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Silverio A, Bellino M, Scudiero F, Attisano T, Baldi C, Catalano A, Centore M, Cesaro A, Di Maio M, Esposito L, Granata G, Maiellaro F, Muraca I, Musumeci G, Parodi G, Personeni D, Valenti R, Vecchione C, Calabrò P, Galasso G. Intravenous antiplatelet therapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention : A report from the INVEST-STEMI group. J Thromb Thrombolysis 2024:10.1007/s11239-024-02970-7. [PMID: 38615155 DOI: 10.1007/s11239-024-02970-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/15/2024]
Abstract
The use of intravenous antiplatelet therapy during primary percutaneous coronary intervention (PPCI) is not fully standardized. The aim is to evaluate the effectiveness and safety of periprocedural intravenous administration of cangrelor or tirofiban in a contemporary ST-segment elevation myocardial infarction (STEMI) population undergoing PPCI. This was a multicenter prospective cohort study including consecutive STEMI patients who received cangrelor or tirofiban during PPCI at seven Italian centers. The primary effectiveness measure was the angiographic evidence of thrombolysis in myocardial infarction (TIMI) flow < 3 after PPCI. The primary safety outcome was the in-hospital occurrence of BARC (Bleeding Academic Research Consortium) 2-5 bleedings. The study included 627 patients (median age 63 years, 79% males): 312 received cangrelor, 315 tirofiban. The percentage of history of bleeding, pulmonary edema and cardiogenic shock at admission was comparable between groups. Patients receiving cangrelor had lower ischemia time compared to tirofiban. TIMI flow before PPCI and TIMI thrombus grade were comparable between groups. At propensity score-weighted regression analysis, the risk of TIMI flow < 3 was significantly lower in patients treated with cangrelor compared to tirofiban (adjusted OR: 0.40; 95% CI: 0.30-0.53). The risk of BARC 2-5 bleeding was comparable between groups (adjusted OR:1.35; 95% CI: 0.92-1.98). These results were consistent across multiple prespecified subgroups, including subjects stratified for different total ischemia time, with no statistical interaction. In this real-world multicenter STEMI population, the use of cangrelor was associated with improved myocardial perfusion assessed by coronary angiography after PPCI without increasing clinically-relevant bleedings compared to tirofiban.
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Affiliation(s)
- Angelo Silverio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy.
| | - Michele Bellino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy
| | - Fernando Scudiero
- Cardiology Unit, Medical Sciences Departement, ASST Bergamo Est, Seriate, Bergamo, Italy
| | - Tiziana Attisano
- Interventional Cardiology Unit, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Cesare Baldi
- Interventional Cardiology Unit, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Angelo Catalano
- Cardiology Unit, Hospital Maria SS. Addolorata, Eboli, Italy
| | - Mario Centore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy
- Cardiology Unit, Hospital Maria SS. Addolorata, Eboli, Italy
| | - Arturo Cesaro
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Marco Di Maio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy
| | - Luca Esposito
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Giovanni Granata
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy
| | | | - Iacopo Muraca
- Division of Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, Florence, Italy
| | - Giuseppe Musumeci
- Cardiology Department, Azienda Ospedaliera Ordine Mauriziano Umberto I, Turin, Italy
| | - Guido Parodi
- Cardiology Unit, Department of Medicine, Lavagna Hospital, Lavagna, Italy
| | - Davide Personeni
- Cardiology Unit, Medical Sciences Departement, ASST Bergamo Est, Seriate, Bergamo, Italy
| | - Renato Valenti
- Division of Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, Florence, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy
| | - Paolo Calabrò
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy
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Viprey VF, Granata G, Vendrik KEW, Davis GL, Petrosillo N, Kuijper EJ, Vilken T, Lammens C, Schotsman JJ, Benson AD, Cataldo MA, van der Kooi TII, Wilcox MH, Davies KA, Davies KA, Wilcox MH, Kuijper E, Rupnik M, Wingen-Heimann S, Tacconelli E, Vilken T, Petrosillo N, Bonten M, Cleuziat P, Webber C, Rupnik M, Wilcox M. European survey on the current surveillance practices, management guidelines, treatment pathways and heterogeneity of testing of Clostridioides difficile, 2018-2019: results from The Combatting Bacterial Resistance in Europe CDI (COMBACTE-CDI). J Hosp Infect 2023; 131:213-220. [PMID: 36462673 DOI: 10.1016/j.jhin.2022.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 09/14/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Awareness and compliance with international guidelines for diagnosis and clinical management of Clostridioides difficile infection (CDI) are unknown. AIM To compare the awareness and compliance with the recommended strategies for diagnosis and clinical management of CDI across Europe in 2018-2019. METHODS Hospital sites and their associated community practices across 12 European countries completed an online survey in 2018-2019, to report on their practices in terms of surveillance, prevention, diagnosis, and treatment of CDI. Responses were collected from 105 hospitals and 39 community general practitioners (GPs). FINDINGS Hospital sites of 11 countries reported participation in national surveillance schemes compared with six countries for international schemes. