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Abstract
Recently, social anxiety disorder (SAD) and paranoia have been demonstrated to be closely related. However, data were primarily drawn from adult community samples or patients with schizophrenia. The present study used a cross-sectional design to evaluate a sample of adolescents with SAD (n = 30, mean age 15.3 ± 0.9 years) compared with an age- and sex-matched group of healthy controls (n = 26, mean age 15.9 ± 1.6 years). The SAD group displayed more frequent and intense paranoid thoughts than the control group (t = 4.16, p < 0.001). The level of paranoid thoughts was significantly predicted by the degree of social phobia, even after adjusting for sex and other anxiety disorders, although adjusting for depression slightly reduced the extent and significance of the prediction. A lack of awareness about the association between SAD and paranoia may lead to incorrect diagnoses (e.g. misdiagnosis of psychotic disorders), or it may negatively influence the (psycho)therapeutic process and patient outcomes.
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Affiliation(s)
- S Pisano
- Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, via Pansini 5, 80131, Naples, Italy.
| | - G Catone
- Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, via Pansini 5, 80131, Naples, Italy
| | - A Pascotto
- Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, via Pansini 5, 80131, Naples, Italy
| | - R Iuliano
- Department of Pediatrics, Hospital ''F. Veneziale'', Isernia, Italy
| | - C Tiano
- Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, via Pansini 5, 80131, Naples, Italy
| | - A Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - G Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - A Gritti
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
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2
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Coppola G, Grosso S, Franzoni E, Veggiotti P, Zamponi N, Parisi P, Spalice A, Habetswallner F, Fels A, Verrotti A, D’Aniello A, Mangano S, Balestri A, Curatolo P, Pascotto A. Rufinamide in refractory childhood epileptic encephalopathies other than Lennox–Gastaut syndrome. Eur J Neurol 2011; 18:246-251. [DOI: 10.1111/j.1468-1331.2010.03113.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G. Coppola
- Clinic of Child Neuropsychiatry, Second University of Naples, Naples
| | - S. Grosso
- Department of Pediatrics, Pediatric Neurology Section, University of Siena, Siena
| | - E. Franzoni
- Child Neuropsychiatry Unit, Bologna University, Bologna
| | - P. Veggiotti
- Department of Child Neurology and Psychiatry, C. Mondino Institute, University of Pavia, Pavia
| | - N. Zamponi
- Pediatric Neurology Department, G. Salesi Hospital, Ancona
| | - P. Parisi
- Chair of Pediatrics, Second Faculty of Medicine, Sapienza University
| | - A. Spalice
- Department of Pediatrics, First Faculty of Medicine, Sapienza University, Sapienza
| | | | - A. Fels
- Clinical Neurophysiology Unit, Cardarelli Hospital, Naples
| | - A. Verrotti
- Department of Pediatrics, University of Chieti, Chieti
| | - A. D’Aniello
- Clinic of Child Neuropsychiatry, Second University of Naples, Naples
| | - S. Mangano
- Child Neuropsychiatry, Palermo University, Palermo
| | - A. Balestri
- Department of Pediatrics, Pediatric Neurology Section, University of Siena, Siena
| | - P. Curatolo
- Pediatric Neuroscience Unit, Tor Vergata University of Rome, Rome, Italy
| | - A. Pascotto
- Clinic of Child Neuropsychiatry, Second University of Naples, Naples
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Coppola G, Verrotti A, D'Aniello A, Arcieri S, Operto FF, Della Corte R, Ammendola E, Pascotto A. Valproic acid and phenobarbital blood levels during the first month of treatment with the ketogenic diet. Acta Neurol Scand 2010; 122:303-7. [PMID: 21077847 DOI: 10.1111/j.1600-0404.2010.01359.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [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: 01/01/2023]
Abstract
OBJECTIVE The aim of this study was to assess how the ketogenic diet influences the blood levels of antiepileptic drugs in the first month of treatment in a pediatric population with drug-resistant epilepsy. METHODS The plasma concentrations of antiepileptic drugs were investigated in an open study on 36 consecutive children and adolescents (20 males), aged between 6 months and 16 years (mean age 4.7 years), who were put on the ketogenic diet because of medically refractory epilepsy. The plasma levels of antiepileptic drugs were determined 30 days and immediately before the diet and on days 8, 15, 22 and 29 after the start of the diet. The daily dose of each drug was not changed during the first month of treatment, while the daily dose of benzodiazepines was reduced by up to 30% if excessive sedation or drowsiness occurred. RESULTS While plasma concentrations of phenobarbital did not change in the first month on the ketogenic diet (mean increase of 2.3 mg/l ± 1.0), valproic acid showed a slight but not significant decrease (mean decrease of 6.7 mg/l ± 3.2), 2 weeks after the start of the diet. CONCLUSIONS Adjustments in the daily dose of either drug before the start of the diet do not however appear to be justified.
