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Giaccari LG, Mastria D, Barbieri R, De Maglio R, Madaro F, Paiano G, Pace MC, Sansone P, Pulito G, Mascia L. Bickerstaff encephalitis in childhood: a review of 74 cases in the literature from 1951 to today. Front Neurol 2024; 15:1387505. [PMID: 38533411 PMCID: PMC10963475 DOI: 10.3389/fneur.2024.1387505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Bickerstaff brainstem encephalitis (BBE) is a rare autoimmune disease characterized by the subacute onset of bilateral external ophthalmoplegia, ataxia, and decreased level of consciousness. BBE is part of a group of rare autoimmune diseases in children that can affect the nervous system at any level. The onset of neurological deficits is often sudden and nonspecific. The diagnosis is based on clinical findings and abnormal findings on cerebrospinal fluid (CSF), electroencephalography (EEG), electromyography (EMG), and magnetic resonance imaging (MRI). BBE is associated with the presence of the antiganglioside antibody, anti-GQ1b and anti-GM1. Intravenous immunoglobulin (IVIg) and plasma exchange are often used as treatments for these patients. We conducted a review on clinical presentation, diagnosis, treatment and outcome of reported cases of BBE. 74 cases are reported in the literature from the first cases described in 1951 to today. The prevalence is unknown while the incidence is higher in males. In 50% of cases, BBE occurs following respiratory or gastrointestinal tract infections. The most frequent initial symptoms were consciousness disturbance, headache, vomiting, diplopia, gait disturbance, dysarthria and fever. During illness course, almost all the patients developed consciousness disturbance, external ophthalmoplegia, and ataxia. Lumbar puncture showed pleocytosis or cytoalbuminological dissociation. Abnormal EEG and MRI studies revealed abnormalities in most cases. Anti-GQ1b antibodies were detected in more than half of the patients; anti-GM1 antibodies were detected in almost 40% of patients. Treatment guidelines are missing. In our analysis, steroids and IVIg were administered alone or in combination; as last option, plasmapheresis was used. BBE has a good prognosis and recovery in childhood is faster than in adulthood; 70% of patients reported no sequelae in our analysis. Future studies need to investigate pathogenesis and possible triggers, and therapeutic possibilities.
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Affiliation(s)
| | - Donatella Mastria
- Department of Anesthesia and Intensive Care, “Vito Fazzi” Hospital, Lecce, Italy
| | - Rosella Barbieri
- Department of Anesthesia and Intensive Care, “Vito Fazzi” Hospital, Lecce, Italy
| | - Rossella De Maglio
- Department of Anesthesia and Intensive Care, “Vito Fazzi” Hospital, Lecce, Italy
| | - Francesca Madaro
- Department of Anesthesia and Intensive Care, “Vito Fazzi” Hospital, Lecce, Italy
| | - Gianfranco Paiano
- Department of Anesthesia and Intensive Care, “Vito Fazzi” Hospital, Lecce, Italy
| | - Maria Caterina Pace
- Department of Women, Child, General and Specialist Surgery, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Pasquale Sansone
- Department of Women, Child, General and Specialist Surgery, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Giuseppe Pulito
- Department of Anesthesia and Intensive Care, “Vito Fazzi” Hospital, Lecce, Italy
| | - Luciana Mascia
- Department of Experimental Medicine, University of Salento, Lecce, Italy
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Giaccari LG, Coppolino F, Aurilio C, Pace MC, Passavanti MB, Pota V, Alicino D, Pulito G, Sansone P. Pulsed Radiofrequency and Platelet Rich Plasma in Degenerative Joint Arthritis: Two Case Reports and Literature Analyses. Life (Basel) 2023; 13:1334. [PMID: 37374117 DOI: 10.3390/life13061334] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/29/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Osteoarthritis (OA) is a debilitating joint disease. The are several therapies available for OA. According to current knowledge, the combination of Platelet-Rich Plasma (PRP) and Pulsed Radiofrequency (PRF) can be applied in the treatment of pain of nociceptive origin due to peripheral tissue damage. (2) Methods: We performed a narrative review identifying the articles by searching electronic databases. A retrospective analysis of patients with OA treated with PRF and PRP in "Vito Fazzi" Hospital (Lecce, Italy) was performed. (3) Results: A total of four publications on the use of PRP and PRF in degenerative joint arthritis were included in our review. In our experience, two patients with OA were treated with PRP and PRF after unsuccessful conservative treatment. Patient pain score, daily activity ability, active range of activity, and muscle strength improved after treatment. Patients reported a higher level of satisfaction. No major adverse events were reported. (4) Conclusions: The goal of the combined application of the two treatments is to make full use of the analgesic effect of PRF and the repairing effect of PRP. At present, the therapeutic potential of PRP and PRF in OA remains unmet.