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID)-recommended CDI testing methodologies were used by 82% (86/105) of hospitals, however countries reporting the highest incidence of CDI used non-recommended tests. Over 75% (80/105) of hospitals were aware of the most recent European CDI treatment guidelines at the time of this survey compared with only 26% (10/39) of surveyed GPs. However, up to 15% (16/105) of hospitals reported using the non-recommended metronidazole for recurrent CDI cases, sites in countries with lower awareness of CDI treatment guidelines. Only 37% (39/105) of hospitals adopted contact isolation precautions in case of suspected CDI. CONCLUSION Good awareness of guidelines for the management of CDI was observed across the surveyed European hospital sites. However, low compliance with diagnostic testing guidelines, infection control measures for suspected CDI, and insufficient awareness of treatment guidelines continued to be reported in some countries.
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Affiliation(s)
- V F Viprey
- Healthcare Associated Infections Research Group, Leeds Institute of Medical Research, University of Leeds, Leeds, UK.
| | - G Granata
- National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy
| | - K E W Vendrik
- Leiden University Medical Center, Leiden, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - G L Davis
- Healthcare Associated Infections Research Group, Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - N Petrosillo
- National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy
| | - E J Kuijper
- Leiden University Medical Center, Leiden, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands; European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Study Group for Clostridioides Difficile (ESGCD)
| | - T Vilken
- Laboratory of Medical Microbiology, University of Antwerp, Antwerp, Belgium
| | - C Lammens
- Laboratory of Medical Microbiology, University of Antwerp, Antwerp, Belgium
| | - J J Schotsman
- University Medical Centre Utrecht, Utrecht, the Netherlands
| | - A D Benson
- Healthcare Associated Infections Research Group, Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - M A Cataldo
- National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy
| | - T I I van der Kooi
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - M H Wilcox
- Healthcare Associated Infections Research Group, Leeds Institute of Medical Research, University of Leeds, Leeds, UK; European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Study Group for Clostridioides Difficile (ESGCD); Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - K A Davies
- Healthcare Associated Infections Research Group, Leeds Institute of Medical Research, University of Leeds, Leeds, UK; European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Study Group for Clostridioides Difficile (ESGCD); Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Cataldo M, Granata G, Caraffa E, Adamoli L, Borromeo R, Fossati S, Franceschini E, Giacobbe D, Giacometti E, Lagi F, Lombardi A, Oliva A, Pandolfo A, Trapani F, Petrosillo N. Recurrence of Clostridioides difficile infection: A multicenter study on incidence and risk factors. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Petrosillo N, Cataldo M, Granata G, Davies K. Current diagnosis, management and treatment pathways for Clostridioides difficile infection in Italy. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.368] [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: 10/22/2022] Open
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Granata G, Valle G, Di Iorio R, Iodice F, Petrini FM, Strauss I, D'anna E, Iberite F, Lauretti L, Fernandez E, Romanello R, Stieglitz T, Raspopovic S, Calabresi P, Micera S, Rossini PM. Cortical plasticity after hand prostheses use: Is the hypothesis of deafferented cortex "invasion" always true? Clin Neurophysiol 2020; 131:2341-2348. [PMID: 32828036 DOI: 10.1016/j.clinph.2020.06.023] [Citation(s) in RCA: 2] [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] [Received: 03/23/2020] [Revised: 05/14/2020] [Accepted: 06/11/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To study motor cortex plasticity after a period of training with a new prototype of bidirectional hand prosthesis in three left trans-radial amputees, correlating these changes with the modification of Phantom Limb Pain (PLP) in the same period. METHODS Each subject underwent a brain motor mapping with Transcranial Magnetic Stimulation (TMS) and PLP evaluation with questionnaires during a six-month training with a prototype of bidirectional hand prosthesis. RESULTS The baseline motor maps showed in all three amputees a smaller area of muscles representation of the amputated side compared to the intact limb. After training, there was a partial reversal of the baseline asymmetry. The two subjects affected by PLP experienced a statistically significant reduction of pain. CONCLUSIONS Two apparently opposite findings, the invasion of the "deafferented" cortex by neighbouring areas and the "persistence" of neural structures after amputation, could vary according to different target used for measurement. Our results do not support a correlation between PLP and motor cortical changes. SIGNIFICANCE The selection of the target and of the task is essential for studies investigating motor brain plasticity. This study boosts against a direct and unique role of motor cortical changes on PLP genesis.