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Affiliation(s)
- G Coppola
- Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy.
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4
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Coppola G, Verrotti A, D'Aniello A, Arcieri S, Operto FF, Della Corte R, Ammendola E, Pascotto A. Valproic acid and phenobarbital blood levels during the first month of treatment with the ketogenic diet. Acta Neurol Scand 2010. [DOI: 10.1111/j.1600-0404.2010.001359.x] [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: 12/24/2022]
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Treede H, Schofer J, Tübler T, Franzen O, Pascotto A, Meinertz T, Reichenspurner H. 6 months results of the repositionable and retrievable direct flow medical aortic valve for transfemoral aortic valve replacement. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246977] [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: 10/20/2022]
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Carotenuto M, Santoro N, Grandone A, Santoro E, Pascotto C, Pascotto A, Perrone L, del Giudice EM. The insulin gene variable number of tandemrepeats (INS VNTR) genotype and sleep disordered breathing in childhood obesity. J Endocrinol Invest 2009; 32:752-5. [PMID: 19574727 DOI: 10.1007/bf03346531] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aim of our study is to verify the association between the genetic predisposition to hyperinsulinism due to the presence of the insulin gene (INS) I/I genotype and the development of sleep-related breathing disorders (SRBD) in obese children and adolescents. Two hundred and fifty-six obese children and adolescents (125 girls) have been investigated. As initial screening all subjects' mothers filled out the Sleep Disturbances Scale for Children (SDSC). The Sleep-Disordered Breathing (SDB) scale has been taken into account. Successively, a subgroup of 34 patients belonging to the first (14 children) and the last (20 children) SDB score quintiles underwent an overnight polysomnography and the apnea-hypopnea index (AHI) was evaluated. All subjects were genotyped for the INS VNTR and fasting insulin levels were evaluated. The population was divided into two groups according to the genotype: the first group was comprehensive of patients homozygotes for class I allele and the second group was composed by class III allele heterozygotes and homozygotes patients. Subjects I/I showed statistically signifIcant higher insulin levels (p<0.001) and SDB scores (p<0.001). Moreover, in the subgroup of patients investigated with polysomnography, class I homozygous subjects showed higher AHI compared to those patients carrying class III allele (p<0.001). Our data support the hypothesis that INS VNTR is associated with the development of SDB among obese children and adolescents.