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Affiliation(s)
| | - Francesco Coppolino
- Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Caterina Aurilio
- Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Maria Caterina Pace
- Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Maria Beatrice Passavanti
- Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Vincenzo Pota
- Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Dario Alicino
- Department of Anesthesia and Intensive Care, "Vito Fazzi" Hospital, 73100 Lecce, Italy
| | - Giuseppe Pulito
- Department of Anesthesia and Intensive Care, "Vito Fazzi" Hospital, 73100 Lecce, Italy
| | - Pasquale Sansone
- Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy
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Negro P, Congedo M, Zizza A, Guido M, Sacquegna G, Pulito G, Lobreglio G. Role of ABO blood system in COVID-19: Findings from a southern Italian study. Transfus Med 2021; 32:243-247. [PMID: 34114287 DOI: 10.1111/tme.12797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/10/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND COVID-19 is a worldwide infection caused by SARS-CoV-2 and infects humans by binding to the ACE2 receptor. Blood group ABO glycoproteins can influence the binding of the virus to ACE2. The role of ABO blood system in the susceptibility to infection as well as in the clinical outcome of infected patients is still controversial and needs to be clarified. METHODS We conducted a retrospective study of 167 patients positive for SARS-CoV-2 who underwent nasopharyngeal swab, and of a control group represented by 891 subjects negative for SARS-CoV-2, to assess the association between ABO and Rh blood system and occurrence of SARS-CoV-2 infection, clinical presentation, and outcome of disease. RESULTS In the cohort of patients positive for SARS-CoV-2, no statistically significant difference in the distribution of ABO blood types compared with controls was observed. Patients with blood type A had a higher risk of developing symptomatic disease (p = 0.002; odds ratio [OR = 3.592]; 95% confidence interval [CI] = 1.576-8.187) compared to patients with blood types B, AB, and O. Patients with blood types B (p = 0.021; OR = 0.293; 95%CI = 0.099-0.869) and O (p = 0.018; OR = 0.417; 95%CI = 0.199-0.871) showed a lower risk in comparison to the other groups. The clinical progression to mild/moderate and severe/critical disease and the mortality showed no association. Moreover, no relationship with Rh blood type was found. CONCLUSIONS Our findings support a role of ABO blood type in the development of symptomatic disease with a higher risk in subjects with blood type A and a protective effect of blood types B and O. Blood types do not seem, however, to play a role in susceptibility, progression to severe disease, and death.
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Affiliation(s)
- Pierpaolo Negro
- Inter-company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Lecce, Immunohaematology and Transfusion Medicine Unit, Vito Fazzi Hospital, Lecce, Italy
| | | | - Antonella Zizza
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Marcello Guido
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | - Gianfranco Sacquegna
- Inter-company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Lecce, Immunohaematology and Transfusion Medicine Unit, Vito Fazzi Hospital, Lecce, Italy
| | - Giuseppe Pulito
- Intensive Care and Resuscitation Unit, Vito Fazzi Hospital, Lecce, Italy
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Genovese S, Epifano F, Palumbo L, Pulito G, Bastianini M, Cardellini F, Spogli R, Fiorito S. Solid phase adsorption of emodin on hydrotalcites and inorganic oxides: A preliminary study. J Pharm Biomed Anal 2020; 187:113348. [DOI: 10.1016/j.jpba.2020.113348] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/25/2020] [Accepted: 04/28/2020] [Indexed: 01/19/2023]
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Cappiello G, Camarda L, Pulito G, Tarantino A, Di Martino D, Russi V, Stramazzo L, Ragusa C, Guarino G, Ripani U. Continuous Femoral Catheter for Postoperative Analgesia After Total Knee Arthroplasty. Med Arch 2020; 74:54-57. [PMID: 32317836 PMCID: PMC7164727 DOI: 10.5455/medarh.2020.74.54-57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Postoperative pain management in the total knee replacement (TKR) represent a fundamental step for a positive outcome, allowing rapid mobilization, already on the first day. Further, continuous peripheral nerve block techniques have been reported to allow effective and safe control of acute postoperative pain, ensuring the implementation and completion of an accurate and intensive joint rehabilitation program. Aim: The aim of this study was to assess early mobility and compliance of patients that underwent TKR surgery using the femoral block. Methods: For the study, all patients that underwent TKR from 2015 to 2018 with ASA score between II-III was evaluated. Patients underwent vital parameters monitoring and were treated initially with midazolam (0.05mg / kg) e.v. combined sciatic block + femoral perineural catheter positioning using a peripheral nerve stimulation-assisted technique. Results: Intraoperatively, satisfactory analgesia was guaranteed in all patients, associated with a complete muscle relaxation of the affected limb. High patient compliance, associated with good control of acute postoperative pain was obtained in the first 24 hours after surgery (VAS 0- 1). The ROM outcomes were good in all rehabilitation stages, managing to reach 90 degrees bending on the seventh day with an average KSS score of 88-90. Patient satisfaction and impact on quality of life were assessed with the SF-36 showing average scores of 78. Conclusion: Continuous femoral nerve blocking ensures good postoperative analgesia in TKR allowing an early joint mobilization, a rapid functional recovery of the knee and increasing patient compliance during the post-operative rehabilitation program.
