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Schultze A, Martin I, Messina D, Bots S, Belitser S, José Carreras-Martínez J, Correcher-Martinez E, Urchueguía-Fornes A, Martín-Pérez M, García-Poza P, Villalobos F, Pallejà-Millán M, Alberto Bissacco C, Segundo E, Souverein P, Riefolo F, Durán CE, Gini R, Sturkenboom M, Klungel O, Douglas I. A comparison of four self-controlled study designs in an analysis of COVID-19 vaccines and myocarditis using five European databases. Vaccine 2024; 42:3039-3048. [PMID: 38580517 DOI: 10.1016/j.vaccine.2024.03.043] [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: 11/09/2023] [Revised: 03/16/2024] [Accepted: 03/17/2024] [Indexed: 04/07/2024]
Abstract
INTRODUCTION The aim of this study was to assess the possible extent of bias due to violation of a core assumption (event-dependent exposures) when using self-controlled designs to analyse the association between COVID-19 vaccines and myocarditis. METHODS We used data from five European databases (Spain: BIFAP, FISABIO VID, and SIDIAP; Italy: ARS-Tuscany; England: CPRD Aurum) converted to the ConcePTION Common Data Model. Individuals who experienced both myocarditis and were vaccinated against COVID-19 between 1 September 2020 and the end of data availability in each country were included. We compared a self-controlled risk interval study (SCRI) using a pre-vaccination control window, an SCRI using a post-vaccination control window, a standard SCCS and an extension of the SCCS designed to handle violations of the assumption of event-dependent exposures. RESULTS We included 1,757 cases of myocarditis. For analyses of the first dose of the Pfizer vaccine, to which all databases contributed information, we found results consistent with a null effect in both of the SCRI and extended SCCS, but some indication of a harmful effect in a standard SCCS. For the second dose, we found evidence of a harmful association for all study designs, with relatively similar effect sizes (SCRI pre = 1.99, 1.40 - 2.82; SCRI post 2.13, 95 %CI - 1.43, 3.18; standard SCCS 1.79, 95 %CI 1.31 - 2.44, extended SCCS 1.52, 95 %CI = 1.08 - 2.15). Adjustment for calendar time did not change these conclusions. Findings using all designs were also consistent with a harmful effect following a second dose of the Moderna vaccine. CONCLUSIONS In the context of the known association between COVID-19 vaccines and myocarditis, we have demonstrated that two forms of SCRI and two forms of SCCS led to largely comparable results, possibly because of limited violation of the assumption of event-dependent exposures.
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Affiliation(s)
- Anna Schultze
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Ivonne Martin
- Department of Data Science and Biostatistics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Davide Messina
- Agenzia Regionale di Sanità (ARS), Florence, Toscana, Italy
| | - Sophie Bots
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Svetlana Belitser
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Juan José Carreras-Martínez
- Vaccine Research Department, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO - Public Health), Valencia, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Elisa Correcher-Martinez
- Vaccine Research Department, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO - Public Health), Valencia, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Arantxa Urchueguía-Fornes
- Vaccine Research Department, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO - Public Health), Valencia, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Mar Martín-Pérez
- Spanish Agency for Medicines and Medical Devices (AEMPS), Madrid, Spain
| | | | - Felipe Villalobos
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Meritxell Pallejà-Millán
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Carlo Alberto Bissacco
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Elena Segundo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Patrick Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Fabio Riefolo
- Teamit Institute, Partnerships, Barcelona Health Hub, Barcelona, Spain
| | - Carlos E Durán
- Department of Data Science and Biostatistics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Rosa Gini
- Agenzia Regionale di Sanità (ARS), Florence, Toscana, Italy
| | - Miriam Sturkenboom
- Department of Data Science and Biostatistics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Olaf Klungel
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ian Douglas
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Riefolo F, Castillo-Cano B, Martín-Pérez M, Messina D, Elbers R, Brink-Kwakkel D, Villalobos F, Ingrasciotta Y, Garcia-Poza P, Swart-Polinder K, Souverein P, Saiz LC, Bissacco CA, Leache L, Tari M, Crisafulli S, Grimaldi L, Vaz T, Gini R, Klungel O, Martín-Merino E. Effectiveness of homologous/heterologous booster COVID-19 vaccination schedules against severe illness in general population and clinical subgroups in three European countries. Vaccine 2023; 41:7007-7018. [PMID: 37858451 DOI: 10.1016/j.vaccine.2023.10.011] [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: 07/24/2023] [Revised: 09/22/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
Using 4 data-sources (Spain, Italy, United Kingdom) data and a 1:1 matched cohort study, we aimed to estimate vaccine effectiveness (VE) in preventing SARS-CoV-2 infections with hospitalisations (±30 days) and death (±56 days) in general population and clinical subgroups with homologous/heterologous booster schedules (Comirnaty-BNT and Spikevax-MOD original COVID-19 vaccines) by comparison with unboosted individuals, during Delta and beginning of Omicron variants. Hazard Ratio (HR, by Cox models) and VE ([1-HR]*100) were calculated by inverse probability weights. Between December 2020-February 2022, in adults without prior SARS-CoV-2 infection, we matched 5.5 million people (>1 million with immunodeficiency, 343,727 with cancer) with a booster (3rd) dose by considering doses 1 and 2 vaccine brands and calendar time, age, sex, region, and comorbidities (immunodeficiency, cancer, severe renal disease, transplant recipient, Down Syndrome). We studied booster doses of BNT and MOD administered after doses 1 and 2 with BNT, MOD, or Oxford-AstraZeneca during a median follow-up between 9 and 16 weeks. BNT or MOD showed VE ranging from 70 to 86% across data sources as heterologous 3rd doses, whereas it was 42-88% as homologous 3rd doses. Depending on the severity and available follow-up, 3rd-dose effectiveness lasted between 1 and 5 months. In people with immunodeficiency and cancer, protection across data sources was detected with both heterologous (VE = 54-83%) and homologous (VE = 49-80%) 3rd doses. Overall, both heterologous and homologous 3rd doses with BTN or MOD showed additional protection against the severe effects of SARS-CoV-2 infections for the general population and for patients at potentially high risk of severe COVID-19 (elderly, people with immunodeficiency and cancer) in comparison with two doses schemes during Delta or early Omicron periods. The early VE after vaccination may be due to less testing among vaccinated pairs and unknown confounders, deserving cautious interpretation. The VE wane over time needs further in-depth research to properly envisage when or whether a booster of those vaccines should be administered.
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Affiliation(s)
- Fabio Riefolo
- Teamit Institute, Partnerships, Barcelona Health Hub, Barcelona, Spain; VAccine Monitoring Collaboration for Europe, Brussels, Belgium
| | | | - Mar Martín-Pérez
- Spanish Agency of Medicines and Medical Devices-AEMPS, Madrid, Spain
| | | | - Roel Elbers
- Department of Data Science and Biostatistics, University Medical Center Utrecht, the Netherlands
| | - Dorieke Brink-Kwakkel
- Department of Data Science and Biostatistics, University Medical Center Utrecht, the Netherlands
| | - Felipe Villalobos
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Ylenia Ingrasciotta
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | | | - Patrick Souverein
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands
| | - Luis Carlos Saiz
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
| | - Carlo Alberto Bissacco
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Leire Leache
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
| | | | | | - Lamiae Grimaldi
- l'Assistance Publique-Hôpitaux de Paris (APHP), University Paris-Saclay, Paris, France
| | - Tiago Vaz
- Department of Data Science and Biostatistics, University Medical Center Utrecht, the Netherlands
| | - Rosa Gini
- VAccine Monitoring Collaboration for Europe, Brussels, Belgium; Agenzia Regionale di Sanita' Toscana, Florence, Italy
| | - Olaf Klungel
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands
| | - Elisa Martín-Merino
- VAccine Monitoring Collaboration for Europe, Brussels, Belgium; Spanish Agency of Medicines and Medical Devices-AEMPS, Madrid, Spain.
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Messina D, Brennan M. Can transillumination improve the detection of deep pectoral myopathy in turkey carcases when compared with postmortem inspection alone? Vet Rec 2023; 192:484. [PMID: 37326194 DOI: 10.1002/vetr.3193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Davide Messina
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Marnie Brennan
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
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Gardner B, Betson M, Cabal Rosel A, Caniça M, Chambers MA, Contadini FM, Gonzalez Villeta LC, Hassan MM, La Ragione RM, de Menezes A, Messina D, Nichols G, Olivença DV, Phalkey R, Prada JM, Ruppitsch W, Santorelli LA, Selemetas N, Tharmakulasingam M, M van Vliet AH, Woegerbauer M, Deza-Cruz I, Lo Iacono G. Mapping the evidence of the effects of environmental factors on the prevalence of antibiotic resistance in the non-built environment: Protocol for a systematic evidence map. Environ Int 2023; 171:107707. [PMID: 36566718 DOI: 10.1016/j.envint.2022.107707] [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: 09/02/2021] [Revised: 12/09/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Human, animal, and environmental health are increasingly threatened by the emergence and spread of antibiotic resistance. Inappropriate use of antibiotic treatments commonly contributes to this threat, but it is also becoming apparent that multiple, interconnected environmental factors can play a significant role. Thus, a One Health approach is required for a comprehensive understanding of the environmental dimensions of antibiotic resistance and inform science-based decisions and actions. The broad and multidisciplinary nature of the problem poses several open questions drawing upon a wide heterogeneous range of studies. OBJECTIVE This study seeks to collect and catalogue the evidence of the potential effects of environmental factors on the abundance or detection of antibiotic resistance determinants in the outdoor environment, i.e., antibiotic resistant bacteria and mobile genetic elements carrying antibiotic resistance genes, and the effect on those caused by local environmental conditions of either natural or anthropogenic origin. METHODS Here, we describe the protocol for a systematic evidence map to address this, which will be performed in adherence to best practice guidelines. We will search the literature from 1990 to present, using the following electronic databases: MEDLINE, Embase, and the Web of Science Core Collection as well as the grey literature. We shall include full-text, scientific articles published in English. Reviewers will work in pairs to screen title, abstract and keywords first and then full-text documents. Data extraction will adhere to a code book purposely designed. Risk of bias assessment will not be conducted as part of this SEM. We will combine tables, graphs, and other suitable visualisation techniques to compile a database i) of studies investigating the factors associated with the prevalence of antibiotic resistance in the environment and ii) map the distribution, network, cross-disciplinarity, impact and trends in the literature.