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Affiliation(s)
- M Carotenuto
- clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy
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Grassi G, Coceani N, Farra R, Dapas B, Racchi G, Fiotti N, Pascotto A, Rehimers B, Guarnieri G, Grassi M. Propaedeutic study for the delivery of nucleic acid-based molecules from PLGA microparticles and stearic acid nanoparticles. Int J Nanomedicine 2007; 1:523-33. [PMID: 17722283 PMCID: PMC2676633 DOI: 10.2147/nano.2006.1.4.523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 11/23/2022] Open
Abstract
We studied the mechanism governing the delivery of nucleic acid-based drugs (NABD) from microparticles and nanoparticles in zero shear conditions, a situation occurring in applications such as in situ delivery to organ parenchyma. The delivery of a NABD molecule from poly(DL-lactide-co-glycolide) (PLGA) microparticles and stearic acid (SA) nanoparticles was studied using an experimental apparatus comprising a donor chamber separated from the receiver chamber by a synthetic membrane. A possible toxic effect on cell biology, as evaluated by studying cell proliferation, was also conducted forjust PLGA microparticles. A mathematical model based on the hypothesis that NABD release from particles is due to particle erosion was used to interpret experimental release data. Despite zero shear conditions imposed in the donor chamber, particle erosion was the leading mechanism for NABD release from both PLGA microparticles and SA nanoparticles. PLGA microparticle erosion speed is one order of magnitude higher than that of competing SA nanoparticles. Finally, no deleterious effects of PLGA microparticles on cell proliferation were detected. Thus, the data here reported can help optimize the delivery systems aimed at release of NABD from micro- and nanoparticles.
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Affiliation(s)
- G Grassi
- Department of Internal Medicine, University Hospital of Trieste, Italy
- Department of Molecular Pathology, University Hospital of Tübingen, Tübingen, Germany
| | - N Coceani
- Department of Biochemistry, Biophysics and Macromolecular Chemistry, University of Trieste, Italy
| | - R Farra
- Department of Internal Medicine, University Hospital of Trieste, Italy
| | - B Dapas
- Department of Internal Medicine, University Hospital of Trieste, Italy
| | - G Racchi
- Department of Molecular Pathology, University Hospital of Tübingen, Tübingen, Germany
| | - N Fiotti
- Department of Internal Medicine, University Hospital of Trieste, Italy
| | - A Pascotto
- Cardiovascular Department, Civic Hospital, Venezia, Italy
| | - B Rehimers
- Cardiovascular Department, Civic Hospital, Venezia, Italy
| | - G Guarnieri
- Department of Internal Medicine, University Hospital of Trieste, Italy
| | - M Grassi
- Department of Chemical Engineering, DICAMP, University of Trieste, Italy
- Correspondence: Mario Grassi, Department of Chemical, Environmental and Raw Materials Engineering, DICAMP, Piazzale Europa 1, I - 34127, Trieste, Italy, Tel +39 040 558 3435, Fax +39 040 569823, Email
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Bellini G, Miceli F, Mangano S, Miraglia del Giudice E, Coppola G, Barbagallo A, Taglialatela M, Pascotto A. HYPEREKPLEXIA CAUSED BY DOMINANT-NEGATIVE SUPPRESSION OF GLYRA1 FUNCTION. Neurology 2007; 68:1947-9. [PMID: 17536053 DOI: 10.1212/01.wnl.0000263193.75291.85] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- G Bellini
- Department of Pediatrics, 2nd University of Naples, Naples, Italy
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Grassi G, Farra R, Noro E, Voinovich D, Lapasin R, Dapas B, Alpar O, Zennaro C, Carraro M, Giansante C, Guarnieri G, Pascotto A, Rehimers B, Grassi M. Characterization of nucleic acid molecule/liposome complexes and rheological effects on pluronic/alginate matrices. J Drug Deliv Sci Technol 2007. [DOI: 10.1016/s1773-2247(07)50050-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Grassi G, Crevatin A, Farra R, Guarnieri G, Pascotto A, Rehimers B, Lapasin R, Grassi M. Rheological properties of aqueous Pluronic-alginate systems containing liposomes. J Colloid Interface Sci 2006; 301:282-90. [PMID: 16777132 DOI: 10.1016/j.jcis.2006.04.068] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [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: 12/22/2005] [Revised: 04/22/2006] [Accepted: 04/24/2006] [Indexed: 01/22/2023]
Abstract
