples, 80131 Naples, Italy;
| | - Vincenzo D’Agostino
- Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy; (F.S.); (V.P.); (G.M.E.L.T.); (C.S.); (F.F.); (O.V.); (G.P.); (V.D.)
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Sánchez van Kammen M, Aguiar de Sousa D, Poli S, Cordonnier C, Heldner MR, van de Munckhof A, Krzywicka K, van Haaps T, Ciccone A, Middeldorp S, Levi MM, Kremer Hovinga JA, Silvis S, Hiltunen S, Mansour M, Arauz A, Barboza MA, Field TS, Tsivgoulis G, Nagel S, Lindgren E, Tatlisumak T, Jood K, Putaala J, Ferro JM, Arnold M, Coutinho JM, Sharma AR, Elkady A, Negro A, Günther A, Gutschalk A, Schönenberger S, Buture A, Murphy S, Paiva Nunes A, Tiede A, Puthuppallil Philip A, Mengel A, Medina A, Hellström Vogel Å, Tawa A, Aujayeb A, Casolla B, Buck B, Zanferrari C, Garcia-Esperon C, Vayne C, Legault C, Pfrepper C, Tracol C, Soriano C, Guisado-Alonso D, Bougon D, Zimatore DS, Michalski D, Blacquiere D, Johansson E, Cuadrado-Godia E, De Maistre E, Carrera E, Vuillier F, Bonneville F, Giammello F, Bode FJ, Zimmerman J, d'Onofrio F, Grillo F, Cotton F, Caparros F, Puy L, Maier F, Gulli G, Frisullo G, Polkinghorne G, Franchineau G, Cangür H, Katzberg H, Sibon I, Baharoglu I, Brar J, Payen JF, Burrow J, Fernandes J, Schouten J, Althaus K, Garambois K, Derex L, Humbertjean L, Lebrato Hernandez L, Kellermair L, Morin Martin M, Petruzzellis M, Cotelli M, Dubois MC, Carvalho M, Wittstock M, Miranda M, Skjelland M, Bandettini di Poggio M, Scholz MJ, Raposo N, Kahnis R, Kruyt N, Huet O, Sharma P, Candelaresi P, Reiner P, Vieira R, Acampora R, Kern R, Leker R, Coutts S, Bal S, Sharma SS, Susen S, Cox T, Geeraerts T, Gattringer T, Bartsch T, Kleinig TJ, Dizonno V, Arslan Y. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia. JAMA Neurol 2021; 78:1314-1323. [PMID: 34581763 DOI: 10.1001/jamaneurol.2021.3619] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, Setting, and Participants This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main Outcomes and Measures Clinical characteristics and mortality rate. Results Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.0-7.4), respectively. The mortality rate was 61% (14 of 23) among patients in the TTS group diagnosed before the condition garnered attention in the scientific community and 42% (22 of 53) among patients diagnosed later. Conclusions and Relevance In this cohort study of patients with CVST, a distinct clinical profile and high mortality rate was observed in patients meeting criteria for TTS after SARS-CoV-2 vaccination.
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Affiliation(s)
- Mayte Sánchez van Kammen
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Diana Aguiar de Sousa
- Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte, University of Lisbon, Lisbon, Portugal
| | - Sven Poli
- Department of Neurology and Stroke, Eberhard-Karls University, Tuebingen, Germany.,Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tuebingen, Germany
| | - Charlotte Cordonnier
- Department of Neurosciences and Cognition, Lille University Hospital, Lille, France
| | - Mirjam R Heldner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anita van de Munckhof
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Katarzyna Krzywicka
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Thijs van Haaps
- Department of Internal Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Alfonso Ciccone
- Department of Neurology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale di Mantova, Mantua, Italy
| | - Saskia Middeldorp
- Department of Internal Medicine, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marcel M Levi
- National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Johanna A Kremer Hovinga
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Suzanne Silvis
- Department of Neurology, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Sini Hiltunen
- Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Maryam Mansour
- Sina Hospital, Hamadan University of Medical Science, Hamadan, Iran
| | - Antonio Arauz
- National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico
| | - Miguel A Barboza
- Neurosciences Department, Hospital Dr R.A. Calderón Guardia, San José, Costa Rica
| | - Thalia S Field
- Division of Neurology, University of British Columbia, Vancouver Stroke Program, Vancouver, British Columbia, Canada
| | - Georgios Tsivgoulis
- Second Department of Neurology in National, Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Simon Nagel
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Erik Lindgren
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Turgut Tatlisumak
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Katarina Jood
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jukka Putaala
- Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Jose M Ferro
- Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte, University of Lisbon, Lisbon, Portugal
| | - Marcel Arnold
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jonathan M Coutinho
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Aarti R Sharma
- Imperial College London School of Medicine, Imperial College London, London, United Kingdom
| | - Ahmed Elkady
- Department of Neurology, Saudi German Hospital, Jeddah, Saudi Arabia
| | - Alberto Negro
- Department of Neuroradiology, Ospedale del Mare, Naples, Italy
| | - Albrecht Günther
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Alexander Gutschalk
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Alina Buture
- Acute Stroke Service, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Sean Murphy
- Acute Stroke Service, Mater Misericordiae University Hospital, Dublin, Ireland.,UCD School of Medicine, University College Dublin, Dublin, Ireland.,School of Medicine, University of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ana Paiva Nunes
- Department of Neurology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Andreas Tiede
- Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | | | - Annerose Mengel
- Department of Neurology and Stroke, University Hospital Tuebingen, Tuebingen, Germany
| | - Antonio Medina
- Department of Neurology, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | | | - Audrey Tawa
- Department of Anesthesia and Intensive Care, University Hospital of Rennes, Rennes, France
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, Cramlington, United Kingdom
| | - Barbara Casolla
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, Cramlington, United Kingdom.,Stroke Unit, Hôpital Pasteur 2, URRIS - UR2CA, Unité de Recherche Clinique Cote d'Azur, Cote d'Azur University, Nice, France
| | - Brian Buck
- Division of Neurology, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Carla Zanferrari
- Department of Neurology, Azienda Ospedaliera di Melegnano e della Martesana, Melegnano, Italy
| | | | - Caroline Vayne
- Department of Hematology and Hemostasis, Tours University Hospital, Tours, France
| | - Catherine Legault
- Department of Neurology and Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Christian Pfrepper
- Division of Hemostaseology, Leipzig University Hospital, Leipzig, Germany
| | | | - Cristina Soriano
- Department of Neurology, Hospital General de Castellón, Castelló, Spain
| | | | - David Bougon
- Department of Critical Care, Annecy Genevois Hospital, Annecy, France
| | | | - Dominik Michalski
- Department of Neurology, Leipzig University Hospital, Leipzig, Germany
| | - Dylan Blacquiere
- Division of Neurology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Elias Johansson
- Department Clinical Science, Wallenberg Center for Molecular Medicine, Umeå University, Umeå, Sweden
| | | | | | - Emmanuel Carrera
- Department of Neurology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | | | - Fabrice Bonneville
- Department of Neuroradiology, Toulouse University Hospital, Toulouse, France
| | - Fabrizio Giammello
- Translational Molecular Medicine and Surgery, XXXV Cycle, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Felix J Bode
- Department of Neurology, Universitätsklinikum Bonn, Bonn, Germany
| | - Julian Zimmerman
- Department of Neurology, Universitätsklinikum Bonn, Bonn, Germany
| | | | - Francesco Grillo
- Stroke Unit, Department of Clinical and Experimental Medicine, University Hospital G. Martino, Messina, Italy
| | - Francois Cotton
- Department of Radiology, Lyon University Hospital, Lyon, France
| | - François Caparros
- Department of Neurosciences and Cognition, Lille University Hospital, Lille, France
| | - Laurent Puy
- Department of Neurosciences and Cognition, Lille University Hospital, Lille, France
| | - Frank Maier
- Department of Neurology, Caritas Hospital Saarbrücken, Saarbrücken, Germany
| | - Giosue Gulli
- Department of Medicine, Ashford and St Peters Hospital NHS Foundation Trust, Surrey, United Kingdom
| | - Giovanni Frisullo
- Department of Neurology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Guillaume Franchineau
- Department of Intensive Care, Centre Hospitalier Intercommunal de Poissy Saint Germain en Laye, Poissy, France
| | - Hakan Cangür
- Department of Neurology, Hospital of the City of Wolfsburg, Wolfsburg, Germany
| | - Hans Katzberg
- Department of Neuromuscular Medicine, Toronto General Hospital, Toronto, Ontario, Canada
| | - Igor Sibon
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | - Irem Baharoglu
- Department of Neurology, Haga Hospital, The Hague, the Netherlands
| | - Jaskiran Brar
- Department of Neurology, Surrey Memorial Hospital, Surrey, British Columbia, Canada
| | | | - Jim Burrow
- Department of Neurology, Royal Darwin Hospital, Tiwi, Australia
| | - João Fernandes
- Department of Neurology, Norra Älvsborgs Länssjukhus, Trollhattan, Sweden
| | - Judith Schouten
- Department of Neurology, Rijnstate Hospital Arnhem, Arnhem, the Netherlands
| | | | - Katia Garambois
- Stroke Unit, University Hospital of Grenoble, Grenoble, France
| | - Laurent Derex
- Department of Neurology, Hospices Civils de Lyon, Lyon, France
| | | | | | - Lukas Kellermair
- Department of Neurology, Johannes Kepler University Linz, Linz, Austria
| | - Mar Morin Martin
- Department of Neurology, Hospital Complex of Toledo, Toledo, Spain
| | - Marco Petruzzellis
- Department of Neurology, AOU Consorziale Policlinico di Bari, Bari, Italy
| | - Maria Cotelli
- Department of Neurology, ASL Vallecamonica-Sebino, Breno, Italy
| | - Marie-Cécile Dubois
- Department of Anesthesia and Intensive Care, University Hospital of Poitiers, Poitiers, France
| | - Marta Carvalho
- Department of Neurology, Centro Hospitalar Universitário de São João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Miguel Miranda
- Department of Neurology, Hospital de Cascais Dr José de Almeida, Cascais, Portugal
| | - Mona Skjelland
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | | | - Moritz J Scholz
- Department of Neurology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Nicolas Raposo
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - Robert Kahnis
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - Nyika Kruyt
- Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Olivier Huet
- UFR de Bio-médecine, Hospital de la Cavale Blanche, CHRU de Brest, Brest, France
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, United Kingdom
| | - Paolo Candelaresi
- Department of Neurology and Stroke, Cardarelli Hospital, Naples, Italy
| | - Peggy Reiner
- Department of Neurology, Lariboisière Hospital, Paris, France
| | - Ricardo Vieira
- Department of Hematology, Universidade Federal do Cariri, Juazeiro do Norte, Brazil
| | | | - Rolf Kern
- Department of Neurology, Kempten Hospital, Kempten, Germany
| | - Ronen Leker
- Department of Neurology, Hadassah University Medical Center, Jerusalem, Israel
| | - Shelagh Coutts
- Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Simerpreet Bal
- Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Shyam S Sharma
- Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Sophie Susen
- Department of Hematology and Transfusion, Lille University Hospital, Lille, France
| | - Thomas Cox
- Department of Neurology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Thomas Geeraerts
- Department of Anesthesiology and Critical Care, Toulouse University Hospital, Toulouse, France
| | | | - Thorsten Bartsch
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Timothy J Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, Australia
| | - Vanessa Dizonno
- Division of Neurology, University of British Columbia, Vancouver Stroke Program, Vancouver, British Columbia, Canada
| | - Yildiz Arslan
- Neurology Clinic, Medicana İzmir International Hospital, Izmir, Turkey
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Di Giorgio E, Cuocolo A, Mansi L, Sicignano M, Squame F, Gaudieri V, Giordano P, Giugliano FM, Mazzaferro MP, Negro A, Villa A, Spadafora M. Assessment of therapy response to Regorafenib by 18F-DOPA-PET/CT in patients with recurrent high-grade gliomas: a case series. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Rimegepant is an oral calcitonin gene-related peptide (CGRP) receptor antagonist developed with a novel quick-dissolve oral tablet formulation for the acute treatment of migraine by Biohaven Pharmaceuticals, under license from Bristol Myers Squibb. The completed phase II and III trials showed its efficacy in terms of pain freedom, pain relief, release of migraine symptoms and lifestyle recovery, with an effect sustained up to 48 h. Significant clinical efficacy has been reported with a rimegepant single dose. Rimegepant was well tolerated and the few adverse events were mild or moderate and did not cause trial discontinuation. It received Food and Drug Administration (FDA) approval on February 27, 2020, for the acute treatment of migraine headache. Three clinical trials are currently ongoing to evaluate: i) the long-term safety as migraine acute treatment; ii) the efficacy and safety as a preventive treatment for migraine; and iii) the efficacy and safety for refractory trigeminal neuralgia. Future studies should be designed also to evaluate potential drug-drug interactions.
