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Barison I, Giarraputo A, Rossi E, Vedovelli L, Minuzzo S, Fedrigo M, Castellani C, Tona F, Bottio T, Toscano G, Basso C, Gerosa G, Mandruzzato S, Abate D, Gregori D, Angelini A. MicroRNA Microarray Analysis in Infections Post Heart-Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1310] [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: 04/05/2023] Open
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Pradegan N, Evangelista G, Tessari C, Guerra G, Ciccarelli G, Gallo M, Toscano G, Feltrin G, Tarzia V, Gerosa G. Uncontrolled Cardiac Arrest of Donor Heart Before Donation Does Not Affect Heart Transplant Recipient Outcomes: Proof of Concept for DCD Long-Term Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.637] [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: 04/05/2023] Open
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Italiano E, Pradegan N, Tessari C, Toscano G, Marinello S, Gerosa G. Successful Management of Massive Brain Nocardiosis in a Heart Transplant Recipient. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.662] [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: 04/05/2023] Open
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Pradegan N, Evangelista G, Tessari C, Fabozzo A, Guerra G, Ciccarelli G, Gallo M, Toscano G, Angelini A, Gerosa G. A Very 37-Year Heart Transplantation Single-Center Experience: The Impact of Donor-Recipient Age Mismatch on Long-Term Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1612] [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: 04/05/2023] Open
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Schmid N, Bruderer S, Paruzzo F, Fischetti G, Toscano G, Graf D, Fey M, Henrici A, Ziebart V, Heitmann B, Grabner H, Wegner JD, Sigel RKO, Wilhelm D. Deconvolution of 1D NMR spectra: A deep learning-based approach. J Magn Reson 2023; 347:107357. [PMID: 36563418 DOI: 10.1016/j.jmr.2022.107357] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/01/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
The analysis of nuclear magnetic resonance (NMR) spectra to detect peaks and characterize their parameters, often referred to as deconvolution, is a crucial step in the quantification, elucidation, and verification of the structure of molecular systems. However, deconvolution of 1D NMR spectra is a challenge for both experts and machines. We propose a robust, expert-level quality deep learning-based deconvolution algorithm for 1D experimental NMR spectra. The algorithm is based on a neural network trained on synthetic spectra. Our customized pre-processing and labeling of the synthetic spectra enable the estimation of critical peak parameters. Furthermore, the neural network model transfers well to the experimental spectra and demonstrates low fitting errors and sparse peak lists in challenging scenarios such as crowded, high dynamic range, shoulder peak regions as well as broad peaks. We demonstrate in challenging spectra that the proposed algorithm is superior to expert results.
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Affiliation(s)
- N Schmid
- Zurich University of Applied Sciences (ZHAW), Switzerland; University of Zurich (UZH), Switzerland.
| | | | | | | | | | - D Graf
- Bruker Switzerland AG, Switzerland
| | - M Fey
- Bruker Switzerland AG, Switzerland
| | - A Henrici
- Zurich University of Applied Sciences (ZHAW), Switzerland
| | - V Ziebart
- Zurich University of Applied Sciences (ZHAW), Switzerland
| | | | - H Grabner
- Zurich University of Applied Sciences (ZHAW), Switzerland
| | | | | | - D Wilhelm
- Zurich University of Applied Sciences (ZHAW), Switzerland
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6
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Da Ros V, Pusceddu F, Lattanzi S, Scaggiante J, Sallustio F, Marrama F, Bandettini di Poggio M, Toscano G, Di Giuliano F, Rolla-Bigliani C, Ruggiero M, Haznedari N, Sgreccia A, Sanfilippo G, Finocchi C, Diomedi M, Tomasi SO, Palmisciano P, Umana GE, Strigari L, Griessenauer CJ, Pitocchi F, Garaci F, Floris R. Endovascular treatment of patients with acute ischemic stroke and tandem occlusion due to internal carotid artery dissection: A multicenter experience. Neuroradiol J 2023. [PMID: 35699167 DOI: 10.1177/19714009221089026]] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The optimal management of patients with acute ischemic stroke (AIS) due to tandem occlusion (TO) and underlying carotid dissection (CD) remains unclear. OBJECTIVE We present our multicenter-experience of endovascular treatment (EVT) approach used and outcomes for AIS patients with CD-related TO (CD-TO). METHODS Consecutive AIS patients underwent EVT for CD-TO at five Italian Neuro-interventional Tertiary Stroke Centers were retrospectively identified. TO from atherosclerosis and other causes of, were excluded from the final analysis. Primary outcome was successful (mTICI 2b-3) and complete reperfusion (mTICI 3); secondary outcome was patients' 3-months functional independence (mRS≤2). RESULTS Among 214 AIS patients with TO, 45 presented CD-TO. Median age was 54 years (range 29-86), 82.2% were male. Age <65 years (p < 0.0001), lower baseline NIHSS score (p = 0.0002), and complete circle of Willis (p = 0.0422) were associated with mRS ≤ 2 at the multivariate analysis. Comparisons between antegrade and retrograde approaches resulted in differences for baseline NIHSS scores (p = 0.001) and number of EVT attempts per-procedure (p = 0.001). No differences in terms of recanalization rates were observed between antegrade and retrograde EVT approaches (p = 0.811) but higher rates of mTICI3 revascularization was observed with the retrograde compared to the antegrade approach (78.6% vs 73.3%), anyway not statistically significant. CD management technique (angioplasty vs aspiration vs emergent stenting) did not correlate with 3-months mRS≤2. CONCLUSION AIS patients with CD-TO were mostly treated with the retrograde approach with lower number of attempts per-procedure but it offered similar recanalization rates compared with the antegrade approach. Emergent carotid artery stenting (CAS) proved to be safe for CD management but it does not influence 3-months patients' clinical outcomes.
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Affiliation(s)
- Valerio Da Ros
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, 9318University of Rome Tor Vergata, Italy
| | - Federica Pusceddu
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, 9318University of Rome Tor Vergata, Italy
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Italy
| | - Jacopo Scaggiante
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA
| | | | - Federico Marrama
- Comprehensive Stroke Center, 9318University of Rome Tor Vergata, Italy
| | | | - Gianpaolo Toscano
- Stroke Unit University Policlinico San Matteo, IRCCS Mondino Fundation, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, 9318University of Rome Tor Vergata, Italy
| | - Claudia Rolla-Bigliani
- Department of Diagnostic and Interventional Neuroradiology, University Hospital, San Martino, Italy
| | | | | | - Alessandro Sgreccia
- Clinic of Neuroradiology and Interventional Neuroradiology, 18494AOU Ospedali Riuniti di Ancona, Italy
| | - Giuseppina Sanfilippo
- Department of Diagnostic and Interventional Radiology and Neuroradiology, IRCCS Policlinico San Matteo, Italy
| | - Cinzia Finocchi
- Department of Neurosciences, Policlinico Hospital San Martino, University of Genova, Italy
| | - Marina Diomedi
- Department of Systemic Medicine, 9318University of Rome Tor Vergata, Italy
| | - Santino O Tomasi
- Department of Neurological Surgery, Christian Doppler Klinik, 31507Paracelsus Medical University, Salzburg, Austria.,Laboratory for Microsurgical Neuroanatomy, Christian Doppler Klinik, 31507Paracelsus Medical University, Salzburg, Austria
| | - Paolo Palmisciano
- Department of Neurosurgery, Trauma and Gamma-Knife Center, 18531Cannizzaro Hospital, Italy
| | - Giuseppe E Umana
- Department of Neurosurgery, Trauma and Gamma-Knife Center, 18531Cannizzaro Hospital, Italy
| | - Lidia Strigari
- Department of Medical Physics, 18494IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Christoph J Griessenauer
- Department of Neurological Surgery, Christian Doppler Klinik, 31507Paracelsus Medical University, Salzburg, Austria.,Department of Neurosurgery, Geisinger Health System, Danville, PA, USA.,Research Institute of Neurointervention, 31507Paracelsus Medical University, Salzburg, Austria
| | - Francesca Pitocchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, 9318University of Rome Tor Vergata, Italy
| | - Francesco Garaci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, 9318University of Rome Tor Vergata, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, 9318University of Rome Tor Vergata, Italy
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7
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Da Ros V, Pusceddu F, Lattanzi S, Scaggiante J, Sallustio F, Marrama F, Bandettini di Poggio M, Toscano G, Di Giuliano F, Rolla-Bigliani C, Ruggiero M, Haznedari N, Sgreccia A, Sanfilippo G, Finocchi C, Diomedi M, Tomasi SO, Palmisciano P, Umana GE, Strigari L, Griessenauer CJ, Pitocchi F, Garaci F, Floris R. Endovascular treatment of patients with acute ischemic stroke and tandem occlusion due to internal carotid artery dissection: A multicenter experience. Neuroradiol J 2023; 36:86-93. [PMID: 35699167 PMCID: PMC9893158 DOI: 10.1177/19714009221108673] [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] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The optimal management of patients with acute ischemic stroke (AIS) due to tandem occlusion (TO) and underlying carotid dissection (CD) remains unclear. OBJECTIVE We present our multicenter-experience of endovascular treatment (EVT) approach used and outcomes for AIS patients with CD-related TO (CD-TO). METHODS Consecutive AIS patients underwent EVT for CD-TO at five Italian Neuro-interventional Tertiary Stroke Centers were retrospectively identified. TO from atherosclerosis and other causes of, were excluded from the final analysis. Primary outcome was successful (mTICI 2b-3) and complete reperfusion (mTICI 3); secondary outcome was patients' 3-months functional independence (mRS≤2). RESULTS Among 214 AIS patients with TO, 45 presented CD-TO. Median age was 54 years (range 29-86), 82.2% were male. Age <65 years (p < 0.0001), lower baseline NIHSS score (p = 0.0002), and complete circle of Willis (p = 0.0422) were associated with mRS ≤ 2 at the multivariate analysis. Comparisons between antegrade and retrograde approaches resulted in differences for baseline NIHSS scores (p = 0.001) and number of EVT attempts per-procedure (p = 0.001). No differences in terms of recanalization rates were observed between antegrade and retrograde EVT approaches (p = 0.811) but higher rates of mTICI3 revascularization was observed with the retrograde compared to the antegrade approach (78.6% vs 73.3%), anyway not statistically significant. CD management technique (angioplasty vs aspiration vs emergent stenting) did not correlate with 3-months mRS≤2. CONCLUSION AIS patients with CD-TO were mostly treated with the retrograde approach with lower number of attempts per-procedure but it offered similar recanalization rates compared with the antegrade approach. Emergent carotid artery stenting (CAS) proved to be safe for CD management but it does not influence 3-months patients' clinical outcomes.