Rheological and erosion studies regarding a liposome-containing polymeric blend that is propaedeutic to its use in paving techniques in tubular organs, such as blood vessels, are reported. Attention is focused on an aqueous polymeric blend composed of Pluronic (PF127) and alginate (Protanal LF 10/60) because both polymers, when dissolved in water at a sufficiently high concentration, are subjected to different structural mechanisms, which are driven by temperature increase and addition of bivalent cations, respectively, and both result in marked viscoelastic and plastic properties. After proving the compatibility between PF127 and alginate, we show that the structural transition temperature of the blend, T(ST), can be properly modulated. In particular, we found that T(ST) for an aqueous solution of pure Pluronic 20% w/w is about 21 degrees C and that even slight reductions in polymer concentration result in considerable T(ST) decrease. The addition of salts or alginate (provided as Na-alginate) provokes a substantial decrease of T(ST) and thus the alginate concentration in the blend should not exceed 1% w/w. In addition, liposomes slow down the structural transition but do not substantially affect the rheological properties of the system in the final state at higher temperatures, thus showing that they can be added to the polymeric blend without significant effects. Finally, erosion tests show that after contact with a source of bivalent cations, the polymeric blend containing PF127 and alginate shows an erosion resistance neatly improved with respect to the simple structured Pluronic system having the same polymer concentration. As a whole, all these results constitute the basis for future potential applications of the considered polymeric blend in tubular organs such as blood vessels.
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Affiliation(s)
- G Grassi
- Department of Internal Medicine, University Hospital of Trieste, Cattinara, I-34149 Trieste, Italy.
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11
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Grosso S, Franzoni E, Coppola G, Iannetti P, Verrotti A, Cordelli DM, Marchiani V, Pascotto A, Spalice A, Acampora B, Morgese G, Balestri P. Efficacy and safety of levetiracetam: An add-on trial in children with refractory epilepsy. Seizure 2005; 14:248-53. [PMID: 15911359 DOI: 10.1016/j.seizure.2005.02.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [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: 04/07/2004] [Indexed: 11/21/2022] Open
Abstract
The aim of this multicentric, prospective and uncontrolled study was to evaluate the efficacy and safety of levetiracetam in 110 children with refractory epilepsy, of whom 21 were less than 4 years old. After a median follow-up period of 7 months, levetiracetam administration was effective (responders with >50% decrease in seizure frequency) in 39% of children, of whom 10 (9%) became seizure-free. The efficacy was higher in patients with localization-related epilepsy (58% of responders) than in those with generalized epilepsy (37% of responders). Levetiracetam was well tolerated. The main side effects of somnolence and irritability occurred in 14% of patients. In one patient acute choreoathetosis occurred after few doses of levetiracetam. Overall, the adverse effects were not severe. Children younger than 4 years were particularly tolerant. In conclusion, the present study confirms that levetiracetam is effective and well tolerated as an add-on treatment in children with refractory epilepsy. Our preliminary data also indicate that levetiracetam may be a valid therapeutic option for epilepsy in infants and young children.
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Affiliation(s)
- S Grosso
- Pediatrics Department, University of Siena, Ospedale Santa Maria alle Scotte, Via M. Bracci, 53100 Siena, Italy
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12
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Coppola G, Castaldo P, Miraglia del Giudice E, Bellini G, Galasso F, Soldovieri MV, Anzalone L, Sferro C, Annunziato L, Pascotto A, Taglialatela M. A novel KCNQ2 K+ channel mutation in benign neonatal convulsions and centrotemporal spikes. Neurology 2003; 61:131-4. [PMID: 12847176 DOI: 10.1212/01.wnl.0000069465.53698.bd] [Citation(s) in RCA: 46] [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: 11/15/2022] Open
Abstract
Patients with benign familial neonatal convulsions (BFNC) may develop various epilepsies or epilepsy-associated EEG traits. A heterozygous 1-base pair deletion (2043DeltaT) in the KCNQ2 gene encoding for K+ channel subunits was found in a patient with BFNC who showed centrotemporal spikes at age 3 years. Electrophysiologic studies showed that mutant K+ channel subunits failed to give rise to functional homomeric channels or exert dominant-negative effects when expressed with KCNQ2/KCNQ3 subunits.
