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Scaglione G, Oliviero G, Labianca O, Bianco MA, Granata R, Ruggiero L, Iovino P. One-Day versus Three-Day Low-Residue Diet and Bowel Preparation Quality before Colonoscopy: A Multicenter, Randomized, Controlled Trial. Dig Dis 2023; 41:708-718. [PMID: 36649696 DOI: 10.1159/000529087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/08/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND One-day low-residue diet (LRD) is recommended before colonoscopy, but only three single-center trials compared the 1-day versus 3-day LRD. The aim of this multicenter study was to compare the impact of a 3-day versus 1-day LRD on its ability to adequately and successfully prepare the bowel of outpatients that require a colonoscopy. The outpatients' tolerance and adherence to the LRD were also considered. METHODS Consecutive outpatients were randomized to 1-day versus 3-day LRD at three open-access endoscopy units. The primary endpoint consisted of the proportion of patients with a satisfactory degree of bowel cleanliness (Score 2-3 on the Boston Bowel Preparation Scale [BBPS] in each segment). Secondary endpoints were patients' tolerance and adherence to the prescribed diet evaluated by a standardized questionnaire. RESULTS 289 patients were included in the study (1-day LRD arm = 143, 3-day LRD arm = 146). BBPS ≥2 was not significantly different in the two dietary regimens in any of the three colonic segments (71% vs. 72%, p = 0.9). The percentage of patients with incomplete preparation was similar in the two arms (9% vs. 9%; p = 1.0). No significant differences were found among colonoscopy findings in terms of abnormalities (81% vs. 84%, p = 0.8). Both groups scored similarly in overall tolerance to LRD (48% vs. 49%, p = 1.0) and also in whether they would have adopted a different dietary regimen (p = 0.3). CONCLUSION Our multicenter randomized study confirmed that optimal bowel cleansing is reached through a 1-day LRD.
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Affiliation(s)
- Giuseppe Scaglione
- Gastroenterology and Digestive Endoscopy Unit, G. Rummo, Benevento, Italy
| | - Giovanni Oliviero
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," Gastrointestinal Unit, University of Salerno, Baronissi, Italy
| | - Orazio Labianca
- Digestive Endoscopy Unit, Gaetano Fucito Hospital, Mercato San Severino, Italy
| | - Maria Antonia Bianco
- Gastroenterology and Digestive Endoscopy Unit, Maresca Hospital, Torre del Greco, Italy
| | - Rocco Granata
- Gastroenterology and Digestive Endoscopy Unit, G. Rummo, Benevento, Italy
| | - Luigi Ruggiero
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," Gastrointestinal Unit, University of Salerno, Baronissi, Italy
| | - Paola Iovino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," Gastrointestinal Unit, University of Salerno, Baronissi, Italy
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Oliviero G, Gagliardi M, Napoli M, Labianca O, D'Antonio A, Sica M, Maurano A, Zulli C. Fatal Outcome Consequent to an Endoscopic Full Thickness Resection of a Colonic Lateral Spreading Tumor: A Case Report. Am J Case Rep 2020; 21:e922855. [PMID: 32729555 PMCID: PMC7414825 DOI: 10.12659/ajcr.922855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Patient: Male, 77-year-old Final Diagnosis: Enterocolic fistula Symptoms: Diarrhea • pain and guarding of the abdomen • weight loss Medication:— Clinical Procedure: Colonoscopy with colon biopsy Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Giovanni Oliviero
- Gastroenterology Unit, San Giovanni di Dio e Ruggi D'Aragona Hospital, Salerno, Italy
| | - Mario Gagliardi
- Gastroenterology Unit, San Giovanni di Dio e Ruggi D'Aragona Hospital, Salerno, Italy
| | - Marco Napoli
- Digestive Surgical Endoscopy Unit, Polyclinic Agostino Gemelli Foundation, Rome, Italy
| | - Orazio Labianca
- Digestive Endoscopy Unit, Gaetano Fucito Hospital, Mercato San Severino, Italy
| | - Antonio D'Antonio
- Pathological Anatomy Unit, San Giovanni di Dio e Ruggi D'Aragona Hospital, Salerno, Italy