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Affiliation(s)
- Valerio Da Ros
- Diagnostic Imaging Unit, Department
of Biomedicine and Prevention, University of Rome Tor
Vergata, Italy
| | - Federica Pusceddu
- Diagnostic Imaging Unit, Department
of Biomedicine and Prevention, University of Rome Tor
Vergata, Italy
| | - Simona Lattanzi
- Neurological Clinic, Department of
Experimental and Clinical Medicine, Marche Polytechnic
University, Italy
| | - Jacopo Scaggiante
- Department of Radiology and
Radiological Science, Medical University of South
Carolina, Charleston, USA
| | | | - Federico Marrama
- Comprehensive Stroke Center, University of Rome Tor
Vergata, Italy
| | | | - Gianpaolo Toscano
- Stroke Unit University Policlinico
San Matteo, IRCCS Mondino Fundation, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging Unit, Department
of Biomedicine and Prevention, University of Rome Tor
Vergata, Italy
| | - Claudia Rolla-Bigliani
- Department of Diagnostic and
Interventional Neuroradiology, University Hospital, San Martino, Italy
| | | | | | - Alessandro Sgreccia
- Clinic of Neuroradiology and
Interventional Neuroradiology, AOU Ospedali Riuniti di
Ancona, Italy
| | - Giuseppina Sanfilippo
- Department of Diagnostic and
Interventional Radiology and Neuroradiology, IRCCS Policlinico San
Matteo, Italy
| | - Cinzia Finocchi
- Department of Neurosciences,
Policlinico Hospital San Martino, University of Genova, Italy
| | - Marina Diomedi
- Department of Systemic Medicine, University of Rome Tor
Vergata, Italy
| | - Santino O Tomasi
- Department of Neurological
Surgery, Christian Doppler Klinik, Paracelsus Medical
University, Salzburg, Austria
- Laboratory for Microsurgical
Neuroanatomy, Christian Doppler Klinik, Paracelsus Medical
University, Salzburg, Austria
| | - Paolo Palmisciano
- Department of Neurosurgery,
Trauma and Gamma-Knife Center, Cannizzaro Hospital, Italy
| | - Giuseppe E Umana
- Department of Neurosurgery,
Trauma and Gamma-Knife Center, Cannizzaro Hospital, Italy
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda
Ospedaliero-Universitaria di Bologna, Italy
| | - Christoph J Griessenauer
- Department of Neurological
Surgery, Christian Doppler Klinik, Paracelsus Medical
University, Salzburg, Austria
- Department of Neurosurgery, Geisinger Health System, Danville, PA, USA
- Research Institute of
Neurointervention, Paracelsus Medical
University, Salzburg, Austria
| | - Francesca Pitocchi
- Diagnostic Imaging Unit, Department
of Biomedicine and Prevention, University of Rome Tor
Vergata, Italy
| | - Francesco Garaci
- Diagnostic Imaging Unit, Department
of Biomedicine and Prevention, University of Rome Tor
Vergata, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department
of Biomedicine and Prevention, University of Rome Tor
Vergata, Italy
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Fanella G, Baiata C, Candeloro E, Toscano G, Colnaghi S, Mauri M, Cariddi LP, Rebecchi V, Solazzo F, Banfi P, Piatti M, Ferrarese C, Versino M. New-onset myasthenia gravis after mRNA SARS-CoV-2 vaccination: a case series. Neurol Sci 2022; 43:5799-5802. [PMID: 35870026 PMCID: PMC9308404 DOI: 10.1007/s10072-022-06284-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
Background Myasthenia gravis (MG) is an autoimmune disease that targets acetylcholine receptor (AChR) of the neuromuscular junction. New-onset MG after SARS-CoV-2 vaccination has rarely been reported. Case presentation We report about three patients who presented new-onset myasthenia gravis after receiving mRNA SARS-CoV-2 vaccination. The patients were all males and older than 55 years. All the patients presented with ocular and bulbar symptoms. The interval between vaccine administration and MG onset ranged from 3 days after the first dose to 10 days after the second dose. All the patients had elevated serum AChR antibodies and responded to pyridostigmine. Two out of three patients were successfully treated with IVIG or plasma exchange and with long-term immunosuppression. Conclusions MG is a rare disease; clinicians should be aware of possible new-onset MG after SARS-CoV-2 vaccination, especially with the current recommendation of booster doses. The hyperstimulation of the innate immune system or the exacerbation of a subclinical pre-existing MG could be possible explanations.
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Affiliation(s)
- Gaia Fanella
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy.
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
| | - Claudio Baiata
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Elisa Candeloro
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
| | - Gianpaolo Toscano
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
| | - Silvia Colnaghi
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
| | - Marco Mauri
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
- DMC, University of Insubria, Varese, Italy
| | - Lucia Princiotta Cariddi
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
- Clinical and Experimental Medicine and Medical Humanities, Center of Research in Medical Pharmacology, University of Insubria, Varese, Italy
| | - Valentina Rebecchi
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
| | - Francesca Solazzo
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
| | - Paola Banfi
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
| | - Marialuisa Piatti
- Department of Neurology, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Carlo Ferrarese
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Department of Neurology, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Maurizio Versino
- Neurology and Stroke Unit, Circolo Hospital ASST Sette Laghi, Varese, Italy
- DMC, University of Insubria, Varese, Italy
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Zanella L, Toscano G, Gerosa G. P38 HEART FAILURE IN TRANSPLANTED HEART DUE TO TOXOCARA CANIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.036] [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]
Abstract
Abstract
Toxocara Canis is a parasitic roundworm which cause zoonotic infections worldwide. It could affect heart causing myocarditis, pericarditis and Loffler’s endocarditis, with a clinical presentation ranged from asymptomatic to life threating conditions with heart failure. After heart transplantation, patients are immunosuppressed, therefore they could experience reactivation of hidden parasitosis like Toxocariasis. To our knowledge, some cases of Toxocara Canis affecting the heart have been described in literature, but there are no described cases of this infection in a transplanted heart. A 65–year–old woman underwent transplant heart surgery due to post–ischaemic dilatative cardiomyopathy. After transplantation she experienced supraventricular tachycardia, reduction of the new heart ejection fraction from 52% to 30% (Figure 1) requiring inotropic drug therapy and mild to severe mitral valve regurgitation due to ventricular dilatation. The unique finding was the presence of antibodies against Toxocara Canis in her blood and high level of immunoglobulin E. In addition, endomyocardial biopsy revealed a cystic intracellular inclusion. Specific therapy with albendazole and corticosteroids was immediately started: heart ejection fraction slowly grew up and mitral regurgitation became milder. Time correlation between Toxocara Canis antibodies positivity and worsening of heart ejection fraction, moreover the recovery with specific antibiotic therapy against this parasite, make us think that it could have been the cause of heart function deterioration in this patient. Often diagnostic findings of Toxocara Canis infection are not specific, heart damage seemed to be driven by direct invasion of the larvae and by immunological reaction. In conclusion, Toxocara Canis could be a cause of heart function deterioration after heart transplant. It should be considered in differential diagnosis of post–transplant heart failure.
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Affiliation(s)
- L Zanella
- CARDIOCHIRURGIA, DIPARTIMENTO DI SCIENZE CARDIO–TORACO–VASCOLARI E SANITÀ PUBBLICA, AZIENDA OSPEDALIERA DI PADOVA, PADOVA
| | - G Toscano
- CARDIOCHIRURGIA, DIPARTIMENTO DI SCIENZE CARDIO–TORACO–VASCOLARI E SANITÀ PUBBLICA, AZIENDA OSPEDALIERA DI PADOVA, PADOVA
| | - G Gerosa
- CARDIOCHIRURGIA, DIPARTIMENTO DI SCIENZE CARDIO–TORACO–VASCOLARI E SANITÀ PUBBLICA, AZIENDA OSPEDALIERA DI PADOVA, PADOVA
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Cantini L, Mentrasti G, Lo Russo G, Signorelli D, Pasello G, Rijavec E, Russano M, Antonuzzo L, Rocco D, Giusti R, Adamo V, Genova C, Tuzi A, Morabito A, Gori S, La Verde N, Chiari R, Cortellini A, Cognigni V, Pecci F, Indini A, De Toma A, Zattarin E, Oresti S, Pizzutilo E, Frega S, Erbetta E, Galletti A, Citarella F, Fancelli S, Caliman E, Della Gravara L, Malapelle U, Filetti M, Piras M, Toscano G, Zullo L, De Tursi M, Di Marino P, D’Emilio V, Cona M, Guida A, Caglio A, Salerno F, Spinelli G, Bennati C, Morgillo F, Russo A, Dellepiane C, Vallini I, Sforza V, Inno A, Rastelli F, Tassi V, Nicolardi L, Pensieri M, Emili R, Roca E, Migliore A, Galassi T, Rocchi M, Berardi R. Erratum to ‘Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario’. ESMO Open 2022; 7:100471. [PMID: 35378403 PMCID: PMC8973259 DOI: 10.1016/j.esmoop.2022.100471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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11
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Fabozzo A, Pradegan N, Lombardi V, Bergonzoni E, Cibin G, Lorenzoni G, Toscano G, Gregori D, Gerosa G. Can Malnutrition at the Time of Heart Transplantation Affect Early and Late Mortality? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1753] [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: 11/16/2022] Open
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12
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Cantini L, Mentrasti G, Russo GL, Signorelli D, Pasello G, Rijavec E, Russano M, Antonuzzo L, Rocco D, Giusti R, Adamo V, Genova C, Tuzi A, Morabito A, Gori S, Verde NL, Chiari R, Cortellini A, Cognigni V, Pecci F, Indini A, De Toma A, Zattarin E, Oresti S, Pizzutilo EG, Frega S, Erbetta E, Galletti A, Citarella F, Fancelli S, Caliman E, Della Gravara L, Malapelle U, Filetti M, Piras M, Toscano G, Zullo L, De Tursi M, Di Marino P, D'Emilio V, Cona MS, Guida A, Caglio A, Salerno F, Spinelli G, Bennati C, Morgillo F, Russo A, Dellepiane C, Vallini I, Sforza V, Inno A, Rastelli F, Tassi V, Nicolardi L, Pensieri V, Emili R, Roca E, Migliore A, Galassi T, Rocchi MLB, Berardi R. Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario. ESMO Open 2022; 7:100406. [PMID: 35219245 PMCID: PMC8810307 DOI: 10.1016/j.esmoop.2022.100406] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 12/18/2022] Open
Abstract
Introduction COVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time. Methods Consecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were included. Access rate and temporal intervals between date of symptoms onset and diagnostic and therapeutic services were compared with the same period in 2019. Differences between the 2 years were analyzed using the chi-square test for categorical variables and the Mann–Whitney U test for continuous variables. Results A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019 (1523 versus 1637, P = 0.09). Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease (P < 0.01) and to be current smokers (someone who has smoked more than 100 cigarettes, including hand-rolled cigarettes, cigars, cigarillos, in their lifetime and has smoked in the last 28 days) (P < 0.01). The drop in terms of new diagnoses was greater in the lockdown period (percentage drop −12% versus −3.2%) compared with the other months included. More LC pts were referred to a low/medium volume hospital in 2020 compared with 2019 (P = 0.01). No differences emerged in terms of interval between symptoms onset and radiological diagnosis (P = 0.94), symptoms onset and cytohistological diagnosis (P = 0.92), symptoms onset and treatment start (P = 0.40), and treatment start and first radiological revaluation (P = 0.36). Conclusions Our study pointed out a reduction of new diagnoses with a shift towards higher stage at diagnosis for LC pts in 2020. Despite this, the measures adopted by Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts. The COVID-19 outbreak had an impact on access to lung cancer (LC) diagnosis and treatment. A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019. Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease. The Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts. A reverse migration from high-volume to low-volume cancer centers was noted during the pandemic.