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Affiliation(s)
- Brian Gardner
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK
| | - Martha Betson
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK
| | | | - Manuela Caniça
- National Institute of Health Dr. Ricardo Jorge, Portugal
| | - Mark A Chambers
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK; School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, UK
| | - Francesca M Contadini
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK
| | - Laura C Gonzalez Villeta
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK
| | - Marwa M Hassan
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK
| | - Roberto M La Ragione
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK; School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, UK
| | | | - Davide Messina
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | | | | | | | - Joaquin M Prada
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK
| | | | - Lorenzo A Santorelli
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, UK
| | - Nick Selemetas
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, UK
| | - Mukunthan Tharmakulasingam
- Centre for Vision, Speech and Signal Processing, Faculty of Electronics and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, UK
| | - Arnoud H M van Vliet
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK
| | | | - Iñaki Deza-Cruz
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK
| | - Giovanni Lo Iacono
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK; The Surrey Institute for People-Centred Artificial Intelligence, UK.
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5
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Bots SH, Riera-Arnau J, Belitser SV, Messina D, Aragón M, Alsina E, Douglas IJ, Durán CE, García-Poza P, Gini R, Herings RMC, Huerta C, Sisay MM, Martín-Pérez M, Martin I, Overbeek JA, Paoletti O, Pallejà-Millán M, Schultze A, Souverein P, Swart KMA, Villalobos F, Klungel OH, Sturkenboom MCJM. Myocarditis and pericarditis associated with SARS-CoV-2 vaccines: A population-based descriptive cohort and a nested self-controlled risk interval study using electronic health care data from four European countries. Front Pharmacol 2022; 13:1038043. [PMID: 36506571 PMCID: PMC9730238 DOI: 10.3389/fphar.2022.1038043] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Estimates of the association between COVID-19 vaccines and myo-/pericarditis risk vary widely across studies due to scarcity of events, especially in age- and sex-stratified analyses. Methods: Population-based cohort study with nested self-controlled risk interval (SCRI) using healthcare data from five European databases. Individuals were followed from 01/01/2020 until end of data availability (31/12/2021 latest). Outcome was first myo-/pericarditis diagnosis. Exposures were first and second dose of Pfizer, AstraZeneca, Moderna, and Janssen COVID-19 vaccines. Baseline incidence rates (IRs), and vaccine- and dose-specific IRs and rate differences were calculated from the cohort The SCRI calculated calendar time-adjusted IR ratios (IRR), using a 60-day pre-vaccination control period and dose-specific 28-day risk windows. IRRs were pooled using random effects meta-analysis. Findings: Over 35 million individuals (49·2% women, median age 39-49 years) were included, of which 57·4% received at least one COVID-19 vaccine dose. Baseline incidence of myocarditis was low. Myocarditis IRRs were elevated after vaccination in those aged < 30 years, after both Pfizer vaccine doses (IRR = 3·3, 95%CI 1·2-9.4; 7·8, 95%CI 2·6-23·5, respectively) and Moderna vaccine dose 2 (IRR = 6·1, 95%CI 1·1-33·5). An effect of AstraZeneca vaccine dose 2 could not be excluded (IRR = 2·42, 95%CI 0·96-6·07). Pericarditis was not associated with vaccination. Interpretation: mRNA-based COVID-19 vaccines and potentially AstraZeneca are associated with increased myocarditis risk in younger individuals, although absolute incidence remains low. More data on children (≤ 11 years) are needed.
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Affiliation(s)
- Sophie H. Bots
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Judit Riera-Arnau
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Health, University Medical Center Utrecht, Utrecht, Netherlands,Clinical Pharmacology Service, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Svetlana V. Belitser
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | | | - Maria Aragón
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Ema Alsina
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Health, University Medical Center Utrecht, Utrecht, Netherlands,Clinical Pharmacology Service, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ian J. Douglas
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Carlos E. Durán
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Health, University Medical Center Utrecht, Utrecht, Netherlands,Clinical Pharmacology Service, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Rosa Gini
- Agenzia Regionale di Sanitá, Florence, Toscana, Italy
| | | | - Consuelo Huerta
- Spanish Agency for Medicines and Medical Devices (AEMPS), Madrid, Spain
| | - Malede Mequanent Sisay
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Health, University Medical Center Utrecht, Utrecht, Netherlands,Clinical Pharmacology Service, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mar Martín-Pérez
- Spanish Agency for Medicines and Medical Devices (AEMPS), Madrid, Spain
| | - Ivonne Martin
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Health, University Medical Center Utrecht, Utrecht, Netherlands,Clinical Pharmacology Service, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Olga Paoletti
- Agenzia Regionale di Sanitá, Florence, Toscana, Italy
| | - Meritxell Pallejà-Millán
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Anna Schultze
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Patrick Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | | | - Felipe Villalobos
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Olaf H. Klungel
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Miriam C. J. M. Sturkenboom
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Health, University Medical Center Utrecht, Utrecht, Netherlands,Clinical Pharmacology Service, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain,*Correspondence: Miriam C. J. M. Sturkenboom,
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Sottilotta G, Battazza ML, Buzzi A, Messina D. PROJETO SCORE: SURVEY ON COVID-19 RESILIENCE. Hematol Transfus Cell Ther 2022. [PMCID: PMC9573804 DOI: 10.1016/j.htct.2022.09.1141] [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: 11/06/2022] Open
Abstract
Objetivos O objetivo do Projeto SCORE ‒ Survey on COVID-19 REsilience ‒ foi avaliar as emoções e comportamentos dos adultos brasileiros com hemofilia durante o 1° ano da pandemia. Material e Métodos Foi realizada uma pesquisa online, com 17 perguntas, de março a abril de 2021. Os dados foram coletados por meio de 5 perguntas sobre características demográficas e clínicas e 12 perguntas sobre as preocupações e medos um ano após o início da pandemia de COVID-19. Resultados 40 PCH responderam ao questionário. Faixa etária: 35% de 18–30, 50% 31–50, 15% 51–70. Entre os que responderam, 34 tinham hemofilia A e 6 hemofilia B, com prevalência de casos graves, 1 tinha inibidor; 87,5% PCH faz tratamento de profilaxia enquanto 12,5% realizam tratamento sob demanda. 53,7% declararam não ter sido afetados pela pandemia, enquanto 24,4% relataram que tanto rotina quanto emergência foram alterados. Para 19,5% apesar da suspensão das consultas, os atendimentos de urgência e planos de tratamento foram oferecidos regularmente. Discussão No que diz respeito às emoções e sentimentos, para 53,7% dos pacientes, as informações fornecidas pelo governo e pela mídia não tiveram o efeito de tranquilizar, pelo contrário, muitas vezes criaram confusão e sensação de incerteza. Para 31,7% as noticias traziam ainda mais medo e para 19,5%, as informações geravam estado de tensão. Apenas 17,1% dos pacientes relatou se sentir tranquilo e confiante. Sobre o apoio psicológico, apesar da maioria reconhecer que esta pandemia teria repercussões psicológicas, 60% afirmaram não precisar de apoio na área da saúde mental. Para 31% dos pacientes a informação fornecida pelos Centros de Hemofilia (CTH) foi suficiente, enquanto 9% dos respondentes solicitaram apoio e ajuda psicológica. Quanto ao relacionamento com o CTH, 61% relatou que nada mudou enquanto 12,2% relatou melhora no relacionamento. Para 12,2% houve dificuldades no relacionamento em função do medo de possível contágio. Com relação ao gerenciamento do controle de sangramentos e das consultas programadas, 53,7% declararam não terem sido afetados pela pandemia, enquanto 24,4% relataram que tanto rotina quanto emergência foram alterados. Para 19,5% apesar da suspensão das consultas, os atendimentos de urgência e planos de tratamento foram oferecidos regularmente. Conclusão Nossa pesquisa destacou a adaptabilidade dos pacientes durante a pandemia e que mostrou que a disponibilidade da equipe do CTH. Neste momento, mesmo à distância, garantiu a continuidade das relações e do tratamento.
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Affiliation(s)
- G Sottilotta
- Centro Emofilia - Servizio Emostasi e Trombosi, Réggio Calabria, Itália
| | - ML Battazza
- Associação Brasileira de Pessoas com Hemofilia (ABRAPHEM), São Paulo, SP, Brasil
| | - A Buzzi
- Fondazione Paracelso, Milano, Itália
| | - D Messina
- Fondazione Paracelso, Milano, Itália
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7
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López Ureña NM, Chaudhry U, Calero Bernal R, Cano Alsua S, Messina D, Evangelista F, Betson M, Lalle M, Jokelainen P, Ortega Mora LM, Álvarez García G. Contamination of Soil, Water, Fresh Produce, and Bivalve Mollusks with Toxoplasma gondii Oocysts: A Systematic Review. Microorganisms 2022; 10:517. [PMID: 35336093 PMCID: PMC8954419 DOI: 10.3390/microorganisms10030517] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/13/2022] [Accepted: 02/25/2022] [Indexed: 02/06/2023] Open
Abstract
Toxoplasma gondii is a major foodborne pathogen capable of infecting all warm-blooded animals, including humans. Although oocyst-associated toxoplasmosis outbreaks have been documented, the relevance of the environmental transmission route remains poorly investigated. Thus, we carried out an extensive systematic review on T. gondii oocyst contamination of soil, water, fresh produce, and mollusk bivalves, following the PRISMA guidelines. Studies published up to the end of 2020 were searched for in public databases and screened. The reference sections of the selected articles were examined to identify additional studies. A total of 102 out of 3201 articles were selected: 34 articles focused on soil, 40 focused on water, 23 focused on fresh produce (vegetables/fruits), and 21 focused on bivalve mollusks. Toxoplasma gondii oocysts were found in all matrices worldwide, with detection rates ranging from 0.09% (1/1109) to 100% (8/8) using bioassay or PCR-based detection methods. There was a high heterogeneity (I2 = 98.9%), which was influenced by both the sampling strategy (e.g., sampling site and sample type, sample composition, sample origin, season, number of samples, cat presence) and methodology (recovery and detection methods). Harmonized approaches are needed for the detection of T. gondii in different environmental matrices in order to obtain robust and comparable results.
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Affiliation(s)
- Nadia María López Ureña
- SALUVET Research Group, Animal Health Department, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (N.M.L.U.); (R.C.B.); (L.M.O.M.)
| | - Umer Chaudhry
- Veterinary Epidemiology and Public Health Department, School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK; (U.C.); or (D.M.); (F.E.); (M.B.)
| | - Rafael Calero Bernal
- SALUVET Research Group, Animal Health Department, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (N.M.L.U.); (R.C.B.); (L.M.O.M.)
| | - Santiago Cano Alsua
- Computing Services, Research Support Center, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Davide Messina
- Veterinary Epidemiology and Public Health Department, School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK; (U.C.); or (D.M.); (F.E.); (M.B.)
- Division of Veterinary Clinical Science, School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Loughborough LE12 5RD, UK
| | - Francisco Evangelista
- Veterinary Epidemiology and Public Health Department, School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK; (U.C.); or (D.M.); (F.E.); (M.B.)
| | - Martha Betson
- Veterinary Epidemiology and Public Health Department, School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK; (U.C.); or (D.M.); (F.E.); (M.B.)
| | - Marco Lalle
- Unit of Foodborne and Neglected Parasitic Diseases, Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Roma, Italy;
| | - Pikka Jokelainen
- Department of Bacteria, Parasites and Fungi, Infectious Disease Preparedness, Statens Serum Institute, University of Copenhagen, 2300 Copenhagen, Denmark;
| | - Luis Miguel Ortega Mora
- SALUVET Research Group, Animal Health Department, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (N.M.L.U.); (R.C.B.); (L.M.O.M.)
| | - Gema Álvarez García
- SALUVET Research Group, Animal Health Department, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (N.M.L.U.); (R.C.B.); (L.M.O.M.)