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Affiliation(s)
- G Coppola
- Department of Child Neuropsychiatry, 2nd University of Naples, Italy
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13
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Miraglia Del Giudice E, Coppola G, Bellini G, Ledaal P, Hertz JM, Pascotto A. A novel mutation (R218Q) at the boundary between the N-terminal and the first transmembrane domain of the glycine receptor in a case of sporadic hyperekplexia. J Med Genet 2003; 40:e71. [PMID: 12746425 PMCID: PMC1735464 DOI: 10.1136/jmg.40.5.e71] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Coppola G, Vajro P, De Virgiliis S, Ciccimarra E, Boccone L, Pascotto A. Cerebellar vermis defect, oligophrenia, congenital ataxia, and hepatic fibrocirrhosis without coloboma and renal abnormalities: report of three cases. Neuropediatrics 2002; 33:180-5. [PMID: 12368986 DOI: 10.1055/s-2002-34492] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We describe 3 children (2 siblings aged 10 and 3 years, and 1 sporadic case aged 13 years) with cerebellar vermis defect associated with oligophrenia, congenital ataxia, and hepatic fibrocirrhosis. Differently from what is reported in COACH syndrome, coloboma and renal involvement were absent. Since in one patient hepatic involvement was subclinical and early therapy seemed to prevent disease progression, the presence of liver disease should be carefully investigated in any patient with ataxia and midline cerebellar defects.
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Affiliation(s)
- G Coppola
- Dipartimenti di Pediatria, Seconda Universita' di Napoli, Napoli, Italy
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del Giudice EM, Coppola G, Bellini G, Cirillo G, Scuccimarra G, Pascotto A. A mutation (V260M) in the middle of the M2 pore-lining domain of the glycine receptor causes hereditary hyperekplexia. Eur J Hum Genet 2001; 9:873-6. [PMID: 11781706 DOI: 10.1038/sj.ejhg.5200729] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [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: 06/06/2001] [Revised: 08/22/2001] [Accepted: 08/31/2001] [Indexed: 11/08/2022] Open
Abstract
We investigated the molecular basis of hyperekplexia (STHE), an inherited neurological disorder characterised by neonatal hypertonia and an exaggerated startle response, in a kindred and identified a novel missense mutation in the pore-lining M2 domain of the alpha1 subunit of the glycine receptor (GLRA1). Sequencing analysis of all exons of the GLRA1 gene revealed a G1158A base transition in affected, heterozygous patients. The base transition results in a valine to methionine substitution at codon 260 in the middle of the M2 transmembrane domain. The location within the M2 domain suggests for this substitution a likely role in altering ion channel properties.
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Affiliation(s)
- E M del Giudice
- Department of Pediatrics, Second University of Naples, Naples, Italy
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Abstract
We describe two children with the velocardiofacial syndrome and benign partial-onset seizures. Both presented with slight dysmorphic traits, mild to moderate mental delay, and high-arched palate. A cardiac defect was present in only one of them. In each patient, sporadic rolandic or occipital partial-onset seizures with the clinical and electroencephalographic features of benign idiopathic childhood epilepsy manifested at age 3 and 5 years, respectively. Treatment was started only in one patient, with complete seizure control. These two cases show that benign partial epilepsy can be a component manifestation of the central nervous system-related symptoms of the velocardiofacial syndrome.
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Affiliation(s)
- G Coppola
- Department of Pediatrics /Clinic of Child Neuropsychiatry, Second University of Naples, Via Pansini 5, 80131 Naples, Italy
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Abstract
The purpose of this study was to report paradoxical reaction on the intraocular pressure after treatment with latanoprost in 3 cases of uveitic glaucoma. Serial clinical examinations of intraocular pressure by means of daily tonometric curves were performed in three patients with uveitic glaucoma before and after the beginning of latanoprost therapy. All measurements were performed by two doctors, but every patient's IOP was always measured by the same doctor. Adverse reactions, such as increased intraocular pressure and recurrence of inflammation, were noted to occur 7 to 16 days after rechallenging with topical latanoprost therapy for glaucoma in patients with history of uveitic glaucoma. The conclusion indicates that clinicians should be alerted to these possible complications of topical latanoprost therapy in uveitic glaucoma.