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Affiliation(s)
- Giovanni Cappiello
- Department of Anesthesia, Analgesia and Intensive Care, Vito Fazzi Hospital, Lecce, Italy
| | - Lawrence Camarda
- Department of Orthopaedic and Traumatology (DICHIRONS), University of Palermo, Palermo, Italy
| | - Giuseppe Pulito
- Department of Anesthesia, Analgesia and Intensive Care, Vito Fazzi Hospital, Lecce, Italy
| | - Andrea Tarantino
- Department of Anesthesia, Analgesia and Intensive Care, Vito Fazzi Hospital, Lecce, Italy
| | - Daniela Di Martino
- Department of Anesthesia, Analgesia and Intensive Care, Vito Fazzi Hospital, Lecce, Italy
| | - Valentina Russi
- Department of Orthopaedic and Traumatology (DICHIRONS), University of Palermo, Palermo, Italy
| | - Leonardo Stramazzo
- Department of Orthopaedic and Traumatology (DICHIRONS), University of Palermo, Palermo, Italy
| | - Clara Ragusa
- Department of Biopathology and Medical and Forensic Biotechnologies (DIBIMEF), Section of Anaesthesiology, Analgesia, Emergency and Intensive Care, Policlinico "P. Giaccone," University of Palermo, Palermo, Italy
| | - Gianmarco Guarino
- Department of Anesthesia, Analgesia and Intensive Care, Vito Fazzi Hospital, Lecce, Italy
| | - Umberto Ripani
- Pain Therapy Center, Division of Anesthesia, Analgesia and Intensive Care, Department of Emergency, Ospedali Riuniti di Ancona, Ancona, Italy
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Malferrari G, Pulito G, Pizzini AM, Carraro N, Meneghetti G, Sanzaro E, Prati P, Siniscalchi A, Monaco D. MicroV Technology to Improve Transcranial Color Coded Doppler Examinations. J Neuroimaging 2018; 28:350-358. [DOI: 10.1111/jon.12517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/06/2018] [Accepted: 04/11/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Giovanni Malferrari
- Stroke Unit, Neurology Unit; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
| | - Giuseppe Pulito
- Department of Anaesthesia and Resuscitation Service - Vito Fazzi Hospital; Lecce Italy
| | | | - Nicola Carraro
- Neurology Clinic; Department of Head and Neck - Integrated University Healthcare Company; Trieste Italy
| | - Giorgio Meneghetti
- Department of Neurosciences; University of Padua School of Medicine; Padova Italy
| | - Enzo Sanzaro
- Stroke Unit; Department of Medicine - Umberto I Hospital; Siracusa Italy
| | | | | | - Daniela Monaco
- Stroke Unit; Department of Medicine - Spirito Santo Hospital; Pescara Italy
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Pulito G, Marasi G, Paolucci R, Borghesi L, Monti P. [Use of propofol and buprenorphine for total intravenous anesthesia]. Minerva Anestesiol 1991; 57:29-34. [PMID: 2057087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A study was carried out in 47 patients undergoing general surgery and elective gynecological surgery under totally endovenous general anesthesia. For this purpose, propofol and buprenorphine were used in controlled ventilation with oxygen and air, totally excluding the use of nitrous oxide and halogenate vapours. The following parameters were measured to evaluate the state and depth of anesthesia: arterial pressure (systolic, mean, diastolic), heart rate, sweating, lacrimation (Evan's PRST). The awakening from anesthesia was evaluated using Steward's test. The results of monitoring show that the method represents a valid alternative to anesthesia using inhalatory techniques. Nonetheless, the Authors underline the need for further research on the subject.
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Affiliation(s)
- G Pulito
- Servizio di Anestesia e Rianimazione, USSL n. 50/52-Ospedale Civile di Viadana, Mantova
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