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Affiliation(s)
- A Negro
- Regional Referral Headache Centre, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
| | - P Martelletti
- Regional Referral Headache Centre, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Tortora F, Negro A, Briganti F, Del Basso De Caro ML, Cavallo LM, Solari D, Somma T, Brunese L, Caranci F. Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing's disease-a narrative review. Gland Surg 2020; 9:2260-2268. [PMID: 33447578 DOI: 10.21037/gs-20-654] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cushing's syndrome is a pathological clinical condition caused by an exposure of elevated cortisol levels over a long period of time. It is therefore essential to establish what the cause of hypercortisolism is. In most cases (about 80%) the pathological process is due to adrenocorticotropic hormone (ACTH), while in a minor part of the cases (about 20%) the cause is represented by a pathology of the adrenal glands and therefore not related to ACTH. Most patients with ACTH dependent Cushing's syndrome have a pituitary microadenoma; in the remaining cases (30%), the high level of cortisol is linked to an ectopic secretion of ACTH. Surgical removal of the pituitary adenoma represents the treatment of choice in Cushing's disease (CD) patients; it is therefore necessary to identify and precisely locate the pituitary tumour responsible for the secretion of ACTH. Adequate diagnostic information is very often, even with magnetic resonance imaging (MRI), and in these cases we rely on bilateral inferior petrosal sinuses sampling (BIPSS). This procedure is considered the gold standard method for the diagnosis, but like any other diagnostic method it is not free from erroneous results such as false positives or false negatives.
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Affiliation(s)
- Fabio Tortora
- Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy
| | - Alberto Negro
- Neuroradiology Unit, Ospedale del Mare, Naples, Italy
| | - Francesco Briganti
- Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy
| | | | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University, Naples, Italy
| | - Domenico Solari
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University, Naples, Italy
| | - Teresa Somma
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University, Naples, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Ferdinando Caranci
- Department of Precision Medicine, School of Medicine "Luigi Vanvitelli", University of Campania, Naples, Italy
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Negro A, Paolucci A, Russo C, Di Stasi M, Guerriero P, Arrigoni F, Bruno F, Pagnini F, Angileri SA, Palumbo P, Masciocchi C, Puoti G, Tortora F, Caranci F. Predictive factors of volumetric reduction in lumbar disc herniation treated by O2-O3 chemiodiscolysis. Acta Biomed 2020; 91:89-97. [PMID: 32945283 PMCID: PMC7944679 DOI: 10.23750/abm.v91i8-s.9975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023]
Abstract
Purpose: Aim of this study is to assess the effectiveness of O2-O3 percutaneous chemiodiscolysis by evaluating volumetric changes in lumbar disc herniation on magnetic resonance imaging, in order to identify possible pre-treatment factors affecting such changes Methods: Between January 2014 and December 2017, a total of 87 patients with low back pain and 103 lumbar disc herniations with MRI confirmation were considered for O2-O3 chemiodiscolysis. The volume of each herniated disc was determined before and after the treatment. Results: Multiple linear regression analysis showed a strong correlation between post-treatment LDH volume percent change and both pre-treatment LDH volume and pre-treatment EQ-VAS (p<0.05), while age showed only a weak positive correlation with post-treatment LDH volume percent change (p<0.1). No association was found for other factors, such as sex and herniation disc level. Conclusions: In conclusion, age, baseline LDH volume and self-assessed disease severity score could represent three easy accessible outcome predictive parameters to consider when intradiscal O2-O3 chemiodiscolysis is envisaged. Better results after intradiscal O2-O3 chemiodiscolysis were obtained in older patients with higher pre-treatment LDH volume and low-moderate pre-treatment EQ-VAS. (www.actabiomedica.it)
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Affiliation(s)
- Alberto Negro
- Ospedale del Mare - ASL NA1, Neuroradiology Unit,Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'invecchiamento, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | | | - Camilla Russo
- Advanced Biomedical Sciences Department University of Naples "Federico II", Napoli, Italy.
| | - Martina Di Stasi
- Advanced Biomedical Sciences Department University of Naples "Federico II", Napoli, Italy.
| | - Pasquale Guerriero
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
| | - Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Francesco Pagnini
- Department of Medicine and Surgery, Unit of Radiology, University of Parma, Parma, Italy..
| | - Salvatore Alessio Angileri
- Operative Unit of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan University, Via Francesco Sforza, 35, 20122, Milan, Italy..
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Gianfranco Puoti
- Second Division of Neurology. Department of Advanced Medical and Surgical Sciences, Universityof Campania "Luigi Vanvitelli", Naples, Italy.
| | - Fabio Tortora
- Advanced Biomedical Sciences Department University of Naples "Federico II", Napoli, Italy.
| | - Ferdinando Caranci
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
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Patel N, Maher J, Lie X, Gwaltney C, Morgan S, Meyers O, Workman C, Negro A, Cohen G. P-170 Understanding patient experience in hepatocellular carcinoma: A qualitative patient interview study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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26
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Conticini E, Negro A, Magnani L, Ugolini R, Atienza-Mateo B, Frediani B, Salvarani C. Gitelman syndrome associated with chondrocalcinosis and severe neuropathy: a novel heterozygous mutation in SLC12A3 gene. Reumatismo 2020; 72:67-70. [PMID: 32292023 DOI: 10.4081/reumatismo.2020.1255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/02/2020] [Indexed: 11/22/2022] Open
Abstract
Gitelman syndrome (GS) is an inherited salt-wasting tubulopathy characterized by hypocalciuria, hypokalemia, hypomagnesemia and metabolic alkalosis, due to inactivating mutations in the SLC12A3 gene. Symptoms may be systemic, neurological, cardiovascular, ophthalmological or musculoskeletal. We describe a 70 year-old patient affected by recurrent arthralgias, hypoesthesia and hyposthenia in all 4 limbs and severe hypokalemia, complicated by atrial flutter. Moreover, our patient reported eating large amounts of licorice, and was treated with medium-high dosages of furosemide, thus making diagnosis very challenging. Genetic analysis demonstrated a novel heterozygous mutation in the SLC12A3 gene; therefore, we diagnosed GS and started potassium and magnesium replacement. GS combined with chondrocalcinosis and neurological involvement is quite common, but this is the first case of an EMG-proven severe neuropathy associated with GS. Herein, we underline the close correlation between hypomagnesemia, chondrocalcinosis and neurological involvement. Moreover, we report a new heterozygous mutation in exon 23 (2738G>A), supporting evidence of a large genetic heterogeneity in this late-onset congenital tubulopathy.
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Affiliation(s)
- E Conticini
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Università di Siena, Policlinico Le Scotte, Siena, Italy; Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia.
| | - A Negro
- Department of Medicine, Center for Hypertension, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia.
| | - L Magnani
- Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia.
| | - R Ugolini
- Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia.
| | - B Atienza-Mateo
- Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander.
| | - B Frediani
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Università di Siena, Policlinico Le Scotte, Siena.
| | - C Salvarani
- Unit of Rheumatology, Università di Modena e Reggio Emilia, Modena.
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Capasso R, Negro A, Cirillo S, Iovine S, Puoti G, Cirillo M, Conforti R. Large anterior temporal Virchow–Robin spaces: Evaluating MRI features over the years—Our experience and literature review. Clinical and Translational Neuroscience 2020. [DOI: 10.1177/2514183x20905252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dilated Virchow–Robin spaces (VRSs) are expansions of the normal perivascular spaces with a short axis greater than 2 mm or, according to some authors, greater than 3 mm. They are usually documented at the basal ganglia, at the convexity white matter (WM) and centrum semiovale, and at the mesencephalon. The anterior temporal WM is a recently described preferential location for large (≥5 mm) VRSs. The aim of our study was to evaluate the magnetic resonance imaging (MRI) features and their modifications during a long-term follow-up period (≥24 months) of the anterior temporal VRSs with a retrospective analysis among all brain MRI studies performed at our institution between January 2010 and January 2017. In our study, the presence and the stability of characteristic MRI features certainly increased our diagnostic confidence allowing us to continue conservative approach while the surrounding signal change, as reported in the literature, should not in itself prompt alternative diagnoses to be entertained.