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Affiliation(s)
- L Cantini
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy. https://twitter.com/LucaCantiniMD
| | - G Mentrasti
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - G L Russo
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - D Signorelli
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - G Pasello
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - E Rijavec
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Russano
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - L Antonuzzo
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - D Rocco
- Department of Pulmonology and Oncology, AORN dei Colli Monaldi, Naples, Italy
| | - R Giusti
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - V Adamo
- Oncologia Medica, A.O.Papardo & Università di Messina, Messina, Italy
| | - C Genova
- UOC Clinica di Oncologia Medica, IRCCS Ospedale San Martino, Department of Internal Medicine and Medical Specialties (DIMI), Università degli Studi di Genova, Genoa, Italy
| | - A Tuzi
- Oncologia Medica, ASST Sette Laghi, Varese, Italy
| | - A Morabito
- Thoracic Medical Oncology, Istituto Nazionale Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - S Gori
- UOC Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - N La Verde
- Department of Oncology, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - R Chiari
- Medical Oncology, Ospedali Riuniti Padova Sud, Monselice, Italy
| | - A Cortellini
- Medical Oncology, St Salvatore Hospital, L'Aquila, Italy
| | - V Cognigni
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - F Pecci
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - A Indini
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A De Toma
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - E Zattarin
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - S Oresti
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - E G Pizzutilo
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - S Frega
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - E Erbetta
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - A Galletti
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - F Citarella
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - S Fancelli
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - E Caliman
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - L Della Gravara
- Dipartment of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - U Malapelle
- Department of Public Health, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - M Filetti
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - M Piras
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - G Toscano
- Oncologia Medica, A.O.Papardo, Messina, Italy
| | - L Zullo
- UOC Oncologia Medica 2, IRCCS Ospedale San Martino, Genoa, Italy
| | - M De Tursi
- Department of Innovative Technologies in Medicine & Dentistry, Università G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - P Di Marino
- Department of Innovative Technologies in Medicine & Dentistry, Università G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - V D'Emilio
- UOC Pneumologia, Ospedale Mazzoni, Ascoli Piceno, Italy
| | - M S Cona
- Department of Oncology, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - A Guida
- Oncologia Medica e Traslazionale, AO Santa Maria, Terni, Italy
| | - A Caglio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - F Salerno
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - G Spinelli
- UOC Territorial Oncology, University "Sapienza", AUSL Latina, Cds Aprilia, Aprilia, Italy
| | - C Bennati
- Department of Onco-Hematology, AUSL della Romagna, Ravenna, Italy
| | - F Morgillo
- UOC Oncologia ed Ematologia, Department of Precision Medicine, Università degli studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - A Russo
- Oncologia Medica, A.O.Papardo, Messina, Italy
| | - C Dellepiane
- UOC Oncologia Medica 2, IRCCS Ospedale San Martino, Genoa, Italy
| | - I Vallini
- Oncologia Medica, ASST Sette Laghi, Varese, Italy
| | - V Sforza
- Thoracic Medical Oncology, Istituto Nazionale Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - A Inno
- UOC Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - F Rastelli
- UOC Oncologia, Ospedale Mazzoni, Ascoli Piceno, Italy
| | - V Tassi
- Chirurgia Toracica, AO Santa Maria, Terni, Italy
| | - L Nicolardi
- Medical Oncology, Ospedali Riuniti Padova Sud, Monselice, Italy
| | - V Pensieri
- Medical Oncology, St Salvatore Hospital, L'Aquila, Italy
| | - R Emili
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - E Roca
- Thoracic Oncology - Lung Unit, Pederzoli Hospital, Peschiera Del Garda, Italy
| | - A Migliore
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - T Galassi
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - M L Bruno Rocchi
- Biomolecular Sciences Department, University of Urbino, Urbino, Italy
| | - R Berardi
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy.
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13
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Cagnazzo C, Franchina V, Toscano G, Fagioli F, Franchina T, Ricciardi G, Antonuzzo L, Di Costanzo A, Russo A, Cusenza S, Gori S, Marchetti F, Tambaro M, Piccirillo P, Nanni O, Delfanti S, Di Maio M, D'Ascanio F, Adamo V. 1497P Cancer patients’ awareness about clinical research: The ELPIS study preliminary results. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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14
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Da Ros V, Scaggiante J, Pitocchi F, Sallustio F, Lattanzi S, Umana GE, Chaurasia B, Bandettini di Poggio M, Toscano G, Rolla Bigliani C, Ruggiero M, Haznedari N, Sgreccia A, Sanfilippo G, Diomedi M, Finocchi C, Floris R. Mechanical thrombectomy in acute ischemic stroke with tandem occlusions: impact of extracranial carotid lesion etiology on endovascular management and outcome. Neurosurg Focus 2021; 51:E6. [PMID: 34198245 DOI: 10.3171/2021.4.focus21111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/07/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Different etiologies of extracranial internal carotid artery steno-occlusive lesions (ECLs) in patients with acute ischemic stroke (AIS) and tandem occlusion (TO) have been pooled together in randomized trials. However, carotid atherosclerosis (CA) and carotid dissection (CD), the two most common ECL etiologies, are distinct nosological entities. The authors aimed to determine if ECL etiology has impacts on the endovascular management and outcome of patients with TO. METHODS A multicenter, retrospective study of prospectively collected data was conducted. AIS patients were included who had TO due to internal CA or CD and ipsilateral M1 middle cerebral artery occlusion and underwent endovascular treatment (EVT). Comparative analyses including demographic data, safety, successful recanalization rates, and clinical outcome were performed according to EVT and ECL etiology. RESULTS In total, 214 AIS patients with TOs were included (77.6% CA related, 22.4% CD related). Patients treated with a retrograde approach were more often functionally independent at 3 months than patients treated with an antegrade approach (OR 0.6, 95% CI 0.4-0.9). Patients with CD-related TOs achieved 90-day clinical independence more often than patients with CA-related TOs (OR 1.4, 95% CI 1.1-2.0). Emergency stenting use was associated with good 3-month clinical outcome only in patients with CA-related TOs (OR 1.4, 95% CI 1.1-2.1). Symptomatic intracranial hemorrhage (sICH) occurred in 10.7% of patients, without differences associated with ECL etiology. CONCLUSIONS ECL etiology impacts both EVT approach and clinical outcome in patients with TOs. Patients with CD-related TO achieved higher 3-month functional independence rates than patients with CA-related TOs. A retrograde approach can be desirable for both CA- and CD-related TOs, and emergency stenting is likely better justified in CA-related TOs.
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Affiliation(s)
- Valerio Da Ros
- 1Department of Biomedicine, Interventional Neuroradiology Unit, University of Rome Tor Vergata, Rome
| | - Jacopo Scaggiante
- 1Department of Biomedicine, Interventional Neuroradiology Unit, University of Rome Tor Vergata, Rome.,13Medical University of South Carolina, Division of Neuroradiology, Charleston, South Carolina
| | - Francesca Pitocchi
- 1Department of Biomedicine, Interventional Neuroradiology Unit, University of Rome Tor Vergata, Rome
| | | | - Simona Lattanzi
- 3Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona
| | - Giuseppe Emmanuele Umana
- 4Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Bipin Chaurasia
- 5Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Monica Bandettini di Poggio
- 6Ospedale Policlinico San Martino, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova
| | | | - Claudia Rolla Bigliani
- 8Department of Diagnostic and Interventional Neuroradiology, Policlinico Universitario San Martino, Genova
| | | | | | - Alessandro Sgreccia
- 10Department of Clinical Neuroradiology and Interventional Neuroradiology, AOU Ospedali Riuniti, Ancona
| | - Giuseppina Sanfilippo
- 11Department of Diagnostic and Interventional Radiology and Neuroradiology, IRCCS Policlinico San Matteo, Pavia
| | - Marina Diomedi
- 12Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; and
| | - Cinzia Finocchi
- 6Ospedale Policlinico San Martino, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova
| | - Roberto Floris
- 1Department of Biomedicine, Interventional Neuroradiology Unit, University of Rome Tor Vergata, Rome
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15
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Fedrigo M, Bottigliengo D, Romano A, Gugole E, Bocca T, lorenzoni G, Vescovo G, Barison I, Bottio T, Tarantini G, Toscano G, Nocco A, Benazzi E, Castellani C, De Silvestro G, Gerosa G, Tona F, Gregori D, Angelini A. Vasculitis on Heart Transplant as an Emerging Prognostic Factor. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.834] [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: 10/21/2022] Open
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16
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Fedrigo M, Carrozzini M, Bocca T, Bottigliengo D, Gugole E, Bottio T, Toscano G, De Silvestro G, Tona F, Gregori D, Gerosa G, Angelini A. Endomyocardial Biopsy Monitoring in the Follow Up and Rejection Profile in Htx Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.842] [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: 10/21/2022] Open
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17