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Affiliation(s)
- S Saccà
- Department of Neurological and Visual Sciences, University of Genoa, Ospedale San Martino, Italy.
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Coppola G, Caliendo G, Terracciano MM, Buono S, Pellegrino L, Pascotto A. Topiramate in refractory partial-onset seizures in children, adolescents and young adults: a multicentric open trial. Epilepsy Res 2001; 43:255-60. [PMID: 11248537 DOI: 10.1016/s0920-1211(00)00202-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [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
PURPOSE This study was to evaluate the efficacy and safety of topiramate (TPM) in refractory partial epilepsy in children, adolescents and young adults. METHODS We performed a prospective open label add-on study in 55 patients (age 2-30 years, mean 15 years) with refractory partial seizures. Topiramate was added to one or two other baseline drugs and the efficacy was rated according to seizure type and frequency. RESULTS TPM was initiated at a daily dose of 0.5-1 mg/kg, followed by a 2-week titration at increments of 1-3 mg/kg/24h, up to a maximum daily dose of 12 mg/kg. After 9 months of treatment, 11 patients (20%) had 100% fewer seizures and 25 patients (45%) had a more than 50% seizure reduction. TPM appeared to be effective both in cryptogenic (76.2%) and symptomatic (58.8%) partial epilepsies. Mild to moderate adverse events were present in 25 patients (45.4%), mostly represented by drowsiness, nervousness and hyporexia with or without weight loss. CONCLUSION TPM was an overall effective and safe add-on drug both in cryptogenic and symptomatic childhood refractory partial seizures, the adverse reactions being generally mild or moderate.
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Affiliation(s)
- G Coppola
- Clinic of Child Neuropsychiatry, Department of Pediatrics, Second University of Naples, Via Pansini, 5, 80131, Naples, Italy
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Abstract
AIM To evaluate daily tonometric curves after cataract surgery in patients with cataract only and in patients with cataract and glaucoma. METHODS 108 patients scheduled for cataract surgery were randomly allocated to two groups: 57 patients with cataract only (normal) and 51 with cataract and primary open angle glaucoma (POAG). All patients underwent extracapsular cataract extraction (ECCE) (manual technique with long wound), phacoemulsification (automated technique with short wound), or nucleus capture (manual technique with short wound). Intraocular pressure (IOP) was measured by Goldmann tonometry in all patients every 2 hours for 12 hours before the operation and at 1 and 6 months postoperatively. RESULTS 79 patients completed the 6 month examination. ECCE resulted in greater reductions in IOP than the other procedures (ECCE: 27% and 36% in normal patients and those with POAG, respectively; nucleus capture: 20% and 31%, respectively; phacoemulsification: 19% and 22%, respectively). The fluctuations in IOP before and after surgery were not statistically significant. CONCLUSION Cataract surgery in normal patients reduces IOP but does not eliminate fluctuations which are directly proportional to the IOP value and result partly from circadian rhythms. This important finding might influence our approach to treatment of patients with glaucoma.
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Affiliation(s)
- S Saccà
- Department of Neurological and Visual Sciences, Ophthalmology R, University of Genoa, 16132 Genoa, Italy.