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Tarroni M, Messina D, Balestri C, Cocchi F, Messina G, Nante N. Food and lifestyle education in Tuscan schoolchildren: 2018-2019 follow-up of a long-term campaign. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.219] [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
Nutritional profile, physical activity level and sedentary behaviours, in preteen age, are determinants able to influence both short and long-term state of health, therefore succeeding in health education campaigns addressed to this age group is critical for the interested population. Is currently underway the multiannual follow-up of the Italian “sCOOL FOOD - Per un Futuro di tutto Rispetto” project of Monte dei Paschi Foundation of Siena, Tuscany, which offers year-round cycles of classes and workshops about the themes listed above. Our objective was to assess whether this intervention could significantly influence over time healthy, and unhealthy, behaviours of the participants.
Methods
We structured the follow-up as a prospective cohort study with one-group pretest-posttest design. We used the CAWI technique, building a questionnaire based on the Italian “OKkio alla Salute” survey, and collected data from the whole population of students enrolled in the project (in the school year 2018-2019 they were 3787, aged from 7 to 12) before and after the intervention. Afterwards, we conducted paired data analysis on the frequencies of specific behaviours.
Results
We analysed paired data from 310 respondents. Improvements were gained in: afternoon TV watching (OR 0.54; 0.34 - 0.84; p < 0.01), consumption of sweet (OR 0.39; 0.16 - 0.88; p < 0.05) and salty (0.42; 0.18 - 0.90; p < 0.05) snacks, attitude to play outdoors after school (OR 2.6; 1.21 - 6.04; p < 0.01), sedentary behaviour in leisure time (OR 0.27; 0.16 - 0.44; p < 0.0001), mean weekly sport activity (+0.14 days; +0.02 - +0.27; p < 0.05). No variable has deteriorated.
Conclusions
The improved compliance with healthy behaviours in the participants at this project suggests its viability as a health promotion campaign. Further parallel surveys on control groups are pending, in order to control potential confounders such as the seasonality of some habits and the awareness of the participants on the addressed subjects.
Key messages
A coordinated and cross-disciplinary food and lifestyle year-round education campaign at school can affect health determinants of children. School can correct unfavourable eating and lifestyle behaviours determined by family habits.
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Affiliation(s)
- M Tarroni
- Postgraduate School in Public Health, University of Siena, Siena, Italy
| | - D Messina
- Monte dei Paschi Foundation of Siena, Siena, Italy
| | - C Balestri
- Monte dei Paschi Foundation of Siena, Siena, Italy
| | - F Cocchi
- UOC Formazione, Training Unit, ASL (LHA) Roma 1, Rome, Italy
| | - G Messina
- Postgraduate School in Public Health, University of Siena, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - N Nante
- Postgraduate School in Public Health, University of Siena, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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9
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Salini C, Tarroni M, Messina D, Balestri C, Nante N, Messina G. Every cockroach is beautilful to the eyes of his mother? Parent’s perception of child’s BMI. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.209] [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: 11/14/2022] Open
Abstract
Abstract
Background
Childhood obesity is becoming a social health problem in the western world and an important goal is to analyze and correct risk factors. Part of the problem could be determined by a different perception of the weight. We aim to determine the association between children's BMI and the parent's perception of their Health Status.
Methods
In October 2019 we conduced a cross sectional study in which a questionaire was administrated to the parents of primary and secondary schools children in South-East Tuscany, Italy. Eating habits, lifestyle and biometric data were collected from children and their parents. 4324 persons were included. We used Stata for descriptive and inferential analysis. Cohen's Kappa was used to find the correlation between variables.
Results
Analysis was carried out on 1421 complete questionnaires. We found that most of parents have a wrong perception of weight's children. 88.3% of parents who have obese children belive that his child is normal weight or only “a little overweight” and only 11.7% have a perception of their child's obesity. 67.6% of parents who have overweight children, belive that their child is normal weight. While among underweight children, 74.3% of parents belive that their child is normal weight. Cohen's kappa show poor agreement between real and perceived BMI (K = 0.26; p = 0.0001).
Conclusions
Our results show, among the overweight children, there is a misperception in the weight of the child by the parents, uniformly with the data present in the literature. Acquisition of healty behavior during childhood is extremely important for the state of health in adulthood and for avoiding the onset of associated diseases. Therefore, food education becomes a crucial objective for the future of our country: an essential goal is to create prevention programs addressed to children and parents to increase consciousness of the correct weight and the diseases that can result from bad nutrition.
Key messages
Many parents have a misperception of the weight of their children. It is crucial to educate parents to control their children's weight to avoid the onset of metabolic diseases. Increase consciousness in children and parents of the correct weight should become extremely important to avoid the onset of disease in adulthood.
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Affiliation(s)
- C Salini
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - M Tarroni
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - D Messina
- Monte dei Paschi foundation of Siena, Siena, Italy
| | - C Balestri
- Monte dei Paschi foundation of Siena, Siena, Italy
| | - N Nante
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - G Messina
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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10
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Marmotti A, Messina D, Cykowska A, Beltramo C, Bellato E, Colombero D, Agati G, Mangiavini L, Bruzzone M, Dettoni F, Peretti GM, Castoldi F. Periprosthetic osteolysis: a narrative review. J BIOL REG HOMEOS AG 2020; 34:405-417. Congress of the Italian Orthopaedic Research Society. [PMID: 33261304] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Periprosthetic osteolysis is still one of the major limitations of prosthetic joints longevity. The process of this "silent" iatrogenic disease involves both mechanical and biological factors that initiate a local immune response in the periprosthetic tissue that eventually lead to implant loosening and failure. There are many causes of the primary aseptic loosening inside the periprosthetic microenvironment, but the most important elements are the wear debris and the cell-particle interactions. Together with implant position, micromotion, bearings, joint fluid pressure, and increased load on the joints drive the pathogenesis of the disease. This narrative review aims to summarise recent studies describing the biological and mechanical factors in the pathogenesis of osteolysis and some of the current pharmacological attempts to "rescue" a failing implant.
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Affiliation(s)
- A Marmotti
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
- Molecular Biotechnology Center, University of Turin, Torino, Italy
| | - D Messina
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
| | - A Cykowska
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
| | - C Beltramo
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
| | - E Bellato
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
| | - D Colombero
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
| | - G Agati
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
| | - L Mangiavini
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - M Bruzzone
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
| | - F Dettoni
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
| | - G M Peretti
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - F Castoldi
- Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy
- Molecular Biotechnology Center, University of Turin, Torino, Italy
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11
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Marmotti A, Tencone F, Beltramo C, Messina D, Bellato E, Ferrero G, Bonasia DE, Calò M, Mangiavini L, Agati G, Castoldi F. Rehabilitation protocol after simultaneous anterior cruciate ligament reconstruction and high tibial osteotomy: introducing the concept of the individualized approach. J BIOL REG HOMEOS AG 2020; 34:419-429. Congress of the Italian Orthopaedic Research Society. [PMID: 33261305] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Postoperative rehabilitation after simultaneous anterior cruciate ligament reconstruction and opening wedge high tibial osteotomy is a complex concept. Different osteotomy techniques, extremely selected patients, high expectations in returning to previous sport activities, and the different individual physical profile and performances make traditional chronological criteria impractical and unfeasible. This study presents a novel rehabilitation in which functional objective criteria are considered the key factors for standardizing a 4-step protocol. Each step is "individualized", based on the patient's response to the healing processes and to the different training phases, allowing for a safe return to sports competitions. This definitively implies a strict collaboration between patient, surgeon, physician and physiotherapists, as well as thorough and detailed patient education. Due to the high versatility of these new rehabilitation concepts, the application of the "individualized" steps described in this study may be broadened to include different sports medicine knee injuries that may benefit from a specific, detailed and carefully patient-centered rehabilitation project.
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Affiliation(s)
- A Marmotti
- Department of Orthopaedics and Traumatology, University of Turin, Italy
| | - F Tencone
- Isokinetic Rehabilitation Center, Torino, Italy
| | - C Beltramo
- Department of Orthopaedics and Traumatology, University of Turin, Italy
| | - D Messina
- Department of Orthopaedics and Traumatology, University of Turin, Italy
| | - E Bellato
- Department of Orthopaedics and Traumatology, University of Turin, Italy
| | - G Ferrero
- Department of Orthopaedics and Traumatology, University of Turin, Italy
| | - D E Bonasia
- Department of Orthopaedics and Traumatology, University of Turin, Italy
| | - M Calò
- Department of Orthopaedics and Traumatology, University of Turin, Italy
| | - L Mangiavini
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - G Agati
- Department of Orthopaedics and Traumatology, University of Turin, Italy
| | - F Castoldi
- Department of Orthopaedics and Traumatology, University of Turin, Italy
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12
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Kanis JA, Harvey NC, McCloskey E, Bruyère O, Veronese N, Lorentzon M, Cooper C, Rizzoli R, Adib G, Al-Daghri N, Campusano C, Chandran M, Dawson-Hughes B, Javaid K, Jiwa F, Johansson H, Lee JK, Liu E, Messina D, Mkinsi O, Pinto D, Prieto-Alhambra D, Saag K, Xia W, Zakraoui L, Reginster JY. Correction to: Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporos Int 2020; 31:797-798. [PMID: 32065251 PMCID: PMC7075819 DOI: 10.1007/s00198-020-05297-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The article 'Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures',written by J. A. Kanis, was originally published Online First without Open Access. After publication in volume [#], issue [#] and page [#-#], the author decided to opt for Open Choice and to make the article an Open Access publication.
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Affiliation(s)
- J A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia.