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Affiliation(s)
- G Granata
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - G Valle
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - R Di Iorio
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - F Iodice
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Department of Neuroscience, San Raffaele Pisana IRCCS, Rome, Italy
| | - F M Petrini
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - I Strauss
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - E D'anna
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - F Iberite
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - L Lauretti
- Institute of Neurosurgery, Catholic University of The Sacred Heart, Roma, Italy
| | - E Fernandez
- Institute of Neurosurgery, Catholic University of The Sacred Heart, Roma, Italy
| | - R Romanello
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - T Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg and BrainLinks-BrainTools Center, University of Freiburg, Freiburg, Germany
| | - S Raspopovic
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - P Calabresi
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - S Micera
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - P M Rossini
- Department of Neuroscience, San Raffaele Pisana IRCCS, Rome, Italy
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Ferrara F, Granata G, Pelliccia C, La Porta R, Vitiello A. Glyphozines and treatment of cardiac disease. Geriatr Care 2020. [DOI: 10.4081/gc.2020.9079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Glyphozines also called SGLT2 inhibitors, are a new class of agents that inhibit reabsorption of glucose in the kidney, in proximal tubules, and therefore lower blood sugar. They act by inhibiting sodiumglucose transport protein 2 (SGLT2). Glyphozines are used in the treatment of type II diabetes mellitus. In studies with canagliflozin, a member of this class, the medication was found to enhance blood sugar control as well as reduce body weight and systolic and diastolic blood pressure. In addition to regulate blood glucose, recent studies have shown that glyphozines have important positive cardiovascular benefits, such as weight loss, decreased volaemia and PA, reduced triglycerides, natriuresis and improved endothelial wall dysfunction. Clinical studies have shown reduction in deaths from cardiovascular events among diabetic patients treated with glyphozines. At the moment these drugs are being studied for an extension of the therapeutic indication also for cardiovascular diseases such as heart failure. In this review, we discuss the class of SGLT2 inhibitors in the treatment of diabetes, and studies focused on their possible role in the treatment of cardiac disease.
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Bassetti M, Giacobbe DR, Aliberti S, Barisione E, Centanni S, De Rosa FG, Di Marco F, Gori A, Granata G, Mikulska M, Petrosillo N, Richeldi L, Santus P, Tascini C, Vena A, Viale P, Blasi F. Balancing evidence and frontline experience in the early phases of the COVID-19 pandemic: current position of the Italian Society of Anti-infective Therapy (SITA) and the Italian Society of Pulmonology (SIP). Clin Microbiol Infect 2020; 26:880-894. [PMID: 32360444 PMCID: PMC7195088 DOI: 10.1016/j.cmi.2020.04.031] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/23/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which has rapidly become epidemic in Italy and other European countries. The disease spectrum ranges from asymptomatic/mildly symptomatic presentations to acute respiratory failure. At the present time the absolute number of severe cases requiring ventilator support is reaching or even surpassing the intensive care unit bed capacity in the most affected regions and countries. OBJECTIVES To narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and frontline opinions and to provide balanced answers to pressing clinical questions. SOURCES Inductive PubMed search for publications relevant to the topic. CONTENT The available literature and the authors' frontline-based opinion are summarized in brief narrative answers to selected clinical questions, with a conclusive statement provided for each answer. IMPLICATIONS Many off-label antiviral and anti-inflammatory drugs are currently being administered to patients with COVID-19. Physicians must be aware that, as they are not supported by high-level evidence, these treatments may often be ethically justifiable only in those worsening patients unlikely to improve only with supportive care, and who cannot be enrolled onto randomized clinical trials. Access to well-designed randomized controlled trials should be expanded as much as possible because it is the most secure way to change for the better our approach to COVID-19 patients.
