1
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Ferrari Aggradi CR, Falcier E, Lizio A, Pirola A, Casiraghi J, Zanolini A, Carraro E, Mauro L, Rao F, Roma E, Iannello A, De Mattia E, Barp A, Lupone S, Gatti V, Italiano C, Sansone VA. Assessment of respiratory function and need for non‐invasive ventilation in a cohort of patients with myotonic dystrophy type 1 followed at one single expert centre. Clinical Respiratory J 2022; 17:339. [PMID: 35760069 PMCID: PMC10113278 DOI: 10.1111/crj.13516] [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] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 05/15/2022] [Accepted: 05/25/2022] [Indexed: 12/01/2022]
Abstract
The above article, published online on 27 June 2022 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editors in Chief, Professor Paul Jones and Professor Yuanlin Song and John Wiley and Sons Ltd. The retraction has been agreed due to an error with the publisher and author which caused a duplicate of the article to be published on 27 June 2022. The correct version of the article is to be found at: Carola R. Ferrari Aggradi, Elisa Falcier, Andrea Lizio, Alice Pirola, Jacopo Casiraghi, Alice Zanolini, Elena Carraro, Luca Mauro, Fabrizio Rao, Elisabetta Roma, Antonino Iannello, Elisa De Mattia, Andrea Barp, Sara Lupone, Valentina Gatti, Cristina Italiano, Valeria A. Sansone, "Assessment of Respiratory Function and Need for Noninvasive Ventilation in a Cohort of Patients with Myotonic Dystrophy Type 1 Followed at One Single Expert Center", Canadian Respiratory Journal, vol. 2022, Article ID 2321909, 11 pages, 2022. https://doi.org/10.1155/2022/2321909.
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Affiliation(s)
| | - Elisa Falcier
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Andrea Lizio
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Alice Pirola
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Jacopo Casiraghi
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Alice Zanolini
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Elena Carraro
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Luca Mauro
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Fabrizio Rao
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Elisabetta Roma
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | | | - Elisa De Mattia
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Andrea Barp
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Sara Lupone
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | - Valentina Gatti
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
| | | | - Valeria A. Sansone
- The NEMO (NEuroMuscular Omniservice) Clinical Center Milan Italy
- Neurorehabilitation Unit University of Milan Milan Italy
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2
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Pane M, Coratti G, Pera MC, Sansone VA, Messina S, d'Amico A, Bruno C, Salmin F, Albamonte E, De Sanctis R, Sframeli M, Di Bella V, Morando S, Palermo C, Frongia AL, Antonaci L, Capasso A, Catteruccia M, Longo A, Ricci M, Cutrona C, Pirola A, Bravetti C, Pedemonte M, Brolatti N, Bertini E, Mercuri E. Nusinersen efficacy data for 24-month in type 2 and 3 spinal muscular atrophy. Ann Clin Transl Neurol 2022; 9:404-409. [PMID: 35166467 PMCID: PMC8935309 DOI: 10.1002/acn3.51514] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 12/12/2022] Open
Abstract
The study reports real world data in type 2 and 3 SMA patients treated for at least 2 years with nusinersen. Increase in motor function was observed after 12 months and during the second year. The magnitude of change was variable across age and functional subgroup, with the largest changes observed in young patients with higher function at baseline. When compared to natural history data, the difference between study cohort and untreated patients swas significant on both Hammersmith Functional Motor Scale and Revised Upper Limb Module both at 12 months and at 24 months.