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Giarraputo A, Fedrigo M, Tona F, Rossi E, Barison I, Castellani C, Bottio T, Toscano G, Gerosa G, Mandruzzato S, Michoel T, Joshi A, Angelini A. Gene Network Analysis of Cardiac Allograft Vasculopathy in Heart Transplantation through Messanger RNA Expression Profile. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.680] [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: 10/21/2022] Open
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18
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Castellani C, Burello J, Fedrigo M, Burrello A, Bolis S, Silvestre DDI, Tona F, Bottio T, Biemmi V, Toscano G, Gerosa G, Thiene G, Basso C, Longnus S, Vassalli G, Angelini A, Barile L. Extracellular Vesicles Surface Protein Profile as Biomarkers to Characterize Allograft Rejection in Heart Transplanted Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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19
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Salsano G, Pracucci G, Mavilio N, Saia V, Bandettini di Poggio M, Malfatto L, Sallustio F, Wlderk A, Limbucci N, Nencini P, Vallone S, Zini A, Bigliardi G, Velo M, Francalanza I, Gennari P, Tassi R, Bergui M, Cerrato P, Carità G, Azzini C, Gasparotti R, Magoni M, Isceri S, Commodaro C, Cordici F, Menozzi R, Latte L, Cosottini M, Mancuso M, Comai A, Franchini E, Alexandre A, Marca GD, Puglielli E, Casalena A, Causin F, Baracchini C, Di Maggio L, Naldi A, Grazioli A, Forlivesi S, Chiumarulo L, Petruzzellis M, Sanfilippo G, Toscano G, Cavasin N, Adriana C, Ganimede MP, Prontera MP, Giorgianni A, Mauri M, Auteri W, Petrone A, Cirelli C, Falcou A, Corraine S, Piras V, Ganci G, Tassinari T, Nuzzi NP, Corato M, Sacco S, Squassina G, Invernizzi P, Gallesio I, Ferrandi D, Dui G, Deiana G, Amistà P, Russo M, Pintus F, Baule A, Craparo G, Mannino M, Castellan L, Toni D, Mangiafico S. Complications of mechanical thrombectomy for acute ischemic stroke: Incidence, risk factors, and clinical relevance in the Italian Registry of Endovascular Treatment in acute stroke. Int J Stroke 2020; 16:818-827. [PMID: 33283685 DOI: 10.1177/1747493020976681] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND There are limited data concerning procedure-related complications of endovascular thrombectomy for large vessel occlusion strokes. AIMS We evaluated the cumulative incidence, the clinical relevance in terms of increased disability and mortality, and risk factors for complications. METHODS From January 2011 to December 2017, 4799 patients were enrolled by 36 centers in the Italian Registry of Endovascular Stroke Treatment. Data on demographic and procedural characteristics, complications, and clinical outcome at three months were prospectively collected. RESULTS The complications cumulative incidence was 201 per 1000 patients undergoing endovascular thrombectomy. Ongoing antiplatelet therapy (p < 0.01; OR 1.82, 95% CI: 1.21-2.73) and large vessel occlusion site (carotid-T, p < 0.03; OR 3.05, 95% CI: 1.13-8.19; M2-segment-MCA, p < 0.01; OR 4.54, 95% CI: 1.66-12.44) were associated with a higher risk of subarachnoid hemorrhage/arterial perforation. Thrombectomy alone (p < 0.01; OR 0.50, 95% CI: 0.31-0.83) and younger age (p < 0.04; OR 0.98, 95% CI: 0.97-0.99) revealed a lower risk of developing dissection. M2-segment-MCA occlusion (p < 0.01; OR 0.35, 95% CI: 0.19-0.64) and hypertension (p < 0.04; OR 0.77, 95% CI: 0.6-0.98) were less related to clot embolization. Higher NIHSS at onset (p < 0.01; OR 1.04, 95% CI: 1.02-1.06), longer groin-to-reperfusion time (p < 0.01; OR 1.05, 95% CI: 1.02-1.07), diabetes (p < 0.01; OR 1.67, 95% CI: 1.25-2.23), and LVO site (carotid-T, p < 0.01; OR 1.96, 95% CI: 1.26-3.05; M2-segment-MCA, p < 0.02; OR 1.62, 95% CI: 1.08-2.42) were associated with a higher risk of developing symptomatic intracerebral hemorrhage compared to no/asymptomatic intracerebral hemorrhage. The subgroup of patients treated with thrombectomy alone presented a lower risk of symptomatic intracerebral hemorrhage (p < 0.01; OR 0.70; 95% CI: 0.55-0.90). Subarachnoid hemorrhage/arterial perforation and symptomatic intracerebral hemorrhage after endovascular thrombectomy worsen both functional independence and mortality at three-month follow-up (p < 0.01). Distal embolization is associated with neurological deterioration (p < 0.01), while arterial dissection did not affect clinical outcome at follow-up. CONCLUSIONS Complications globally considered are not uncommon and may result in poor clinical outcome. Early recognition of risk factors might help to prevent complications and manage them appropriately in order to maximize endovascular thrombectomy benefits.
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Affiliation(s)
- Giancarlo Salsano
- IRCCS San Martino Policlinic Hospital, Neuroradiology and Neurology, Genoa, Italy
| | - Giovanni Pracucci
- Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy
| | - Nicola Mavilio
- IRCCS San Martino Policlinic Hospital, Neuroradiology and Neurology, Genoa, Italy
| | - Valentina Saia
- Neuroradiology Unit and Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | - Monica Bandettini di Poggio
- IRCCS San Martino Policlinic Hospital, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy
| | - Laura Malfatto
- IRCCS San Martino Policlinic Hospital, Neuroradiology and Neurology, Genoa, Italy
| | - Fabrizio Sallustio
- Imaging and Interventional Radiology and Stroke Unit, Policlinico Tor Vergata, Roma, Italy
| | - Andrea Wlderk
- Imaging and Interventional Radiology and Stroke Unit, Policlinico Tor Vergata, Roma, Italy
| | - Nicola Limbucci
- Interventional Neurovascular Unit and Stroke Unit, Ospedale Careggi-University Hospital, Firenze, Italy
| | - Patrizia Nencini
- Interventional Neurovascular Unit and Stroke Unit, Ospedale Careggi-University Hospital, Firenze, Italy
| | - Stefano Vallone
- Neuroradiology and Neurology, Ospedale Civile S. Agostino-Estense, University Hospital, Modena, Italy
| | - Andrea Zini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center and Neuroradiology, Maggiore Hospital, Bologna, Italy
| | - Guido Bigliardi
- Neuroradiology and Neurology, Ospedale Civile S. Agostino-Estense, University Hospital, Modena, Italy
| | - Mariano Velo
- Neuroradiology and Stroke Unit, Department of Clinical and Experimental Medicine, University of Messina, Policlinico G. Martino Messina, Italy
| | - Isabella Francalanza
- Neuroradiology and Stroke Unit, Department of Clinical and Experimental Medicine, University of Messina, Policlinico G. Martino Messina, Italy
| | - Paola Gennari
- Neuroradiology and Neurology, 161157AOU Senese, Siena, Italy
| | - Rossana Tassi
- Neuroradiology and Neurology, 161157AOU Senese, Siena, Italy
| | - Mauro Bergui
- Interventional Neuroradiology Unit and Stroke Unit, Città della Salute e della Scienza-Molinette, Torino, Italy
| | - Paolo Cerrato
- Interventional Neuroradiology Unit and Stroke Unit, Città della Salute e della Scienza-Molinette, Torino, Italy
| | - Giuseppe Carità
- Neuroradiology and Neurology, Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | - Cristiano Azzini
- Neuroradiology and Neurology, Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | | | - Mauro Magoni
- Neuroradiology Unit and Stroke Unit, Spedali Civili, Brescia, Italy
| | - Salvatore Isceri
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center and Neuroradiology, Maggiore Hospital, Bologna, Italy
| | - Christian Commodaro
- Department of Neuroradiology, Neurology and Stroke Unit, Cesena-Forlì, AUSL Romagna Azienda Ospedaliera, Cesena, Italy
| | - Francesco Cordici
- Department of Neuroradiology, Neurology and Stroke Unit, Cesena-Forlì, AUSL Romagna Azienda Ospedaliera, Cesena, Italy
| | - Roberto Menozzi
- Neuroradiology Unit and Stroke Unit, Ospedale Universitario, Parma, Italy
| | - Lilia Latte
- Neuroradiology Unit and Stroke Unit, Ospedale Universitario, Parma, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery, 9310University of Pisa, Pisa, Italy
| | - Michelangelo Mancuso
- Department of Translational Research and New Technologies in Medicine and Surgery, 9310University of Pisa, Pisa, Italy
| | - Alessio Comai
- Radiology Unit and Stroke Unit, Ospedale Centrale, Bolzano, Italy
| | - Enrica Franchini
- Radiology Unit and Stroke Unit, Ospedale Centrale, Bolzano, Italy
| | - Andrea Alexandre
- Institute of Neuroradiology and Neurology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Giacomo Della Marca
- Institute of Neuroradiology and Neurology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy
| | | | | | - Francesco Causin
- Stroke Unit and Neurosonology Laboratory, Department of Neuroscience, University of Padua School of Medicine, Padua, Italy
| | - Claudio Baracchini
- Stroke Unit and Neurosonology Laboratory, Department of Neuroscience, University of Padua School of Medicine, Padua, Italy
| | - Luca Di Maggio
- Neuroradiology and Neurology, 18698Ospedale San Giovanni Bosco, Torino, Italy
| | - Andrea Naldi
- Neuroradiology and Neurology, 18698Ospedale San Giovanni Bosco, Torino, Italy
| | - Andrea Grazioli
- UOC Neuroradiologia, DAI Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Stefano Forlivesi
- UOC Neuroradiologia, DAI Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Luigi Chiumarulo
- Interventional Neuroradiology Unit and Stroke Unit, Policlinico, Bari, Italy
| | - Marco Petruzzellis
- Interventional Neuroradiology Unit and Stroke Unit, Policlinico, Bari, Italy
| | - Giuseppina Sanfilippo
- Diagnostic and Interventional Neuroradiology Unit and Stroke Unit, IRCCS Mondino Foundation San Matteo Hospital, Pavia, Italy
| | - Gianpaolo Toscano
- Diagnostic and Interventional Neuroradiology Unit and Stroke Unit, IRCCS Mondino Foundation San Matteo Hospital, Pavia, Italy
| | - Nicola Cavasin
- Neuroradiology Unit and Neurology Unit, Ospedale dell'Angelo, USSL3 Serenissima, Mestre, Italy
| | - Critelli Adriana
- Neuroradiology Unit and Neurology Unit, Ospedale dell'Angelo, USSL3 Serenissima, Mestre, Italy
| | - Maria Porzia Ganimede
- Interventional Radiology Unit and Stroke Unit, Ospedale SS. Annunziata, Taranto, Italy
| | - Maria Pia Prontera
- Interventional Radiology Unit and Stroke Unit, Ospedale SS. Annunziata, Taranto, Italy
| | - Andrea Giorgianni
- Neuroradiology Unit and Stroke Unit, Ospedale Universitario Circolo, ASST Sette Laghi, Varese, Italy
| | - Marco Mauri
- Neuroradiology Unit and Stroke Unit, Ospedale Universitario Circolo, ASST Sette Laghi, Varese, Italy
| | - William Auteri
- Interventional Neuroradiology Unit and Neurology Unit, Azienda Ospedaliera Annunziata, Cosenza, Italy
| | - Alfredo Petrone
- Interventional Neuroradiology Unit and Neurology Unit, Azienda Ospedaliera Annunziata, Cosenza, Italy
| | - Carlo Cirelli
- Department of Human Neurosciences, Interventional Neuroradiology and Neurology, Università degli Studi di Roma Sapienza, Roma, Lazio, Italy
| | - Anne Falcou