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing Mellanby, Sheffield, UK
| | - O Bruyère
- World Health Organization Collaborating Center for the Public Health Aspects of Musculoskeletal Health and Aging, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - N Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani 2, 35128, Padova, Italy
| | - M Lorentzon
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - R Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - G Adib
- Syrian National Osteoporosis Society, Damascus, Syria
| | - N Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - C Campusano
- Clinica Universidad de los Andes and Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - M Chandran
- Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, ACADEMIA, 20, College Road, Singapore, 169856, Singapore
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - K Javaid
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - F Jiwa
- International Osteoporosis Foundation, Osteoporosis Canada, Toronto, Canada
| | - H Johansson
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
| | - J K Lee
- Beacon International Specialist Centre, Petaling Jaya, Malaysia
| | - E Liu
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
| | - D Messina
- IRO Medical Research Center, Buenos Aires and Rheumatology Section, Cosme Argerich, Buenos Aires, Argentina
| | - O Mkinsi
- Department of Rheumatology, Ibn Rochd University Hospital, Casablanca, Morocco
| | - D Pinto
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D Prieto-Alhambra
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
- GREMPAL Research Group, CIBERFes and Idiap Jordi Gol, Instituto de Salud Carlos III and Universitat Autonoma deBarcelona, Barcelona, Spain
| | - K Saag
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - W Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - L Zakraoui
- Service de Rhumatologie, University Tunis Manar and HôpitalMongi-Slim, la Marsa, Tunisia
| | - J Y Reginster
- Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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13
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Kanis JA, Harvey NC, McCloskey E, Bruyère O, Veronese N, Lorentzon M, Cooper C, Rizzoli R, Adib G, Al-Daghri N, Campusano C, Chandran M, Dawson-Hughes B, Javaid K, Jiwa F, Johansson H, Lee JK, Liu E, Messina D, Mkinsi O, Pinto D, Prieto-Alhambra D, Saag K, Xia W, Zakraoui L, Reginster JY. Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporos Int 2020; 31:1-12. [PMID: 31720707 PMCID: PMC7018677 DOI: 10.1007/s00198-019-05176-3] [Citation(s) in RCA: 180] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/18/2019] [Indexed: 01/26/2023]
Abstract
Guidance is provided in an international setting on the assessment and specific treatment of postmenopausal women at low, high and very high risk of fragility fractures. INTRODUCTION The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2019. This manuscript seeks to apply this in an international setting, taking additional account of further categorisation of increased risk of fracture, which may inform choice of therapeutic approach. METHODS Clinical perspective and updated literature search. RESULTS The following areas are reviewed: categorisation of fracture risk and general pharmacological management of osteoporosis. CONCLUSIONS A platform is provided on which specific guidelines can be developed for national use to characterise fracture risk and direct interventions.
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Affiliation(s)
- J A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, S10 2RX, Sheffield, UK.
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia.
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, S10 2RX, Sheffield, UK
- MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing Mellanby, Sheffield, UK
| | - O Bruyère
- World Health Organization Collaborating Center for the Public Health Aspects of Musculoskeletal Health and Aging, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - N Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy
| | - M Lorentzon
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - R Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - G Adib
- Syrian National Osteoporosis Society, Damascus, Syria
| | - N Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Dept., College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - C Campusano
- Clinica Universidad de los Andes and Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - M Chandran
- Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, ACADEMIA, 20, College Road, Singapore, 169856, Singapore
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - K Javaid
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - F Jiwa
- Chair of the Committee of Patients Societies at the International Osteoporosis Foundation, Osteoporosis Canada, Toronto, Canada
| | - H Johansson
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, S10 2RX, Sheffield, UK
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
| | - J K Lee
- Beacon International Specialist Centre, Petaling Jaya, Malaysia
| | - E Liu
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
| | - D Messina
- IRO Medical Research Center, Buenos Aires and Rheumatology section, Cosme Argerich, Buenos Aires, Argentina
| | - O Mkinsi
- Department of Rheumatology, Ibn Rochd University Hospital, Casablanca, Morocco
| | - D Pinto
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D Prieto-Alhambra
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
- GREMPAL Research Group, CIBERFes and Idiap Jordi Gol, Instituto de Salud Carlos III and Universitat Autonoma de Barcelona, Barcelona, Spain
| | - K Saag
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - W Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - L Zakraoui
- Service de Rhumatologie, University Tunis Manar and Hôpital Mongi-Slim, la Marsa, Tunisia
| | - J -Y Reginster
- Chair for Biomarkers of Chronic Diseases, Biochemistry Dept., College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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14
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Messina D, Tarroni M, Catarsi L, Balestri C, Messina G, Nante N. Food and lifestyle education at primary and secondary school: an Italian project on health promotion. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.048] [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: 11/13/2022] Open
Abstract
Abstract
Background
Nutrition and life styles have a crucial role as health determinants. In particular, an intervention on eating habits and physical activity/inactivity does heavily influence obesity and overweight prevention, alongside associated diseases. Preteen and teenage profile is critical for developing the state of health in adulthood, and it is heavily determined by the sociocultural family background. For this reason, school could become an important actor in health promotion, in the form of coordinated and cross-disciplinary courses about food and behaviors. The aim of the study is to verify the effect of an intervention of food education in several schools.
Methods
This cross-sectional study, originated from the “sCOOL FOOD” project of Monte dei Paschi Foundation of Siena, involves schools of southeastern Tuscany, Italy. The project currently engages various classes from primary and secondary schools in which year-round awareness campaigns are conducted. The activities consist in theory classes and workshops held by professionals or teachers of the school previously trained for the purpose. A same questionnaire was administered to families before and after each campaign, exploring eating habits, lifestyle and biometrics. The data analyzed so far date from October 2017 to May 2018. Wilcoxon signed-rank test was performed on the distributions of children BMI classes, defined according to IOTF cutoffs, obtained exclusively from participants who submitted both questionnaires.
Results
308 paired records of data were collected as mentioned above. We found that, after the campaign, children BMI classes distribution shift towards reduction was statistically significant (z=-2.053; p < 0.05).
Conclusions
Since the intervention was able to influence a childhood health determinant, it could be an opportunity to compensate those family dynamics that could lead towards health disadvantages in adulthood.
Key messages
A coordinated and cross-disciplinary food and lifestyle year-round education campaign at school can impact on health determinants of children. School can correct unfavorable eating and lifestyle behaviors determined by family habits.
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Affiliation(s)
- D Messina
- Monte dei Paschi Foundation of Siena, Siena, Italy
| | - M Tarroni
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - L Catarsi
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - C Balestri
- Monte dei Paschi Foundation of Siena, Siena, Italy
| | - G Messina
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - N Nante
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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15
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Messina G, Rosadini D, Burgassi S, Messina D, Nante N, Tani M, Cevenini G. Tanning the bugs - a pilot study of an innovative approach to stethoscope disinfection. J Hosp Infect 2016; 95:228-230. [PMID: 28087140 DOI: 10.1016/j.jhin.2016.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/03/2016] [Indexed: 11/26/2022]
Affiliation(s)
- G Messina
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy; Post Graduate School of Public Health, University of Siena, Siena, Italy.
| | - D Rosadini
- Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - S Burgassi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - D Messina
- Monte dei Paschi Foundation of Siena, Siena, Italy
| | - N Nante
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy; Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - M Tani
- FeT Elettronica S.n.c., via A. Volta 28, Poggibonsi (Siena), Siena, Italy
| | - G Cevenini
- Department of Medical Biotechnology, University of Siena, Siena, Italy
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Messina G, Burgassi S, Messina D, Montagnani V, Cevenini G. A wearable UV-LED medical device for automatic disinfection of stethoscope membrane. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.095] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Russell L, Huang R, Curran J, Bell L, Price L, Messina D, Johnson S, Carbon S, Davis E. The effect of a 12-month multidisciplinary lifestyle education programme on BMI-z score and cardio-metabolic outcomes. Obes Res Clin Pract 2012. [DOI: 10.1016/j.orcp.2012.08.074] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Abstract
Experimental investigation of nanosecond pulsed discharge in premixed CH4/air mixtures at atmospheric pressure has been carried out using laser diagnostics. Electron temperature and number density are measured using laser Thomson scattering. Temperature of neutral molecules is measured by CARS. Finally, OH, CH and CH2O are probed using PLIF to identify their role in the reduction of ignition delay and in the improvement of lean burn capability relative to conventional spark ignition. Measurements are compared with numerical simulations performed using CHEMKIN-based code.
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Affiliation(s)
| | - G. A. Grandin
- Office National d'Etudes et de Recherches Aérospatiales, Palaiseau, Frankreich
| | - D. Messina
- Office National d'Etudes et de Recherches Aérospatiales, Palaiseau, Frankreich
| | - B. Attal-Tretout
- Office National d'Etudes et de Recherches Aérospatiales, Palaiseau, Frankreich
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Morelli M, Arabia G, Novellino F, Salsone M, Giofrè L, Condino F, Messina D, Quattrone A. MRI measurements predict PSP in unclassifiable parkinsonisms: a cohort study. Neurology 2011; 77:1042-7. [PMID: 21832222 DOI: 10.1212/wnl.0b013e31822e55d0] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Magnetic resonance parkinsonism index (MRPI) has been proposed as a powerful tool to discriminate patients with progressive supranuclear palsy (PSP) from those with Parkinson disease (PD) or other parkinsonisms, on an individual basis. We investigated the usefulness of MRPI in predicting the clinical evolution in PSP of patients with clinically unclassifiable parkinsonism (CUP), i.e., parkinsonism not fulfilling the established clinical diagnostic criteria for any parkinsonian disorders, using a cohort study. METHODS Forty-five patients with CUP underwent baseline clinical evaluation and MRI with calculation of MRPI. All patients were divided in 2 groups according to MRPI values. A group included 30 patients with CUP with normal MRPI values while the other group included 15 patients with CUP with MRPI values suggestive of PSP (higher than 13.55). A clinical follow-up was performed in all patients. RESULTS Duration of clinical follow-up in these 2 groups was 28.4 ± 11.7 months (mean ± SD). None of the patients with CUP with normal MRPI values fulfilled established clinical criteria for PSP (follow-up ranging from 24 to 60 months). By contrast, 11 of 15 patients with CUP with abnormal MRPI values (higher than 13.55) developed during the follow-up (range from 6 to 48 months) additional clinical features characteristic of probable (1 patient) or possible (10 patients) PSP. MRPI showed a higher accuracy in predicting PSP (92.9%) than clinical features, such as vertical ocular slowness or first-year falls (61.9% and 73.8%, respectively). CONCLUSIONS Our findings suggest that MRPI is more powerful than clinical features in predicting the evolution of CUP toward PSP phenotypes.