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Affiliation(s)
- Marika Pane
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.,Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giorgia Coratti
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Carmela Pera
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Valeria A Sansone
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Milan, Italy
| | - Sonia Messina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Adele d'Amico
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Claudio Bruno
- Center of Translational and Experimental Myology and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, IRCCS Istituto Giannina Gaslini and University of Genoa, Genoa, Italy
| | - Francesca Salmin
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Milan, Italy
| | - Emilio Albamonte
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Milan, Italy
| | - Roberto De Sanctis
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Sframeli
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vincenzo Di Bella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Simone Morando
- Center of Translational and Experimental Myology and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, IRCCS Istituto Giannina Gaslini and University of Genoa, Genoa, Italy
| | - Concetta Palermo
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Anna Lia Frongia
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Laura Antonaci
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Capasso
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michela Catteruccia
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonella Longo
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Martina Ricci
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Costanza Cutrona
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alice Pirola
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Milan, Italy
| | - Chiara Bravetti
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marina Pedemonte
- Center of Translational and Experimental Myology and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, IRCCS Istituto Giannina Gaslini and University of Genoa, Genoa, Italy
| | - Noemi Brolatti
- Center of Translational and Experimental Myology and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, IRCCS Istituto Giannina Gaslini and University of Genoa, Genoa, Italy
| | - Enrico Bertini
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Eugenio Mercuri
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
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Sansone VA, Proserpio P, Mauro L, Biost AL, Frezza E, Lanza A, Rogliani P, Pezzuto G, Falcier E, Aggradi CF, Pirola A, Rao F, Roma E, Galluzzi C, Spanetta M, Cattaneo F, Rubino A, Agostoni EC, Amico F, Zanolini A, Izzi F, Greco G, Romigi A, Liguori C, Nobili L, Placidi F, Massa R. Assessment of self-reported and objective daytime sleepiness in adult-onset myotonic dystrophy type 1. J Clin Sleep Med 2021; 17:2383-2391. [PMID: 34170223 DOI: 10.5664/jcsm.9438] [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] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Excessive daytime sleepiness (EDS) in myotonic dystrophy type 1 (DM1) is mostly of central origin but it may coexist with sleep-related breathing disorders. However, there is no consensus on the sleep protocols to be used, assessments vary and only a minority of patients are regularly tested or are on treatment for EDS. Our study presents data on self-reported and objective EDS in adult-onset DM1. METHODS 63 adult-onset DM1 patients were subjected to EDS-sleep assessments (polysomnography, PSG; Multiple Sleep Latency Test, MSLT; Epworth Sleepiness Scale, ESS. Correlation coefficients were computed to assess the relationship between sleep and sleepiness test results, fatigue, quality of life. RESULTS 33% and 48% of patients had EDS based respectively on the ESS and the MSLT with a low concordance between these tests (k = 0.19). Thirteen patients (20%) displayed 2 or more sleep-onset REM periods on MSLT. Patients having EDS by MSLT had a shorter disease duration (p<0.05), higher total sleep time, sleep efficiency and lower WASO (Wake After Sleep Onset) on PSG. Patients with self-reported EDS reported significantly higher fatigue score compared to patients without EDS (p<0.05). No other difference was found in demographic, clinical and respiratory features. CONCLUSIONS EDS test results are contradictory making treatment options difficult. Combining quantitative tests and self-reported scales may facilitate physicians in planning EDS care with patients and families.
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Affiliation(s)
- Valeria A Sansone
- Neurorehabilitation Unit, University of Milan, Milan, Italy.,The NEMO Clinical Center in Milan, Italy
| | - Paola Proserpio
- Sleep Medicine Center, Dept. Neuroscience, Niguarda Hospital, Milan, Italy
| | - Luca Mauro
- The NEMO Clinical Center in Milan, Italy
| | | | - Erica Frezza
- Department of Neurology, Tor Vergata University of Rome, Rome, Italy
| | - Andrea Lanza
- Sleep Medicine Center, Dept. Neuroscience, Niguarda Hospital, Milan, Italy
| | - Paola Rogliani
- Department of Respiratory Diseases, Tor Vergata University of Rome, Rome, Italy
| | - Gabriella Pezzuto
- Department of Respiratory Diseases, Tor Vergata University of Rome, Rome, Italy
| | | | | | | | | | | | - Claudia Galluzzi
- Department of Neurology, Tor Vergata University of Rome, Rome, Italy
| | - Matteo Spanetta
- Department of Neurology, Tor Vergata University of Rome, Rome, Italy
| | - Federica Cattaneo
- Sleep Medicine Center, Dept. Neuroscience, Niguarda Hospital, Milan, Italy
| | - Annalisa Rubino
- Sleep Medicine Center, Dept. Neuroscience, Niguarda Hospital, Milan, Italy
| | | | - Federica Amico
- Sleep Medicine Center, Dept. Neuroscience, Niguarda Hospital, Milan, Italy
| | | | - Francesca Izzi
- Department of Neurology, Tor Vergata University of Rome, Rome, Italy
| | - Giulia Greco
- Department of Neurology, Tor Vergata University of Rome, Rome, Italy