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Affiliation(s)
- Raffaella Capasso
- Neuroradiology Unit PO CTO, University of Campania Luigi Vanvitelli, Viale Colli Aminei 21, Napoli, Italy
| | - Alberto Negro
- Neuroradiology Unit PO, Ospedale del Mare, ASL Napoli 1, Via Enrico Rossi, Napoli, Italy
| | - Sossio Cirillo
- Neuroradiology Unit PO CTO, University of Campania Luigi Vanvitelli, Viale Colli Aminei 21, Napoli, Italy
| | - Silvia Iovine
- Dipartimento di Medicina di Precisione, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Gianfranco Puoti
- Dipartimento di Scienze Mediche e Chirurgiche Avanzate (DAMSS), University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Mario Cirillo
- Dipartimento di Scienze Mediche e Chirurgiche Avanzate (DAMSS), University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Renata Conforti
- Dipartimento di Medicina di Precisione, University of Campania Luigi Vanvitelli, Napoli, Italy
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Bruno G, Miele G, Abbadessa G, Di Pietro A, Russo C, Negro A, Bonavita S, Puoti G. Atypical progressive multifocal leukoencephalopathy in a kidney transplant recipient with improving symptoms after immunocompetence recovery. Infez Med 2020; 28:87-90. [PMID: 32172266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Progressive multifocal leukoencephalopathy (PML) is a viral infection due to John Cunningham Virus (JCV) resulting in progressive damage of brain white matter, mostly related to HIV infection or hemato-oncological malignancies. PML onset is usually multifocal with rapid neurological progression and poor prognosis. Here we report an atypical case of PML with monofocal onset and a good outcome in a 64-year-old man who received a kidney transplant for end-stage renal disease (ESRD). The applied antirejection immunosuppressive drug regimen included tacrolimus, prednisone and mycophenolic acid. Three years after the transplant, he complained of right-hand tremor and rapidly progressive right hemiparesis, with prominent involvement of the upper limb. Brain magnetic resonance imaging (MRI) showed a significant demyelinating area in the left frontal lobe, without mass effect and contrast enhancement. Real-time PCR analysis revealed the presence of JCV on cerebrospinal fluid. Consequent immunosuppressive drug suspension resulted in a global improvement of neurological symptoms and a favourable evolution of the neuroradiological findings. Subsequent eight-year follow-up MRI confirmed the stability of imaging findings over time. Therefore, early recognition of PML symptoms and MRI sign along with the rapid suspension of immunosuppressive drugs can modify the natural history of this disease after a kidney transplant.
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Affiliation(s)
- Giorgia Bruno
- Second Division of Neurology. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppina Miele
- Second Division of Neurology. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianmarco Abbadessa
- Second Division of Neurology. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Di Pietro
- Second Division of Neurology. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Camilla Russo
- Department of Advanced Biomedical Sciences, University "Federico II" of Naples, Naples, Italy
| | - Alberto Negro
- Ospedale del Mare, ASL NA1, Neuroradiology Unit, Naples, Italy; Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Simona Bonavita
- Second Division of Neurology. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianfranco Puoti
- Second Division of Neurology. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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Negro A, Nicolai A, D’Anna A, Moscato G, Maffucci R, Gioia MR, Bianco A, Cappabianca S. Magnetic resonance imaging in the identification of anatomical risk factors in patients affected by obstructive sleep apnoea. Imaging 2019. [DOI: 10.1183/13993003.congress-2019.oa1934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Tortora F, Negro A, Grasso LFS, Colao A, Pivonello R, Splendiani A, Brunese L, Caranci F. Pituitary magnetic resonance imaging predictive role in the therapeutic response of growth hormone-secreting pituitary adenomas. Gland Surg 2019; 8:S150-S158. [PMID: 31559182 DOI: 10.21037/gs.2019.06.04] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Growth hormone (GH)-secreting pituitary adenomas, responsible for the development of acromegaly, are the second most frequent type of secreting pituitary adenomas and are characterized by very variable T2-weighted signal intensity on pituitary magnetic resonance imaging (MRI). Previous data have demonstrated a correlation between T2-weighted tumor signal intensity and response to therapy with conventional somatostatin analogs (SSA) in patients with acromegaly. The aim of the current retrospective study was to investigate the correlation between the T2-weighted tumor signal on pituitary MRI and both biochemical and radiological response to first-line SSA therapy. Methods Twenty-two naive patients with acromegaly were eligible for the study (14 females and 8 males, mean age ± SD: 58.8±15.74). A biochemical evaluation (GH and IGF-I levels) and an MRI assessment (volume and signal intensity analysis of adenoma) were conducted in each patient at diagnosis and after 12 months of SSA therapy. Results On diagnostic pituitary MRI, 16 (72.7%) adenomas were T2- hypointense and 6 (27.2%) T2-hyperintense. After 12 months of SSA therapy, IGF-I levels decreased by more than 50% from baseline in 62.5% of patients with T2-hypointense and 33.3% of patients with T2- hyperintense tumor signal, respectively (P=0.03). Moreover, GH levels decreased by more than 80% from baseline in 81.3% and 33.3% of patients with T2-hypointense and T2-hyperintense tumor signal (P=0.02). A significant tumor volume reduction (≥20%) was observed in 75% of the T2-hypointense and 33.3% of the T2-hyperintense adenomas (P=0.001). Conclusions In naive patients with acromegaly, first-line SSA therapy is associated with a better biochemical response and greater tumor shrinkage in T2-hypointense compared to T2-hyperintense adenomas. Therefore, T2-weighted sequences of pituitary MRI can help to classify GH-secreting pituitary adenomas into a T2-hypointense and T2-hyperintense type and, therefore, to identify patients who can better respond to first-line SSA therapy.
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Affiliation(s)
- Fabio Tortora
- Department of Precision Medicine, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alberto Negro
- Department of Precision Medicine, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ludovica F S Grasso
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Ferdinando Caranci
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
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Malandrino D, Manno I, Negro A, Petta A, Serra L, Cantarella C, Scarano V. Social support for collaboration and group awareness in life science research teams. Source Code Biol Med 2019; 14:4. [PMID: 31320922 PMCID: PMC6615102 DOI: 10.1186/s13029-019-0074-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 07/01/2019] [Indexed: 11/10/2022]
Abstract
Background Next-generation sequencing (NGS) technologies have revolutionarily reshaped the landscape of ’-omics’ research areas. They produce a plethora of information requiring specific knowledge in sample preparation, analysis and characterization. Additionally, expertise and competencies are required when using bioinformatics tools and methods for efficient analysis, interpretation, and visualization of data. These skills are rarely covered in a single laboratory. More often the samples are isolated and purified in a first laboratory, sequencing is performed by a private company or a specialized lab, while the produced data are analyzed by a third group of researchers. In this scenario, the support, the communication, and the information sharing among researchers represent the key points to build a common knowledge and to meet the project objectives. Results We present ElGalaxy, a system designed and developed to support collaboration and information sharing among researchers. Specifically, we integrated collaborative functionalities within an application usually adopted by Life Science researchers. ElGalaxy, therefore, is the result of the integration of Galaxy, i.e., a Workflow Management System, with Elgg, i.e., a Social Network Engine. Conclusions ElGalaxy enables scientists, that work on the same experiment, to collaborate and share information, to discuss about methods, and to evaluate results of the individual steps, as well as of entire activities, performed during their experiments. ElGalaxy also allows a greater team awareness, especially when experiments are carried out with researchers which belong to different and distributed research centers. Electronic supplementary material The online version of this article (10.1186/s13029-019-0074-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Delfina Malandrino
- Dipartimento di Informatica, Università degli Studi di Salerno, Via Giovanni Paolo II, Fisciano (SA), Italy
| | - Ilaria Manno
- Dipartimento di Informatica, Università degli Studi di Salerno, Via Giovanni Paolo II, Fisciano (SA), Italy
| | - Alberto Negro
- Dipartimento di Informatica, Università degli Studi di Salerno, Via Giovanni Paolo II, Fisciano (SA), Italy
| | - Andrea Petta
- Dipartimento di Informatica, Università degli Studi di Salerno, Via Giovanni Paolo II, Fisciano (SA), Italy
| | - Luigi Serra
- Dipartimento di Informatica, Università degli Studi di Salerno, Via Giovanni Paolo II, Fisciano (SA), Italy
| | - Concita Cantarella
- 2Consiglio per la Ricerca in Agricoltura e l'Analisi dell'Economia Agraria, Pontecagnano (SA), Salerno, Italy
| | - Vittorio Scarano
- Dipartimento di Informatica, Università degli Studi di Salerno, Via Giovanni Paolo II, Fisciano (SA), Italy
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García-Azorin D, Yamani N, Messina LM, Peeters I, Ferilli MAN, Ovchinnikov D, Speranza ML, Marini V, Negro A, Benemei S, Barloese M. Correction to: A PRISMA-compliant systematic review of the endpoints employed to evaluate symptomatic treatments for primary headaches. J Headache Pain 2019; 20:14. [PMID: 30760196 PMCID: PMC6734367 DOI: 10.1186/s10194-019-0967-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 11/25/2022] Open
Affiliation(s)
- D García-Azorin
- Headache Unit Neurology Department, Hospital Clínico Universitario Valladolid, Avda. Ramón y Cajal 3, 47005, Valladolid, Spain.