| | - Mariano Sica
- Digestive Endoscopy Unit, Gaetano Fucito Hospital, Mercato San Severino, Italy
| | - Attilio Maurano
- Digestive Endoscopy Unit, Gaetano Fucito Hospital, Mercato San Severino, Italy
| | - Claudio Zulli
- Digestive Endoscopy Unit, Gaetano Fucito Hospital, Mercato San Severino, Italy
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Zulli C, Grande G, Tontini GE, Labianca O, Geraci G, Sciumè C, Antypas P, Fiocca F, Manes G, Devani M, Manta R, Maurano A. Endoscopic papillary large balloon dilation in patients with large biliary stones and periampullary diverticula: Results of a multicentric series. Dig Liver Dis 2018; 50:828-832. [PMID: 29709460 DOI: 10.1016/j.dld.2018.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 03/18/2018] [Accepted: 03/27/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Stone extraction represents the most frequent indication for endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic papillary large balloon dilation (EPLBD) is a recent introduced approach consisting of an endoscopic papillary large balloon dilation following limited endoscopic sphyncterotomy (ES), which has been proven to be safe and effective for extraction of large common bile duct (CBD) stones. Peri-ampullary diverticula (PAD) are described in 10-20% of patients undergoing ERCP. Aim of our study is to evaluate efficacy and safety of EPLBD for the extraction of large biliary stones in patients with PAD. METHODS The prospectively collected endoscopy databases of 4 Italian ERCP high-volume centers were reviewed retrospectively, and all consecutive patients with an instrumental diagnosis of large biliary stones and PAD, between September 2014 and October 2016, were included in this study. RESULTS Eighty-one patients (36 males, median age 75 years) were treated between September 2014 and October 2016. Deep biliary cannulation was reached in 78/80 patients. Successful extraction was achieved in 74/78 patients at the first attempt. AEs occurred in 8 patients (1 severe). Younger age, stone size and incomplete stone extraction were significantly associated with AEs. CONCLUSIONS EPLBD is an effective and safe technique in patients with PAD and large biliary stones, which avoids the need of other techniques, thereby reducing the risks of adverse events.
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Affiliation(s)
- Claudio Zulli
- Digestive Endoscopy Unit, University Hospital G. Fucito, Ruggi d'Aragona, Salerno, Italy
| | - Giuseppe Grande
- Department of Gastroenterology and Digestive Endoscopy Unit, OCSAE Hospital, Modena, Italy.
| | - Gian Eugenio Tontini
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Orazio Labianca
- Digestive Endoscopy Unit, University Hospital G. Fucito, Ruggi d'Aragona, Salerno, Italy
| | - Girolamo Geraci
- Section of General and Thoracic Surgery, School of Medicine, University Hospital "Paolo Giaccone" of Palermo, Palermo, Italy
| | - Carmelo Sciumè
- Section of General and Thoracic Surgery, School of Medicine, University Hospital "Paolo Giaccone" of Palermo, Palermo, Italy
| | - Pavlos Antypas
- Emergency Endoscopy Unit, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Fausto Fiocca
- Emergency Endoscopy Unit, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Gianpiero Manes
- Department of Gastroenterology "Salvini" Hospital, Garbagnate, Milan, Italy
| | - Massimo Devani
- Department of Gastroenterology "Salvini" Hospital, Garbagnate, Milan, Italy
| | - Raffaele Manta
- Department of Gastroenterology and Digestive Endoscopy Unit, OCSAE Hospital, Modena, Italy
| | - Attilio Maurano
- Digestive Endoscopy Unit, University Hospital G. Fucito, Ruggi d'Aragona, Salerno, Italy
