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Piscopo P, Crestini A, Carbone E, Rivabene R, Ancidoni A, Lo Giudice M, Corbo M, Vanacore N, Lacorte E. A systematic review on drugs for synaptic plasticity in the treatment of dementia. Ageing Res Rev 2022; 81:101726. [PMID: 36031056 DOI: 10.1016/j.arr.2022.101726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 01/31/2023]
Abstract
The aim of the present systematic review (SR) was to provide an overview of all published and unpublished clinical trials investigating the safety and efficacy of disease-modifying drugs targeting synaptic plasticity in dementia. Searches on CT.gov and EuCT identified 27 trials (4 phase-1, 1 phase-1/2, 18 phase-2, 1 phase-2/3, 1 phase-3, 1 phase-4, and 1 not reported). Twenty of them completed, and seven are currently active or enrolling. The structured bibliographic searches yielded 3585 records. A total of 12 studies were selected on Levetiracetam, Masitinib, Saracatinib, BI 40930, Bryostatin 1, PF-04447943 and Edonerpic drugs. We used RoB tool for quality analysis of randomized studies. Efficacy was assessed as a primary outcome in all studies except one and the main scale used was ADAS-Cog (7 studies), MMSE and CDR (4 studies). Safety and tolerability were reported in eleven studies. The incidence of SAEs was similar between treatment and placebo. At the moment, only one molecule reached phase-3. This could suggest that research on these drugs is still preliminary. Of all, three studies reported promising results on Levetiracetam, Bryostatin 1 and Masitinib.
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Affiliation(s)
- P Piscopo
- Department of Neuroscience, Italian National Institute of Health, Rome, Italy.
| | - A Crestini
- Department of Neuroscience, Italian National Institute of Health, Rome, Italy
| | - E Carbone
- Department of Neuroscience, Italian National Institute of Health, Rome, Italy
| | - R Rivabene
- Department of Neuroscience, Italian National Institute of Health, Rome, Italy
| | - A Ancidoni
- National Center for Disease Prevention ad Heath Promotion, Italian National Institute of Health, Rome, Italy
| | - M Lo Giudice
- Need Institute, Foundation for Cure and Rehabilitation of Neurological Diseases, Milan, Italy
| | - M Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy.
| | - N Vanacore
- National Center for Disease Prevention ad Heath Promotion, Italian National Institute of Health, Rome, Italy
| | - E Lacorte
- National Center for Disease Prevention ad Heath Promotion, Italian National Institute of Health, Rome, Italy
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Bottaro G, Biasci P, Lo Giudice M, Mele G, Montanari G, Napoleone E, Santucci A, Tucci PL, Fano M, Biraghi MG. [5 days Cefaclor vs. 10 days amoxicillin/clavulanate in the treatment of childhood streptococcal pharyngitis. Data from a randomized clinical trial]. Minerva Pediatr 2012; 64:341-346. [PMID: 22555328] [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: 05/31/2023]
Abstract
AIM The duration of therapy represents a fundamental aspect in the compliance to the therapy of child pathologies, such as pharyngotonsillitis, treated with oral therapy. Although penicillin and amoxicillin are the first choice antibiotics in the case of a child suffering from pharyngotonsillitis with the proven presence of Group A β-hemolytic Streptococcus (GAS), the number of orally administered doses and 10 days of therapy, considerably lower the compliance. METHODS An open phase IV randomized multicenter clinical trial was conducted in parallel groups, involving 49 family pediatrician (FP), distributed over the entire national territory, enrolling 435 children suffering from GAS-FT. 210 children received Cefaclor, 50 mg/kg/day, administered twice daily for five days, whilst 213 children received amoxicillin/clavulanate 40 mg/kg/day administered twice daily for 10 days. RESULTS The results showed percentages of eradication of 88.4% for the Cefaclor group and 94.3% for the amoxicillin/clavulanate group, and a positive clinical judgement of 92.3% for the Cefaclor group and 96.6% for the amoxicillin/clavulanate group. The two arms of the study did not have any significant statistical differences, neither for the eradication, nor for the clinical judgement nor for the reduction of the Milano Score between the beginning and the end of treatment, with a P=0.042 for amoxicillin/clavulanate for eradication. CONCLUSION This study confirms that the administration of Cefaclor for five days during GAS-FT has the same efficacy as a 10-day therapy with amoxicillin/clavulanate, with a clearly different compliance.