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Affiliation(s)
- M Morelli
- Institute of Neurology, University Magna Graecia, Germaneto, Catanzaro, Italy
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20
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Doust J, Huang R, Delaney J, Price L, Messina D, Tremayne A, Russell L, Davis E. The impact of family functioning on short term efficacy of a 10 week multidisciplinary obesity management program –A pilot study. Obes Res Clin Pract 2010. [DOI: 10.1016/j.orcp.2010.09.062] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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De Marco EV, Annesi G, Tarantino P, Nicoletti G, Civitelli D, Messina D, Annesi F, Arabia G, Salsone M, Condino F, Novellino F, Provenzano G, Rocca FE, Colica C, Morelli M, Scornaienchi V, Greco V, Giofrè L, Quattrone A. DJ-1 is a Parkinson's disease susceptibility gene in southern Italy. Clin Genet 2009; 77:183-8. [PMID: 19968671 DOI: 10.1111/j.1399-0004.2009.01310.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Mutations in the gene DJ-1 have been shown to be a rare cause of early-onset Parkinson's disease (EOPD). Since DJ-1 mutations have been found in patients with Parkinson's disease (PD) from southern Italy, we aimed to investigate whether polymorphisms within the DJ-1 gene could represent a risk factor for sporadic PD. First, we genotyped 294 patients with PD and 298 controls coming from southern Italy to assess the distribution of the insertion/deletion (Ins/Del) polymorphism. In a second phase, we identified five single-nucleotide polymorphisms (SNPs) useful to delimit a region potentially involved and genotyped all patients and controls for these markers. All the markers analyzed were significantly associated with PD at both allelic and genotypic level. The most significant association with the disease was found at the Ins/Del polymorphism (p = 0.0001; adjusted odds ratio (OR ) = 2.05; confidence interval (CI ) = 1.36-3.08). When we considered a three-marker sliding window, we found a highly significant association between the disease and the haplotypes including markers rs17523802, Ins/Del, and rs3766606 (p = 0.0007) and markers Ins/Del, rs3766606 and rs7517357 (p = 0.0054). Our results indicate that polymorphisms located in a region spanning 3535 bp from the promoter to the intron 2 of the DJ-1 gene confer risk to sporadic PD in southern Italy.
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Affiliation(s)
- E V De Marco
- Institute of Neurological Sciences, National Research Council, Mangone (Cosenza), Italy
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22
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Cerasa A, Messina D, Nicoletti G, Novellino F, Lanza P, Condino F, Arabia G, Salsone M, Quattrone A. Cerebellar atrophy in essential tremor using an automated segmentation method. AJNR Am J Neuroradiol 2009; 30:1240-3. [PMID: 19342539 DOI: 10.3174/ajnr.a1544] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Essential tremor (ET) is a slowly progressive disorder characterized by postural and kinetic tremors most commonly affecting the forearms and hands. Several lines of evidence from physiologic and neuroimaging studies point toward a major role of the cerebellum in this disease. Recently, voxel-based morphometry (VBM) has been proposed to quantify cerebellar atrophy in ET. However, VBM was not originally designed to study subcortical structures, and the complicated anatomy of the cerebellum may hamper the automatic processing of VBM. The aim of this study was to determine the efficacy and utility of using automated subcortical segmentation to identify atrophy of the cerebellum and other subcortical structures in patients with ET. MATERIALS AND METHODS We used a recently developed automated volumetric method (FreeSurfer) to quantify subcortical atrophy in ET by comparing results obtained with this method with those provided by previous evidence. The study included T1-weighted MR images of 46 patients with ET grouped into those having arm ET (n = 27, a-ET) or head ET (n = 19, h-ET) and 28 healthy controls. RESULTS Results revealed the expected reduction of cerebellar volume in patients with h-ET with respect to healthy controls after controlling for intracranial volume. No significant difference was detected in any other subcortical area. CONCLUSIONS Volumetric data obtained with automated segmentation of subcortical and cerebellar structures approximate data from a previous study based on VBM. The current findings extend the literature by providing initial validation for using fully automated segmentation to derive cerebellar volumetric information from patients with ET.
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Affiliation(s)
- A Cerasa
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
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23
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Quattrone A, Cerasa A, Messina D, Nicoletti G, Hagberg GE, Lemieux L, Novellino F, Lanza P, Arabia G, Salsone M. Essential head tremor is associated with cerebellar vermis atrophy: a volumetric and voxel-based morphometry MR imaging study. AJNR Am J Neuroradiol 2008; 29:1692-7. [PMID: 18653686 DOI: 10.3174/ajnr.a1190] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Our aim was to investigate the presence of brain gray matter (GM) abnormalities in patients with different forms of essential tremor (ET). MATERIALS AND METHODS We used optimized voxel-based morphometry (VBM) and manually traced single region-of-interest analysis in 50 patients with familial ET and in 32 healthy subjects. Thirty patients with ET had tremor of the arms (a-ET), whereas the remaining 20 patients had both arm and head tremor (h-ET). RESULTS VBM showed marked atrophy of the cerebellar vermis in the patients with h-ET with respect to healthy subjects (P(corrected) < .001). Patients with a-ET showed a trend toward a vermal GM volume loss that did not reach a significant difference with respect to healthy controls (P(uncorrected) < .01). The region-of-interest analysis showed a reduction of the cerebellar volume (CV) in the h-ET group (98.2 +/- 13.6 mm(3)) compared with healthy controls (110.5 +/- 15.5 mm(3), P < .012) as well as in the entire vermal area (790.3 +/- 94.5 mm(2), 898.6 +/- 170.6 mm(2), P < .04 in h-ET and control groups, respectively). CONCLUSIONS Atrophy of the cerebellar vermis detected in patients with h-ET strongly supports the evidence for the involvement of the cerebellum in the pathophysiology of ET. The lack of a significant CV loss observed in patients with a-ET suggests that a-ET and h-ET might represent distinct subtypes of the same disease.
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Affiliation(s)
- A Quattrone
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy.
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24
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Colnaghi M, Matassa PG, Fumagalli M, Messina D, Mosca F. Pharyngeal pressure value using two continuous positive airway pressure devices. Arch Dis Child Fetal Neonatal Ed 2008; 93:F302-4. [PMID: 18334615 DOI: 10.1136/adc.2007.120428] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The aim of the study was to measure the difference between the set continuous positive airway pressure (CPAP) value and the pharyngeal pressure reading during CPAP in premature infants with mild respiratory distress syndrome, using two different devices: hood CPAP and the conventional nasal system. The preliminary results suggest that hood CPAP may produce more stable pharyngeal pressure than the conventional nasal device.
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Affiliation(s)
- M Colnaghi
- NICU-Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via della Commenda 12, 20122 Milan, Italy.
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25
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Bono F, Messina D, Giliberto C, Cristiano D, Broussard G, D’Asero S, Condino F, Mangone L, Mastrandrea C, Fera F, Quattrone A. Bilateral transverse sinus stenosis and idiopathic intracranial hypertension without papilledema in chronic tension-type headache. J Neurol 2008; 255:807-12. [DOI: 10.1007/s00415-008-0676-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Revised: 05/16/2007] [Accepted: 06/06/2007] [Indexed: 11/28/2022]
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Bono F, Messina D, Giliberto C, Cristiano D, Broussard G, Fera F, Condino F, Lavano A, Quattrone A. Bilateral transverse sinus stenosis predicts IIH without papilledema in patients with migraine. Neurology 2006; 67:419-23. [PMID: 16894101 DOI: 10.1212/01.wnl.0000227892.67354.85] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The headache profile of patients with idiopathic intracranial hypertension without papilledema (IIHWOP) may be indistinguishable from that of migraine. Bilateral transverse sinus stenosis (BTSS) has been found in the majority of patients with IIHWOP. The frequency of BTSS associated with IIHWOP in patients with migraine is unknown. OBJECTIVE To detect the frequency of BTSS in adult patients with migraine and to investigate whether the presence of BTSS identifies patients with IIHWOP. METHODS In a prospective study from December 2000 to November 2005, 724 consecutive patients with recurrent headaches who fulfilled International Headache Society diagnostic criteria for migraine underwent cerebral MR venography (MRV). A portion of these patients underwent a lumbar puncture (LP) to measure CSF pressure. MRV and LP were also performed in 70 age-matched control subjects. RESULTS Six hundred seventy-five of the 724 patients with migraines had normal MRV. Seventy of these 675 patients underwent LP, and all of them had normal CSF pressure. Forty-nine (6.7%) of the 724 patients with migraine had BTSS. Twenty-eight of these 49 patients with BTSS underwent LP, and 19 (67.8%) had IIHWOP. The headache profiles of patients with BTSS and IIHWOP did not differ from those of patients with normal MRVs and CSF pressures within normal limits. CSF pressure was normal in both patients and controls with normal MRV. CONCLUSIONS Of patients with migraine, 6.7% had bilateral transverse sinus stenosis; 67.8% of these patients had idiopathic intracranial hypertension without papilledema (IIHWOP). These results suggest that patients with migraine who present bilateral transverse sinus stenosis on cerebral MR venography should undergo lumbar puncture to exclude IIHWOP.
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Affiliation(s)
- F Bono
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
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27
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Labate A, Ventura P, Gambardella A, Le Piane E, Colosimo E, Leggio U, Ambrosio R, Condino F, Messina D, Lanza P, Aguglia U, Quattrone A. MRI evidence of mesial temporal sclerosis in sporadic "benign" temporal lobe epilepsy. Neurology 2006; 66:562-5. [PMID: 16505312 DOI: 10.1212/01.wnl.0000198208.59347.96] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether there is MRI-detectable mesial temporal sclerosis (MTS) in patients with sporadic benign temporal lobe epilepsy (BTLE). METHODS Brain MRIs were obtained from 101 consecutive, unrelated patients (51 women; mean age 37.3 +/- 17.5 years; range 10 to 83 years) with BTLE, who reported rarely or never having had seizures at the time of long-term (> 2 years) follow-up. The mean age at seizure onset was 22.3 +/- 17.4 years; the mean duration of epilepsy was 16.4 +/- 14.1 years. MRI diagnosis of MTS was based on the occurrence of hippocampal formation atrophy on T1 slices, an increased mesial temporal signal intensity alteration on fluid-attenuated inversion-recovery (FLAIR) or T2 images, or both. RESULTS Thirty-nine of 101 patients (38.6%) had MRI evidence of unilateral MTS (19/39 left MTS, 20/39 right MTS), which correlated with the epileptiform activity. Hyperintense FLAIR and T2 signal with or without atrophy was observed in 24 of 39 individuals. There was no difference between patients with or without MRI-detected MTS in age at onset and duration of epilepsy. Family history of epilepsy or febrile convulsions (FCs) was more frequent in patients with MRI-detected MTS (36%) as compared with patients with normal MRI (22.7%), but the difference was not significant. Antecedent FCs were more frequent (p = 0.03) in patients with MRI-detected MTS (9/39; 23%) vs those with normal MRI (5/62; 8%). CONCLUSIONS MRI-detected mesial temporal sclerosis is often encountered in patients with sporadic benign temporal lobe epilepsy.
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Affiliation(s)
- A Labate
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
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28
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Aguglia U, Gambardella A, Breedveld GJ, Oliveri RL, Le Piane E, Messina D, Quattrone A, Heutink P. Suggestive evidence for linkage to chromosome 13qter for autosomal dominant type 1 porencephaly. Neurology 2004; 62:1613-5. [PMID: 15136694 DOI: 10.1212/01.wnl.0000123113.46672.68] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A large three-generation family with autosomal dominant type 1 porencephaly from southern Italy was studied. A high rate of miscarriages was observed. Of the nine affected individuals, four displayed a severe phenotype, and five had slight pyramidal signs or mild cognitive abnormalities. The MRI study disclosed unilateral porencephalic cyst, or colpocephaly. A genome-wide screen resulted in suggestive evidence for linkage to chromosome 13qter with a maximum logarithm-of-the-odds score of 3.16, from multipoint analysis, with marker D13S285.