| | - N Yamani
- Danish Headache Centre and Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Copenhagen, Denmark.,Headache Department, Iranian Center of Neurological Research Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - L M Messina
- Child Neuropsychiatry School, University of Palermo, Palermo, Italy.,U.O. Neuropsychiatry - ARNAS Civico, PO Di Cristina, Palermo, Italy
| | - I Peeters
- Neurology Department, University Hospital of Brussels, Brussels, Belgium
| | - M A N Ferilli
- Headache Center, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - D Ovchinnikov
- Pavlov First Saint Petersburg State Medical University, Saint Petesburg, Russia.,Almazov National Medical Research Centre, Saint Petesburg, Russia
| | - M L Speranza
- Internal Medicine Department, Sant'Andrea Hospital, Rome, Italy
| | - V Marini
- Internal Medicine Department, Sant'Andrea Hospital, Rome, Italy
| | - A Negro
- Regional Referral Headache Centre, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - S Benemei
- Headache Centre, Careggi University Hospital, University of Florence, Florence, Italy
| | - M Barloese
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging, Hvidovre Hospital, Copenhagen, Denmark
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33
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García-Azorin D, Yamani N, Messina LM, Peeters I, Ferrili M, Ovchinnikov D, Speranza ML, Marini V, Negro A, Benemei S, Barloese M. A PRISMA-compliant systematic review of the endpoints employed to evaluate symptomatic treatments for primary headaches. J Headache Pain 2018; 19:90. [PMID: 30242571 PMCID: PMC6742919 DOI: 10.1186/s10194-018-0920-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/14/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Primary headache are prevalent and debilitating disorders. Acute pain cessation is one of the key points in their treatment. Many drugs have been studied but the design of the trials is not usually homogeneous. Efficacy of the trial is determined depending on the selected primary endpoint and usually other different outcomes are measured. We aim to critically appraise which were the employed outcomes through a systematic review. METHODS We conducted a systematic review of literature focusing on studies on primary headache evaluating acute relief of pain, following the PRISMA guideline. The study population included patients participating in a controlled study about symptomatic treatment. The comparator could be placebo or the standard of care. The collected information was the primary outcome of the study and all secondary outcomes. We evaluated the studied drug, the year of publication and the type of journal. We performed a search and we screened all the potential papers and reviewed them considering inclusion/exclusion criteria. RESULTS The search showed 4288 clinical trials that were screened and 794 full articles were assessed for eligibility for a final inclusion of 495 papers. The studies were published in headache specific journals (58%), general journals (21.6%) and neuroscience journals (20.4%). Migraine was the most studied headache, in 87.8% studies, followed by tension type headache in 4.7%. Regarding the most evaluated drug, triptans represented 68.6% of all studies, followed by non-steroidal anti-inflammatories (25.1%). Only 4.6% of the papers evaluated ergots and 1.6% analyzed opioids. The most frequent primary endpoint was the relief of the headache at a determinate moment, in 54.1%. Primary endpoint was evaluated at 2-h in 69.9% of the studies. Concerning other endpoints, tolerance was the most frequently addressed (83%), followed by headache relief (71.1%), improvement of other symptoms (62.5%) and presence of relapse (54%). The number of secondary endpoints increased from 4.2 (SD = 2.0) before 1991 to 6.39 after 2013 (p = 0.001). CONCLUSION Headache relief has been the most employed primary endpoint but headache disappearance starts to be firmly considered. The number of secondary endpoints increases over time and other outcomes such as disability, quality of life and patients' preference are receiving attention.
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Affiliation(s)
- D. García-Azorin
- Headache Unit Neurology Department, Hospital Clínico Universitario Valladolid, Avda. Ramón y Cajal 3, 47005 Valladolid, Spain
| | - N. Yamani
- Danish Headache Centre and Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Copenhagen, Denmark
- Headache Department, Iranian Center of Neurological Research Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - L. M. Messina
- Child Neuropsychiatry School, University of Palermo, Palermo, Italy
- U.O. Neuropsychiatry - ARNAS Civico, PO Di Cristina, Palermo, Italy
| | - I. Peeters
- Neurology Department, University Hospital of Brussels, Brussels, Belgium
| | - M. Ferrili
- Headache Center, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - D. Ovchinnikov
- Pavlov First Saint Petersburg State Medical University, Saint Petesburg, Russia
- Almazov National Medical Research Centre, Saint Petesburg, Russia
| | - M. L. Speranza
- Internal Medicine Department, Sant’Andrea Hospital, Rome, Italy
| | - V. Marini
- Internal Medicine Department, Sant’Andrea Hospital, Rome, Italy
| | - A. Negro
- Regional Referral Headache Centre, Sant’Andrea Hospital, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - S. Benemei
- Headache Centre, Careggi University Hospital, University of Florence, Florence, Italy
| | - M. Barloese
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging, Hvidovre Hospital, Copenhagen, Denmark
| | - on behalf of the European Headache Federation School of Advanced Studies (EHF-SAS)
- Headache Unit Neurology Department, Hospital Clínico Universitario Valladolid, Avda. Ramón y Cajal 3, 47005 Valladolid, Spain
- Danish Headache Centre and Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Copenhagen, Denmark
- Headache Department, Iranian Center of Neurological Research Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Child Neuropsychiatry School, University of Palermo, Palermo, Italy
- U.O. Neuropsychiatry - ARNAS Civico, PO Di Cristina, Palermo, Italy
- Neurology Department, University Hospital of Brussels, Brussels, Belgium
- Headache Center, Bambino Gesù Children Hospital IRCCS, Rome, Italy
- Pavlov First Saint Petersburg State Medical University, Saint Petesburg, Russia
- Almazov National Medical Research Centre, Saint Petesburg, Russia
- Internal Medicine Department, Sant’Andrea Hospital, Rome, Italy
- Regional Referral Headache Centre, Sant’Andrea Hospital, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
- Headache Centre, Careggi University Hospital, University of Florence, Florence, Italy
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging, Hvidovre Hospital, Copenhagen, Denmark
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Nolfe G, Cirillo M, Iavarone A, Negro A, Garofalo E, Cotena A, Lazazzara M, Zontini G, Cirillo S. Bullying at Workplace and Brain-Imaging Correlates. J Clin Med 2018; 7:jcm7080200. [PMID: 30081562 PMCID: PMC6111669 DOI: 10.3390/jcm7080200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/03/2018] [Accepted: 08/03/2018] [Indexed: 01/05/2023] Open
Abstract
The relationship between psychosocial stress at work and mental health outcome is well-known. Brain-imaging studies hypothesize morphological brain modifications connected to work-related stress. To our knowledge this is the first study describing the link between work characteristics and brain imaging in a sample of work-related psychiatric patients assessed according to standardized clinical and diagnostic criteria. The aims of the study are: (1) to evaluate hippocampal and whole brain volumes in work-related psychiatric disturbances; (2) to verify the relationship between brain changes and the anxious and/or depressive symptoms; (3) to observe the relationship between the brain changes and the degree of the bullying at workplace. The hippocampus and whole brain volumes of 23 patients with work-related adjustment-disorders were compared with 15 controls by means of MRI. MR images highlight a smaller hippocampal volume in patients compared with controls. Significant reduction in the patients’ gray matter was found in three brain areas: right inferior temporal gyrus, left cuneus, left inferior occipital gyrus. The reduction of the hippocampi volumes was related to work distress and, above all, to bullying at workplace. The results confirm that the morphological brain abnormalities could be involved in work-related psychiatric disturbances.
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Affiliation(s)
- Giovanni Nolfe
- Department of Mental Health Naples 1, Work Psychopathology Medical Centre, Naples 89122, Italy.
| | - Mario Cirillo
- Neuroradiology Service, Department of Medical, Surgical, Neurological, Metabolic & Aging Sciences, University of Campania "Luigi Vanvitelli", Naples 80131, Italy.
| | - Alessandro Iavarone
- Neurological and Stroke Unit, Centro Traumatologico Ortopedico Hospital, AORN "Ospedali dei Colli", Naples 80131, Italy.
| | - Alberto Negro
- Neuroradiology Service, Department of Medical, Surgical, Neurological, Metabolic & Aging Sciences, University of Campania "Luigi Vanvitelli", Naples 80131, Italy.
| | - Elisabetta Garofalo
- Neurological and Stroke Unit, Centro Traumatologico Ortopedico Hospital, AORN "Ospedali dei Colli", Naples 80131, Italy.
| | - Annisa Cotena
- Department of Mental Health Naples 1, Work Psychopathology Medical Centre, Naples 89122, Italy.
| | - Massimo Lazazzara
- Department of Mental Health Naples 1, Work Psychopathology Medical Centre, Naples 89122, Italy.
| | - Gemma Zontini
- Department of Mental Health Naples 1, Work Psychopathology Medical Centre, Naples 89122, Italy.
| | - Sossio Cirillo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples 80131, Italy.
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Conforti R, Sardaro A, Negro A, Caiazzo G, Paccone A, De Micco R, Cirillo S, Tessitore A. Dilated Virchow-Robin space and Parkinson's disease: A case report of combined MRI and diffusion tensor imaging. Radiol Case Rep 2018; 13:871-877. [PMID: 29988793 PMCID: PMC6031236 DOI: 10.1016/j.radcr.2018.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/10/2018] [Accepted: 05/23/2018] [Indexed: 12/03/2022] Open
Abstract
In this manuscript we report the case of a 69-year-old female patient, who suffers from Parkinson's disease (PD) with a dilated Virchow-Robin space (dVRS) on the left anterior perforated substance. During a magnetic resonance imaging examination, the presence of a dVRS was discovered on the left anterior perforated substance. Subsequently, the patient has been subjected to further investigation of magnetic resonance imaging and diffusion tensor imaging (DTI). The DTI data of our PD patient showed increased peak frequency of left fractional anisotropy and decreases in the distribution of Mean Diffusivity(MD) with changes in the fiber density compared to the normal contralateral tract. We hypothesize that the DTI changes are due to dVRS. In the text a review of the recent literature on the presence of dVRSs, located in mono and bilateral seat, in patients with PD is reported, explaining its possible implications on disease progression, cognitive decline, and worsening of symptoms.
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Affiliation(s)
- Renata Conforti
- Università degli Studi della Campania Luigi Vanvitelli, Section of Neuroradiology, viale Colli Aminei 21, Napoli 80131, Italy
| | - Angela Sardaro
- Università degli Studi della Campania Luigi Vanvitelli, piazza Miraglia 2, Napoli 80138, Italy
| | - Alberto Negro
- Università degli Studi della Campania Luigi Vanvitelli, Section of Neuroradiology, viale Colli Aminei 21, Napoli 80131, Italy
| | - Giuseppina Caiazzo
- MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, piazza Miraglia 2, Napoli 80138, Italy
| | - Antonella Paccone
- MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, piazza Miraglia 2, Napoli 80138, Italy
| | - Rosita De Micco
- Università degli Studi della Campania Luigi Vanvitelli, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, piazza Miraglia 2, Napoli 80138, Italy
| | - Sossio Cirillo
- Università degli Studi della Campania Luigi Vanvitelli, Section of Neuroradiology, viale Colli Aminei 21, Napoli 80131, Italy
| | - Alessandro Tessitore
- Università degli Studi della Campania Luigi Vanvitelli, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, piazza Miraglia 2, Napoli 80138, Italy
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Signoriello E, Cirillo M, Puoti G, Signoriello G, Negro A, Koci E, Melone MAB, Rapacciuolo A, Maresca G, Lus G. Migraine as possible red flag of PFO presence in suspected demyelinating disease. J Neurol Sci 2018; 390:222-226. [PMID: 29801894 DOI: 10.1016/j.jns.2018.04.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/10/2018] [Accepted: 04/27/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To investigate a possible association between isolated white matter lesions suggestive of demyelinating disease in magnetic resonance imaging (MRI) and patent foramen ovale (PFO) evidence in migraine patients, with or without aura. MATERIALS 31 migraine patients, 28 females and 3 males, with MRI evidence of white matter lesions suggestive of demyelinating disease according to the Barkhof Criteria. All patients underwent further diagnostics including lumbar puncture, autoimmunity panel and cardiological evaluation to detect the presence of PFO. The mean duration of follow-up was 3.46 years and MIPAV software was used to analyze MRI imaging. RESULTS 14 of the 31 patients (45%) had PFO. A significant association was found between PFO and migraine with visual aura (p < 0.001). No difference in lesion number, volume or area between patients with and without PFO was found, but the distribution was mainly occipital (p < 0.001) in patients with PFO. The follow-up showed a stationary lesion load in all PFO patients; no infratentorial or spinal cord lesion and no enhancement or corpus callosum lesion was ever detected. At the end of follow-up four patients developed multiple sclerosis: younger age at first MRI and oligoclonal bands were associated risk factors. CONCLUSIONS Migraine is often one of the main symptoms leading to MRI, and in many cases white matter lesions of unspecific significance are discovered, thus placing demyelinating diseases in the differential diagnosis. Our study underlines the potential pathogenetic role of PFO in generating white matter lesions in migraine patients (45%), particularly those with visual aura and occipital lesions. For this reason, we affirm that PFO represents a cardinal point in the differential diagnosis of suspected demyelinating disease.