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Affiliation(s)
- M Bassetti
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
| | - D R Giacobbe
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - S Aliberti
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy
| | - E Barisione
- Interventional Pulmonology, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - S Centanni
- Department of Health Sciences, University of Milan, Respiratory Unit, ASST Santi Paolo e Carlo, Milan, Italy
| | - F G De Rosa
- Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy
| | - F Di Marco
- Department of Health Sciences, University of Milan, Respiratory Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - A Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - G Granata
- Clinical and Research Department for Infectious Diseases, Severe and Immunedepression-Associated Infections Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy
| | - M Mikulska
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - N Petrosillo
- Clinical and Research Department for Infectious Diseases, Severe and Immunedepression-Associated Infections Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy
| | - L Richeldi
- Dipartimento Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, UOC Pneumologia, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Santus
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Division of Respiratory Diseases, Luigi Sacco University Hospital, Milan, Italy
| | - C Tascini
- Infectious Diseases Clinic, Santa Maria Misericordia Hospital, Udine, Italy
| | - A Vena
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - P Viale
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - F Blasi
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy
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Vitiello A, Ferrara F, Pelliccia C, Granata G, La Porta R. Cytokine storm and colchicine potential role fighting SARS-CoV-2 pneumonia. Ital J Med 2020. [DOI: 10.4081/itjm.2020.1284] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
For some patients with SARS-CoV-2, the worst clinical damage is not caused by the virus itself, but by an overactive inflammatory state. In fact, in some people the immune system goes into overdrive and launches a large-scale assault on the tissue known as cytokine storm. This excessive inflammatory/immune reaction can damage tissue and eventually kill people. Evidence shows that blocking such cytokine storms can be effective and trials are underway to test drugs that act by reducing cytokine response, such as tocilizumab and sarilumab which bind interleukin 6 (IL-6), or anikinra which is the interleukin 1 receptor antagonist (IL-1). However, other drugs that block the cytokine cascade can also be considered. In this article we describe the scientific and molecular motivation for the use of drugs that act by modulating the hyperactive inflammatory system in severe patients suffering from SARS-CoV-2, considering in particular an old drug that has been in use for many years for other therapeutic indications such as colchicine, and that could be favourable to its use, with low cost and good tolerability.
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Tafciu E, Granata G, Ancona F, Stella S, Capogrosso C, Ingallina G, Melillo F, Castiglioni A, De Bonis M, Alfieri O, Agricola E. 1183 Three-dimensional echocardiographic paramenters for mitral valve quantification: a feasibility and validation study. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Mitral regurgitation (MR) severity affects prognosis and a correct quantification is key for surgical indication. A multiparametric approach (MPA) is recommended, as singular parameters suffer pitfalls. Recently suggested three-dimensional echocardiographic (3DE) parameters lack clear reference values. No studies have assessed the feasibility of regurgitant volume (RV) and fraction (RF) using the 3D planimetric area of the mitral annulus (MAA) and of the left ventricular outflow tract (LVOTA).
Purpose
To assess the feasibility and reliability of 3DE, RV and RF obtained by doppler volumetric method using MAA and LVOTA, compare results with 2DE and 3D vena contracta area (VCA) and propose cut-offs for these parameters using MPA as gold standard.
Methods
Patients referred to our Department for MR assessment were enrolled from September 2018 to February 2019 without more than mild aortic regurgitation or severe stenosis, mitral stenosis and previous valvular surgery. Transthoracic 2DE was used to calculate a multiparametric index of MR severity including: jet area/left atrium (LA) area, CW characteristics, 2D vena contracta, PISA, pulmonary vein flow, LA volume and systolic pulmonary artery pressure. Transoesophageal 3DE was used to assess MAA and LVOTA from a 3D dataset. RV and RF were calculated by Doppler volumetric method using the planimetric areas instead of diameters. VCA 3D was calculated from a 3D color dataset as the cross-sectional area of the regurgitant jet. We compared the results between 2DE and 3DE and between functional and organic MR. ROC curves were analyzed to assess diagnostic performance and identify cut-offs for severity prediction. Intraclass correlation coefficient was calculated to assess variability in measurements.
Results
Population was composed by 87 patients (56 male, 65 ± 13 years), 72% organic MR. MAA was larger in 2DE (10.4 ± 3.2 vs 9.8 ± 2.9 cm2,) as was the RV (76.6 ± 36.1 vs 66.4 ± 31.9 ml) and RF (55.4 ± 12.4 vs 50.4 vs 10.9%, all p < 0.0001), while LVOTA was smaller (3.9 ± 0.98 vs 4.1 ± 1.0 cm2, p < 0.0001). RV 2D and RF 2D were larger in the organic MR group (p < 0.0001), meanwhile VCA 3D, RV 3D and RF 3D did not show a significant difference (all p > 0.1). VCA 3D had a good correlation with RV 3D (r = 0.593, p < 0.0001) and RF 3D (r = 0.576, p < 0.0001).