| | - Andrea Romigi
- IRCCS Neuromed Istituto Neurologico Mediterraneo, Pozzilli (IS), Rome, Italy
| | - Claudio Liguori
- Department of Neurology, Tor Vergata University of Rome, Rome, Italy
| | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS Istituto G. Gaslini, Genoa, Italy.,Department of Neuroscience, DINOGMI, University of Genoa, Genoa, Italy
| | - Fabio Placidi
- Department of Neurology, Tor Vergata University of Rome, Rome, Italy
| | - Roberto Massa
- Department of Neurology, Tor Vergata University of Rome, Rome, Italy
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4
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Sansone VA, Pirola A, Lizio A, Greco LC, Coratti G, Casiraghi J, Pane M, Pera MC, Italiano C, Messina S, Pozzi S, Sframeli M, D'Amico A, Bertini E, Bruno C, Mauro L, Salmin F, Stancanelli C, Pedemonte M, Albamonte E, Zizzi C, Heatwole C, Mercuri E. The Spinal Muscular Atrophy Health Index: Italian validation of a disease-specific outcome measure. Neuromuscul Disord 2021; 31:409-418. [PMID: 33773884 DOI: 10.1016/j.nmd.2021.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 10/25/2020] [Revised: 01/23/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
Patient report outcome measures in Spinal Muscular Atrophy (SMA) represent a potential complement to observer rated scales which can be used to better understand treatment response. We developed, translated and validated an Italian version of the Spinal Muscular Atrophy Health Index (SMAHI), a disease-specific, patient reported outcome measure questionnaire, designed to estimate the patients' perception of disease burden. Test-retest reliability was assessed in 37 patients (16 children aged 12-17 and 21 adults) and was excellent in both cohorts. Internal consistency in an additional 98 patients (24 children, 74 adults) was also excellent (Cronbach's alpha = 0.93 and 0.91 respectively). In children the highest level of disease burden was generated from lower limb dysfunction and fatigue as well as their perception of decreased performance in social situations. Most patients in the adult cohort were sitters and complained of problems with upper limb functions as well as of fatigue. The SMAHI-IT was also able to differentiate between SMA types according to diseases severity. The results of our study demonstrate that the SMAHI can be considered a marker of disease-specific burden in patients with SMA with a high test-retest reliability and internal validity in Italian patients aged 12 and older.
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Affiliation(s)
- Valeria A Sansone
- The NEMO Clinical Center in Milan, Milan, Italy; Neurorehabilitation Unit, University of Milan, Milan, Italy.
| | | | | | | | - Giorgia Coratti
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Marika Pane
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy; Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | | | - Sonia Messina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; Nemo SUD Clinical Center, University Hospital "G. Martino", Messina, Italy
| | | | - Maria Sframeli
- Nemo SUD Clinical Center, University Hospital "G. Martino", Messina, Italy
| | - Adele D'Amico
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Enrico Bertini
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Claudio Bruno
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Luca Mauro
- The NEMO Clinical Center in Milan, Milan, Italy
| | | | | | - Marina Pedemonte
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Christine Zizzi
- University of Rochester, NY, United States; Center for Health and Technology (Outcomes Division), Rochester, NY, United States
| | - Chad Heatwole
- University of Rochester, NY, United States; Center for Health and Technology (Outcomes Division), Rochester, NY, United States
| | - Eugenio Mercuri
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
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5
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Sansone VA, Coratti G, Pera MC, Pane M, Messina S, Salmin F, Albamonte E, De Sanctis R, Sframeli M, Di Bella V, Morando S, d'Amico A, Frongia AL, Antonaci L, Pirola A, Pedemonte M, Bertini E, Bruno C, Mercuri E. Sometimes they come back: New and old spinal muscular atrophy adults in the era of nusinersen. Eur J Neurol 2020; 28:602-608. [PMID: 33012052 DOI: 10.1111/ene.14567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/24/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Following the commercial availability of nusinersen, there have been a number of new referrals of adults with spinal muscular atrophy (SMA) not regularly followed in tertiary-care centers or enrolled in any disease registry. METHODS We compared demographics and disease characteristics, including assessment of motor and respiratory function, in regularly followed patients and newcomers subdivided according to the SMA type. RESULTS The cohort included 166 adult patients (mean age: 37.09 years): one type I, 65 type II, 99 type III, and one type IV. Of these 166, there were 67 newcomers. There was no significant difference between newcomers and regularly followed patients in relation to age and disease duration. The Hammersmith Functional Motor Scale Expanded and Revised Upper Limb Module scores were higher in the regularly followed patients compared to newcomers in the whole cohort and in both SMA II and II. A difference was also found on ventilatory status (p = 0.013) and Cobb's angle >50° (p = 0.039) between the two subgroups. No difference was found in scoliosis surgery prevalence (p > 0.05). CONCLUSIONS Our results showed differences between the two subgroups, even if less marked in the type III patients. In the type II patients, there was a higher proportion of newcomers who were in the severe end of the spectrum. Of the newcomers, only approximately a third initiated treatment, as opposed to the 51% in the regularly followed patients. The identification of patients who were not part of the registries will help to redefine the overall prevalence of SMA and the occurrence of different phenotypes.