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Affiliation(s)
- E Signoriello
- Multiple Sclerosis Centre, II Division of Neurology, Department of Surgical Medical Science, Neurological, Metabolic and Aging, Interuniversity Center for research in Neurosciences, University of Campania L. Vanvitelli, Naples, Italy.
| | - M Cirillo
- Department of Surgical Medical Sciences, Neurological, Metabolic and Aging, University of Campania L.Vanvitelli, Naples, Italy
| | - G Puoti
- Multiple Sclerosis Centre, II Division of Neurology, Department of Surgical Medical Science, Neurological, Metabolic and Aging, Interuniversity Center for research in Neurosciences, University of Campania L. Vanvitelli, Naples, Italy
| | - G Signoriello
- Department of Mental Health and Preventive Medicine, University of Campania, L. Vanvitelli, Naples, Italy
| | - A Negro
- Department of Surgical Medical Sciences, Neurological, Metabolic and Aging, University of Campania L.Vanvitelli, Naples, Italy
| | - E Koci
- Department of Advanced, Biomedical Sciences, University Federico II, Naples, Italy
| | - M A B Melone
- Multiple Sclerosis Centre, II Division of Neurology, Department of Surgical Medical Science, Neurological, Metabolic and Aging, Interuniversity Center for research in Neurosciences, University of Campania L. Vanvitelli, Naples, Italy
| | - A Rapacciuolo
- Department of Advanced, Biomedical Sciences, University Federico II, Naples, Italy
| | - G Maresca
- Cardiology Unit, San Leonardo Hospital, Castellammare di Stabia, Italy
| | - G Lus
- Multiple Sclerosis Centre, II Division of Neurology, Department of Surgical Medical Science, Neurological, Metabolic and Aging, Interuniversity Center for research in Neurosciences, University of Campania L. Vanvitelli, Naples, Italy
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Pellesi L, Benemei S, Favoni V, Lupi C, Mampreso E, Negro A, Paolucci M, Steiner TJ, Ulivi M, Cevoli S, Guerzoni S. Quality indicators in headache care: an implementation study in six Italian specialist-care centres. J Headache Pain 2017; 18:55. [PMID: 28477307 PMCID: PMC5419950 DOI: 10.1186/s10194-017-0762-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 04/27/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Headache disorders are highly prevalent, and have a substantial and negative impact on health worldwide. They are largely treatable, but differences in structure, objectives, organization and delivery affect the quality of headache care. In order to recognize and remedy deficiencies in care, the Global Campaign against Headache, in collaboration with the European Headache Federation, recently developed a set of quality indicators for headache services. These require further assessment to demonstrate fitness for purpose. This is their first implementation to evaluate quality in headache care as a multicentre national study. METHODS Between September and December 2016, we applied the quality indicators in six Italian specialist headache centres (Bologna, Firenze, Modena, Padova, Roma Campus Bio-Medico and Roma Sapienza). We used five previously developed assessment instruments, translated into Italian according to Lifting The Burden's translation protocol for hybrid documents. We took data from 360 consecutive patients (60 per centre) by questionnaire and from their medical records, and by different questionnaires from their health-care providers (HCPs), including physicians, nurses, psychologists and nursing assistants. RESULTS The findings, comparable between centres, confirmed the feasibility and practicability of using the quality indicators in Italian specialist headache centres. The questionnaires were easily understood by HCPs and patients, and were not unduly time-consuming. Diagnoses were almost all (> 97%) according to ICHD criteria, and routinely (100%) reviewed during follow-up. Diagnostic diaries were regularly used by 96% of physicians. Referral pathways from primary to specialist care existed in five of the six clinics, as did urgent referral pathways. Instruments to assess disability and quality of life were not used regularly, a deficiency that needs to be addressed. CONCLUSION This Italy-wide survey confirmed in six specialist centres that the headache service quality indicators are fit for purpose. By establishing majority practice, identifying commonalities and detecting deficits as a guide to quality improvement, the quality indicators may be used to set benchmarks for quality assessment. The next step is extend use and evaluation of the indicators into non-specialist care.
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Affiliation(s)
- L Pellesi
- Medical Toxicology - Headache Centre, Policlinic Hospital, University of Modena and Reggio Emilia, Modena, Italy.
| | - S Benemei
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - V Favoni
- IRCCS Institute of Neurological Sciences of Bologna, Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Bologna, Italy
| | - C Lupi
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - E Mampreso
- Department of Neurosciences, Headache Centre, University of Padua, Padua, Italy
| | - A Negro
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - M Paolucci
- Headache Centre, Neurology Unit, University Campus Bio-Medico, Rome, Italy
| | - T J Steiner
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Division of Brain Sciences, Imperial College London, London, UK
| | - M Ulivi
- Headache Centre, Neurology Unit, University Campus Bio-Medico, Rome, Italy
| | - S Cevoli
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - S Guerzoni
- Medical Toxicology - Headache Centre, Policlinic Hospital, University of Modena and Reggio Emilia, Modena, Italy
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Negro A, Delaruelle Z, Ivanova TA, Khan S, Ornello R, Raffaelli B, Terrin A, Reuter U, Mitsikostas DD. Headache and pregnancy: a systematic review. J Headache Pain 2017; 18:106. [PMID: 29052046 PMCID: PMC5648730 DOI: 10.1186/s10194-017-0816-0] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/11/2017] [Indexed: 02/06/2023] Open
Abstract
This systematic review summarizes the existing data on headache and pregnancy with a scope on clinical headache phenotypes, treatment of headaches in pregnancy and effects of headache medications on the child during pregnancy and breastfeeding, headache related complications, and diagnostics of headache in pregnancy. Headache during pregnancy can be both primary and secondary, and in the last case can be a symptom of a life-threatening condition. The most common secondary headaches are stroke, cerebral venous thrombosis, subarachnoid hemorrhage, pituitary tumor, choriocarcinoma, eclampsia, preeclampsia, idiopathic intracranial hypertension, and reversible cerebral vasoconstriction syndrome. Migraine is a risk factor for pregnancy complications, particularly vascular events. Data regarding other primary headache conditions are still scarce. Early diagnostics of the disease manifested by headache is important for mother and fetus life. It is especially important to identify “red flag symptoms” suggesting that headache is a symptom of a serious disease. In order to exclude a secondary headache additional studies can be necessary: electroencephalography, ultrasound of the vessels of the head and neck, brain MRI and MR angiography with contrast ophthalmoscopy and lumbar puncture. During pregnancy and breastfeeding the preferred therapeutic strategy for the treatment of primary headaches should always be a non-pharmacological one. Treatment should not be postponed as an undermanaged headache can lead to stress, sleep deprivation, depression and poor nutritional intake that in turn can have negative consequences for both mother and baby. Therefore, if non-pharmacological interventions seem inadequate, a well-considered choice should be made concerning the use of medication, taking into account all the benefits and possible risks.
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Affiliation(s)
- A Negro
- Department of Clinical and Molecular Medicine, Regional Referral Headache Centre, Sapienza University of Rome, Sant'Andrea Hospital, 00189, Rome, Italy.