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Affiliation(s)
- G Bottaro
- Pediatra di Famiglia, Catania, Italia.
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Ciofi degli Atti ML, Azzari C, Bartolozzi G, Esposito S, Fara GM, Giovanetti F, Lo Giudice M. Pandemic vaccination: new questions and old answers. Ann Ig 2010; 22:177-181. [PMID: 20476657] [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: 05/29/2023]
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Burgio GR, Bernasconi S, Bertelloni S, Jankovic M, Lo Giudice M. [Pediatricians and health education (Twenty years after the ONU Convention on Children's Rights, New York, 1989 November 20)]. Minerva Pediatr 2009; 61:881. [PMID: 19935581] [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: 05/28/2023]
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Lo Giudice M. [How to promote pediatric clinical testing in Italy: the role of the Ethics Committee]. Minerva Pediatr 2009; 61:790-791. [PMID: 19935554] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Giammanco G, Ciriminna S, Barberi I, Titone L, Lo Giudice M, Biasio LR. Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years. Euro Surveill 2009; 14:19321. [PMID: 19728978] [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: 05/28/2023] Open
Abstract
Following the licensure of the Oka/Merck varicella vaccine in Italy in January 2003, the Sicilian health authorities launched a universal vaccination programme in all nine Local Health Units. A two-cohort vaccination strategy was adopted to minimise the shift of the mean age of varicella occurrence to older age groups, with the goal of vaccinating with one dose at least 80% of children in their second year of life and 50% of susceptible adolescents in their 12th year of life. Two studies were implemented in parallel to closely monitor vaccination coverage as well as varicella incidence.
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Affiliation(s)
- G Giammanco
- Department of Hygiene, University of Catania, Italy.
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Giammanco G, Ciriminna S, Barberi I, Titone L, Lo Giudice M, Biasio LR. Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years. Euro Surveill 2009. [DOI: 10.2807/ese.14.35.19321-en] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Following the licensure of the Oka/Merck varicella vaccine in Italy in January 2003, the Sicilian health authorities launched a universal vaccination programme in all nine Local Health Units. A two-cohort vaccination strategy was adopted to minimise the shift of the mean age of varicella occurrence to older age groups, with the goal of vaccinating with one dose at least 80% of children in their second year of life and 50% of susceptible adolescents in their 12th year of life. Two studies were implemented in parallel to closely monitor vaccination coverage as well as varicella incidence. Overall, the programme achieved its target, with 87.5% vaccine coverage for the birth cohort 2005 and 90.2% for adolescents born in 1995 and 1996. Varicella surveillance data obtained from a total of 28,188 children (0-14 years-old) monitored by family paediatricians showed a decline in incidence rates from 95.7 (95% confidence interval (CI): 72.2-126.8) for 1,000 person-years (PY) in 2004 to 9.0 (95% CI: 6.4-12.6) for 1,000 PY in 2007. In Europe, the only similar experience is the routine childhood varicella vaccination programme in Germany that started in 2004 with a single dose at the age of 11-14 months. The two-cohort universal vaccination programme implemented in Sicily, as well as the network for the surveillance study, can offer a model to other European countries that are considering introducing universal childhood varicella vaccination.