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Rotondano G, Rispo A, Bottiglieri ME, De Luca L, Lamanda R, Orsini L, Bruzzese D, Galloro G, Romano M, Miranda A, Loguercio C, Esposito P, Nardone G, Compare D, Magno L, Ruggiero S, Imperatore N, De Palma GD, Gennarelli N, Cuomo R, Passananti V, Cirillo M, Cattaneo D, Bozzi RM, D'Angelo V, Marone P, Riccio E, De Nucci C, Monastra S, Caravelli G, Verde C, Di Giorgio P, Giannattasio F, Capece G, Taranto D, De Seta M, Spinosa G, De Stefano S, Familiari V, Cipolletta L, Bianco MA, Sansone S, Galasso G, De Colibus P, Romano M, Borgheresi P, Ricco G, Martorano M, Gravina AG, Marmo R, Rea M, Maurano A, Labianca O, Colantuoni E, Iuliano D, Trovato C, Fontana A, Pasquale L, Morante A, Perugini B, Scaglione G, Mauro B. Quality of bowel cleansing in hospitalized patients undergoing colonoscopy: A multicentre prospective regional study. Dig Liver Dis 2015; 47:669-74. [PMID: 26028360 DOI: 10.1016/j.dld.2015.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 12/19/2014] [Revised: 04/13/2015] [Accepted: 04/18/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Quality of bowel cleansing in hospitalized patients undergoing colonoscopy is often unsatisfactory. No study has investigated the inpatient or outpatient setting as cause of inadequate cleansing. AIMS To assess degree of bowel cleansing in inpatients and outpatients and to identify possible predictors of poor bowel preparation in the two populations. METHODS Prospective multicentre study on consecutive colonoscopies in 25 regional endoscopy units. Univariate and multivariate analysis with odds ratio estimation were performed. RESULTS Data from 3276 colonoscopies were analyzed (2178 outpatients, 1098 inpatients). Incomplete colonoscopy due to inadequate cleansing was recorded in 369 patients (11.2%). There was no significant difference in bowel cleansing rates between in- and outpatients in both colonic segments. In the overall population, independent predictors of inadequate cleansing both at the level of right and left colon were: male gender (odds ratio, 1.20 [1.02-1.43] and 1.27 [1.05-1.53]), diabetes mellitus (odds ratio, 2.35 [1.68-3.29] and 2.12 [1.47-3.05]), chronic constipation (odds ratio, 1.60 [1.30-1.97] and 1.55 [1.23-1.94]), incomplete purge intake (odds ratio, 2.36 [1.90-2.94] and 2.11 [1.68-2.65]) and a runway time >12h (odds ratio, 3.36 [2.40-4.72] and 2.53 [1.74-3.67]). CONCLUSIONS We found no difference in the rate of inadequate bowel preparation between hospitalized patients and outpatients.
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Affiliation(s)
- Gianluca Rotondano
- Division of Gastroenterology and Digestive Endoscopy, Maresca Hospital, Torre del Greco, Italy.
| | - Antonio Rispo
- Gastroenterology Unit, Department of Gastroenterology, Surgery and Endocrinology, "Federico II" University Hospital, Napoli, Italy
| | | | - Leonardo De Luca
- Gastroenterology and Digestive Endoscopy Unit, Pellegrini Hospital, Napoli, Italy
| | - Roberto Lamanda
- Gastroenterology Unit, S.M. delle Grazie Hospital, Pozzuoli, Italy
| | - Luigi Orsini
- Gastroenterology Unit, Cardarelli Hospital, Napoli, Italy
| | - Dario Bruzzese
- Department of Public Health, University "Federico II" School of Medicine, Napoli, Italy
| | - Giuseppe Galloro
- Department of Clinical Medicine and Surgery, Surgical Digestive Endoscopy Unit, University "Federico II" School of Medicine, Napoli, Italy
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Castiglione F, Diaferia M, Morace F, Labianca O, Meucci C, Cuomo A, Panarese A, Romano M, Sorrentini I, D'Onofrio C, Caporaso N, Rispo A. Risk factors for inflammatory bowel diseases according to the "hygiene hypothesis": a case-control, multi-centre, prospective study in Southern Italy. J Crohns Colitis 2012; 6:324-9. [PMID: 22405169 DOI: 10.1016/j.crohns.2011.09.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [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] [Received: 06/07/2011] [Revised: 08/29/2011] [Accepted: 09/09/2011] [Indexed: 02/08/2023]
Abstract