- Department of Human Neurosciences, Interventional Neuroradiology and Neurology, Università degli Studi di Roma Sapienza, Roma, Lazio, Italy
| | - Simona Corraine
- Neuroscience Department, Azienda Ospedaliera G. Brotzu, Cagliari, Sardinia, Italy
| | - Valeria Piras
- Neuroscience Department, Azienda Ospedaliera G. Brotzu, Cagliari, Sardinia, Italy
| | - Giuseppe Ganci
- Neuroradiology Unit and Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | - Tiziana Tassinari
- Neuroradiology Unit and Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | | | - Manuel Corato
- IRCCS Humanitas Clinical and Research Center, Rozzano, Milano, Italy
| | - Simona Sacco
- Department of Clinical Scieces and Biotechnology, Presidio Ospedaliero SS. Filippo e Nicola, Avezzano, Italy
| | - Guido Squassina
- Neuroradiology Unit and Stroke Unit, Spedali Civili, Brescia, Italy
| | - Paolo Invernizzi
- Neuroradiology Unit and Stroke Unit, Spedali Civili, Brescia, Italy
| | - Ivan Gallesio
- Department of Radiology and Neuroradiological Unit, Department of Neurology, Azienda ospedaliera "SS Antonio e Biagio e C. Arrigo," Alessandria, Italy
| | - Delfina Ferrandi
- Department of Radiology and Neuroradiological Unit, Department of Neurology, Azienda ospedaliera "SS Antonio e Biagio e C. Arrigo," Alessandria, Italy
| | - Giovanni Dui
- Radiology and Interventional Radiology Unit and Neurology Unit, 97998Ospedale San Francesco, Nuoro, Italy
| | - Gianluca Deiana
- Radiology and Interventional Radiology Unit and Neurology Unit, 97998Ospedale San Francesco, Nuoro, Italy
| | - Pietro Amistà
- Department of Neuroradiology and Neurology, Hospital of Rovigo, Rovigo, Italy
| | - Monia Russo
- Department of Neuroradiology and Neurology, Hospital of Rovigo, Rovigo, Italy
| | - Francesco Pintus
- Unit of Neuroradiology and Stroke Unit, Santissima Annunziata Hospital, Sassari, Italy
| | - Antonio Baule
- Unit of Neuroradiology and Stroke Unit, Santissima Annunziata Hospital, Sassari, Italy
| | - Giuseppe Craparo
- Department of Neuroradiology and Neurology, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | - Marina Mannino
- Department of Neuroradiology and Neurology, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | - Lucio Castellan
- IRCCS San Martino Policlinic Hospital, Neuroradiology and Neurology, Genoa, Italy
| | - Danilo Toni
- Emergency Department Stroke Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Salvatore Mangiafico
- Interventional Neurovascular Unit and Stroke Unit, Ospedale Careggi-University Hospital, Firenze, Italy
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20
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De Icco R, Putortì A, De Paoli I, Ferrara E, Cremascoli R, Terzaghi M, Toscano G, Allena M, Martinelli D, Cosentino G, Grillo V, Colagiorgio P, Versino M, Manni R, Sances G, Sandrini G, Tassorelli C. Anodal transcranial direct current stimulation in chronic migraine and medication overuse headache: A pilot double-blind randomized sham-controlled trial. Clin Neurophysiol 2020; 132:126-136. [PMID: 33271482 DOI: 10.1016/j.clinph.2020.10.014] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/14/2020] [Accepted: 10/01/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Little evidence is available on the role of transcranial direct current stimulation (tDCS) in patients affected by chronic migraine (CM) and medication overuse headache (MOH). We aim to investigate the effects of tDCS in patients with CM and MOH as well as its role on brain activity. METHODS Twenty patients with CM and MOH were hospitalized for a 7-day detoxification treatment. Upon admission, patients were randomly assigned to anodal tDCS or sham stimulation delivered over the primary motor cortex contralateral to the prevalent migraine pain side every day for 5 days. Clinical data were recorded at baseline (T0), after 1 month (T2) and 6 months (T3). EEG recording was performed at T0, at the end of the tDCS/Sham treatment, and at T2. RESULTS At T2 and T3, we found a significant reduction in monthly migraine days (p = 0.001), which were more pronounced in the tDCS group when compared to the sham group (p = 0.016). At T2, we found a significant increase of alpha rhythm in occipital leads, which was significantly higher in tDCS group when compared to sham group. CONCLUSIONS tDCS showed adjuvant effects to detoxification in the management of patients with CM and MOH. The EEG recording showed a significant potentiation of alpha rhythm, which may represent a correlate of the underlying changes in cortico-thalamic connections. SIGNIFICANCE This study suggests a possible role for tDCS in the treatment of CM and MOH. The observed clinical improvement is coupled with a potentiation of EEG alpha rhythm.
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Affiliation(s)
- R De Icco
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - A Putortì
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - I De Paoli
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - E Ferrara
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - R Cremascoli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - M Terzaghi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - G Toscano
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stroke Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - M Allena
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - D Martinelli
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - G Cosentino
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - V Grillo
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - P Colagiorgio
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - M Versino
- Neurology and Stroke Unit, Circolo Hospital and Macchi Foundation, Varese, Italy; DMC Department, Insubria University, Varese, Italy
| | - R Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - G Sances
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - G Sandrini
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - C Tassorelli
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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21
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Toscano G, Palmerini F, Ravaglia S, Ruiz L, Invernizzi P, Cuzzoni MG, Franciotta D, Baldanti F, Daturi R, Postorino P, Cavallini A, Micieli G. Guillain-Barré Syndrome Associated with SARS-CoV-2. N Engl J Med 2020; 382:2574-2576. [PMID: 32302082 PMCID: PMC7182017 DOI: 10.1056/nejmc2009191] [Citation(s) in RCA: 927] [Impact Index Per Article: 231.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | | | | | - Luigi Ruiz
- Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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22
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Fedrigo M, Bottigliengo D, Romano A, Gugole E, Bocca T, Vescovo G, Castellani C, Bottio T, Bottio T, Toscano G, Nocco A, Benazzi E, Basso C, Gerosa G, Tona F, Gregori D, Angelini A. Clinical Relevance of Vasculitis in Heart Transplant. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1252] [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] Open
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23
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Postuma RB, Iranzo A, Hu M, Högl B, Boeve BF, Manni R, Oertel WH, Arnulf I, Ferini-Strambi L, Puligheddu M, Antelmi E, Cochen De Cock V, Arnaldi D, Mollenhauer B, Videnovic A, Sonka K, Jung KY, Kunz D, Dauvilliers Y, Provini F, Lewis SJ, Buskova J, Pavlova M, Heidbreder A, Montplaisir JY, Santamaria J, Barber TR, Stefani A, St Louis EK, Terzaghi M, Janzen A, Leu-Semenescu S, Plazzi G, Nobili F, Sixel-Doering F, Dusek P, Bes F, Cortelli P, Ehgoetz Martens K, Gagnon JF, Gaig C, Zucconi M, Trenkwalder C, Gan-Or Z, Lo C, Rolinski M, Mahlknecht P, Holzknecht E, Boeve AR, Teigen LN, Toscano G, Mayer G, Morbelli S, Dawson B, Pelletier A. Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study. Brain 2020; 142:744-759. [PMID: 30789229 PMCID: PMC6391615 DOI: 10.1093/brain/awz030] [Citation(s) in RCA: 535] [Impact Index Per Article: 133.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 11/06/2018] [Accepted: 11/09/2018] [Indexed: 12/27/2022] Open
Abstract
Idiopathic REM sleep behaviour disorder (iRBD) is a powerful early sign of Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. This provides an unprecedented opportunity to directly observe prodromal neurodegenerative states, and potentially intervene with neuroprotective therapy. For future neuroprotective trials, it is essential to accurately estimate phenoconversion rate and identify potential predictors of phenoconversion. This study assessed the neurodegenerative disease risk and predictors of neurodegeneration in a large multicentre cohort of iRBD. We combined prospective follow-up data from 24 centres of the International RBD Study Group. At baseline, patients with polysomnographically-confirmed iRBD without parkinsonism or dementia underwent sleep, motor, cognitive, autonomic and special sensory testing. Patients were then prospectively followed, during which risk of dementia and parkinsonsim were assessed. The risk of dementia and parkinsonism was estimated with Kaplan-Meier analysis. Predictors of phenoconversion were assessed with Cox proportional hazards analysis, adjusting for age, sex, and centre. Sample size estimates for disease-modifying trials were calculated using a time-to-event analysis. Overall, 1280 patients were recruited. The average age was 66.3 ± 8.4 and 82.5% were male. Average follow-up was 4.6 years (range = 1-19 years). The overall conversion rate from iRBD to an overt neurodegenerative syndrome was 6.3% per year, with 73.5% converting after 12-year follow-up. The rate of phenoconversion was significantly increased with abnormal quantitative motor testing [hazard ratio (HR) = 3.16], objective motor examination (HR = 3.03), olfactory deficit (HR = 2.62), mild cognitive impairment (HR = 1.91-2.37), erectile dysfunction (HR = 2.13), motor symptoms (HR = 2.11), an abnormal DAT scan (HR = 1.98), colour vision abnormalities (HR = 1.69), constipation (HR = 1.67), REM atonia loss (HR = 1.54), and age (HR = 1.54). There was no significant predictive value of sex, daytime somnolence, insomnia, restless legs syndrome, sleep apnoea, urinary dysfunction, orthostatic symptoms, depression, anxiety, or hyperechogenicity on substantia nigra ultrasound. Among predictive markers, only cognitive variables were different at baseline between those converting to primary dementia versus parkinsonism. Sample size estimates for definitive neuroprotective trials ranged from 142 to 366 patients per arm. This large multicentre study documents the high phenoconversion rate from iRBD to an overt neurodegenerative syndrome. Our findings provide estimates of the relative predictive value of prodromal markers, which can be used to stratify patients for neuroprotective trials.