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Affiliation(s)
- G Giammanco
- Department of Hygiene, University of Catania, Catania, Italy
| | - S Ciriminna
- Regional Public Health Office, Palermo, Italy
| | - I Barberi
- Department of Paediatric Sciences, University of Messina, Messina, Italy
| | - L Titone
- Department of Infectious Diseases, University of Palermo, Palermo, Italy
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Altavilla A, Giaquinto C, Giocanti D, Manfredi C, Aboulker JP, Bartoloni F, Cattani E, Lo Giudice M, Mellado Peña M, Nagler R, Peterson C, Vajnerova O, Bonifazi F, Ceci A. Activity of Ethics Committees in Europe on issues related to clinical trials in paediatrics: Results of a survey. ACTA ACUST UNITED AC 2009. [DOI: 10.3233/ppl-2009-0208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- A. Altavilla
- Mediterranean University – Espace Ethique Méditerranéen, Bioethics Research Centre, Marseille, France
| | - C. Giaquinto
- Department of Paediatrics, University of Padova, Padova, Italy
| | - D. Giocanti
- Mediterranean University – Division of Legal Medicine, Marseille, France
| | - C. Manfredi
- Consorzio per Valutazioni Biologiche e Farmacologiche, Pavia, Italy
| | - J.-P. Aboulker
- Institut National de la Sante et Recherche Medicale, Villejuif, France
| | - F. Bartoloni
- I.RI.D.I.A. srl, Health Care Engineering, Bari, Italy
| | - E. Cattani
- Consorzio per Valutazioni Biologiche e Farmacologiche, Pavia, Italy
| | - M. Lo Giudice
- Family paediatrician, AUSL 6 Palermo, Palermo, Italy
| | | | - R. Nagler
- Department of Oral and Maxillofacial Surgical and Oral Biochemistry Laboratory, Rambam Medical Center and Rappaport, Faculty of Medicine, Israel Institute of Technology-Technion, Haifa, Israel
| | - C. Peterson
- Department of Clinical Pharmacology, Linkopings Universitet, Linkopings, Sweden
| | - O. Vajnerova
- Department of Neurophysiology of Memory and Computational Neuroscience, Institute of Physiology, Academy of Sciences, Prague, Czech Republic
| | - F. Bonifazi
- I.RI.D.I.A. srl, Health Care Engineering, Bari, Italy
| | - A. Ceci
- Consorzio per Valutazioni Biologiche e Farmacologiche, Pavia, Italy
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Elia M, Falco M, Ferri R, Spalletta A, Bottitta M, Calabrese G, Carotenuto M, Musumeci SA, Lo Giudice M, Fichera M. CDKL5 mutations in boys with severe encephalopathy and early-onset intractable epilepsy. Neurology 2008; 71:997-9. [PMID: 18809835 DOI: 10.1212/01.wnl.0000326592.37105.88] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [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 To search for CDKL5 gene mutations in boys presenting with severe early-onset encephalopathy and intractable epilepsy, a clinical picture very similar to that already described in girls with CDKL5 mutations. METHODS Eight boys (age range 3-16 years, mean age 8.5 years, SD 4.38) with severe or profound mental retardation and early-onset intractable seizures were selected for CDKL5 gene mutation screening by denaturing high-performance liquid chromatography analysis. RESULTS We found three unrelated boys carrying three different missense mutations of the CDKL5 gene: c.872G>A (p.C291Y), c.863C>T (p.T288I), and c.533G>C (p.R178P). They presented early-onset, polymorphous, and drug-resistant seizures, mostly myoclonic and tonic or spasms. EEG showed epileptiform abnormalities which were multifocal during wakefulness, and pseudoperiodic bisynchronous during sleep. CONCLUSIONS This study describes three boys carrying CDKL5 missense mutations and their detailed clinical and EEG data, and indicates that CDKL5 gene mutations may represent a cause of severe or profound mental retardation and early-onset intractable seizures, also in boys. Screening for CDKL5 mutations is strongly recommended in individuals with these clinical features.
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Affiliation(s)
- M Elia
- Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via Conte Ruggero 73, 94018 Troina (EN), Italy.