| | - Z Delaruelle
- Department of Neurology, Ghent University Hospital, 9000, Ghent, Belgium
| | - T A Ivanova
- Institute of Professional Education, Chair of Neurology. I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - S Khan
- Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, -2600, Glostrup, DK, Denmark
| | - R Ornello
- Department of Neurology, University of L'Aquila, 67100, L'Aquila, Italy
| | - B Raffaelli
- Department of Neurology, Charité Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - A Terrin
- Department of Neurosciences, Headache Centre, University of Padua, 35128, Padua, Italy
| | - U Reuter
- Department of Neurology, Charité Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - D D Mitsikostas
- Neurology Department, Aeginition Hospital, National and Kapodistrian University of Athens, 11528, Athens, Greece
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Zanelli M, Negro A, Santi R, Bisagni A, Ragazzi M, Ascani S, De Marco L. Letter: sprue-like enteropathy associated with angiotensin II receptor blockers other than olmesartan. Aliment Pharmacol Ther 2017; 46:471-473. [PMID: 28707802 DOI: 10.1111/apt.14176] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- M Zanelli
- Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emila, Italy
| | - A Negro
- Internal Medicine and Hypertension Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emila, Italy
| | - R Santi
- Internal Medicine and Hypertension Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emila, Italy
| | - A Bisagni
- Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emila, Italy
| | - M Ragazzi
- Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emila, Italy
| | - S Ascani
- Institute of Pathology, Ospedale di Terni, University of Perugia, Perugia, Italy
| | - L De Marco
- Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emila, Italy
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Allazetta S, Negro A, Lutolf MP. Microfluidic Programming of Compositional Hydrogel Landscapes. Macromol Rapid Commun 2017; 38. [DOI: 10.1002/marc.201700255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 05/09/2017] [Indexed: 12/13/2022]
Affiliation(s)
- S. Allazetta
- Laboratory of Stem Cell Bioengineering; Institute of Bioengineering; School of Life Sciences and School of Engineering; Ecole Polytechnique Fédérale de Lausanne (EPFL); CH-1015 Lausanne Switzerland
| | - A. Negro
- Laboratory of Stem Cell Bioengineering; Institute of Bioengineering; School of Life Sciences and School of Engineering; Ecole Polytechnique Fédérale de Lausanne (EPFL); CH-1015 Lausanne Switzerland
| | - M. P. Lutolf
- Laboratory of Stem Cell Bioengineering; Institute of Bioengineering; School of Life Sciences and School of Engineering; Ecole Polytechnique Fédérale de Lausanne (EPFL); CH-1015 Lausanne Switzerland
- Institute of Chemical Sciences and Engineering; School of Basic Sciences; EPFL; CH-1015 Lausanne Switzerland
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Rodríguez D, Morales J, Flechoso F, Sánchez JA, Negro A, Lizana M. On the distribution and general abundance of non-native species associated with the Ebro River (Castejón, Navarra, Ne Spain). Russ J Biol Invasions 2017. [DOI: 10.1134/s2075111717020072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Sivakumar S, Taccone FS, Desai KA, Lazaridis C, Skarzynski M, Sekhon M, Henderson W, Griesdale D, Chapple L, Deane A, Williams L, Strickland R, Lange K, Heyland D, Chapman M, Rowland MJ, Garry P, Westbrook J, Corkill R, Antoniades CA, Pattinson KT, Fatania G, Strong AJ, Myers RB, Lazaridis C, Jermaine CM, Robertson CS, Rusin CG, Hofmeijer J, Sondag L, Tjepkema-Cloostermans MC, Beishuizen A, Bosch FH, van Putten MJAM, Carteron L, Patet C, Solari D, Oddo M, Ali MA, Dias C, Almeida R, Vaz-Ferreira A, Silva J, Monteiro E, Cerejo A, Rocha AP, Elsayed AA, Abougabal AM, Beshey BN, Alzahaby KM, Pozzebon S, Ortiz AB, Cristallini S, Lheureux O, Brasseur A, Vincent JL, Creteur J, Taccone FS, Hravnak M, Yousef K, Chang Y, Crago E, Friedlander RM, Abdelmonem SA, Tahon SA, Helmy TA, Meligy HS, Puig F, Dunn-Siegrist I, Pugin J, Gupta S, Govil D, Srinivasan S, Patel SJ, N JK, Gupta A, Tomar DS, Shafi M, Harne R, Arora DP, Talwar N, Mazumdar S, Papakrivou EE, Makris D, Manoulakas E, Tsolaki B, Karadodas B, Zakynthinos E, Garcia IP, Martin AD, Encinares VS, Ibañez MP, Montero JG, Labrador G, Cangueiro TC, Poulose V, Koh J, Kam JW, Yeter H, Stepinska J, Pérez AG, Ordoñez PF, Giribet A, Cuervo MAA, Cuervo RA, Esteban MAR, Fraile LI, Mittelbrum CP, Albaiceta GM, Kara A, Koeze J, Keus F, Dieperink W, van der Horst ICC, van Meurs M, Zijlstra JG, Roberts S, Caballero CH, Isgro G, Hall D, Aktepe O, Beitland S, Trøseid AMS, Brusletto BS, Waldum-Grevbo BE, Berg JP, Sunde K, Huertas DG, Manzano F, Quintana MMJ, Osuna A, Topeli A, Santiago-Ruiz F, Rodríguez-Mejías C, Wangensteen R, Jamaati HR, Masjedi M, Zand F, Hashemian SMR, Sabetian G, Abbasi G, Khaloo V, Tsolakoglou I, Tabei SH, Kafilzadeh A, Bakhodaei HH, Diaz JA, Silva R, Garcia DJ, Luis E, Gomez MN, Soriano R, Gonzalez PL, Intas G, Ibrahim IA, Rafik MM, Al-Ansary AM, Algendi MA, Ali AA, Fuhrmann V, Roedl K, Horvatits T, Drolz A, Rutter K, Stergiannis P, Benten D, Kluwe J, Siedler S, Kluge S, Adedugbe I, Bird GT, Kennedy RM, Sharma S, Butler MB, Yugi G, Kolaros AA, Haroon BA, Witter T, Khaliq W, Singer M, Havaldar AA, Krishna B, Sriram S, Espinoza EDV, Pozo MO, Edul VSK, Chalari E, Furche M, Motta MF, Vazquez AR, Birri PNR, Ince C, Dubin A, Dogliotti A, Ramos A, Lovesio C, Delile E, Athanasiadou E, Nevière R, Thiébaut PA, Maupoint J, Mulder P, Coquerel D, Renet S, do Rego JC, Rieusset J, Richard V, Tamion F, Martika A, Khaliq W, Andreis DT, Singer M, Smit B, Smulders YM, de Waard MC, van Straaten HMO, Girbes ARJ, Eringa EC, Man AMESD, Fildisis G, Alegría L, Soto D, Luengo C, Gomez J, Jarufe N, Bruhn A, Castro R, Kattan E, Tapia P, Rebolledo R, Faivre V, Achurra P, Ospina-Tascón G, Bakker J, Hernández G, Bertini P, Guarracino F, Baldassarri R, Pinsky MR, Alegría L, Vera M, Mengelle C, Dreyse J, Carpio D, Henriquez C, Gajardo D, Bravo S, Castro R, Ospina-Tascón G, Bakker J, Hernández G, Kim S, Favier B, Lee M, Park SY, So S, Lee H, Kačar MB, Kačar SM, Uddin I, Belhaj AM, Aydın MA, Avsec D, Payen D, Kapuağası A, Kaymak Ç, Kovach L, Şencan İ, Meço B, Özçelik M, Ünal N, Lazaridis C, Jenni-Moser B, Jeitziner MM, Poppe A, Galassi MS, Sales FL, de Moraes KCL, Batista CL, Júnior JADS, Marcari TB, Lobato R, Castro CSAA, de Souza LM, Rodrigues FFP, Winkler MS, Correa NG, Pelegrini AM, Eid RAC, Timenetsky KT, Cazati D, Lobato M, Diniz PS, Rocha LL, Cavalheiro AM, Lucinio NM, Mudersbach E, Santos ER, Norrenberg M, Gleize A, Preiser JC, Simón IF, Carmona SA, Valhonrat IL, Domínguez JP, Abellán AN, Almudévar PM, Schreiber J, Dávila F, Rubio JJ, Ramos AJ, Reina ÁJR, López NP, Pérez MA, Apolo DXC, Villén LM, López FMP, García IP, Wruck ML, Izurieta JRN, Guerrero JJE, Calvert S, Quint M, Adeniji K, Young R, Shevill DD, Robertson E, Garside P, Walter E, Schwedhelm E, Isotti P, De Vecchi MM, Perduca AE, Negro A, Villa G, Manara DF, Cabrini L, Zangrillo A, Frencken JF, van Baal L, Kluge S, Peelen LM, Donker DW, Horn J, van der Poll T, van Klei WA, Bonten MJM, Cremer OL, Menard CE, Kumar A, Rimmer E, Zöllner C, Doucette S, Turgeon AF, Houston BL, Houston DS, Zarychanski R, Pinto BB, Carrara M, Ferrario M, Bendjelid K, Nunes J, Tavladaki T, Diaz P, Silva G, Escórcio S, Chaves S, Jardim M, Fernandes N, Câmara M, Duarte R, Pereira CA, Vieira J, Spanaki AM, Nóbrega JJ, Robles CMC, de Oca-Sandoval MAM, Sánchez-Rodríguez A, Joya-Galeana JG, Correa-Morales A, Camarena-Alejo G, Aguirre-Sánchez J, Franco-Granillo J, Soliman M, Dimitriou H, Al Azab A, El Hossainy R, Nagy H, Nirmalan M, Crippa IA, Cavicchi FZ, Vincent JL, Creteur J, Taccone FS, Chaari A, Kondili E, Hakim KA, Hassanein H, Etman M, El Bahr M, Bousselmi K, Khalil ES, Kauts V, Casey WF, Imahase H, Sakamoto Y, Choulaki C, Inoue S, Yamada KC, Koami H, Miike T, Nagashima F, Iwamura T, Boscolo A, Lucchetta V, Piasentini E, Bertini D, Meleti E, Manesso L, Spiezia L, Simioni P, Ori C, Souza RB, Martins AM, Liberatore AMA, Kang YR, Nakamae MN, Vieira JCF, Kafetzopoulos D, Koh IHJ, Hanslin K, Wilske F, Skorup P, Sjölin J, Lipcsey M, Long WJ, Zhen CE, Vakalos A, Avramidis V, Georgopoulos D, Wu SH, Shyu LJ, Li CH, Yu CH, Chen HC, Wang CH, Lin KH, Aray ZE, Gómez CF, Tejero AP, Briassoulis G, Monge DD, Losada VM, Tarancón CM, Cortés SD, Gutiérrez AM, Álvarez TP, Rouze A, Jaffal K, Six S, Stolz K, la Torre AGD, Cattoen V, Nseir S, Arnal JM, Saoli M, Novotni D, Garnero A, Becher T, Buchholz V, Schädler D, Frerichs I, de la Torre-Prados MV, Weiler N, Eronia N, Mauri T, Gatti S, Maffezzini E, Bronco A, Alban L, Sasso T, Marenghi C, Grasselli G, Tsvetanova-Spasova T, Pesenti A, Bellani G, Al-Fares A, Del Sorbo L, Anwar S, Facchin F, Azad S, Zamel R, Ferguson N, Cypel M, Nuevo-Ortega P, Keshavjee S, Fan E, Durlinger E, Spoelstra-de Man A, Smit B, de Grooth HJ, Girbes A, Straaten HOV, Smulders Y, Alfaro MA, Rueda-Molina C, Parrilla F, Meli A, Pellegrini M, Rodriguez N, Goyeneche JM, Morán I, Aguirre H, Mancebo J, Heines SJH, Strauch U, Fernández-Porcel A, Bergmans DCJJ, Blankman P, Shono A, Hasan D, Gommers D, Chung WY, Lee KS, Jung YJ, Park JH, Sheen SS, Camara-Sola E, Park KJ, Worral R, Denham S, Isherwood P, Rees SE, Larraza S, Dey N, Spadaro S, Brohus JB, Winding RW, Salido-Díaz L, Volta CA, Karbing DS, Ampatzidou F, Vlachou A, Kehagioglou G, Karaiskos T, Madesis A, Mauromanolis C, Michail N, Drossos G, García-Alcántara A, Saraj N, Rijkenberg S, Feijen HM, Endeman H, Donnelly AAJ, Morgan E, Garrard H, Buckley H, Russell L, Haase N, Tavladaki T, Perner A, Goh C, Mouyis K, Woodward CLN, Halliday J, Encina