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Miraglia del Giudice E, Coppola G, Scuccimarra G, Cirillo G, Bellini G, Pascotto A. Benign familial neonatal convulsions (BFNC) resulting from mutation of the KCNQ2 voltage sensor. Eur J Hum Genet 2000; 8:994-7. [PMID: 11175290 DOI: 10.1038/sj.ejhg.5200570] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Benign familial neonatal convulsions (BFNC) is a rare autosomal inherited epilepsy. We studied the KCNQ2 coding region in a large, four-generation, Italian family with BFNC. A missense mutation C686T predicting the change of one of the innermost arginine (R214W) of the key functional voltage sensor (S4 helix), has been found in all affected members. This substitution probably reduces the movement of the voltage sensor that precedes channel opening during voltage-dependent activation. Several mutations affecting the trans-membrane domain and the pore region of the K+ channels belonging to the KQT-like family have been described in some human diseases associated with altered regulation of cellular excitability (ie BFNC, some LQT syndromes and DFNA2). R214W represents the first mutation involving the region of the voltage sensor.
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Abstract
We describe two sisters affected by pontocerebellar hypoplasia type 2 associated with microcephaly, hypertonia, severe choreiform movements, an almost complete lack of psychomotor development, and generalized tonic-clonic seizures. Clinical and neuroradiological findings ruled out other conditions associated with pontocerebellar hypoplasia, i.e. pontocerebellar hypoplasia type 1, carbohydrate-deficient glycoprotein syndrome, and olivopontocerebellar hypoplasia/atrophy.
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Affiliation(s)
- G Coppola
- Clinic of Child Neuropsychiatry, Department of Pediatrics, Second University of Naples, Naples, Italy
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22
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Abstract
Seventy-seven children and adolescents with drug-resistant epilepsies received vigabatrin as add-on therapy for a median of 18 months (range 4-36 months) at a dose of 50 mg/kg/day divided in two doses; patients with spasms were given a maximum dose of 100 mg/kg/day. In 23 patients (29.9%), seizure frequency decreased by 50-100% and in 12 patients (15.6%) by 25-50%. The number of seizures remained unchanged in 34 patients (44.1%) and increased in seven (9.1%). Vigabatrin was most effective in cryptogenic and symptomatic partial seizures (39% and 43%, respectively), and in infantile spasms (25%). Adverse events occurred in 20 patients (26%), though they were generally mild and transient, suggesting that vigabatrin is well tolerated.
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Affiliation(s)
- G Coppola
- Dipartimento di Pediatria, Seconda Università di Napoli, Italy
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23
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Abstract
We report the results of an open trial with lamotrigine (LTG) as add-on drug in children and adolescents with refractory epilepsy and mental delay. Thirty-seven outpatients received LTG for a median period of 7 months at a daily dose of 5 and 15 mg/kg in valproate and non-valproate patients, respectively. The total number of seizures decreased by 100% in eight patients (21.6%) and by >50% in five patients (13.5%). However, the number of seizures remained unchanged in 20 patients (54.1%) and increased in four (10.8%). Lamotrigine was more effective in patients with typical and atypical absences, and in patients affected by atonic seizures. Six children (16.2%) developed generally mild adverse side-effects suggesting that LTG is well tolerated.
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Affiliation(s)
- G Coppola
- Child Neuropsychiatry Clinic, Department of Pediatrics, Second University of Naples, Italy
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24
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Abstract
We report the results of a double-blind, placebo-controlled cross-over trial with allopurinol as add-on therapy in childhood refractory epilepsy. Seventeen patients received allopurinol and matched placebo for 12 weeks in 2 doses (10 mg/kg/day during the first week and 15 mg/kg/day thereafter with a washout period of 2 weeks between treatment phases. The total number of seizures was reduced by 50-98% in 4 patients (23.5%) and by 25-49% in another 4 (23.5%). However, the number of seizures remained unchanged in 5 patients (29.4%) and worsened in 4 (23.5%). Adverse side effects (17.6%) were generally mild and transient, suggesting that allopurinol is well-tolerated. A mean follow-up of 10 months of the responders did not show any relevant efficacy of allopurinol as an adjuvant therapy for refractory epilepsy, even at high doses.