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Fichera M, Falco M, Lo Giudice M, Castiglia L, Guarnaccia V, Calì F, Spalletta A, Scuderi C, Avola E. Skewed X-inactivation in a family with mental retardation and PQBP1 gene mutation. Clin Genet 2005; 67:446-7. [PMID: 15811016 DOI: 10.1111/j.1399-0004.2005.00436.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fichera M, Lo Giudice M, Falco M, Sturnio M, Amata S, Calabrese O, Bigoni S, Calzolari E, Neri M. Evidence of kinesin heavy chain (KIF5A) involvement in pure hereditary spastic paraplegia. Neurology 2004; 63:1108-10. [PMID: 15452312 DOI: 10.1212/01.wnl.0000138731.60693.d2] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [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: 11/15/2022] Open
Abstract
Hereditary spastic paraplegias (HSPs) are characterized by progressive lower extremity spasticity due to an axonal degeneration of motor and sensory neurons. We report a four-generation pedigree segregating an autosomal dominant phenotype for HSP and showing a linkage to the SPG10 locus, coding for Kinesin family member 5A. Subsequent to a denaturing high performance liquid chromatography (dHPLC) mutation screening we found a new missense mutation 838C>T (R280C) at an invariant arginine residue in a region involved in the microtubule binding activity.
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Affiliation(s)
- M Fichera
- Genetic Diagnostic Laboratory, IRCCS Oasi M. SS. Troina, Italy.
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Fichera M, Silengo M, Spalletta A, Giudice ML, Romano C, Ragusa A. Prenatal diagnosis of ATR-X syndrome in a fetus with a new G>T splicing mutation in the XNP/ATR-X gene. Prenat Diagn 2001; 21:747-51. [PMID: 11559911 DOI: 10.1002/pd.142] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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: 11/10/2022]
Abstract
The molecular cause of the alpha-thalassemia/mental retardation syndrome (ATR-X) resides in mutations affecting the XNP/ATR-X gene. Recently molecular defects in the gene have been found in singular cases of a discrete number of X-linked mental retardation (XLMR). ATR-X-affected males are characterised by severe mental retardation, distinct facial dysmorphisms and genital abnormalities, besides a wide spectrum of pathological features and an extremely limited biological fitness. Given that molecular investigation of XNP/ATR-X mutations is made onerous by the length of the gene transcript, we carried out a prenatal diagnosis in a fetus at risk for ATR-X syndrome by initially determining the XNP/ATR-X gene haplotype before considering gene sequencing. Disease-associated haplotype analysis was performed selecting five genic (CA)n repeats that showed high heterozygosity (Het>0.7) in the general population. The fetus segregated an identical allelic pattern to that of the affected child of the family under investigation who shows features suggestive of the ATR-X syndrome. Subsequent mutational analysis of the gene revealed a novel IVS3+1G>T splicing mutation confirming the diagnosis.
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Affiliation(s)
- M Fichera
- Laboratorio di Patologia Genetica, IRCCS Oasi Maria SS, Troina, EN, Italy
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Borgione E, Giudice ML, Galesi O, Castiglia L, Failla P, Romano C, Ragusa A, Fichera M. How microsatellite analysis can be exploited for subtelomeric chromosomal rearrangement analysis in mental retardation. J Med Genet 2001; 38:E1. [PMID: 11134240 PMCID: PMC1734711 DOI: 10.1136/jmg.38.1.e1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
The purpose of this study was to evaluate the efficacy of the use of continuous passive motion (CPM) of the digits in combination with limb elevation to reduce hand edema. The effects of 30 min of CPM of the digits with the limb elevated were compared with the effects of 30 min of limb elevation alone. Each of 16 subjects with hand edema of varied etiology received both treatments, one on each of 2 consecutive days. Measures of hand volume, finger circumference, and finger stiffness were taken before and after each treatment. Analyses comparing mean percentage change scores for both treatments showed large and significant treatment effects for all three dependent measures. The findings indicate that, for this sample, CPM with limb elevation was a more effective treatment for the reduction of hand edema than limb elevation alone. The results of analyses performed on a subgroup of 11 subjects with hemiplegia were similar, thus suggesting that CPM with limb elevation may be an effective method by which to reduce hand edema for this patient population.
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Affiliation(s)
- M L Giudice
- Department of Occupational Therapy, Sargent College of Allied Health Professions, Boston University, Massachusetts
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