GB, Ros J, Lagunes L, Tabernero J, Bosch F, Spanaki AM, Rello J, Huertas DG, Manzano F, Morente-Constantin E, Rivera-Ginés B, Colmenero-Ruiz M, Abellán AN, Pérez LP, Lucendo AP, Almudévar PM, Dimitriou H, Domínguez JP, Villamizar PR, Sanz JG, Simon IF, Valbuena BL, Carmona SA, Pais M, Ramalingam S, Díaz C, Fox L, Kondili E, Santafe M, Barba P, García M, Leal S, Pérez M, Pérez MLP, Abellán AN, Lucendo AP, Almudevar PM, Domínguez JP, Choulaki C, Villamizar PR, Veganzones J, Simón IF, Valbuena BL, Martínez N, Carmona SA, Moors I, Mokart D, Pène F, Lambert J, Meleti DE, Kouatchet A, Mayaux J, Vincent F, Nyunga M, Bruneel F, Laisne L, Rabbat A, Lebert C, Perez P, Chaize M, Kafetzopoulos D, Renault A, Meert AP, Hamidfar R, Jourdain M, Darmon M, Schlemmer B, Chevret S, Lemiale V, Azoulay E, Benoit D, Georgopoulos D, Martins-Branco D, Sousa M, Marum S, Bouw MJ, Galstyan G, Makarova P, Parovichnikova E, Kuzmina L, Troitskaya V, Drize N, Briassoulis G, Gemdzhian E, Savchenko V, Chao HC, Kılıc E, Demiriz B, Uygur ML, Sürücü M, Cınar K, Yıldırım AE, Kiss K, Suberviola B, Köves B, Csernus V, Molnár Z, Ntantana A, Matamis D, Savvidou S, Giannakou M, Gouva M, Nakos G, Koulouras V, Riera J, Gaffney S, Black E, Docking R, Judge C, Drew T, Misran H, Munshi R, McGovern L, Coyle M, Dunne L, Rellan L, Deasy E, Lavin P, Fahy A, Darcy DM, Donnelly M, Ismail NH, Hall T, Wykes K, Jack J, Ngu WC, Sanchez M, Morgan P, Ruiz-Ramos J, Ramirez P, Gordon M, Villarreal E, Frasquet J, Poveda-Andrés JL, Castellanos A, Ijssennagger CE, ten Hoorn S, Robles JC, van Wijk A, van den Broek JM, Tuinman PR, Elmenshawy AM, Hammond BD, Gibbon G, Belcham T, Burton K, Taniguchi LU, Ramos FJS, Lopez E, Momma AK, Martins-Filho APR, Bartocci JJ, Lopes MFD, Sad MH, Rodrigues CM, Pires EMC, Vieira JM, Leite MA, Murbach LD, Vicente R, Osaku EF, Barreto J, Duarte ST, Taba S, Miglioranza D, Gund DP, Lordani CF, Costa CRLM, Ogasawara SM, Jorge AC, Miñambres E, Duarte PAD, Spadaro S, Capuzzo M, Corte FD, Terranova S, Scaramuzzo G, Fogagnolo A, Bertacchini S, Bellonzi A, Ragazzi R, Santibañez M, Volta CA, Cruz C, Nunes A, Pereira FS, Aragão I, Cardoso AF, Santos C, Malheiro MJ, Castro H, Cardoso T, Le Guen M, Paratz J, Kenardy J, Comans T, Coyer F, Thomas P, Boots R, Pereira N, Vilas-Boas A, Gomes E, Dias C, Moore J, Torres J, Carvalho D, Molinos E, Vales C, Araújo R, Cruz C, Nunes A, Pereira FS, Cardoso AF, Santos C, Mason N, Malheiro MJ, Castro H, Cardoso T, Karnatovskaia L, Philbrick K, Ognjen G, Clark M, Montero RM, Varas JL, Sánchez-Elvira LA, Windpassinger M, Delgado CP, Díaz PV, Ruiz BL, Guerrero AP, Galache JAC, Jiménez R, Rebollo S, Alejandro O, Fernández A, Moreno S, Plattner O, Herrera L, Ojados A, Galindo M, Murcia J, Contreras M, Sánchez-Argente S, Bonilla Y, Rodríguez MD, Allegue JM, Cakin Ö, Mascha E, Parlak H, Kirca H, Mutlu F, Aydınlı B, Cengiz M, Ramazanoglu A, Jung EJ, Oh SY, Lee H, Filho NMF, Sessler DI, Ricaldi EF, Gomes SS, Ramos BB, De Lucia CV, Ballalai CS, Oliveira JCA, Araponga GP, Veiga LN, Silva CS, Garrido ME, Research O, Domenech JC, Montalvo AP, Chornet TC, Martinez PC, Ribas MP, Costa RG, Ortega AC, Forbes C, Prescott H, Lal A, Melia U, Khan FA, Dela Pena EG, Dizon JS, Perez PPP, Wong CMJ, Garach MM, Romero OM, Puerta RR, Diaz FA, Bailon AMP, Fontanet J, Pinel AC, Maldonado LP, Kalaiselvan MS, kumar RLS, Renuka MK, Kumar ASA, De Rosa S, Ferrari F, Checcacci SC, Rigobello A, van den Berg JP, Joannidis M, Politi F, Pellizzari A, Bonato R, Fernandez-Carmona A, 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PI, Perner A, Soliman IW, de Lange DW, van Dijk D, van Delden JJM, Cremer OL, Slooter AJC, Peelen LM, McWilliams D, Snelson C, Neves AD, Loudet CI, Busico M, Vazquez D, Villalba D, Veronesi M, Lischinsky A, López FJL, Mori LB, Plotnikow G, Díaz A, Giannasi S, Hernandez R, Krzisnik L, Cecotti C, Viola L, Lopez R, Sottile JP, Benavent G, Estenssoro E, Chen CM, Lai CC, Cheng KC, Chou W, Chan KS, Roeker LE, Horkan CM, Gibbons FK, Christopher KB, Weijs PJM, Mogensen KM, Rawn JD, Robinson MK, Christopher KB, Tang Z, Qiu C, Ouyang B, Cai C, Guan X, Regueira T, Cea L, Carlos SJ, Elisa B, Puebla C, Vargas A, Poulsen MK, Thomsen LP, Kjærgaard S, Rees SE, Karbing DS, Wollersheim T, Frank S, Müller MC, Carbon NM, Skrypnikov V, Pickerodt PA, Falk R, Mahlau A, Weber-Carstens S, Lee A, Inglis R, Morgan R, Barker G, Kamata K, Abe T, Saitoh D, Tokuda Y, Green RS, Butler MB, Erdogan M, Hwa HT, Gil LJ, Vaquero RH, Rodriguez-Ruiz E, Lago AL, Allut JLG, Gestal AE, Gonzalez MAG, Thomas-Rüddel DO, Schwarzkopf D, Fleischmann C, Reinhart K, Suwanpasu S, Sattayasomboon Y, Filho NMF, Oliveira JCA, Ballalai CS, De Lucia CV, Araponga GP, Veiga LN, Silva CS, Garrido ME, Ramos BB, Ricaldi EF, Gomes SS, Gemmell L, MacKay A, Wright C, Docking RI, Doherty P, Black E, Stenhouse P, Plummer MP, Finnis ME, Phillips LK, Kar P, Bihari S, Biradar V, Moodie S, Horowitz M, Shaw JE, Deane AM, Yatabe T, Inoue S, Sakaguchi M, Egi M, Abdelhamid YA, Plummer MP, Finnis ME, Phillips LK, Kar P, Bihari S, Biradar V, Moodie S, Horowitz M, Shaw JE, Deane AM, Hokka M, Egi M, Mizobuchi S, Kar P, Plummer M, Abdelhamid YA, Giersch E, Summers M, Hatzinikolas S, Heller S, Chapman M, Jones K, Horowitz M, Deane A, Schweizer R, Jacquet-Lagreze M, Portran P, Junot S, Allaouchiche B, Fellahi JL, Guerci P, Ergin B, Kapucu A, Ince C, Cioccari L, Luethi N, Crisman M, Bellomo R, Mårtensson J, Shinotsuka CR, Fagnoul D, Brasseur A, Orbegozo D, Vincent JL, Preiser JC, Preiser JC, Lheureux O, Thooft A, Brimioulle S, Vincent JL, Iwasaka H, Tahara S, Nagamine M, Ichigatani A, Cabrera AR, Zepeda EM, Granillo JF, Sánchez JSA, Montoya AAT, Montenegro AP, Blanco GAG, Robles CMC, Drolz A, Horvatits T, Roedl K, Rutter K, Kluge S, Funk GC, Schneeweiss B, Fuhrmann V, Sabetian G, Pooresmaeel F, Zand F, Ghaffaripour S, Farbod A, Tabei H, Taheri L, Anandanadesan R, Metaxa V, Teixeira C, Pereira SM, Hernández-Marrero P, Carvalho AS, Beckmann M, Hartog CS, Schwarzkopf D, Raadts A, Robertsen A, Førde R, Skaga NO, Helseth E, Honeybul S, Ho K, Lopez PM, Gonzalez MN, Ortega PN, Sola EC, Spasova T, de la Torre-Prados MV, Kopecky O, Rusinova K, Waldauf P, Cepeplikova Z, Balik M, Domínguez JP, Almudevar PM, Carmona SA, Muñoz JJR, Castañeda DP, Abellán AN, Villamizar PR, Ramos JV, Pérez LP, Lucendo AP, Ejarque MC, Estella A, Camps VL, Martín MC, Masnou N, Barbosa S, Varela A, Palma I, Cristina L, Nunes E, Pereira I, Campello G, Granja C, Pande R, Pandey M, Varghese S, Chanu M, Van Dam MJ, Ter Braak EWMT, Estella A, Gracia M, Viciana R, Recuerda M, Fontaiña LP, Tharmalingam B, Kovari F, Rose L, Mcginlay M, Amin R, Burns K, Connolly B, Hart N, Jouvet P, Katz S, Leasa D, Mawdsley C, Mcauley D, Schultz M, Blackwood B, Denham S, Worrall R, Arshad M, Isherwood P, Khadjibaev A, Sabirov D, Rosstalnaya A, Parpibaev F, Sharipova V, Blanco GAG, Guzman CIO, Sánchez JSA, Granillo JF, Gupta S, Govil D, Srinivasan S, Patel SJ, N JK, Gupta A, Shafi M, Tomar DS, Harne R, Arora DP, Talwar N, Mazumdar S, Cha YS, Lee SJ, Tyagi N, Rajput RK, Taneja S, Singh VK, Sharma SC, Mittal S, Rao BK, Ayachi J, Fraj N, Romdhani S, Khedher A, Meddeb K, Sma N, Azouzi A, Bouneb R, Chouchene I, El Ghardallou M, Boussarsar M, Jennings R, Walter E, Ribeiro JM, Moniz I, Marçal R, Santos AC, Candeias C, e Silva ZC, Gomez SEZ, Nieto ORP, Gonzalez JAC, Cuellar AIV, Mildh H, Pettilä V, Korhonen AM, Karlsson S, Ala-Kokko T, Reinikainen M, Vaara ST, Zaleska-Kociecka M, Grabowski M, Dąbrowski M, Wozniak S, Piotrowska K, Banaszewski M, Imiela J. ESICM LIVES 2016: part two. Intensive Care Med Exp 2016. [PMCID: PMC5042923 DOI: 10.1186/s40635-016-0099-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Conforti R, Cirillo M, Sardaro A, Caiazzo G, Negro A, Paccone A, Sacco R, Sparaco M, Gallo A, Lavorgna L, Tedeschi G, Cirillo S. Dilated perivascular spaces and fatigue: is there a link? Magnetic resonance retrospective 3Tesla study. Neuroradiology 2016; 58:859-66. [PMID: 27423658 DOI: 10.1007/s00234-016-1711-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 05/31/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Fatigue (F) is a common, inexplicable, and disabling symptom in multiple sclerosis (MS) patients. The purpose of this study was to evaluate a possible correlation between fatigue and morpho-volumetric features and site of dilated perivascular spaces (dPS), visible on 3T magnetic resonance (MR) in fatigued multiple sclerosis patients (FMS). METHODS We studied 82 relapsing remitting (RR) FMS patients and 43 HC, matched for age, sex, and education. F was assessed by the Fatigue Severity Scale (FSS). To evaluate a possible correlation between degree of F and characteristics of dPS, patients were divided in two groups: more (mFMS) (FSS ≥ 5; n = 30) and less fatigued (lFMS) (FSS ≥ 4; n = 52), compared to a matched healthy control (HC) subject group. The MR study was performed with 3T scanner by SpinEcho T1, Fast-SpinEcho DP-T2, FLAIR, and 3D FSPGR T1 sequences. dPS volumes were measured with Medical Image Processing Analysis and Visualization (MIPAV); Global Cerebral Atrophy (GCA), expressed as Brain Parenchymal Fraction (BPF), was assessed by FSL SIENAX. RESULTS The t test showed significantly increased dPS number (p = 0.021) in FMS patients (mFMS p = 0.0024 and lFMS p = 0.033) compared to HC. Pearson correlation revealed a significant correlation between dPS number and FSS (r = 0.208 p = 0.051). Furthermore, the chi-squared test confirms the intragroup (HC, mFMS, lFMS) differences about dPS location (p = 0.01) and size (p = 0.0001). CONCLUSION Our study confirms that PS in MS patients presents with different volumetric and site characteristics as compared to HC; moreover, F severity significantly correlates with dPS number, site, and size.