We proposed a cut-off value of 41.5 mm2 for VCA 3D (94% sens, 96% spec, AUC 0.978), 52 ml for RV 3D (84% sens, 78% spec, AUC 0.901) and 47.6% for RF 3D (91% sens, 90% spec, AUC 0.966) to predict MR severity as assessed by MPA.
Intraclass correlation coefficient was 0.980 for MAA and 0.985 for LVOTA for intra-observer variability, while for inter-observer variability it was 0.951 for MAA and 0.962 for LVOTA.
Conclusion
2DE overestimates MA dimensions and underestimates LVOT dimensions thus overestimating RV and RF. 3DE measures are relatively simple and reproducible. Proposed cut-offs for RV, RF and VCA 3D have a good diagnostic power.
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Affiliation(s)
- E Tafciu
- San Raffaele Scientific Institute, Milan, Italy
| | - G Granata
- San Raffaele Scientific Institute, Milan, Italy
| | - F Ancona
- San Raffaele Scientific Institute, Milan, Italy
| | - S Stella
- San Raffaele Scientific Institute, Milan, Italy
| | | | - G Ingallina
- San Raffaele Scientific Institute, Milan, Italy
| | - F Melillo
- San Raffaele Scientific Institute, Milan, Italy
| | | | - M De Bonis
- San Raffaele Scientific Institute, Milan, Italy
| | - O Alfieri
- San Raffaele Scientific Institute, Milan, Italy
| | - E Agricola
- San Raffaele Scientific Institute, Milan, Italy
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Granata G, Veltri A, Iuliano S, Romano V, Stella S, Capogrosso C, Ancona F, Ingallina G, Melillo F, Montorfano M, Agricola E. P218 Accuracy and reproducibility of aortic root assessment by eSie Valves in patients candidate to transcatheter aortic valve implantation: a comparative study with computed tomography. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Accurate imaging assessment of the aortic root (AR) is critical for prosthesis sizing in transcatheter aortic valve implantation. Multislice computed tomography (MSCT) is the gold standard for this purpose. 3D transesophageal (3D-TOE) reconstruction tools have recently been introduced, which automatically configures a geometric model of AR from 3D-TOE dataset and perform quantitative analyses of the AR.
Purpose
The aim of the study was to compare semi-automated measurements of AR obtained by eSie Valves (EV) (Siemens Medical Solution, California, USA) tool with MSCT.
Methods
We prospectively enrolled 26 consecutive patients (mean age 79.5 ± 7.5 years; 38% men) with severe symptomatic aortic stenosis (mean gradient 48.8± 13.6 mmHg) who underwent both 3D-TOE and MSCT as part of TAVI evaluation protocol. Volumetric datasets of the AR, acquired with 3D-TOE in mid-esophageal view, were analyzed with EV tool. EV tool automatically detected AR landmarks and, after user validation, created 3D model of AR providing values of area, perimeter, diameters of aortic annulus (AA) and coronary ostia heights (Fig 1).
Results
EV tool analysis on 3D-TOE volumetric data sets was feasible in all patients.
Strong correlation between EV tool and MSCT assessment for AA major diameter (r = 0.79), AA minor diameter (r = 0.81), AA perimeter (r = 0.89) and AA area (r = 0.89) (all p< 0.0001) was found. On average EV tool underestimated MSCT measurements of AA major diameter (1.2 mm, 4.5%), AA minor diameter (2.6 mm, 11.3%), AA perimeter (4 mm, 5.2%) and AA area (65.3 mmq, 13.6%).
Moderate correlation between the two methods, already in this initial sample, for right coronary artery ostium height (r = 0.53, p = 0.007) was discovered. Finally, weak correlation for left coronary artery ostium height (r = 0.33, p = 0.1) was revealed.
EV tool measurements from two different volumetric datasets of the same patient showed an excellent reproducibility
intraclass correlation coefficient (ICC) for AA area 0.94 and ICC for right coronary height 0.98.
Conclusion
With these initial results EV tool could be used in clinical practice for quick and reliable assessment of AA area, perimeter and diameters. A larger group of patients will be needed to assess the consistency of coronary ostia height evaluation by EV tool.