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Affiliation(s)
- V A Sansone
- The NEMO Center in Milan, Neurorehabilitation Unit, ASST Niguarda Hospital, University of Milan, Milan, Italy
| | - G Coratti
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.,Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M C Pera
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.,Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M Pane
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.,Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - S Messina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Nemo SUD Clinical Center, University Hospital 'G. Martino', Messina, Italy
| | - F Salmin
- The NEMO Center in Milan, Neurorehabilitation Unit, ASST Niguarda Hospital, University of Milan, Milan, Italy
| | - E Albamonte
- The NEMO Center in Milan, Neurorehabilitation Unit, ASST Niguarda Hospital, University of Milan, Milan, Italy
| | - R De Sanctis
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M Sframeli
- Nemo SUD Clinical Center, University Hospital 'G. Martino', Messina, Italy
| | - V Di Bella
- Nemo SUD Clinical Center, University Hospital 'G. Martino', Messina, Italy
| | - S Morando
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - A d'Amico
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A L Frongia
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.,Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - L Antonaci
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.,Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Pirola
- The NEMO Center in Milan, Neurorehabilitation Unit, ASST Niguarda Hospital, University of Milan, Milan, Italy
| | - M Pedemonte
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - E Bertini
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - C Bruno
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - E Mercuri
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.,Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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6
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Pirola A, De Mattia E, Lizio A, Sannicolò G, Carraro E, Rao F, Sansone V, Lunetta C. The prognostic value of spirometric tests in Amyotrophic Lateral Sclerosis patients. Clin Neurol Neurosurg 2019; 184:105456. [PMID: 31382080 DOI: 10.1016/j.clineuro.2019.105456] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 05/21/2019] [Revised: 07/24/2019] [Accepted: 07/28/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Amyotrophic lateral sclerosis (ALS) patients tend to develop progressive respiratory muscle weakness, leading to ventilatory failure and ineffective cough, principal causes of morbidity and mortality. Since patients are usually unaware of these symptoms, these are generally not noticed until the advanced stages and are associated with poor prognosis. The monitoring of respiratory function on a regular basis is therefore of great importance. Despite the availability of several pulmonary function tests, none of them was found to be the best indicator of the disease progression throughout the course of this condition. The main aim of our work was to evaluate the prognostic value of these respiratory measures evaluated in a brief period of observation and their correlation with motor functional impairments in an ALS cohort. PATIENTS AND METHODS Patients with ALS who had respiratory assessments performed and functional motor scales administered at baseline and six months later were included. All patients were assessed with forced vital capacity, both in seated and supine position (FVC; sFVC), peak expiratory flow (PEF), peak expiratory cough flow (PCEF), the revised ALS functional rating scale (ALSFRS-R), at baseline and after six months, and their disease progression rate (ΔFS) was obtained. RESULTS We included 73 patients with probable or definite ALS according to El-Escorial revised Criteria. At baseline, PCEF and PEF significantly correlated with ALSFRS-R total, bulbar and spinal subscores and ΔFS, while FVC% significantly correlated with ΔFS. After 6 months all the respiratory parameters significantly correlated with ALSFRS-R and all its subscores. Longitudinally, FVC%, sFVC% and PCEF significantly correlated with ΔFS and some of ALSFRS-R subscores. As concerns the survival analysis, monthly declines of FVC% and sFVC%, significantly correlated with the survival. The worse prognosis in terms of survival was finally found in those whose FVC% and sFVC% dropped below their respective cut-offs. CONCLUSION Throughout the course of ALS disease, the monitoring of several respiratory markers, namely FVC, sFVC, PEF and PCEF, plays a critical role in predicting the prognosis of these subjects, both in terms of survival and functional ability. The implementation of monthly cut-offs in the evaluation of FVC and sFVC may allow a faster recognition of those patients with worse prognosis and therefore an optimized tailored clinical care, as well as a better stratification in clinical trials.