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Affiliation(s)
- U Aguglia
- Regional Epilepsy Center, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Cal., Italy.
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29
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Zappia M, Annesi G, Nicoletti G, Serra P, Arabia G, Pugliese P, Messina D, Caracciolo M, Romeo N, Annesi F, Pasqua AA, Spadafora P, Civitelli D, Romeo N, Epifanio A, Morgante L, Quattrone A. Association of tau gene polymorphism with Parkinson's disease. Neurol Sci 2004; 24:223-4. [PMID: 14600827 DOI: 10.1007/s10072-003-0141-z] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
We investigated the segregation of the dinucleotide GT repeat polymorphism in the intron between exons 9 and 10 of the tau gene in 300 patients with Parkinson's disease (PD) and in 197 normal controls. The A3 allele was more frequent in cases than in controls (30% versus 16%, p<0.001), and individuals carrying at least one A3 allele in their genotype had an increased risk of developing PD (odds ratio 2.78, 95% confidence interval 1.81-4.29). No significant differences were found between patients by considering the age at onset and the presence of family history or dementia. Our findings suggest a possible involvement of the tau gene in the pathogenesis of PD.
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Affiliation(s)
- M Zappia
- Clinica Neurologica, Università di Catanzaro, Via Campanella, Catanzaro, Italy
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30
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Cannizzaro MA, Caruso L, Costanzo M, Messina D, Sallemi R, Veroux M. [Surgery of thyroid pathologies in one-day surgery]. Ann Ital Chir 2002; 73:501-3; discussion 503-4. [PMID: 12704990] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
The surgery of the thyroid pathologies in Day and/or One-Day-Surgery requires a thorough choice former of the surgery of the patients and the availability of the team specialist that could guarantee an adequate nursing after surgery. The authors describe the advantages and the limits of the short confined to stay in hospital for the surgery of the thyroid pathologies. The selection criteria for patients undergoing thyroidectomy in One-Day-Surgery have been: euthyroid patients with benign pathologies concentrate only thyroid lobe and lack of associated pathologies as cardiopathy, broncopathy, nephropathy, hepatopaty, diabetes, etc. Were executed in general anaesthesia forty lobectomies for uninodular thyroid disease and three enucleoresections for a nodule of pyramidal lobe, and only two cases the histological definitive diagnosis of carcinoma has caused a second hospital stay. In all forty-three cases was used a drainage, removed after 24 hours.
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Affiliation(s)
- M A Cannizzaro
- Università degli Studi di Catania, Servizio Autonomo Clinicizzato di Endocrinochirurgia, P.O. S. Luigi, Currò, Catania
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31
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Messina D, Annesi G, Serra P, Nicoletti G, Pasqua A, Annesi F, Tomaino C, Cirò-Candiano IC, Carrideo S, Caracciolo M, Spadafora P, Zappia M, Savettieri G, Quattrone A. Association of the 5-HT6 receptor gene polymorphism C267T with Parkinson's disease. Neurology 2002; 58:828-9. [PMID: 11889255 DOI: 10.1212/wnl.58.5.828] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- D Messina
- Institute of Neurological Sciences , National Research Council, Piano Lago di Mangone, Cosenza, Italy
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32
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Labate A, Gambardella A, Messina D, Tammaro S, Le Piane E, Pirritano D, Cosco C, Doldo P, Mazzei R, Oliveri RL, Bosco D, Zappia M, Valentino P, Aguglia U, Quattrone A. Silent celiac disease in patients with childhood localization-related epilepsies. Epilepsia 2001; 42:1153-5. [PMID: 11580763 DOI: 10.1046/j.1528-1157.2001.45700.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate how many patients with a clinical picture of idiopathic childhood localization-related epilepsies may also have silent celiac disease (CD). This will help determine whether investigation for CD should be restricted to those patients with childhood partial epilepsy with occipital paroxysms (CPEO) or should be extended to all patients with childhood partial epilepsy (CPE) regardless of seizure type and electroencephalographic (EEG) paroxysms. METHODS The study group consisted of 72 patients (31 girls and 41 boys; mean age, 12.6 +/- 4.28 years; age at onset, 6.4 +/- 3.7 years) who were observed consecutively over a 5-year period and who received an initial diagnosis of idiopathic CPE. A diagnosis of CD was confirmed by using enzyme-linked immunosorbent assay (ELISA) to assess the presence of antigliadin antibodies and the immunofluorescent undirected test to assess the presence of antiendomysium antibodies. RESULTS Twenty-five patients had CPEO, whereas the remaining 47 had CPE with centrotemporal spikes (CPEC). None of the patients with CPEC had positive antibody tests. Of the 25 patients with CPEO, two (8%) had antiendomysium immunoglobulin (Ig) A antibodies. In both of these patients, the jejunal biopsy showed atrophy of the villi and hyperplasia of the crypts, consistent with a diagnosis of CD. Brain computed tomography (CT) was normal in one of these patients and revealed occipital corticosubcortical calcifications in the other. CONCLUSIONS Our study indicates that CD screening should be performed routinely only in patients with CPEO.
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Affiliation(s)
- A Labate
- Institute of Neurology, University Magna Graecia of Catanzaro, Italy
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Krakow K, Lemieux L, Messina D, Scott CA, Symms MR, Duncan JS, Fish DR. Spatio-temporal imaging of focal interictal epileptiform activity using EEG-triggered functional MRI. Epileptic Disord 2001; 3:67-74. [PMID: 11431168] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
EEG-triggered, blood oxygen level-dependent functional MRI (BOLD-fMRI) was used in 24 patients with localization-related epilepsy and frequent interictal epileptiform discharges (spikes) to identify those brain areas involved in generating the spikes, and to study the evolution of the BOLD signal change over time. The location of the fMRI activation was compared with the scalp EEG spike focus and the structural MR abnormality. Twelve patients (50%) had an fMRI activation concordant with the EEG focus and structural brain abnormalities where present (n = 7). In 2 other patients, the fMRI activation was non-concordant with electroclinical findings. The remaining 10 patients (41.7%) showed no significant fMRI activation. These patients had significantly lower mean spike amplitudes compared to those with positive fMRI results (p = 0.03). The time course of the BOLD response was studied in 3 patients and this revealed a maximum signal change 1.5 to 7.5 sec after the spike. In conclusion, EEG-triggered fMRI can directly identify the generators of interictal epileptiform activity, with high spatial resolution, in selected patients with frequent spikes. The superior spatial resolution obtainable through EEG-triggered fMRI may provide an additional non-invasive tool in the presurgical evaluation of patients with intractable focal seizures.
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Affiliation(s)
- K Krakow
- MRI Unit, National Society for Epilepsy, Chalfont St. Peter, Buckinghamshire SL9 0RJ, UK
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Abstract
We used spike-triggered functional MRI in a patient with localization-related epilepsy to determine whether individual (as opposed to averaged) focal interictal epileptiform discharges (spikes) were associated with hemodynamic changes detectable with blood oxygen level-dependent functional MRI (fMRI). It was found that 15 of 43 spikes (34.9%) were associated with significant focal fMRI activation. Single event-related fMRI of interictal spikes is feasible in selected patients, giving complementary information to that provided by averaged fMRI data.
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Affiliation(s)
- K Krakow
- Epilepsy Research Group, Department of Clinical Neurology, Institute of Neurology, University College London, London and National Society for Epilepsy, Chalfont St. Peter, Buckinghamshire, United Kingdom
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Oliveri RL, Zappia M, Annesi G, Annesi F, Spadafora P, Pasqua AA, Tomaino C, Nicoletti G, Bosco D, Messina D, Logroscino G, Manobianca G, Epifanio A, Morgante L, Savettieri G, Quattrone A. The parkin gene is not a major susceptibility locus for typical late-onset Parkinson's disease. Neurol Sci 2001; 22:73-4. [PMID: 11487208 DOI: 10.1007/s100720170053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We investigated the parkin gene in 118 patients with typical Parkinson's disease (PD), i.e. in patients who had an onset of PD after the age of 45 years. The study group included 95 subjects with sporadic PD and 23 subjects from 18 families with autosomal recessive PD. No pathogenetic mutations in the parkin gene were detected either in familial or in sporadic patients. Our findings indicate that the parkin gene is not involved in the pathogenesis of classic late-onset PD.
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Affiliation(s)
- R L Oliveri
- Neurology Clinic, University of Catanzaro, Italy
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Aguglia U, Gambardella A, Quartarone A, Girlanda P, Le Piane E, Messina D, Oliveri RL, Zappia M, Quattrone A. Interhemispheric threshold differences in idiopathic generalized epilepsies with versive or circling seizures determined with focal magnetic transcranial stimulation. Epilepsy Res 2000; 40:1-6. [PMID: 10771252 DOI: 10.1016/s0920-1211(99)00105-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The interhemispheric difference of the motor-cortical threshold (IDMT) was studied with focal magnetic transcranial stimulation (TCS) in ten patients with idiopathic generalized epilepsy (IGE) who also displayed versive or circling seizures (IGEvc). The data were compared with those obtained from two control groups; 13 patients with IGE without asymmetrical motor seizures, and 25 normal volunteer subjects. The IDMT, referred to as the percentage of maximum stimulator output, was assessed by focal TCS applied to the hand areas. Seven patients with IGEvc and only one patient with IGE had an interhemispheric motor threshold beyond the normal range. The IDMT in IGEvc patients was significantly higher compared to that of IGE patients and normal individuals. An interhemispheric imbalance of cortical excitability may explain lateralized ictal motor manifestations in patients with IGEvc.
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Affiliation(s)
- U Aguglia
- Clinica Neurologica, Policlinico Materdomini, Università degli Studi di Catanzaro, Via T. Campanella, 88100, Catanzaro, Italy.
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Messina D. Recipes for success? Bioinformatics: Methods and Protocols, edited by S. Misener and S.A. Krawetz. Trends Biotechnol 2000. [DOI: 10.1016/s0167-7799(00)01435-9] [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: 10/17/2022]
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Gambardella A, Messina D, Le Piane E, Oliveri RL, Annesi G, Zappia M, Andermann E, Quattrone A, Aguglia U. Familial temporal lobe epilepsy autosomal dominant inheritance in a large pedigree from southern Italy. Epilepsy Res 2000; 38:127-32. [PMID: 10642040 DOI: 10.1016/s0920-1211(99)00080-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
To further elucidate the inheritance pattern and range of phenotypic manifestations of benign familial temporal lobe epilepsy (FTLE), we report a large family recently identified in southern Italy. There were 8 patients (4 men), ranging in age from 31 to 68 years in three generations. One affected patient was deceased at the time of the study. Genealogical study strongly supported autosomal dominant inheritance with incomplete penetrance, as three unaffected individuals transmitted the disease. Clinical anticipation could not be assessed because of the ascertainment method. Male to male transmission occurred. Identifiable antecedents for seizures were present in only two patients, who had a simple febrile convulsion and a closed head trauma, respectively. Migraine was overrepresented in this family. Onset of seizures ranged from 17 to 52 years (mean: 27 years). All patients had weekly simple partial seizures suggestive of temporal origin with vegetative or experiential phenomena. Very rare partial complex seizures occurred in 6/7 patients. One had two generalized nocturnal seizures as well. Two had previously been misdiagnosed as having gastritis or panic attacks, and one had not been diagnosed. Interictal anteromesiotemporal spiking was seen in 5/7 patients, and occurred mostly during NREM sleep. Neurological examination, brain CT or MR scans were normal. Antiepileptic medication always controlled the seizures.