Abstract P218 Figure. eSie Valve landmarks and 3D model of AR
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Affiliation(s)
- G Granata
- Università degli studi della Campania Luigi Vanvitelli, Caserta, Italy
| | - A Veltri
- Umberto I Polyclinic of Rome, Rome, Italy
| | - S Iuliano
- Umberto I Polyclinic of Rome, Rome, Italy
| | - V Romano
- University Vita-Salute San Raffaele, Milan, Italy
| | - S Stella
- University Vita-Salute San Raffaele, Milan, Italy
| | - C Capogrosso
- University Vita-Salute San Raffaele, Milan, Italy
| | - F Ancona
- University Vita-Salute San Raffaele, Milan, Italy
| | - G Ingallina
- University Vita-Salute San Raffaele, Milan, Italy
| | - F Melillo
- University Vita-Salute San Raffaele, Milan, Italy
| | - M Montorfano
- University Vita-Salute San Raffaele, Milan, Italy
| | - E Agricola
- University Vita-Salute San Raffaele, Milan, Italy
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11
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Fusco F, Scognamiglio G, Colonna D, Palma M, Granata G, Russo MG, Sarubbi B. 1107 An unusual vegetation on a prosthetic pulmonary valve. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Patient presentation
During a routine check up, a 47yo man with Tetralogy of Fallot and congenital absence of left pulmonary branch was found to have a vegetation on his prosthetic pulmonary valve. His surgical history included TOF repair with left pulmonary branch bypass aged 4 years and a redo surgery for pulmonary valve replacement 3 years earlier. Before last surgery, CMR showed severe pulmonary regurgitation, dilated RV with mildly impaired systolic function (EF 40%) and absent flow in left pulmonary branch due to bypass occlusion.
Diagnostic work-up
The patient reported increasing shortness of breath (NYHA class III) over the last months. He reported one single fever peak two months before.He was on Apixaban and Amiodarone for previous history of AF. He was afebrile and an ejective systolic 4/6 murmur was heard. He was in sinus rhythm at 70 bpm. The TTE showed dilated RV with severely reduced systolic function (FAC 12%), severe pulmonary stenosis (peak gradient of 70 mmHg) with mild regurgitation, and a mobile and echogenic vegetation of 10 X 9 mm was seen on the prosthetic pulmonary valve. His blood tests at the admission demostrated raised WBC (9.460/uL) and PCR 11.7 mg/dl (n.v. < 3.0). The PCR remained stable during the following days. Serial blood samples for cultures were obtained, but all resulted negative. Uncommom causes of negative blood culteres infective endocarditis were investigated with specific serological tests for research of fastious agents, but all resulted negative. Antinuclear and antiphospholipid antibodies were also tested. A total-body CT was performed and it showed several liver formations. A FDG PET-CT was requested and it demostrated active marked glucose uptake by a mediastinic node, as well as by liver, brain and prosthetic pulmonary valve.
Diagnosis and outcome
After a careful review of all the clinical and imaging data, our opinion was that the most probable diagnosis was non infective thrombotic endocarditis in patient with metastatic cancer. In this situation, the valvular glucose uptake was likely due active thrombus formation rathen then being a sign of inflammatory response. Unfortunately, the patient died suddenly two weeks after the PET-CT and it was impossible to confirm the diagnosis with biopsy.
Conclusion
Differential diagnosis of cardiac vegetations is a challenging process including microbological tests, multi modality imaging and clinical reasoning. It is always necessary to consider alternative diagnosis, even when traditional imaging tests seem to suggest infective endocarditis.
Non infective thrombotic endocarditis are a rare form of negative blood culteres endocarditis related to systemic hypercoagulable state (i.e. antiphospholipid syndrome, systemic lupus, behcet syndrome, cancer). Malignancies can be considered an unusual cause of cardiac vegetation and they must be taken into account on differential diagnosis.
Abstract 1107 Figure. FDG uptake in pulmonary position
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Affiliation(s)
- F Fusco
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | | | - D Colonna
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - M Palma
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - G Granata
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - M G Russo
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - B Sarubbi
- AO dei Colli-Monaldi Hospital, Naples, Italy
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12
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Fusco F, Scognamiglio G, Vitiello F, Gilli M, Piantedosi F, Colonna D, Palma M, Granata G, Sarubbi B. P781 Role of serum biomarkers combined with two-dimensional speckle tracking echocardiography for screening of immunotherapy-induced cardiotoxicity. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Immune checkpoint inhibitors (ICIs) are a novel class of antineoplastic drugs which have dramatically changed the management of non-small cell lung cancer. ICI-associated cardiotoxicity is rare, but potentially fatal, presenting in most of cases as autoimmune acute myocarditis during the first phase of treatment. However, since an extensive cardiac monitoring is not routinely performed in most immunotherapy trials, the true incidence of ICIs related cardiac effects is largely unknown.
