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Peraio S, Mantovani G, Araceli T, Mongardi L, Noris A, Fino E, Formica F, Piccinini L, Melani F, Lenge M, Scalise R, Battini R, Di Rita A, D'Incerti L, Appleton T, Cavallo MA, Guerrini R, Giordano F. Unilateral deep brain stimulation (DBS) of nucleus ventralis intermedius thalami (Vim) for the treatment of post-traumatic tremor in children: a multicentre experience. Childs Nerv Syst 2024:10.1007/s00381-024-06380-1. [PMID: 38573550 DOI: 10.1007/s00381-024-06380-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE Deep brain stimulation (DBS) of nucleus ventralis intermedius thalami (Vim) is a validated technique for the treatment of essential tremor (ET) in adults. Conversely, its use for post traumatic tremor (PTT) and in paediatric patients is still debated. We evaluated the efficacy of Vim-DBS for lesional tremor in three paediatric patients with drug-resistant post-traumatic unilateral tremor. METHODS We retrospectively collected data regarding three patients with unilateral tremor due to severe head injury, with no MRI evidence of basal ganglia lesions. The three patients underwent stereotactic frame-based robot-assisted DBS of Vim contralateral to the tremor side. RESULTS Mean follow-up was 48 months (range: 36-60 months). Tremor was reduced in all patients with a better control of voluntary movements and improvement of functional status (mean FIM scale improvement + 7 points). No surgical complications occurred. CONCLUSION Unilateral contralateral DBS of Vim could be efficacious in post-traumatic tremor, even in paediatric patients and should be offered in PTT drug-resistant patients.
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Affiliation(s)
- Simone Peraio
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Giorgio Mantovani
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
| | - Tommaso Araceli
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Neurosurgery, University Hospital Regensburg, Regensburg, Germany
| | - Lorenzo Mongardi
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
| | - Alice Noris
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Edoardo Fino
- Pediatric Neurology Clinic - Meyer Children's Hospital IRCCS, Florence, Italy
- University of Florence, Florence, Italy
| | - Francesca Formica
- Istituto Medea "La Nostra Famiglia" IRCCS, Bosisio Parini, LC, Italy
| | - Luigi Piccinini
- Istituto Medea "La Nostra Famiglia" IRCCS, Bosisio Parini, LC, Italy
| | - Federico Melani
- Pediatric Neurology Clinic - Meyer Children's Hospital IRCCS, Florence, Italy
| | - Matteo Lenge
- Pediatric Neurology Clinic - Meyer Children's Hospital IRCCS, Florence, Italy.
| | - Roberta Scalise
- Istituto Stella Maris - IRCCS - University of Pisa, Pisa, Italy
| | - Roberta Battini
- Istituto Stella Maris - IRCCS - University of Pisa, Pisa, Italy
| | - Andrea Di Rita
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Ludovico D'Incerti
- Department of Radiology, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | | | - Renzo Guerrini
- Pediatric Neurology Clinic - Meyer Children's Hospital IRCCS, Florence, Italy
- University of Florence, Florence, Italy
| | - Flavio Giordano
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
- University of Florence, Florence, Italy
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Fino E, Barbato A, Scaturro GM, Procopio E, Balestrini S. DNAJC12 deficiency: Mild hyperphenylalaninemia and neurological impairment in two siblings. Mol Genet Metab Rep 2023; 37:101008. [PMID: 38053929 PMCID: PMC10694740 DOI: 10.1016/j.ymgmr.2023.101008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/09/2023] [Accepted: 09/10/2023] [Indexed: 12/07/2023] Open
Abstract
Background DNAJC12 co-chaperone protein deficiency has been recently described as a stand-alone metabolic disorder explaining many cases of mild hyperphenylalaninemia (HPA) that are not caused by variants in the PAH gene, which encodes for the hepatic enzyme phenylalanine hydroxylase (PAH), or inGCH1, PTS, QDPR, PCBD1 and DHPR, involved in tetrahydrobiopterin (BH4) biosynthesis and activity. Results We describe two sisters born to consanguineous parents. The youngest sister (Patient 1), initially asymptomatic, tested positive at NewBorn Screening (NBS) for mild HPA. After variants in the PAH and BH4 related-genes were excluded, we performed DNAJC12 genetic analysis and found a previously described homozygous deletion [NM_021800.3: c.58_59del p.(Gly20Metfs*2)]. The older sister (Patient 2), homozygous for the same variant and exhibiting mild HPA, was diagnosed subsequently and presented with ataxia and repeated falls, upper limb dyskinesia, intentional tremor, and mild intellectual disability. Patient 1 was started on treatment with low Phenylalanine (Phe) diet, BH4, l-3,4-dihydroxyphenylalanine/carbidopa (L-DOPA) and 5-OH-Tryptophan, soon after diagnosis, and despite poor adherence to the dietary regimen, only manifested language impairment at last follow-up (age 5 years and 4 months). Patient 2, who started the same treatment at school age, experienced a minimal progression of neurological symptoms, with some improvement in her motor skills. Conclusions These two new patients with DNAJC12-associated HPA, in addition to previous reports, point to DNAJC12 deficiency as a new metabolic syndrome that must be considered in patients with unexplained HPA.