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Affiliation(s)
- Alice Pirola
- NEuroMuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy.
| | - Elisa De Mattia
- NEuroMuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy
| | - Andrea Lizio
- NEuroMuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy
| | | | - Elena Carraro
- NEuroMuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy
| | - Fabrizio Rao
- NEuroMuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy
| | - Valeria Sansone
- NEuroMuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy; Neurorehabilitation Unit, Dept. Biomedical Sciences of Health, University of Milan, Italy
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7
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Sansone VA, Albamonte E, Salmin F, Casiraghi J, Pirola A, Bettinelli M, Rao F, Mancini L, Tovaglieri N, Fedeli F, Stoia P, Heinen M, Cozzi V, Carraro E, Lunetta C, Di Bari A, Mercuri E. Intrathecal nusinersen treatment for SMA in a dedicated neuromuscular clinic: an example of multidisciplinary and integrated care. Neurol Sci 2018; 40:327-332. [PMID: 30430317 DOI: 10.1007/s10072-018-3622-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/24/2018] [Indexed: 11/29/2022]
Abstract
Nusinsersen is now available in Italy for all SMA types. We describe the experience with intrathecal treatment with nusinersen in 50 patients with SMA at the NEMO Center (NEuroMuscular Omniservice Clinical Center) in Milan, a neuromuscular patient-centered clinic hosted within Niguarda Hospital, a National Public General Hospital. Our results indicate that the pathway of care described outweighs the burden due to the repeated intrathecal injections. Irrespective of age and severity, the treatment is feasible, accessible, and replicable provided that there is a multidisciplinary team having experience and training in SMA.
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Affiliation(s)
- Valeria A Sansone
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy.
| | - Emilio Albamonte
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | - Francesca Salmin
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | - Jacopo Casiraghi
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | - Alice Pirola
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | - Massimo Bettinelli
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | - Fabrizio Rao
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | | | | | | | - Paolo Stoia
- Dept of Pediatrics, ASST Niguarda, Milan, Italy
| | | | | | - Elena Carraro
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | - Christian Lunetta
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | - Alessandra Di Bari
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Milan, Italy
| | - Eugenio Mercuri
- Child Neurology Department, the NEMO Clinical Center, Policlinico Universitario "A. Gemelli", Rome, Italy
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Locasciulli A, Uderzo C, Pirola A, Masera G, Portmann B, Alberti A. Pattern of Liver Disease Following High-Dose Cytosine Arabinoside (HDARAC) Therapy in Children with Acute Myeloid Leukemia. Leuk Lymphoma 2016; 2:229-33. [PMID: 27456739 DOI: 10.3109/10428199009053528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The occurrence of liver disease and its relation to HBV markers were investigated in ten children with AML who were given HDARAC as late consolidation therapy. None of them developed jaundice or biochemical evidence of cholestasis. During therapy, SGPT values were normal in 5/10 patients, while in the other 5 a sharp increase was noted. These enzyme elevations followed an unusual timing, peaking just before each infusion of HDARAC. Evidence of long-lasting hepatocellular necrosis after therapy withdrawal was found in 8/8 cases. One child died of fulminant type B hepatitis and HBsAg positivity was found in 2/10 patients during therapy and 3/8 after withdrawal of the drug. Three children developed HBV antibodies during the observation period. We conclude that the use of HDARAC in childhood leukemia is not associated with major evidence of direct drug hepatotoxicity while it clearly affects the natural outcome of viral hepatitis.