Aim
Aim of our study is to ascertain a possible subclinical cardiac involvement in patients with non-small cell lung cancer treated with ICIs.
Methods
We prospectively recruited 40 patients (13 males; mean age 64.3 ± 8.3 years) starting immunotherapy with PD-1/PDL-1 inhibitors for non-small lung cancer between January and August 2018. Demographic and clinical data were recorded and all patients underwent a standard 12-lead ECG and a transthoracic echocardiogram with assessment of left ventricular global longitudinal strain (LV GLS). Furthermore, blood samples for pro BNP-nt and high sensitivity Troponin T (hsTnT) measurements were collected. Serial assessments were performed before and 1 and 3 months after initiation of immunotherapy.
Results
A history of previous coronary artery disease was documented in eight cases (20%). At follow-up no cardiovascular events were recorded. Compared with baseline, echocardiographic parameters of ventricular function did not significantly changed at 1 and 3 months (LVEF 61 ± 6% at baseline, 61 ± 5% at 1 month, 60,2 ± 5% at 3 months, p =0.1; E/E’at baseline 9.2 ± 3, 9.2 ± 2.8 at 1 month, 9.1 ±3,5 at 3 months, p = 0.2;TAPSE 20 ± 3.4 mm at baseline, 21.3 ± 2.8 mm at 1 month, 20 ± 3.8 mm at 3 months, p =0.1; LV GLS -20.3 ± 3.6% at baseline, -20.8 ± 2.3% at 1 month, -20.6 ± 3% at 3 months; p = 0.4). Analogously, no significant increase in circulating levels of cardiac biomarkers was found with hsTnT <0.015 ng/ml in all patients at baseline, 1 month and 3 months and median proBNP-nt 118 pg/ml (IQR 47-200) at baseline, 171 pg/ml (IQR 91-520) at 1 month, and 182 pg/ml (IQR 78-470) at 3 months, p = 0.9.
Conclusions
In our study no significant clinical or subclinical evidence of myocardial involvement was detected during treatment with ICIs in patients with non-small cell lung cancer, thus suggesting the potential cardiovascular safety of this promising class of antineoplastic drugs.
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Affiliation(s)
- F Fusco
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | | | - F Vitiello
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - M Gilli
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | | | - D Colonna
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - M Palma
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - G Granata
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - B Sarubbi
- AO dei Colli-Monaldi Hospital, Naples, Italy
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13
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Strauss I, Valle G, Artoni F, D'Anna E, Granata G, Di Iorio R, Guiraud D, Stieglitz T, Rossini PM, Raspopovic S, Petrini FM, Micera S. Characterization of multi-channel intraneural stimulation in transradial amputees. Sci Rep 2019; 9:19258. [PMID: 31848384 PMCID: PMC6917705 DOI: 10.1038/s41598-019-55591-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 11/20/2019] [Indexed: 11/29/2022] Open
Abstract
Although peripheral nerve stimulation using intraneural electrodes has been shown to be an effective and reliable solution to restore sensory feedback after hand loss, there have been no reports on the characterization of multi-channel stimulation. A deeper understanding of how the simultaneous stimulation of multiple electrode channels affects the evoked sensations should help in improving the definition of encoding strategies for bidirectional prostheses. We characterized the sensations evoked by simultaneous stimulation of median and ulnar nerves (multi-channel configuration) in four transradial amputees who had been implanted with four TIMEs (Transverse Intrafascicular Multichannel Electrodes). The results were compared with the characterization of single-channel stimulation. The sensations were characterized in terms of location, extent, type, and intensity. Combining two or more single-channel configurations caused a linear combination of the sensation locations and types perceived with such single-channel stimulations. Interestingly, this was also true when two active sites from the same nerve were stimulated. When stimulating in multi-channel configuration, the charge needed from each electrode channel to evoke a sensation was significantly lower than the one needed in single-channel configuration (sensory facilitation). This result was also supported by electroencephalography (EEG) recordings during nerve stimulation. Somatosensory potentials evoked by multi-channel stimulation confirmed that sensations in the amputated hand were perceived by the subjects and that a perceptual sensory facilitation occurred. Our results should help the future development of more efficient bidirectional prostheses by providing guidelines for the development of more complex stimulation approaches to effectively restore multiple sensations at the same time.