BACKGROUND Ulcerative colitis (UC) and Crohn's disease (CD) are inflammatory bowel diseases (IBD) of unknown aetiology. The 'hygiene hypothesis' (HH) suggests that several hygiene-related factors may have contributed to the increased incidence of IBD. The aim of the study was to evaluate risk factors for IBD related to HH in a cohort of IBD patients from the south of Italy. METHODS We prospectively performed a one-year, questionnaire-based, case-control, multi-centre study focusing on the principal risk factors for IBD according to HH. We investigated the main surrogate markers of HH (helmintic infections and antibiotics in childhood; breastfeeding; family size/sibship;urban upbringing; personal and domestic hygiene in childhood) in UC and CD patients, in comparison with a control group of healthy subjects. In addition, the traditional risk factors for IBD were also recorded. RESULTS The study population included 527 cases of UC, 468 CD and 562 controls. None of the surrogate risk factors of HH was significantly associated with IBD. On the contrary, the traditional risk factors confirmed their statistical significance in this IBD population. Familial aggregation: OR 4.07 for UC; OR 4.83 for CD; smoking: OR 0.38 for UC; OR 1.40 for CD; appendectomy: OR 0.28 for UC; OR 1.61 for CD. CONCLUSION Even though risk factors associated to the HH have been proposed as a possible explanation for the increasing calendar trend of IBD incidence, their role does not appear to be statistically significant. Familial aggregation, smoking habits and appendectomy still remain the main risk factors associated with IBD.
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De Palma GD, Galloro G, Romano G, Sottile R, Puzziello A, Persico F, Masone S, Labianca O, Persico G. Long-term follow-up after endoscopic biliary stent placement for bile duct strictures from laparoscopic cholecystectomy. Hepatogastroenterology 2003; 50:1229-31. [PMID: 14571706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND/AIMS The outcome of endoscopic biliary stent insertion for postoperative bile duct stenosis was retrospectively evaluated. METHODOLOGY Fifty-seven patients with biliary stenosis from laparoscopic cholecystectomy were included from February 1992 to January 2000. One to three stents were inserted for an average of 12.4 months, with stent exchange every 3 months to avoid cholangitis caused by clogging. RESULTS Successful stent insertion was achieved in 43/57 (75.4%) patients. Stent insertion failed in 10 patients with complete and in 4 patients with incomplete biliary obstruction. Early complications occurred in 4 patients. Late complications occurred in 5/43 patients. Five patients experienced recurrence of stenosis. CONCLUSIONS Endoscopic treatment should be the initial management of choice for postoperative bile duct stenosis.
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Affiliation(s)
- Giovanni D De Palma
- Department of Surgery and Advanced Technolgoies, Service of Surgical Digestive Endoscopy, University Federico II, School of Medicine, Naples, Italy.
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De Palma GD, Persico F, Masone S, Labianca O, Mastantuono L, Di Marino M, Persico G. [Endoscopic palliative treatment of the common bile duct at the hepatic hilum. Results in 583 patients treated in a single center over a 10-year period]. MINERVA CHIR 2003; 58:175-9. [PMID: 12738927] [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
BACKGROUND The outcomes of endoscopic biliary drainage for malignant stenoses at the hepatic hilum were retrospectively evaluated. METHODS From January 1990 to June 2001, 583 patients, 368 males, average age 69+/-18.5 years, were recruited. Endoscopic procedure consisted of insertion of 1 ore multiple stents, plastic or metallic, across the stricture, under mild sedation. RESULTS Successful stent insertion was achieved in 518/583 (88.8%) patients and successful drainage in 474 (81.3%) patients. Early complications were observed in 101 (17.3%) patients with related-mortality of 17 (2.9%) patients. Late complications occurred in 39.9% of patients. Survival was of 189 days, on average. CONCLUSIONS Endoscopic palliation should be the initial management of choice for malignant biliary stenoses at the hepatic hilum.
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Affiliation(s)
- G D De Palma
- Dipartimento di Chirurgia Generale, Oncologica ed Endoscopia Digestiva, Università degli Studi Federico II, Napoli, Italy.