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Affiliation(s)
- Ronald B Postuma
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada.,Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada
| | - Alex Iranzo
- Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Michele Hu
- Oxford Parkinson's Disease Centre (OPDC) and Oxford University, Oxford, UK
| | - Birgit Högl
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS, C.Mondino Foundation, Pavia, Italy
| | | | - Isabelle Arnulf
- Sleep disorders unit, Pitie-Salpetriere Hospital, IHU@ICM and Sorbonne University, Paris, France
| | - Luigi Ferini-Strambi
- Sleep Disorders Center, Department of Neurology, Scientific Institute Ospedale San Raffaele, Vita-Salute University, Milan, Italy
| | - Monica Puligheddu
- Sleep Center, Department of Cardiovascular and Neurological Sciences, University of Cagliari, Italy
| | - Elena Antelmi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Institute of the Neurological Sciences, Ospedale Bellaria, ASL di Bologna, Bologna, Italy
| | - Valerie Cochen De Cock
- Sleep and Neurology Unit, Beau Soleil Clinic, Montpellier, France; EuroMov, University of Montpellier, Montpellier, France
| | - Dario Arnaldi
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, and Polyclinic San Martino Hospital, Genoa, Italy
| | - Brit Mollenhauer
- Department of Neurosurgery (C.T.) University Medical Center, Göttingen; Paracelsus-Elena-Klinik (B.M., C.T. F. S-D.), Kassel, Germany
| | - Aleksandar Videnovic
- Movement Disorders Unit and Division of Sleep Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Karel Sonka
- Department of Neurology and Centre of Clinical Neurosciences of the First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ki-Young Jung
- Neuroscience Research Institute, Seoul National University College of Medicine, Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Dieter Kunz
- Institute of Physiology Charité-Universitätsmedizin Berlin. Germany
| | - Yves Dauvilliers
- Sleep Unit, Department of Neurology, Hôpital Gui de Chauliac, Montpellier, INSERM U1061, Montpellier, F-34093 Cedex 5 France
| | - Federica Provini
- Department of Biomedical and Neuromotor Sciences, Bellaria Hospital, University of Bologna, Bologna, Italy.,IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Simon J Lewis
- Brain and Mind Centre University of Sydney, Camperdown, Australia
| | - Jitka Buskova
- National Institute of Mental Health, Klecany, Third Faculty of Medicine, Charles Unviersity, Prague, Czech Republic
| | - Milena Pavlova
- Department of Neurology, Brigham and Women's Hospital, Boston; Harvard Medical School, Boston, USA
| | - Anna Heidbreder
- Institute for Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Muenster, Germany
| | - Jacques Y Montplaisir
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada
| | - Joan Santamaria
- Sleep and Neurology Unit, Beau Soleil Clinic, Montpellier, France; EuroMov, University of Montpellier, Montpellier, France
| | - Thomas R Barber
- Oxford Parkinson's Disease Centre (OPDC) and Oxford University, Oxford, UK
| | - Ambra Stefani
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Michele Terzaghi
- Unit of Sleep Medicine and Epilepsy, IRCCS, C.Mondino Foundation, Pavia, Italy
| | - Annette Janzen
- Department of Neurology, Philipps-Universität, Marburg, Germany
| | - Smandra Leu-Semenescu
- Sleep disorders unit, Pitie-Salpetriere Hospital, IHU@ICM and Sorbonne University, Paris, France
| | - Guiseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Institute of the Neurological Sciences, Ospedale Bellaria, ASL di Bologna, Bologna, Italy
| | - Flavio Nobili
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, and Polyclinic San Martino Hospital, Genoa, Italy
| | - Friederike Sixel-Doering
- Department of Neurosurgery (C.T.) University Medical Center, Göttingen; Paracelsus-Elena-Klinik (B.M., C.T. F. S-D.), Kassel, Germany
| | - Petr Dusek
- Department of Neurology and Centre of Clinical Neurosciences of the First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Frederik Bes
- Institute of Physiology Charité-Universitätsmedizin Berlin. Germany
| | - Pietro Cortelli
- Department of Biomedical and Neuromotor Sciences, Bellaria Hospital, University of Bologna, Bologna, Italy.,IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | | | - Jean-Francois Gagnon
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Carles Gaig
- Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Marco Zucconi
- Sleep Disorders Center, Department of Neurology, Scientific Institute Ospedale San Raffaele, Vita-Salute University, Milan, Italy
| | - Claudia Trenkwalder
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, and Polyclinic San Martino Hospital, Genoa, Italy
| | - Ziv Gan-Or
- Department of Human Genetics, McGill University, Montreal, Canada.,Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Christine Lo
- Oxford Parkinson's Disease Centre (OPDC) and Oxford University, Oxford, UK
| | - Michal Rolinski
- Oxford Parkinson's Disease Centre (OPDC) and Oxford University, Oxford, UK
| | - Philip Mahlknecht
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Evi Holzknecht
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | | | | | - Gianpaolo Toscano
- Unit of Sleep Medicine and Epilepsy, IRCCS, C.Mondino Foundation, Pavia, Italy
| | - Geert Mayer
- Department of Neurology, Hephata Klinik, Schwalmstadt-Treysa, Germany
| | - Silvia Morbelli
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa and Polyclinic San Martino Hospital, Genoa, Italy
| | - Benjamin Dawson
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada
| | - Amelie Pelletier
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada.,Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada
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24
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Toscano G, Carboni M, Rubega M, Spinelli L, Pittau F, Bartoli A, Momjian S, Manni R, Terzaghi M, Vulliemoz S, Seeck M. Visual analysis of high density EEG: As good as electrical source imaging? Clin Neurophysiol Pract 2019; 5:16-22. [PMID: 31909306 PMCID: PMC6939057 DOI: 10.1016/j.cnp.2019.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 09/19/2019] [Accepted: 09/29/2019] [Indexed: 11/29/2022] Open
Abstract
Visual analysis of HD-EEG is an excellent tool to explore the epileptogenic focus. ESI remains the gold standard for presurgical evaluation of the cortical source. ESI at 50% slope/ESI at peak discordance could predict worse surgical outcome.
Objective In this study, we sought to determine whether visual analysis of high density EEG (HD-EEG) would provide similar localizing information comparable to electrical source imaging (ESI). Methods HD-EEG (256 electrodes) recordings from 20 patients suffering from unifocal, drug-resistant epilepsy (13 women, mean age 29.1 ± 2.62 years, 11 with temporal lobe epilepsy) were examined. In the visual analysis condition, we identified the 5 contacts with maximal spike amplitude and determined their localization with respect to the underlying cortex. ESI was computed using the LAURA algorithm of the averaged spikes in the patient’s individual MRI. We considered the localization “correct” if all 5 contacts were concordant with the resection volume underneath or if ESI was located within the resection as determined by the postoperative MRI. Results Twelve patients were postoperatively seizure-free (Engel Class IA), while the remaining eight were in class IB to IV. Visual analysis and ESI showed sensitivity of 58% and 75%, specificity of 75% and 87%, and accuracy of 65% and 80%, respectively. In 70% of cases, visual analysis and ESI provided concordant results. Conclusions Localization of the electrodes with maximal spike amplitude provides very good estimation of the localization of the underlying source. However, ESI has a higher accuracy and adds 3D information; therefore, it should remain the tool of choice for presurgical evaluation. Significance The present study proposes the possibility to analyze HD-EEG visually, in tandem with ESI or alone, if ESI is not accessible.
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Affiliation(s)
- Gianpaolo Toscano
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland.,Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Italy
| | - Margherita Carboni
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland.,Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Maria Rubega
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Laurent Spinelli
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland
| | - Francesca Pittau
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland
| | - Andrea Bartoli
- Department of Neurosurgery, University Hospital of Geneva, Geneva, Switzerland
| | - Shahan Momjian
- Department of Neurosurgery, University Hospital of Geneva, Geneva, Switzerland
| | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - Michele Terzaghi
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Italy
| | - Serge Vulliemoz
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland
| | - Margitta Seeck
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland
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25
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Carboni M, Rubega M, Iannotti GR, De Stefano P, Toscano G, Tourbier S, Pittau F, Hagmann P, Momjian S, Schaller K, Seeck M, Michel CM, van Mierlo P, Vulliemoz S. The network integration of epileptic activity in relation to surgical outcome. Clin Neurophysiol 2019; 130:2193-2202. [PMID: 31669753 DOI: 10.1016/j.clinph.2019.09.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/21/2019] [Accepted: 09/12/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Epilepsy is a network disease with epileptic activity and cognitive impairment involving large-scale brain networks. A complex network is involved in the seizure and in the interictal epileptiform discharges (IEDs). Directed connectivity analysis, describing the information transfer between brain regions, and graph analysis are applied to high-density EEG to characterise networks. METHODS We analysed 19 patients with focal epilepsy who had high-density EEG containing IED and underwent surgery. We estimated cortical activity during IED using electric source analysis in 72 atlas-based cortical regions of the individual brain MRI. We applied directed connectivity analysis (information Partial Directed Coherence) and graph analysis on these sources and compared patients with good vs poor post-operative outcome at global, hemispheric and lobar level. RESULTS We found lower network integration reflected by global, hemispheric, lobar efficiency during the IED (p < 0.05) in patients with good post-surgical outcome, compared to patients with poor outcome. Prediction was better than using the IED field or the localisation obtained by electric source imaging. CONCLUSIONS Abnormal network patterns in epilepsy are related to seizure outcome after surgery. SIGNIFICANCE Our finding may help understand networks related to a more "isolated" epileptic activity, limiting the extent of the epileptic network in patients with subsequent good post-operative outcome.
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Affiliation(s)
- M Carboni
- EEG and Epilepsy, Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland; Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland.
| | - M Rubega
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - G R Iannotti
- EEG and Epilepsy, Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland; Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland; Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - P De Stefano
- EEG and Epilepsy, Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - G Toscano
- EEG and Epilepsy, Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland; Unit of Sleep Medicine and Epilepsy, C. Mondino National Neurological Institute, Pavia, Italy
| | - S Tourbier
- Connectomics Lab, Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - F Pittau
- EEG and Epilepsy, Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - P Hagmann
- Connectomics Lab, Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - S Momjian
- Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - K Schaller
- Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - M Seeck
- EEG and Epilepsy, Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - C M Michel
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - P van Mierlo
- EEG and Epilepsy, Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland; Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - S Vulliemoz
- EEG and Epilepsy, Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland.
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26
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Terzaghi M, Toscano G, Casoni F, Picascia M, Arnaldi D, Rustioni V, Versino M, Sinforiani E, Manni R. Assessment of cognitive profile as a prodromal marker of the evolution of rapid eye movement sleep behavior disorder. Sleep 2019; 42:5477298. [DOI: 10.1093/sleep/zsz103] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/26/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study Objectives
To search for a specific neuropsychological profile in idiopathic REM sleep behavior disorder (iRBD), able to predict the onset of neurodegenerative disorders.
Methods
In a longitudinal follow-up study of 63 consecutive iRBD patients (follow-up duration 6.7 ± 3.8 years), the baseline cognitive profile of converters to neurodegenerative disease was compared with that of the nonconverters. Five cognitive domains were assessed: memory, attention-working memory, executive functions, visuospatial abilities, language. Mild cognitive impairment (MCI) was diagnosed according to the Movement Disorder Society’s diagnostic criteria for Parkinson’s disease.
Results
30 subjects (47.6%) developed a neurodegenerative disease (latency to conversion 60.33 ± 44.81 months). MCI was found in 50% of the converters and 12% of the nonconverters (p = .001), and its presence conferred a neurodegenerative disease risk of 10% at 3 years, 36% at 5 years, and 73% at 10 years (p = .002). Pathological equivalent scores on at least one neuropsychological test were detected in 46.7% of the converters versus 21.2% of the nonconverters in the memory domain (p = .032), in 40.0% versus 6.1% in that of executive functions (p = .002), and in 20.0% versus 3% in the visuospatial abilities domain (p = .047). On multivariate analysis, impaired executive functions significantly correlated with phenoconversion (p = .018). Lower Mini Mental State Examination (MMSE) scores (p = .004) and memory deficits (p = .031) were found in patients who developed dementia first.
Conclusions
Cognitive profile is useful for stratifying risk of phenoconversion in patients with iRBD. The presence of MCI and impaired executive functions, memory, and visuospatial abilities discriminated the converters. Lower MMSE scores and memory deficits may characterize those subjects who first develop dementia.