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Affiliation(s)
- Renata Conforti
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy
| | - Mario Cirillo
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy
| | - Angela Sardaro
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy.
| | - Giuseppina Caiazzo
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Alberto Negro
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy
| | - Antonella Paccone
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Rosaria Sacco
- Department of Neurology, Second University of Naples, Naples, Italy
| | | | - Antonio Gallo
- Department of Neurology, Second University of Naples, Naples, Italy
| | - Luigi Lavorgna
- Department of Neurology, Second University of Naples, Naples, Italy
| | | | - Sossio Cirillo
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy
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Cappabianca S, Somma F, Negro A, Rotondo M, Scuotto A, Rotondo A. Extracranial internal carotid artery: anatomical variations in asymptomatic patients. Surg Radiol Anat 2016; 38:893-902. [PMID: 26932907 DOI: 10.1007/s00276-016-1652-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 02/13/2016] [Indexed: 12/12/2022]
Abstract
The anatomical variations of internal carotid artery (ICA) are mostly asymptomatic, thus being disregarded and only incidentally diagnosed, with very few symptomatic patients. The awareness of these anomalies is crucial to solve the differential with other neck lesions, preventing accidental injuries during neck surgery. Therefore, the aim of our study is to estimate the prevalence of ICA anomalies, using magnetic resonance angiography (MRA) and computed tomography angiography (CTA). 253 patients underwent head and neck MRA and CTA examinations, with multiplanar and volumetric reformations. For each set of images, the following items were investigated: origin, development, course, persistence of embryonic vessels and anomalous origin of collateral branches. In our series, ICA arose from the bifurcation of the common carotid artery at the level of: C4 in 303 hemi-necks (59.9 %); C3 in 98 hemi-necks (19.3 %); C5 in 57 hemi-necks (11.3 %); C2 in 48 hemi-necks (9.5 %). ICA kinking and/or coiling was found in 105 hemi-necks, and location variation of ICA (reversed-type) in two hemi-necks. In just one case the origin of the ascending pharyngeal artery was from ICA (0.2 %), while an anomalous persistence of the proatlantal artery was noticed in three cases (0.6 %). CTA and MRA showed similar accuracy in detecting ICA anomalies.
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Affiliation(s)
- Salvatore Cappabianca
- Radiology Department, Second University of Naples, P.za Miraglia 2, 80131, Naples, Italy
| | - Francesco Somma
- Radiology Department, Second University of Naples, P.za Miraglia 2, 80131, Naples, Italy.
| | - Alberto Negro
- Radiology Department, Second University of Naples, P.za Miraglia 2, 80131, Naples, Italy
| | - Michele Rotondo
- Radiology Department, Second University of Naples, P.za Miraglia 2, 80131, Naples, Italy
| | - Assunta Scuotto
- Radiology Department, Second University of Naples, P.za Miraglia 2, 80131, Naples, Italy
| | - Antonio Rotondo
- Radiology Department, Second University of Naples, P.za Miraglia 2, 80131, Naples, Italy
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Cabrini L, Landoni G, Antonelli M, Bellomo R, Colombo S, Negro A, Pelosi P, Zangrillo A. Critical care in the near future: patient-centered, beyond space and time boundaries. Minerva Anestesiol 2015:R02Y9999N00A150136. [PMID: 26474269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Modern Critical Care aims at improving patient-centered outcomes, not limited to survival. Recently, along with traditional research evaluating single drugs or procedures, more elusive elements have been evaluated, like organizational and teamwork aspects, delivery of critical care before Intensive Care Unit (ICU) admission and after discharge. The aim of this review is to offer an up-to-date, comprehensive, and maybe "visionary" big picture of Critical Care in the near future beyond its traditional boundaries. In particular, we wish to suggest key elements that will allow a leap forward in terms of quality of care. Patient-centeredness will be the main issue, taking the patient's wishes into account more than in the past. This means improving communication with patients and their relatives, and pursuing a holistic approach: we should pay more attention to natural light, noise reduction, music, prevention of sleep fragmentation, soft colors for walls, privacy, psychological support. An open visiting policy should be the standard. End-of-Life practices should become centered on patient wishes and dignity. Rapid response teams will bring timely critical care services to patients outside ICUs, preventing avoidable adverse events and unplanned ICU admission. In ICU, standardized protocols, checklists, daily goals sheets, advanced information technology and multidisciplinary rounds will improve quality of care and safety. Multicenter studies will be made easier and research should become part of daily practice in most ICU. Finally, the post ICU syndrome should be prevented and treated by a well-designed longitudinal care model taking care of patients from the ICU to the outpatient setting.
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Affiliation(s)
- L Cabrini
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy -
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Mawet J, Eikermann-Haerter K, Park K, Helenius J, Daneshmand A, Pearlman L, Avery R, Negro A, Velioglu M, Arsava E, Ay H, Ayata C. Migraine modulates the evolution of penumbra in acute ischemic stroke. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Palmisani S, Smith T, Arcioni R, Mercieri M, Vano V, Tigano S, Negro A, Al-Kaisy A, Martelletti P. EHMTI-0322. Effect of cervical epidural 10khz spinal cord stimulation on patients suffering from chronic, medically-refractory migraine. J Headache Pain 2014. [PMCID: PMC4182027 DOI: 10.1186/1129-2377-15-s1-g22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Ranga A, Gobaa S, Okawa Y, Mosiewicz K, Negro A, Lutolf MP. 3D niche microarrays for systems-level analyses of cell fate. Nat Commun 2014; 5:4324. [PMID: 25027775 PMCID: PMC4104440 DOI: 10.1038/ncomms5324] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 06/08/2014] [Indexed: 01/10/2023] Open
Abstract
The behaviour of mammalian cells in a tissue is governed by the three-dimensional (3D) microenvironment and involves a dynamic interplay between biochemical and mechanical signals provided by the extracellular matrix (ECM), cell-cell interactions and soluble factors. The complexity of the microenvironment and the context-dependent cell responses that arise from these interactions have posed a major challenge to understanding the underlying regulatory mechanisms. Here we develop an experimental paradigm to dissect the role of various interacting factors by simultaneously synthesizing more than 1,000 unique microenvironments with robotic nanolitre liquid-dispensing technology and by probing their effects on cell fate. Using this novel 3D microarray platform, we assess the combined effects of matrix elasticity, proteolytic degradability and three distinct classes of signalling proteins on mouse embryonic stem cells, unveiling a comprehensive map of interactions involved in regulating self-renewal. This approach is broadly applicable to gain a systems-level understanding of multifactorial 3D cell-matrix interactions.
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Affiliation(s)
- A Ranga
- Laboratory of Stem Cell Bioengineering, Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015, Switzerland
| | - S Gobaa
- 1] Laboratory of Stem Cell Bioengineering, Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015, Switzerland [2]
| | - Y Okawa
- 1] Laboratory of Stem Cell Bioengineering, Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015, Switzerland [2]
| | - K Mosiewicz
- 1] Laboratory of Stem Cell Bioengineering, Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015, Switzerland [2]
| | - A Negro
- 1] Laboratory of Stem Cell Bioengineering, Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015, Switzerland [2]
| | - M P Lutolf
- Laboratory of Stem Cell Bioengineering, Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015, Switzerland
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Conforti R, Capasso R, Negro A, Della Gatta L, De Cristofaro M, Cioce F, Amato M, Giganti M, Genovese EA. [Diagnostic tools in neurodegenerative disorders of adult-elderly]. Recenti Prog Med 2013; 104:295-8. [PMID: 24042395 DOI: 10.1701/1315.14563] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Neurodegenerative disorders are an inhomogeneous group of neurological diseases that affect a large part of the population because of the rise in life expectancy. Although clinical manifestations are important to make the correct diagnosis, the new advanced imaging technique represent a very useful tool for the diagnostic work-up.
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Conforti R, Cirillo M, Saturnino PP, Gallo A, Sacco R, Negro A, Paccone A, Caiazzo G, Bisecco A, Bonavita S, Cirillo S. Dilated Virchow–Robin spaces and multiple sclerosis: 3 T magnetic resonance study. Radiol med 2013; 119:408-14. [DOI: 10.1007/s11547-013-0357-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/30/2013] [Indexed: 10/26/2022]
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