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Affiliation(s)
- A Locasciulli
- a Clinica Pediatrica Universita's di Milano, Ospedale "S. Gerardo", Monza, Milan, Italy
| | - C Uderzo
- a Clinica Pediatrica Universita's di Milano, Ospedale "S. Gerardo", Monza, Milan, Italy
| | - A Pirola
- a Clinica Pediatrica Universita's di Milano, Ospedale "S. Gerardo", Monza, Milan, Italy
| | - G Masera
- a Clinica Pediatrica Universita's di Milano, Ospedale "S. Gerardo", Monza, Milan, Italy
| | - B Portmann
- b Liver Unit, King's College Hospital and Medical School, London, UK
| | - A Alberti
- c Istituto di Medicina Clinica, Clinica Medica II Universita's di, Padova, Italy
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Ceccon M, Mologni L, Giudici G, Piazza R, Pirola A, Fontana D, Gambacorti-Passerini C. Treatment Efficacy and Resistance Mechanisms Using the Second-Generation ALK Inhibitor AP26113 in Human NPM-ALK-Positive Anaplastic Large Cell Lymphoma. Mol Cancer Res 2014; 13:775-83. [PMID: 25421750 DOI: 10.1158/1541-7786.mcr-14-0157] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 11/12/2014] [Indexed: 11/16/2022]
Abstract
UNLABELLED ALK is a tyrosine kinase receptor involved in a broad range of solid and hematologic tumors. Among 70% to 80% of ALK(+) anaplastic large cell lymphomas (ALCL) are caused by the aberrant oncogenic fusion protein NPM-ALK. Crizotinib was the first clinically relevant ALK inhibitor, now approved for the treatment of late-stage and metastatic cases of lung cancer. However, patients frequently develop drug resistance to Crizotinib, mainly due to the appearance of point mutations located in the ALK kinase domain. Fortunately, other inhibitors are available and in clinical trial, suggesting the potential for second-line therapies to overcome Crizotinib resistance. This study focuses on the ongoing phase I/II trial small-molecule tyrosine kinase inhibitor (TKI) AP26113, by Ariad Pharmaceuticals, which targets both ALK and EGFR. Two NPM-ALK(+) human cell lines, KARPAS-299 and SUP-M2, were grown in the presence of increasing concentrations of AP26113, and eight lines were selected that demonstrated resistance. All lines show IC50 values higher (130 to 1,000-fold) than the parental line. Mechanistically, KARPAS-299 populations resistant to AP26113 show NPM-ALK overexpression, whereas SUP-M2-resistant cells harbor several point mutations spanning the entire ALK kinase domain. In particular, amino acid substitutions: L1196M, S1206C, the double F1174V+L1198F and L1122V+L1196M mutations were identified. The knowledge of the possible appearance of new clinically relevant mechanisms of drug resistance is a useful tool for the management of new TKI-resistant cases. IMPLICATIONS This work defines reliable ALCL model systems of AP26113 resistance and provides a valuable tool in the management of all cases of relapse upon NPM-ALK-targeted therapy.
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Affiliation(s)
- M Ceccon
- Department of Health Science, University of Milano-Bicocca, Monza, Italy.
| | - L Mologni
- Department of Health Science, University of Milano-Bicocca, Monza, Italy
| | - G Giudici
- Tettamanti Research Centre, Pediatric Clinic, University of Milano-Bicocca, Monza, Italy
| | - R Piazza
- Department of Health Science, University of Milano-Bicocca, Monza, Italy
| | - A Pirola
- Department of Health Science, University of Milano-Bicocca, Monza, Italy
| | - D Fontana
- Department of Health Science, University of Milano-Bicocca, Monza, Italy
| | - C Gambacorti-Passerini
- Department of Health Science, University of Milano-Bicocca, Monza, Italy. Section of Haematology, San Gerardo Hospital, Monza, Italy
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Llagunes J, Casanova I, Reina C, Carmona P, Pirola A, de Andrés J. [Late-onset postpartum sepsis with septic shock and heart dysfunction]. Rev Esp Anestesiol Reanim 2011; 58:387-389. [PMID: 21797090 DOI: 10.1016/s0034-9356(11)70089-5] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report a case of late-onset postpartum sepsis from endometritis due to group A streptococci (GAS) in a 37-year-old white woman. The patient developed septic shock, with mitral regurgitation and cardiac dysfunction. Early treatment with broad-spectrum antibiotics and hemodynamic support was essential for a favorable outcome. Because of the resurgence of virulent strains of GAS that can cause fatal infections, these pathogens should be included in the differential diagnosis of postpartum infections in the mother. Although cardiac dysfunction is rare in association with GAS infection, it should be ruled out by echocardiography when the condition of a patient with sepsis does not improve.