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Affiliation(s)
- Michele Terzaghi
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Gianpaolo Toscano
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesca Casoni
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marta Picascia
- Laboratory of Neuropsychology/Alzheimer’s Disease Assessment Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Dario Arnaldi
- Clinical Neurology, DINOGMI, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Valter Rustioni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Maurizio Versino
- DMC University of Insubria, ASST Sette laghi Ospedale di Circolo, Varese, Italy
| | - Elena Sinforiani
- Laboratory of Neuropsychology/Alzheimer’s Disease Assessment Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
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Rubega M, Carboni M, Seeber M, Pascucci D, Tourbier S, Toscano G, Van Mierlo P, Hagmann P, Plomp G, Vulliemoz S, Michel CM. Estimating EEG Source Dipole Orientation Based on Singular-value Decomposition for Connectivity Analysis. Brain Topogr 2018; 32:704-719. [PMID: 30511174 DOI: 10.1007/s10548-018-0691-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 11/29/2018] [Indexed: 12/14/2022]
Abstract
In the last decade, the use of high-density electrode arrays for EEG recordings combined with the improvements of source reconstruction algorithms has allowed the investigation of brain networks dynamics at a sub-second scale. One powerful tool for investigating large-scale functional brain networks with EEG is time-varying effective connectivity applied to source signals obtained from electric source imaging. Due to computational and interpretation limitations, the brain is usually parcelled into a limited number of regions of interests (ROIs) before computing EEG connectivity. One specific need and still open problem is how to represent the time- and frequency-content carried by hundreds of dipoles with diverging orientation in each ROI with one unique representative time-series. The main aim of this paper is to provide a method to compute a signal that explains most of the variability of the data contained in each ROI before computing, for instance, time-varying connectivity. As the representative time-series for a ROI, we propose to use the first singular vector computed by a singular-value decomposition of all dipoles belonging to the same ROI. We applied this method to two real datasets (visual evoked potentials and epileptic spikes) and evaluated the time-course and the frequency content of the obtained signals. For each ROI, both the time-course and the frequency content of the proposed method reflected the expected time-course and the scalp-EEG frequency content, representing most of the variability of the sources (~ 80%) and improving connectivity results in comparison to other procedures used so far. We also confirm these results in a simulated dataset with a known ground truth.
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Affiliation(s)
- M Rubega
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Campus Biotech, Chemin des Mines 9, 1202, Geneva, Switzerland.
| | - M Carboni
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Campus Biotech, Chemin des Mines 9, 1202, Geneva, Switzerland.,EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland
| | - M Seeber
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Campus Biotech, Chemin des Mines 9, 1202, Geneva, Switzerland
| | - D Pascucci
- Perceptual Networks Group, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - S Tourbier
- Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - G Toscano
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland.,Unit of Sleep Medicine and Epilepsy, C. Mondino National Neurological Institute, Pavia, Italy
| | - P Van Mierlo
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland.,Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - P Hagmann
- Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - G Plomp
- Perceptual Networks Group, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - S Vulliemoz
- EEG and Epilepsy Unit, University Hospital of Geneva, Geneva, Switzerland
| | - C M Michel
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Campus Biotech, Chemin des Mines 9, 1202, Geneva, Switzerland.,Lemanic Biomedical Imaging Centre (CIBM), Lausanne, Geneva, Switzerland
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28
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Russo A, Battaglia A, Provazza G, Lo Certo G, Ricciardi G, Picciotto M, Scimone A, Toscano G, Adamo V, Franchina T. P1.04-28 Baseline Markers of Inflammation and Outcome with Nivolumab in Pretreated Non Small Cell Lung Cancers: A Retrospective Study. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.743] [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: 10/28/2022]
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29
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Russo A, Franchina T, Ricciardi GRR, Toscano G, Schifano S, Lo Certo G, Battaglia A, Pantò E, Scaffidi Fonti M, Adamo V. The changing scenario of 1 st line therapy in non-oncogene addicted NSCLCs in the era of immunotherapy. Crit Rev Oncol Hematol 2018; 130:1-12. [PMID: 30196906 DOI: 10.1016/j.critrevonc.2018.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/23/2018] [Accepted: 06/13/2018] [Indexed: 11/27/2022] Open
Abstract
During the last two decades front-line treatment of metastatic Non Small Cell Lung Cancer (NSCLC) has profoundly changed moving from the old "one size fits all" concept to a "histology-based" approach and then, for a small subgroup of patients to a "molecularly-selected" one. The development of immune checkpoint inhibitors and the unprecedented results reported in 2nd/3rd line prompted the evaluation of these novel therapeutic agents in chemotherapy-naïve patients either alone or in combination with platinum-based chemotherapy. Several randomized trials are evaluating the impact of immune-checkpoint inhibitors in 1st line and some of them have yet produced preliminary evidence of efficacy. However, still a long way to go and several questions are still unanswered, including proper patients selection, optimal sequential/combinatorial use of these agents, appropriate treatment duration, and finally the identification of predictive biomarkers. The aim of this paper is to provide a comprehensive overview on the growing role of immune checkpoint inhibitors in the upfront treatment of advanced non-oncogene addicted NSCLC either as single agent or in combination with other agents.
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Affiliation(s)
- A Russo
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - T Franchina
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - G R R Ricciardi
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - G Toscano
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - S Schifano
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - G Lo Certo
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - A Battaglia
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - E Pantò
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - M Scaffidi Fonti
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy
| | - V Adamo
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy.
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30
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Carboni M, Toscano G, Seeck M. Bildgebung: elektrische EEG-Quellenanalyse. KLIN NEUROPHYSIOL 2018. [DOI: 10.1055/s-0043-125302] [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: 10/14/2022]
Abstract
ZusammenfassungQuellenanalyse auf der Basis von Skalp-EEG, idealerweise von hochauflösendem EEG, hat sich etabliert als ein bildgebendes Medium, welches bestehende Verfahren ergänzt. Im Gegensatz zu anderen Techniken kann EEG-basierte Bildgebung die Quelle der neuronalen Aktivität millisekundengenau zu diesem Zeitpunkt abbilden, d.h es handelt sich nicht um indirekte Korrelate der elektrischen Aktivität wie Blutfluss oder Glucosekonsum. Prospektive Studien konnten zeigen, dass Quellenanalyse in einer Mehrheit der Patienten, die sich einer epilepsiechirugischen Therapie unterzogen, den Fokus korrekt im strukturellen MRI des Patienten lokalisiert. Bis dato konnte dies in mehreren Hundert Patienten gezeigt werden: die Wahrscheinlichkeit, nach einer resektiven Intervention anfallsfrei zu sein, ist 10 x höher wenn die elektrische Quelle zusammen mit der strukturellen Anomalie reseziert wurde als wenn dies nicht der Fall war. Studien in operierten Patienten und/oder mit intrakraniellem EEG konnten zeigen, dass es eine hohe Konkordanz zwischen der errechneten Quelle und dem intrakraniellem Fokus gibt. Weitere Anwendungen finden sich in der Lokalisierung von vitalem Kortex mithilfe von evozierten Potenzialen. Insgesamt ist die EEG-basierte Bildgebung relativ einfach zu akquirieren, kann auch bei Kindern und anderen Personen mit begrenzter Kollaboration durchgeführt werden, kann mit fMRI kombiniert werden und ist, vergleichen mit anderen Bildgebungsverfahren, relativ billig. Mögliche zukünftige Anwendungen betreffen die Ermittelung von epileptogener Aktivität bei vermeindlich normalem EEG und Netzwerkanalysen sowie die Netzwerk-Dysfunktionen in anderen neurologischen und psychiatrischen Erkrankungen.
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Affiliation(s)
| | - Gianpaolo Toscano
- EEG & Epilepsy Unit, Hôpital Universitaire Genève, Schweiz
- IRCCS Istituto Neurologico Mondino, Italien
| | - Margitta Seeck
- EEG & Epilepsy Unit, Hôpital Universitaire Genève, Schweiz
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31
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32
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Toscano G, Carboni M, Rubega M, Manni R, Vulliémoz S, Seeck M. F180. The effectiveness of high-density EEG visual analysis and electrical source imaging in detecting the epileptogenic zone in focal epilepsy. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.343] [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: 11/27/2022]
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33
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Maisano R, Caristi N, Toscano G, Aragona M, Spadaro P, Amadio P, Mare M, Zavettieri M, La Torre F. Oxaliplatin and Raltitrexed in the Treatment of Inoperable Malignant Pleural Mesothelioma: Results of a Pilot Study. Tumori 2018; 87:391-3. [PMID: 11989592 DOI: 10.1177/030089160108700607] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 11/16/2022]
Abstract
Aims and Background The treatment of inoperable malignant pleural mesothelioma is a challenge for the oncologist. Available chemotherapy regimens achieve poor results, therefore new agents or combinations are needed. In a phase I study, the combination of oxaliplatin and raltitrexed was shown to be active against malignant pleural mesothelioma. We herein report the results of a pilot study about the treatment of this disease. Methods From April 1999 to June 2000, we enrolled 11 chemotherapy-naïve patients with inoperable malignant pleural mesothelioma suitable to receive the following combination chemotherapy: raltitrexed, 3 mg/m2 iv, and oxaliplatin, 130 mg/m2, as a 2-hr infusion every 3 weeks. Results Four partial responses, 1 regression of disease (objective response rate, 45%; 95% Cl, 15.6-74.4%), 4 stable diseases and 2 progressions of disease were observed. An improvement in disease-related symptoms was recorded in all responders and in 2 patients with stable disease. Toxicity was mild, with no toxic-related death and only 1 episode of grade 4 neurotoxicity. Conclusions We consider the combination promising and worthy of further studies.
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Affiliation(s)
- R Maisano
- IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Messina, Italy.
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34
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Bretti S, Berruti A, Dogliotti L, Castagneto B, Bertulli R, Spadaro P, Toscano G, Astorre P, Verusio C, Lionetto R, Bruzzi P, Santoro A. Combined Epirubicin and Interleukin-2 Regimen in the Treatment of Malignant Mesothelioma: A Multicenter Phase II Study of the Italian Group on Rare Tumors. Tumori 2018; 84:558-61. [PMID: 9862516 DOI: 10.1177/030089169808400509] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 11/16/2022]
Abstract
The Italian Group on Rare Tumors undertook a phase II study of a combination of epirubicin and interleukin-2 in 21 chemotherapy-naive patients with malignant mesothelioma. All patients had bidimensionally measurable disease at CT scan. Treatment included intravenous administration of epirubicin at a dose of 110 mg/m2 i.v. on day 1, and interleukin-2 at a dose of 9 MU subcutaneously from day 8 to day 12 and from day 15 to day 19. Cycles were repeated every three weeks, up to six times in the absence of progressive disease. Treatment response was evaluated after two cycles of therapy. Only one patient achieved a partial response, resulting in an overall response rate of 5% (1/21) with a median progression-free and overall survival of 5 and 10 months, respectively. Toxicity was relevant and caused treatment discontinuation in many patients. These results do not support the use of such a combination in the management of malignant mesothelioma.