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Affiliation(s)
- A Gambardella
- Cattedra ed U.O. di Neurologia, Facoltà di Medicina e Chirurgia di Catanzaro, Policlinico Mater Domini, Catanzaro, Italy.
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Gambardella A, Aguglia U, Cittadella R, Romeo N, Sibilia G, LePiane E, Messina D, Manna I, Oliveri RL, Zappia M, Quattrone A. Apolipoprotein E polymorphisms and the risk of nonlesional temporal lobe epilepsy. Epilepsia 1999; 40:1804-7. [PMID: 10612348 DOI: 10.1111/j.1528-1157.1999.tb01602.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate whether the inheritance of the apolipoprotein E (ApoE) epsilon4 allele is a risk factor for nonlesional temporal lobe epilepsy (TLE), and to determine whether the newly described -491 A/T ApoE polymorphism may independently affect the risk of nonlesional TLE. METHODS The study group consisted of 63 patients (35 women and 28 men; age at onset of epilepsy, 30.6 +/- 19.6 years; mean (+/-SD). All of them had received a diagnosis of nonlesional TLE after a detailed clinical, electroencephalographic, and brain magnetic resonance investigation. The ApoE polymorphisms were determined from blood samples by standard methods. The molecular study also was performed in 220 age- and sex-matched normal individuals. RESULTS There were no differences between TLE patients and controls in either allelic or genotypic frequencies of the ApoE and -491A/T polymorphisms. Moreover, no effect of ApoE or -491A/T polymorphisms was found on the age at onset and severity of epilepsy. CONCLUSIONS The allelic and genotypic frequencies of ApoE polymorphisms in Italian patients with nonlesional TLE are comparable to control values, indicating that ApoE polymorphisms are not a significant genetic risk factor for the occurrence of nonlesional TLE.
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Affiliation(s)
- A Gambardella
- Institute of Neurology, School of Medicine of Catanzaro, Italy.
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Aguglia U, Le Piane E, Gambardella A, Messina D, Russo C, Sirchia SM, Porta G, Quattrone A. Emotion-induced myoclonic absence-like seizures in a patient with inv-dup(15) syndrome: a clinical, EEG, and molecular genetic study. Epilepsia 1999; 40:1316-9. [PMID: 10487199 DOI: 10.1111/j.1528-1157.1999.tb00865.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We have described a clinical EEG and molecular genetic study of a 9-year-old boy with inv-dup(15) syndrome in whom seizures were induced by emotionally gratifying stimuli. The reflex seizures began 5-20 s after the onset of repeated cheek-kissing from his mother or after viewing of pleasant or funny events. They were characterized by bilateral discharges involving mainly the temporal regions and evolving into myoclonic absence-like seizures. Nonemotional stimuli, such as a pinch, sucking or rubbing his cheeks, or the sound of the kiss alone, failed to provoke seizures. The seizures were resistant to antiepileptic (AED) treatments. Molecular genetic investigations revealed a correct methylation pattern of the chromosomes 15, and three copies (two maternal and one paternal) of the segment 15q11-q13, including the GABRb3 gene. We hypothesize that an overexpression of cerebral gamma-aminobutyric acid (GABA)-mediated inhibition accounts for the severe epilepsy that we observed in this patient.
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MESH Headings
- Child
- Chromosome Aberrations/genetics
- Chromosome Inversion
- Chromosomes, Human, Pair 15/genetics
- Electroencephalography/statistics & numerical data
- Emotions/physiology
- Epilepsies, Myoclonic/diagnosis
- Epilepsies, Myoclonic/etiology
- Epilepsies, Myoclonic/genetics
- Epilepsy, Absence/diagnosis
- Epilepsy, Absence/etiology
- Epilepsy, Absence/genetics
- Gene Duplication
- Humans
- Male
- Receptors, GABA/genetics
- Receptors, GABA/physiology
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Affiliation(s)
- U Aguglia
- Department of Medical Sciences, School of Medicine, University of Catanzaro, Italy.
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Aguglia U, Gambardella A, Le Piane E, Messina D, Russo C, Oliveri RL, Zappia M, Quattrone A. Idiopathic generalized epilepsies with versive or circling seizures. Acta Neurol Scand 1999; 99:219-24. [PMID: 10225351 DOI: 10.1111/j.1600-0404.1999.tb07350.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe the electroclinical features of the idiopathic generalized epilepsies (IGEs) with versive or circling seizures. METHODS Sixteen patients with versive or circling seizures and interictal electroclinical features of IGE were studied. Patients with insufficient clinical or imaging data, with a follow-up period less than 1 year or with partial seizures in addition to the versive or circling ones were excluded from the study. All patients underwent full interictal clinical and neurophysiological studies. The EEG patterns of 13 versive or circling seizures from 4 patients were also analyzed. RESULTS A specific IGE syndrome was recognized in 9 out of the 16 patients (56%). More specific, 1 patient had childhood absence epilepsy (CAE), 4 had juvenile absence epilepsy (JAE), and 4 had juvenile myoclonic epilepsy (JME). No specific IGE syndrome was recognizable in the remaining 7 patients (44%). These 7 patients had a juvenile epileptic syndrome (mean age at onset of seizures was 15.7 years) characterized by versive or circling seizures followed or not by generalized tonic-clonic fits. Three main EEG patterns were identified during versive or circling seizures: 1) generalized spike-and-wave discharges at 3-4 cps; 2) generalized polyspike-and-wave discharges at 1 to 2.5 cps beginning with generalized fast activity at 12-14 cps, and 3) generalized spike-and-wave discharges at 3-4 cps intermingled with fast activity at 12-14 cps. Most patients had good response to treatment on a single drug regimen (mainly valproic acid). CONCLUSIONS Versive or circling seizures may occur in the context of an IGE. Although many individuals share the features of different IGE syndromes including CAE, JAE and JME, a consistent number of patients, who show circling or versive seizures solely, remain without a specific syndromic diagnosis. When occurring in the context of IGE, circling or versive seizures do not worsen the prognosis.
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Affiliation(s)
- U Aguglia
- Institute of Neurology, School of Medicine, University of Catanzaro, Italy
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42
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Aguglia U, Gambardella A, Le Piane E, Messina D, Oliveri RL, Russo C, Zappia M, Quattrone A. Mild non-lesional temporal lobe epilepsy. A common, unrecognized disorder with onset in adulthood. Neurol Sci 1998; 25:282-6. [PMID: 9827228 DOI: 10.1017/s0317167100034284] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To compare mild vs. severe non-lesional temporal lobe epilepsy (TLE). METHODS Data from 104 consecutive patients with non-lesional TLE were reviewed. Seventy-three of the 104 fulfilled the criteria for inclusion in this study of a follow-up period longer than three years at our Institute. Patients were considered to have a mild TLE if they were seizure free for at least three years after appropriate antiepileptic medication, or had rare (< or = 2/year) complex partial or secondarily generalized seizures for at least three years with or without appropriate antiepileptic therapy. Clinical, EEG and MRI data of mild vs. severe non-lesional TLE patients were compared on the basis of a cross-sectional study design. RESULTS Of the 73 patients with non-lesional TLE included in the study, 43 (59%) had mild TLE, and 30 (41%) had severe TLE. Duration of epilepsy was significantly shorter (mean 15.2 +/- 10.5 years vs. 26.4 +/- 13.2 years) and age at onset was significantly higher (mean 34.3 +/- 15.3 years vs. 7.8 +/- 6.8 years) in mild than in severe TLE group. Patients with mild TLE had also a significantly higher prevalence of positive family history of epilepsy (37.2% vs. 10%), and a significantly lower occurrence rate of febrile convulsions (FC) (4.7% vs. 33.3%), mesial temporal sclerosis (MTS) (6.9% vs. 36.7%), and intelligence deficiency (0% vs. 20%). In mild TLE there was also a significantly high rate (58.1 vs. 0%) of delayed diagnosis (from 1 to 28 years), because of misdiagnosis (39.5%) or no medical counseling (18.6%). CONCLUSIONS Mild non-lesional TLE is a common, unrecognized disorder mainly characterized by both onset in adulthood and high prevalence of familial history of epilepsy. The present findings suggest that mild non-lesional TLE may represent a clinical entity different from severe non-lesional TLE.
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Affiliation(s)
- U Aguglia
- Institute of Neurology, School of Medicine, University of Catanzaro, Italy
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Gambardella A, Pucci F, La Piane E, Messina D, Russo C, Zappia M, Oliveri RL, Quattrone A, Aguglia U. Usefulness of latero-orbital electrodes in detecting interictal epileptiform activity--a study of 60 patients with complex partial seizures. Electroencephalogr Clin Neurophysiol 1998; 107:174-6. [PMID: 9751288 DOI: 10.1016/s0013-4694(98)00049-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The use of latero-orbital (Lo) electrodes is a routine practice in any EEG laboratory to evaluate eye motion, but there are no data about their usefulness in revealing interictal epileptiform abnormalities. METHODS In 60 consecutive patients (27 men, 33 women, mean age 36.8 years, range 17-72) with complex partial seizures, we prospectively evaluated the utility of Lo electrodes in comparison with anterior temporal (AT) electrodes, for the detection of interictal epileptiform discharges (SW). RESULTS No epileptiform abnormality was seen in 4/60 patients. Both AT and Lo electrodes were significantly superior to 10-20 electrodes for detection of both patients and foci. Indeed, the standard 10-20 system alone allowed the detection of only 39 independent epileptiform foci in 35/56 (63%) patients, while AT and Lo electrodes were necessary for detection of 23 epileptiform foci in the remaining 21/56 (37%) patients. Importantly, there was no statistically significant difference in detection between AT and Lo electrodes. CONCLUSIONS Recordings from Lo electrodes are comparable to those from AT electrodes and are useful for localizing interictal temporal spiking activity. Lo electrodes may be substituted for basal electrodes in the day-to-day evaluation of patients with complex partial seizures.
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Affiliation(s)
- A Gambardella
- Institute of Neurology School of Medicine, Catanzaro, Italy.