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De Palma GD, Galloro G, Sivero L, Di Matteo E, Labianca O, Siciliano S, Abbruzzese P, Catanzano C. Self-expanding metal stents for palliation of inoperable carcinoma of the esophagus and gastroesophageal junction. Am J Gastroenterol 1995; 90:2140-2142. [PMID: 8540503 DOI: 10.1111/j.1572-0241.1995.tb08133.x] [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: 10/08/2023]
Abstract
OBJECTIVES Rapid palliation of malignant dysphagia is usually possible with endoscopic implantation of plastic prosthesis, but this device has a high rate of complications. Recently expandable metal stents have become available that may have a reduced complications rate. METHODS This report details our experience with 32 patients treated from September of 1992 through June of 1994. Twenty-three patients were treated primarily with the Ultraflex esophageal prosthesis, and five patients were treated with postoperative malignant stricture, three with failed laser therapy and one with postradiation therapy malignant stricturing. Implantation was successful in 30/32 patients (94%). No major bleeding or perforation followed placement. The dysphagia score improved dramatically from 3 to 0.5. Twenty-six patients had a follow-up of at least 30 days. No stent migration occurred. Food impaction was seen in three patients, tumor ingrowth in three, and overgrowth in one patient. The median survival was 6.2 months with a range of 1.8-11.3 months. CONCLUSIONS Expandable metal stents are effective and safe for palliation of malignant obstruction of the esophagus and gastro-esophageal junction. However, long term problems remain to be addressed, such as ingrowth by tumor, food impaction, and limitation of stent expansion by tumor rigidity.
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Affiliation(s)
- G D De Palma
- Service of Surgical Digestive Endoscopy, University of Naples Federico II, School of Medicine, Italy
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Abstract
In 73 normal subjects, from 10 to 82 years of age, maximum orthodromic sensory nerve conduction velocity was measured in the median nerve before and during a 30 minute period of vascular occlusion. During ischaemia progressive slowing in conduction velocity, decrease in amplitude, and increase in duration of the sensory action potential evoked at wrist and elbow by supramaximal stimulation of digit III were observed. However, a statistically significant difference (P<0·05 to P<0·01) between subjects was noted by grouping them by age: the older the subject, the longer the persistence of sensory response and the less marked the slowing in conduction velocity. The mechanism of the phenomenon has been discussed in relation to a similar longer resistance to ischaemia found in peripheral nerves of diabetic and uraemic patients.
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Caruso G, Labianca O, Ferrannini E. [Effects of ischemia on orthodromic sensory conduction velocity of the median nerve in normal subjects of different ages. Preliminary note]. Acta Neurol (Napoli) 1972; 27:1-11. [PMID: 5023019] [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: 01/13/2023]
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Caruso G, Brienza A, Labianca O, Ferrannini E, Perniola T. [Muscular electrophysiological and histochemical findings in a case of botulinic poisoning]. Acta Neurol (Napoli) 1971; 26:23-35. [PMID: 4251898] [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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Buscaino GA, Campanella G, Serlenga L, Labianca O. [Unusual nueromusclular pathology. 2: Clinical, muscular histoenzymatic and electromyographic aspects of a case of generalized spastic rigidity causing falls (stiff-man syndrome?)]. Acta Neurol (Napoli) 1970; 25:509-23. [PMID: 5491151] [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: 01/15/2023]
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Buscaino GA, Caruso G, De Giacomo P, Labianca O, Ferrannini E. [Unusual neuromuscular pathology. I. Electromyographic and histoenzymatic findings in the muscles in a subject with "continuous muscular activity syndrome" ("neuromyotonia")]. Acta Neurol (Napoli) 1970; 25:206-24. [PMID: 5422847] [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: 01/15/2023]
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Buscaino GA, De Giacomo P, Perniola T, Labianca O. [2 cases of mitochondrial myopathy: clinical, histological and histochemical aspects]. Boll Soc Ital Biol Sper 1969; 45:221-4. [PMID: 5346804] [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: 01/14/2023]
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Caruso G, Spadetta V, Labianca O, Mastrangelo F, Amerio A. [Latent uremic neuropathy. Electromyographic and electroencephalographic observations in chronic renal patients treated with conservative therapy and with peritoneal dialysis]. Riv Patol Nerv Ment 1968; 89:348-72. [PMID: 5760426] [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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