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Affiliation(s)
- S Bretti
- Divisione di Oncologia Medica, Ospedale Oncologico S. Giovanni A.S., Torino, Italy
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Di Francesco A, Fedrigo M, Santovito D, De Pascale F, Castellani C, Toscano G, Feltrin G, Fraiese A, Nocco A, Benazzi E, Thiene G, Valle G, Schober A, Gerosa G, Angelini A. MicroRNAs Signature in Heart Transplant Enhances Diagnosis of Different Types of Acute Rejection. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.078] [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] Open
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36
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Carrozzini M, Bejko J, Comisso M, Toto F, Toscano G, Tarzia V, Gambino A, Cozzi E, Gregori D, Bottio T, Gerosa G. Impact of Continuous Flow Left Ventricular Assist Device on Graft Rejection and Donor-specific Antibodies Development After Heart Transplant. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.966] [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] Open
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37
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Fedrigo M, Romano A, Bottio T, Toscano G, Di Francesco A, Feltrin G, Castellani C, Zanco F, Fraiese A, Veronesi A, De Silvestro G, Nocco A, Benazzi E, Gerosa G, Thiene G, Angelini A. Vasculitis in Post-Heart Transplant Endomyocardial Biopsy: Possible Relationship with Mixed Rejection, Circulating Donor Specific Antibodies and Worse Outcome. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.767] [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: 11/29/2022] Open
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38
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Russo A, Scimone A, Picciotto M, Toscano G, Raiti F, Sava S, Battaglia A, Adamo V. Baseline absolute neutrophil count (ANC), derived neutrophil-to-lymphocyte ratio (dNLR) and platelet-to-lymphocyte ratio (PLR) and outcome in non small cell lung cancer (NSCLC) treated with nivolumab or docetaxel: a preliminary analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Cremascoli R, De Icco R, Toscano G, Terzaghi M, Manni R. Social Jet Lag in epilepsy: its entity and features in a clinical series of adult patients. Sleep Med 2017; 32:269. [DOI: 10.1016/j.sleep.2016.07.029] [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] [Received: 05/21/2016] [Revised: 07/15/2016] [Accepted: 07/18/2016] [Indexed: 11/28/2022]
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40
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Fedrigo M, Romano A, Di Francesco A, Castellani C, Fraiese A, Toscano G, Feltrin G, Nocco A, Benazzi E, Veronesi A, Thiene G, Gerosa G, Angelini A. Is Vasculitis on Endomyocardial Biopsies a Marker of Circulating Donor Specific Antibodies in Adult Heart Transplanted Patients? J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1276] [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: 10/19/2022] Open
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41
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Di Francesco A, Fedrigo M, De Pascale F, Castellani C, Feltrin G, Toscano G, Fraiese A, Benazzi E, Nocco A, Thiene G, Valente M, Gerosa G, Valle G, Angelini A. Identification of MicroRNA Expression Profile of Different Types of Rejection During the First Year After Heart Transplantation with Next Generation Sequencing Technology. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.759] [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: 11/16/2022] Open
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42
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Romero MJA, Pizzi A, Toscano G, Busca G, Bosio B, Arato E. Deoxygenation of waste cooking oil and non-edible oil for the production of liquid hydrocarbon biofuels. Waste Manag 2016; 47:62-8. [PMID: 25869843 DOI: 10.1016/j.wasman.2015.03.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 01/14/2015] [Revised: 03/19/2015] [Accepted: 03/22/2015] [Indexed: 05/25/2023]
Abstract
Deoxygenation of waste cooking vegetable oil and Jatropha curcas oil under nitrogen atmosphere was performed in batch and semi-batch experiments using CaO and treated hydrotalcite (MG70) as catalysts at 400 °C. In batch conditions a single liquid fraction (with yields greater than 80 wt.%) was produced containing a high proportion of hydrocarbons (83%). In semi-batch conditions two liquid fractions (separated by a distillation step) were obtained: a light fraction and an intermediate fraction containing amounts of hydrocarbons between 72-80% and 85-88% respectively. In order to assess the possible use of the liquid products as alternative fuels a complete chemical characterization and measurement of their properties were carried out.
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Affiliation(s)
- M J A Romero
- DICCA, Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia, 15, 16145 Genoa, Italy.
| | - A Pizzi
- D3A, Department of Agricultural, Food and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 10, 60131 Ancona, Italy
| | - G Toscano
- D3A, Department of Agricultural, Food and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 10, 60131 Ancona, Italy
| | - G Busca
- DICCA, Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia, 15, 16145 Genoa, Italy
| | - B Bosio
- DICCA, Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia, 15, 16145 Genoa, Italy
| | - E Arato
- DICCA, Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia, 15, 16145 Genoa, Italy
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Russo A, Franchina T, Picone A, Raiti F, Ricciardi G, Franchina V, Ferraro G, Scimone A, Toscano G, Adamo V. Epidermal Growth Factor Receptor mutational status predicts patterns of metastatic spread in treatment-naïve Adenocarcinomas of the lung. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv343.44] [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: 11/14/2022] Open
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44
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Smiroldo V, Franchina T, Silvestro M, Chillari F, Provazza G, Toscano G, Chiofalo G, Adamo V. Changing incidence and clinical implications of bone metastases in colorectal cancer: a pooled analysis. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.26] [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: 11/14/2022] Open
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45
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Toscano G, Fabozzo A, Fedrigo M, Gambino A, Angelini A, Gerosa G. Post-transplant Lymphoproliferative Disorders: A Rare Case of Primary Pericardial Involvement Epstein-Barr Virus-Correlated in Heart Transplantation. Transplant Proc 2015; 47:2287-90. [PMID: 26361701 DOI: 10.1016/j.transproceed.2015.04.085] [Citation(s) in RCA: 2] [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] [Received: 03/25/2015] [Accepted: 04/15/2015] [Indexed: 11/18/2022]
Abstract
Post-transplant lymphoproliferative disorders (PTLDs) are considered a fatal consequence of immunosuppression. We report a case of a 52-year-old patient, who underwent a cardiac transplantation and presented undefined recurrent episodes of pleuropericardial effusions without lymphoadenomegaly at chest radiographs and computed tomography. Histopathological analysis of the bioptic pericardium showed a specific chronic inflammation. Monitoring endomyocardial biopsies (EMBs) showed only 1 episodes of greater than grade 2R acute cellular rejection requiring immunosuppressive treatment, mild vasculitis in 2 subsequently EMBs while constantly negative for antibody-mediated rejection or infection. Only a post-mortem examination demonstrated the presence of an aggressive acute non-Epstein-Barr virus (EBV)-related proliferative disorder with unusual primitive localization into the pericardium and with coronary epicardial and intramyocardial necrotizing vasculitis and superimposed occlusive and subocclusive thrombosis. Recurrence of unexplained early pleuropericardial effusion and mild intramyocardial vasculitis should raise the suspicion of PTLD requiring reduction of immunosuppression, even in the setting of negative intramyocardial cellular infiltrate and tissue EBV-negative molecular assessment.
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Affiliation(s)
- G Toscano
- Heart Transplant Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy.
| | - A Fabozzo
- Heart Transplant Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - M Fedrigo
- Pathological Anatomy, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | - A Gambino
- Heart Transplant Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - A Angelini
- Pathological Anatomy, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | - G Gerosa
- Heart Transplant Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
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Franchina T, Russo A, Picone A, Ricciardi G, Raiti F, Scimone A, Chiofalo G, Toscano G, Adamo V. Impact of Maintenance Pemetrexed in the Management of Non-Progressing Malignant Mesotheliomas After Standard Fist-Line Chemotherapy: a Single Institution Experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv052.05] [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: 11/13/2022] Open
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Perazzo A, Tomaiuolo G, Sicignano L, Toscano G, Meadows RE, Nolan SP, Guido S. A microfluidic approach for flexible and efficient operation of a cross-coupling reactive flow. RSC Adv 2015. [DOI: 10.1039/c5ra10971j] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Baldi E, Contri E, Somaschini A, Cornara S, Epis F, Zelaschi B, Fratino S, Bassi S, Fichtner F, Toscano G. Two minutes training with visual feedback significantly improves CPR quality in lay-rescuers. Resuscitation 2014. [DOI: 10.1016/j.resuscitation.2014.03.117] [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: 11/29/2022]
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Fedrigo M, Poli F, Esposito G, Feltrin G, Toscano G, d'Agostino C, Schiavon B, Gerosa G, Amadori A, Valente M, Thiene G, Angelini A. HLA-DRB1 typing by micro-bead array assay identifies the origin of early lymphoproliferative disorder in a heart transplant recipient. Am J Transplant 2013; 13:802-7. [PMID: 23331771 DOI: 10.1111/ajt.12063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 11/01/2012] [Accepted: 11/19/2012] [Indexed: 01/25/2023]
Abstract
We report the case of a 68-year-old woman who underwent heart transplantation for hypertrophic cardiomyopathy. Two months after the transplant she developed mild fever and dyspnea with a marked drop in left ventricle ejection fraction of 31%. Coronary angiography was negative for cardiac allograft vasculopathy. Endomyocardial biopsy revealed ischemic damage with no evidence of acute cellular rejection, antibody-mediated rejection or viral myocarditis. A neoplastic process was suspected even though full-body computerized tomography was negative for malignancy. The patient died 4 months after transplantation. The autopsy showed acute antero-septal myocardial infarction due to a nodular epicardial EBV-related posttransplant lymphoproliferative disorder (PTLD) infiltrating the left anterior descending coronary artery with occlusive neoplastic thrombosis. We highlight two major aspects of this case: (1) the unusual occurrence of early PTLD involving the cardiac allograft and causing a fatal outcome, (2) the application of an immunological technique for HLA-DRB1 typing to posttransplant paraffin-embedded autopsy material to identify the recipient origin of this early malignancy, thus excluding a possible donor-transmitted neoplasm.
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Affiliation(s)
- M Fedrigo
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
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Toscano G, Raza S, Xiao S, Wubs M, Jauho AP, Bozhevolnyi SI, Mortensen NA. Surface-enhanced Raman spectroscopy: nonlocal limitations. Opt Lett 2012; 37:2538-2540. [PMID: 22743447 DOI: 10.1364/ol.37.002538] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Giant field enhancement and field singularities are a natural consequence of the commonly employed local-response framework. We show that a more general nonlocal treatment of the plasmonic response leads to new and possibly fundamental limitations on field enhancement with important consequences for our understanding of surface-enhanced Raman spectroscopy (SERS). The intrinsic length scale of the electron gas serves to smear out assumed field singularities, leaving the SERS enhancement factor finite, even for geometries with infinitely sharp features. For silver nanogroove structures, mimicked by periodic arrays of half-cylinders (up to 120 nm in radius), we find no enhancement factors exceeding 10 orders of magnitude (10(10)).
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Affiliation(s)
- G Toscano
- Department of Photonics Engineering, Technical University of Denmark, DK-2800 Kgs. Lyngby, Denmark
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