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Affiliation(s)
- J Llagunes
- Servicio de Anestesiologia, Cuidados Críticos y Medicina del Dolor, Consorcio Hospital General Universitario, Valencia
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Termine C, Stella G, Capsoni C, Rosso E, Binda A, Pirola A, Conti C, Gruppi E, Lanzi G, Salini S, Tognatti C, Zoppello M, Balottin U. Neuropsychological profile of pre-schoolers with metaphonological difficulties: results from a non-clinical sample. Child Care Health Dev 2007; 33:703-12. [PMID: 17944779 DOI: 10.1111/j.1365-2214.2007.00732.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The level of language development reached in pre-school age is considered the most reliable predictor of reading acquisition. In normally developing children, learning to read is strongly related to early language skills, and in particular to phonological processing abilities. In dyslexic children, reading abilities seem to show a correlation with phonological awareness. METHODS A group of 65 children (aged 5-6 years) were recruited and submitted to an in-depth neuropsychological assessment [i.e. metaphonological skills, intelligence, verbal short-term memory (VSTM) and other aspects of receptive and expressive language]. We were able to identify 14 children with significant metaphonological difficulties (MD): 11 children with exclusively MD, and the other three children with specific language impairment. This study compares the neuropsychological profile obtained from children with MD with that of a peer group without any language impairment (N). RESULTS The performances of the MD were within the normal ability range in almost all the administered tests but significantly lower compared with those of their peers without language impairment (N) in some items of the intelligence scale (Wechsler Preschool and Primary Scale of Intelligence) and in the tests of VSTM and of receptive/expressive language. Nevertheless, there were not statistically significant differences between MD and N in output phonology. CONCLUSIONS In pre-school age, in a group of non-clinical children, with a range of abilities, those with MD appear to be at the lower end of the normal range in many other verbal skills. These children could be considered at-risk for possible subsequent difficulties learning to read and thus need to be identified and to warrant prompt treatment.
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Affiliation(s)
- C Termine
- Child Neuropsychiatry Unit, University of Insubria, Varese, Italy.
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Iacomini M, Casu B, Guerrini M, Naggi A, Pirola A, Torri G. "Linkage region" sequences of heparins and heparan sulfates: detection and quantification by nuclear magnetic resonance spectroscopy. Anal Biochem 1999; 274:50-8. [PMID: 10527496 DOI: 10.1006/abio.1999.4230] [Citation(s) in RCA: 27] [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] [Indexed: 11/22/2022]
Abstract
The (13)C NMR spectra of most heparin and heparan sulfate preparations display minor signals not attributable to the glycosaminoglycan chains of these polysaccharides. These signals have been "concentrated" in oligosaccharides isolated from an acid hydrolyzate of heparin and shown to arise from the sequence GlcA-Gal-Gal-Xyl of the "linkage region" (LR) connecting the carbohydrate chains to the peptide chains in the original proteoglycans. Mono- and two-dimensional (1)H and (13)C NMR analysis of the major oligosaccharide (LR-OLIGO) indicated the prevalent structure GlcA-GlcNAc-GlcA-Gal-Gal-Xyl, where GlcNAc is partially 6-O-sulfated. (13)C NMR signals at 84.6 and 85.0 ppm, arising from C-3 of the two Gal residues, lend themselves to easy detection and quantification of the linkage region in heparins and heparan sulfates and can be used to assess the importance of the LR in the modulation of various biological activities of these glycosaminoglycans.
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Affiliation(s)
- M Iacomini
- Istituto di Ricerche Chimiche e Biochimiche "G. Ronzoni,", via G. Colombo, Milan, 81-20133, Italy
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Abstract
The gene coding for the Bacillus subtilis extracellular neutral protease was isolated from strain BGSC 1A341, an overproducer carrying the nprR2 region, and from strain 168, a normal producer with the nprR1 sequence. The sequence of about 600 nucleotides upstream from the start codon of the protease gene was determined for both strains. The two regions are highly homologous except for a stretch of 66 base pairs close to the promoter region, which is absent in the BGSC 1A341 gene. Northern blot analysis of the in vivo RNAs indicated that the different levels of enzyme secreted by the two strains were due to different amounts of transcripts that accumulated in the cells. Furthermore, at the end of exponential growth, the amount of transcript increased dramatically in the overproducer strain but remained approximately constant in the normal producer strain. The start point(s) for transcription, however, as determined by S1 nuclease mapping of the in vivo transcripts, appeared to be the same for both genes.
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