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Affiliation(s)
- G Coppola
- Child Neuropsychiatry Clinic, Department of Pediatrics, Second University of Naples, Italy
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25
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Abstract
We report the case of a baby with transient generalized stiffness noticeable from the first days of life, hyperreflexia, massive jerks in response to sudden tactile and acoustic stimuli, and long-lasting myoclonic jerks closely resembling epileptic seizures. The father and paternal grandfather both had hyperekplexia. At age 3 years, the child had normal psychomotor development and persistent abnormal startle response to unexpected sounds or touch.
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Affiliation(s)
- A Pascotto
- Department of Pediatrics, Naples University, Italy
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26
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Volpe E, Guizzaro A, Coppola G, Pascotto A. [Epileptic crisis at the onset of SSPE (subacute sclerosing panencephalitis): considerations apropos of a case]. Riv Neurol 1988; 58:193-8. [PMID: 3231987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A case of SSPE is reported and discussed; in all the evolution of this history, epileptic seizures were precocious (a long time before the onset of characteristic features of the disease) and dominant. The Authors, also on the basis of the literature (a definite pattern of evolution of epilepsy within SSPE is not reported), emphasize that this disease must be however considered among the possible aetiologies of an epileptic syndrome with onset in childhood.
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Affiliation(s)
- E Volpe
- Facoltà di Medicina e Chirurgia, Università, Napoli, Cattedra di Neurofisiopatologia
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27
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Pascotto A, Liguori G, Coppola G. [Electroencephalographic aspects of pediatric brain tumors. Considerations in 151 cases]. Acta Neurol (Napoli) 1986; 8:382-6. [PMID: 3776719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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28
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Bravaccio F, Volpe E, Guizzaro A, Pascotto A. [The electroencephalogram and clinico-evolutive aspects of children with febrile convulsions]. Pediatria (Napoli) 1983; 91:151-163. [PMID: 6664726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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29
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Rinaldi MM, Militerni R, Pascotto A, Scarano G, Renda S, Cavaliere ML, Santulli B, Esposito M, Ventruto V. [Severe mental retardation and slight dysmorphism in a child with a bisatellite extrachromosome: inversion duplication (15)?]. Pediatr Med Chir 1982; 4:559-61. [PMID: 6927358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
A de novo tetrasomy 15 has been reported, in a 6 years old child. The patient had severe mental retardation an minimal physical stigmata, consisting in slight skeletal and facial dismorphism. Cytogenetic analysis showed that extrachromosome, G-like long, was bisatellited and dicentric and was interpreted either as an inversion duplication 15 or as 15; G or D translocation.
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30
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Federico A, Annunziata P, D'Amore I, Pallini R, Palmeri S, Pascotto A. Glycosaminoglycan and glycoprotein changes in subacute sclerosing leucoencephalitis. Acta Neurol (Napoli) 1981; 3:496-9. [PMID: 7282469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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31
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Guazzi GC, Bravaccio F, Pascotto A, Carlomagno S. Ichthyosis and epilepsy: a peculiar form of Rud's syndrome. Acta Neurol (Napoli) 1978; 33:208-16. [PMID: 747137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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32
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Paolozzi C, Carlomagno S, Pascotto A, Guazzi GC. [Electroencephalography of various forms of mucopolysaccharidosis: serial studies of patients and occurence in close relatives]. Acta Neurol (Napoli) 1977; 32:778-817. [PMID: 415522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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33
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Vertucci P, Pascotto A, Volpe E. [Paroxysmal choreoathetosis (report of a case)]. Acta Neurol (Napoli) 1977; 32:293-7. [PMID: 883523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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34
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Carlomagno S, Militerni R, Pascotto A, Guazzi GC. [1st Italian family affected by type A Sanfilippo's disease]. Acta Neurol (Napoli) 1977; 32:97-107. [PMID: 404848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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35
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Federico A, Pascotto A, Labella A, Carlomagno S, Giordano GG, Balbi R, Guazzi GC. [Sporadic Refsum-Thiébaut disease in a family with 3 cases of ichthyosis simplex]. Acta Neurol (Napoli) 1974; 29:202-19. [PMID: 4136443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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