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Affiliation(s)
- Edoardo Fino
- Meyer Children's Hospital IRCCS, Neuroscience Department, Florence, Italy
| | | | - Giusi M. Scaturro
- Meyer Children's Hospital IRCCS, Metabolic and Neuromuscular Unit, Florence, Italy
| | - Elena Procopio
- Meyer Children's Hospital IRCCS, Metabolic and Neuromuscular Unit, Florence, Italy
| | - Simona Balestrini
- Meyer Children's Hospital IRCCS, Neuroscience Department, Florence, Italy
- University of Florence, Florence, Italy
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Fino E, Martoni M, Russo PM. Specific mindfulness traits protect against negative effects of trait anxiety on medical student wellbeing during high-pressure periods. Adv Health Sci Educ Theory Pract 2021; 26:1095-1111. [PMID: 33675487 PMCID: PMC8338863 DOI: 10.1007/s10459-021-10039-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 02/16/2021] [Indexed: 05/03/2023]
Abstract
Medical education is highly demanding and evidence shows that medical students are three times more susceptible to deteriorating physical and mental health than the average college student. While trait anxiety may further increase such risk, little is known about the role of trait mindfulness in mitigating these effects. Here we examine the protective role of specific mindfulness facets as mediators in pathways from trait anxiety to perceived stress, psychosomatic burden and sleep-wake quality in medical students, across repeated measurements throughout the first trimester of the school year. Preclinical medical students enrolled in the second year of the Medical School of University of Bologna completed self-report questionnaires examining personality traits as well as physical and psychological wellbeing. Data were collected at the beginning (Time 1: N = 349) and the end of the first trimester (Time 2: N = 305). As students approached the end of the trimester and upcoming exams, reported levels of perceived stress, psychosomatic problems and difficulties in wakefulness increased significantly compared to the beginning of the trimester. Mediation results showed that trait anxiety predicted such outcomes whereas the protective role of mindfulness facets in mitigating these effects was significant only at Time 2. Specific facets of Nonjudging of inner experience and Acting with awareness proved to be the most effective mediators. Findings highlight that the beneficial role of mindfulness facets in mitigating negative consequences of trait anxiety on medical student wellbeing is revealed in high-pressure periods and when self-regulation is needed the most. Cultivating awareness and nonjudgmental acceptance of one's inner experiences is a crucial self-regulation resource that can help medical students sustain their wellbeing as they learn and throughout their high-pressure education and professional careers.
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Affiliation(s)
- E Fino
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum - University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy.
| | - M Martoni
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum - University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy.
| | - P M Russo
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum - University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
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Fino E, Mema D, Russo PM. War trauma exposed refugees and posttraumatic stress disorder: The moderating role of trait resilience. J Psychosom Res 2020; 129:109905. [PMID: 31869693 DOI: 10.1016/j.jpsychores.2019.109905] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/16/2019] [Accepted: 12/15/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Examining how exposure to pre-migration war related trauma and duration of living in refugee camp can impact on PTSD and psychiatric morbidity, while assessing the moderating role of trait resilience and coping style. METHODS In a cross-sectional study, exposure to war related trauma and duration of living in refugee camp was evaluated in a sample of 83 asylum seekers and refugees from the Middle East, together with an assessment of PTSD and psychiatric morbidity via self-rating instruments. Trait resilience and coping style were also measured. RESULTS Eighty-three participants were included in the analysis, 96.4% reported having experienced more than one war related traumatic event while the mean duration of living in refugee camps was 23.6 (SD = 7.6) years. Of the entire sample, 32.5% reached the threshold for clinical presence of PTSD and 38.8% for psychiatric morbidity. Both pre-migration war related trauma (F(1,82) = 24.118, p < .001) and duration of living in refugee camp (F(2,81) = 2.511, p = .008) were significantly associated with PTSD. Trait resilience moderated effects of high-profile trauma exposure on PTSD severity, R2 = 0.26, MSE = 0.547, F(3,79) = 9.6357, p < .0001, with higher resilience levels weakening the effect of traumatic exposure on PTSD development. CONCLUSIONS Our results shed light on the ways that resilience can influence the relationship between war trauma exposure and PTSD symptoms. Findings support the role of resilience-based interventions in order to bolster resilient functioning and optimize treatment of this disadvantaged and highly distressed population.