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44
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Aguglia U, Gambardella A, Le Piane E, Messina D, Farnarier G, Oliveri RL, Zappia M, Quattrone A. Disappearance of periodic sharp wave complexes in Creutzfeldt-Jakob disease. Neurophysiol Clin 1997; 27:277-82. [PMID: 9350060 DOI: 10.1016/s0987-7053(97)85825-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Periodic sharp wave complexes (PSWC) are sensitive and specific of Creutzfeldt-Jakob disease (CJD). Once they have emerged, PSWC may exceptionally disappear in the terminal stage of the disease, as a consequence of the flattening of scalp electroencephalogram (EEG). We document the disappearance of PSWC in serial EEG during the clinical course in two women (57 and 70 years of age) with pathologically proven CJD. Despite PSWC disappearance, diffuse theta-delta activity was still well recognizable. Moreover, external stimuli failed to trigger PSWC. The absence of PSWC in CJD might be due to the timing and frequency of EEG recordings. PSWC disappearance should not be interpretated as evidence against the diagnosis of CJD.
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Affiliation(s)
- U Aguglia
- Università degli studi, policlinico Materdomini, clinica neurologica, Catanzaro, Italy
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Suarez-Almazor M, Homik JE, Messina D, Davis P. Attitudes and beliefs of family physicians and gynecologists in relation to the prevention and treatment of osteoporosis. J Bone Miner Res 1997; 12:1100-7. [PMID: 9200010 DOI: 10.1359/jbmr.1997.12.7.1100] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The objective of this study was to evaluate the attitudes and beliefs of primary care physicians (PCPs) and obstetricians/gynecologists (O&Gs) in relation to the prevention and treatment of osteoporosis (OP) in postmenopausal women. A survey was mailed to a random sample of PCPs and to all O&Gs registered in the province of Alberta (Canada). The survey evaluated their practice patterns using closed-ended questions, Likert scaled items, and two case studies. Cases 1 and 2 were 52-year-old and 62-year-old healthy postmenopausal women, respectively, with no known risks for OP. Neither had received hormone replacement therapy (HRT). One hundred fifty-seven PCPs and 57 O&Gs participated in the study. Thirty-eight percent of the PCPs and 32% of the O&Gs stated that they never requested bone mineral density measurements (BMDm) in early postmenopausal women. Most would request BMDm only in the presence of risk factors. The most important criteria to request BMDm were chronic glucocorticoid use and recent fractures. For case 1, 7% of the PCPs and 11% of the O&Gs would request BMDm; 76% of the PCPs and 80% of the O&Gs would recommend HRT. For case 2, 29% of the PCPs and 47% of the O&Gs would request BMDm (p = 0.01); 43% of the PCPs and 49% of the O&Gs would prescribe HRT. In general, O&Gs were more inclined to intervene in relation to BMDm and HRT. O&Gs were also more likely to be influenced by clinical trials than PCPs (p < 0.001). Our findings show variations in the patterns of practice of physicians in relation to the prevention of OP. In general, use of densitometry appears to be low. The results of the case studies suggest that individual physician perceptions may be more influential than patient characteristics when requesting BMDm and prescribing HRT, particularly in older postmenopausal women. This group of healthy older women have approximately equal odds of being offered versus not being offered BMDm and HRT according to the physician they consult.
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Affiliation(s)
- M Suarez-Almazor
- Department of Public Health Sciences, University of Alberta, Edmonton, Canada
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Morán CE, Sosa EG, Martinez SM, Geldern P, Messina D, Russo A, Boerr L, Bai JC. Bone mineral density in patients with pancreatic insufficiency and steatorrhea. Am J Gastroenterol 1997; 92:867-71. [PMID: 9149203] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Low bone mineral density (BMD) has been demonstrated in some patients with chronic intestinal disorders accompanied by diarrhea and malabsorption. However, very few studies have evaluated BMD in patients with pancreatic insufficiency due to cystic fibrosis. Our aim was to assess the prevalence and severity of bone loss in a cohort of patients with pancreatic insufficiency as a consequence of chronic pancreatitis. METHODS Fourteen patients with chronic pancreatitis were studied. All of them presented with severe pancreatic insufficiency (secretin test: bicarbonate < or = 40 mEq/L) and steatorrhea (fecal fat > 7 g/day) and had been abstinent from alcohol for a median of 2.5 yr (range 1-15 yr). BMD was measured with a total-body scanner for dual-energy x-ray absorptiometry. Results were expressed as T-score (number of SD by which a patient density differs from the mean of sex-matched 30-yr-old healthy controls) in lumbar spine (L2-L4) and femoral neck. Total serum calcium, 25-(OH)D3, alkaline phosphatase, and midmolecular parathyroid hormone were determined. RESULTS Ten patients demonstrated osteopenia (T-score -1 to -2.5) in the lumbar spine and in the femoral neck. Three patients displayed osteoporosis (T-score < -2.5) in the lumbar spine and two in the femoral neck. Mean T-scores (+/- SEM) were -1.44 +/- 0.37 in the lumbar spine and -1.79 +/- 0.27 in the femoral neck. Total and ionic serum calcium, serum parathyroid hormone, and alkaline phosphatase were in the normal range in all patients. Serum 25-(OH)D3 was below normal range in 7 of 12 patients. T-scores of patients with pancreatitis of alcoholic etiology (n = 10) were similar to those of nonalcoholic patients (n = 4). BMD did not correlate with age, bicarbonate secretion, fecal fat excretion, stool volume, parameters of mineral metabolism, duration of alcoholism, or mean alcohol intake. CONCLUSIONS Most patients with pancreatic insufficiency as a consequence of chronic pancreatitis exhibit osteopenia, and some show evidence of osteoporosis. Identifying the intimate mechanisms for low BMD are beyond the limitations of the present study. More in-depth metabolic studies are necessary to define the pathogenic mechanism of osteopenia associated with chronic pancreatic disorders.
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Affiliation(s)
- C E Morán
- Clinical Department, Hospital de Gastroenterologia Dr Carlos Bonorino Udaondo Universidad del Salvador, Buenos Aires, Argentina
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Panebianco V, Calanducci F, Poli A, Ferreri ME, Puzzo L, Pistritto A, Blandino R, Messina D, Caruso L, Latteri P. [Surgical treatment of spontaneous pneumothorax: comparison of thoracotomy and thoracoscopy]. G Chir 1997; 18:131-3. [PMID: 9206495] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The video-thoracoscopic treatment of spontaneous pneumothorax currently has the same role of laparoscopic cholecystectomy in abdominal surgery. The Authors consider thoracoscopic approach and traditional thoracotomy examining advantages versus disadvantages, comparing 50 patients with spontaneous pneumothorax treated by thoracoscopy, from February 1992 up to February 1995, and 50 patients, previously treated by open surgery. Video-thoracoscopy has the same percentage of recurrences of thoracotomic approach but assures a quicker functional recovery and, above all, a remarkable reduction of pain.
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Affiliation(s)
- V Panebianco
- Divisione di P.S. e Chirurgia d'Urgenza, Ospedale Cannizzaro, USL 36, Catania
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48
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Messina D, Meister K, Montgomery WJ. Bilateral congenital absence of the patellar tendon. Am J Knee Surg 1997; 10:23-5; discussion 26. [PMID: 9051174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- D Messina
- Department of Radiology, University of Florida, Gainesville, USA
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49
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Panebianco V, Calanducci F, Poli A, Blandino R, Pistritto A, Ferreri ME, Grasso A, Puzzo L, Messina D, Magnano V. [Pleuroscopy and talc pleurodesis in recurrent pleural effusions: experience with 51 cases]. G Chir 1995; 16:437-41. [PMID: 8588987] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
From January '92 up to January '94 thoracoscopy was performed in 51 patients with recurrent pleural effusion: 49 of these patients underwent talc pleurodesis. 10 pleural mesotheliomas, 29 diffuse metastasic pleural involvement and 12 benign effusions were diagnosed. Intrapleural talc therapy allowed a definitive pleurodesis in 43 patients with a success rate of 87%.
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Affiliation(s)
- V Panebianco
- Divisione di P.S. e Chirurgia d'Urgenza, Università degli Studi di Catania, Ospedale Cannizzaro, Catania
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50
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Degrossi OJ, Ortiz M, Degrossi EB, García del Río H, Barreira JC, Messina D, Kerzberg E, Roldán EJ, Montuori E, Pérez Lloret A. Serum kinetics, bioavailability and bone scanning of 99mTc-labelled sodium olpadronate in patients with different rates of bone turnover. Eur J Clin Pharmacol 1995; 48:489-94. [PMID: 8582468 DOI: 10.1007/bf00194339] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The activity of olpadronate labelled with technetium-99m(99mTc) was monitored in plasma and urine samples after single oral (925 MBq 99mTc/10 mg, coadministered with 50 mg cold drug) and intravenous (925 MBq 99mTc/5 mg) administrations to two groups of patients with different rates of bone turnover. The first group comprised high bone turnover (HBTO) patients suffering from Paget's bone disease; the second group comprised patients with normal to low bone turnover (NBTO) having the diagnosis of rheumatoid arthritis and secondary osteoporosis. Kinetic variables were correlated with anthropomorphometric variables, biological markers of bone metabolism and plasma proteins. Data were also obtained after repeatedly dosing the HBTO patients. Additionally, Paget's bone and healthy bone (PB/HB) uptake before and after low-dose oral treatment were assessed by means of scintigraphy. Results showed that most of the kinetic variables did not differ between the two groups of patients, except for a greater Vss and smaller blood area under the curve AUC in the patients with HBTO. After a repeated-dose administration period, the blood AUC activity and Whole Body Retention (WBR) of the HBTO patients tended to be similar to those of the NBTO patients. In both groups, after oral dosing, the Cmax was 20 times lower than the C0.5 after i.v. injection, and the oral bioavailability ranged from 3% to 4%. Finally, the plasma t1/2 beta ranged from 9 to 14 h. Correlation coefficients were obtained from multiple regression analysis; kinetic variables showed very low correlations with anthropomorphometric measurements. In contrast the Vss and WBR were significantly correlated with serum alkaline phosphatase levels and the Vss also with urine hydroxyproline levels. Plasma protein concentration was also correlated with excretion parameters such as CLP and plasma t1/2 beta after an oral dose. Scintigraphic studies in the HBTO group allowed bone selectivity to be seen through skeletal drug uptake. The 15 Pagetic lesions analysed in the HBTO group showed a decrease in PB/HB ratio from 3.8 in the basal study to 2.7 after olpadronate administration for 30 days at the rate of 50 mg/day. In conclusion, the kinetic profile of 99mTc-labelled olpadronate, mainly AUC and WBR, showed a dependence upon bone metabolism and seemed unrelated to body size variables. HBTO patients showed a lower blood AUC but a higher Vss. Both variables may have been reflecting the fact that the drug binds selectively with calcified tissues and, in turn, with the target compartment. Scintigraphy confirmed the labelled-compound bone selectivity as a desirable feature for a bone-scanning agent.
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Affiliation(s)
- O J Degrossi
- Nuclear Medicine Center, German Hospital, Buenos Aires, Argentina
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