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Affiliation(s)
- E Fino
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES), Alma Mater Studiorum - Università di Bologna, Viale Berti Pichat 5, 40126, Bologna, Italy.
| | - Denis Mema
- Psychosocial support unit, Refugee and Migrant Services (RMSA) Tirana, Albania
| | - P M Russo
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES), Alma Mater Studiorum - Università di Bologna, Viale Berti Pichat 5, 40126, Bologna, Italy
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Russo P, Fino E, Mancini C, Mazzetti M, Starace M, Piraccini B. HrQoL in hair loss‐affected patients with alopecia areata, androgenetic alopecia and telogen effluvium: the role of personality traits and psychosocial anxiety. J Eur Acad Dermatol Venereol 2018; 33:608-611. [DOI: 10.1111/jdv.15327] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/04/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P.M. Russo
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
| | - E. Fino
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
| | - C. Mancini
- Dermatology Unit Sant'Orsola‐Malpighi Hospital Bologna Italy
| | - M. Mazzetti
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
| | - M. Starace
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
- Dermatology Unit Sant'Orsola‐Malpighi Hospital Bologna Italy
| | - B.M. Piraccini
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
- Dermatology Unit Sant'Orsola‐Malpighi Hospital Bologna Italy
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Knopman J, Grifo J, Noyes N, Fino E, Mullin C, Berkeley A. Is bigger better: the association between follicle size and livebirth rate following IVF. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Reh A, Mullin C, Fino E, Grifo J, Krey L, Noyes N. Intentions, goals, and quality-of-life (QOL) assessment in female cancer patients seeking fertility preservation (FP) ± treatment: preliminary results of a university-based cancer registry at one year. Fertil Steril 2009. [DOI: 10.1016/j.fertnstert.2009.07.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Knopman JM, Noyes N, Talebian S, Fino E, Krey L, Curtin JP, Grifo JA, Licciardi F. Women with cancer undergoing IVF for fertility preservation: A case-control study of response to exogenous gonadotropins. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Knopman J, Lee J, Krey L, Fino E, Adler A, Noyes N. Monozygotic twinning: A 5 year experience in a large IVF center doing blastocyst transfers on day 5. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.1058] [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: 10/22/2022]
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Keegan D, Talebian S, Fino E, Krey L, Berkeley A, Grifo J. Embryo performance in a day 5 extended culture protocol predicts IVF outcome better than age and may be helpful in preventing multiple gestation. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fino E, Keegan D, Edenfield A, Krey L, Grifo J. Minimizing the risk of high order multiples without compromising pregnancy rates: one center's 5-year experience with ovulation induction. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.868] [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: 10/22/2022]
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Noyes N, Melander B, Adler A, Grifo J, Fino E, Krey L. Microsort® processed sperm requires ICSI; embryo selection is enhanced by PGD for aneuploidy when used for gender selection in sex-linked disorders. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.136] [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: 10/22/2022]
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Noyes N, Fino E, McCaffrey C, Adler A, Krey L, Grifo J. Embryo biopsy the fate of biopsied abnormal pronuclear embryos. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Noyes N, Chang H, Labella P, McCaffrey C, Fino E, Grifo J. Visualization of meiotic spindle predicts usefulness of female gametes in an oocyte cryopreservation (OC) program. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Keegan D, Talebian S, Fino E, Krey L, Grifo J, Berkeley A. Availability of good quality blastocysts for cryopreservation (CRYO) on day 5 (d5) of a fresh embryo transfer (ET) identifies candidates for single blastocyst transfer (SBT). Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fino E, Keegan D, Noyes N, Licciardi F, Berkeley A, Grifo J. Reducing the Risk of Multiple Gestations With Ovulation Induction and Intrauterine Insemination: One Center’s Experience. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fino E, Noyes N, Keegan D, Grifo J, Berkeley A, Licciardi F. Surgical Correction of Uterine Septum Improves Fertility and Pregnancy Outcome. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.1237] [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: 10/25/2022]
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Fino E, Krey L, Grifo J, McCaffrey C, Adler A, Noyes N. How Good Is Embryo Morphology at Predicting Chromosomal Integrity? When Is Aneuploidy PGD Useful? Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.237] [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: 11/16/2022]
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Chelo E, Fino E, Livi C, Rizzo F. O-090. Factors motivating and deterring egg donation: a comparison between fertile and infertile women. Hum Reprod 1997. [DOI: 10.1093/humrep/12.suppl_2.42-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sforza E, Fera G, Fino E. [A case of typhoid with the clinical appearance of acute ischemic myocardiopathy]. G Clin Med 1988; 69:353-8. [PMID: 3169464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Fino E, Colonna L. [Evaluation of the calcium antagonist fendilin in exertion angina]. Clin Ter 1985; 112:445-51. [PMID: 3893860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Carnimeo N, Fino E, Maiorano V, Marzullo F. [Clinico-experimental studies of the mucolytic action of N-cyclohexyl-N-methyl-(2-amino-3,5-dibromobenzyl)-ammonium chloride, in oral and parenteral administration, in acute and chronic pneumopathies]. Minerva Med 1969; 60:3557-64. [PMID: 5823750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Maiorano G, Fino E, Roma F. [Spatial velocity of the QRS vectorcardiographic loop in the course of left ventricular hypertrophy]. Boll Soc Ital Biol Sper 1969; 45:228-30. [PMID: 4242199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Maiorano G, Triggiani G, Fino E, Roma F. [Modular velocity of the QRS loop in left ventricular hypertrophy. Vectorcardiographic studies]. Folia Cardiol 1968; 27:213-21. [PMID: 4237894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Maiorano G, Triggiani G, Russo L, Fino E, Roma F. [Ventricular activation in the Wolff-Parkinson-White syndrome, type B. Vectorcardiographic studies]. Boll Soc Ital Biol Sper 1968; 44:914-7. [PMID: 5699363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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