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Affiliation(s)
- I Strauss
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - G Valle
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - F Artoni
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - E D'Anna
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - G Granata
- Fondazione Policlinico Agostino Gemelli-IRCCS, Roma, Italy
| | - R Di Iorio
- Institute of Neurology, Catholic University of The Sacred Heart, Policlinic A. Gemelli Foundation, Roma, Italy
| | - D Guiraud
- University of Montpellier, INRIA, CAMIN team, 860 Rue St Priest, 34090, Montpellier, France
| | - T Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center, BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Freiburg, D-79110, Germany
| | - P M Rossini
- Fondazione Policlinico Agostino Gemelli-IRCCS, Roma, Italy
- Institute of Neurology, Catholic University of The Sacred Heart, Policlinic A. Gemelli Foundation, Roma, Italy
| | - S Raspopovic
- Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich (ETH), Zürich, 8092, Switzerland
| | - F M Petrini
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
- Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich (ETH), Zürich, 8092, Switzerland.
| | - S Micera
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy.
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14
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Risso G, Valle G, Iberite F, Strauss I, Stieglitz T, Controzzi M, Clemente F, Granata G, Rossini PM, Micera S, Baud-Bovy G. Optimal integration of intraneural somatosensory feedback with visual information: a single-case study. Sci Rep 2019; 9:7916. [PMID: 31133637 PMCID: PMC6536542 DOI: 10.1038/s41598-019-43815-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 04/23/2019] [Indexed: 02/05/2023] Open
Abstract
Providing somatosensory feedback to amputees is a long-standing objective in prosthesis research. Recently, implantable neural interfaces have yielded promising results in this direction. There is now considerable evidence that the nervous system integrates redundant signals optimally, weighting each signal according to its reliability. One question of interest is whether artificial sensory feedback is combined with other sensory information in a natural manner. In this single-case study, we show that an amputee with a bidirectional prosthesis integrated artificial somatosensory feedback and blurred visual information in a statistically optimal fashion when estimating the size of a hand-held object. The patient controlled the opening and closing of the prosthetic hand through surface electromyography, and received intraneural stimulation proportional to the object's size in the ulnar nerve when closing the robotic hand on the object. The intraneural stimulation elicited a vibration sensation in the phantom hand that substituted the missing haptic feedback. This result indicates that sensory substitution based on intraneural feedback can be integrated with visual feedback and make way for a promising method to investigate multimodal integration processes.
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Affiliation(s)
- G Risso
- Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia, Genoa, Italy
- DIBRIS, Università degli studi di Genova, Genoa, Italy
| | - G Valle
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - F Iberite
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - I Strauss
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - T Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK & Bernstein Center, University of Freiburg, Freiburg, D-79110, Germany
| | - M Controzzi
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - F Clemente
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - G Granata
- Institute of Neurology, Catholic University of The Sacred Heart, Policlinic A. Gemelli Foundation, Roma, Italy
| | - P M Rossini
- Institute of Neurology, Catholic University of The Sacred Heart, Policlinic A. Gemelli Foundation, Roma, Italy
| | - S Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - G Baud-Bovy
- Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia, Genoa, Italy.
- Vita-Salute San Raffaele University & Unit of Experimental Psychology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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15
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Valle G, Petrini FM, Strauss I, Iberite F, D'Anna E, Granata G, Controzzi M, Cipriani C, Stieglitz T, Rossini PM, Mazzoni A, Raspopovic S, Micera S. Comparison of linear frequency and amplitude modulation for intraneural sensory feedback in bidirectional hand prostheses. Sci Rep 2018; 8:16666. [PMID: 30420739 PMCID: PMC6232130 DOI: 10.1038/s41598-018-34910-w] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/28/2018] [Indexed: 11/09/2022] Open
Abstract
Recent studies have shown that direct nerve stimulation can be used to provide sensory feedback to hand amputees. The intensity of the elicited sensations can be modulated using the amplitude or frequency of the injected stimuli. However, a comprehensive comparison of the effects of these two encoding strategies on the amputees' ability to control a prosthesis has not been performed. In this paper, we assessed the performance of two trans-radial amputees controlling a myoelectric hand prosthesis while receiving grip force sensory feedback encoded using either linear modulation of amplitude (LAM) or linear modulation of frequency (LFM) of direct nerve stimulation (namely, bidirectional prostheses). Both subjects achieved similar and significantly above-chance performance when they were asked to exploit LAM or LFM in different tasks. The feedbacks allowed them to discriminate, during manipulation through the robotic hand, objects of different compliances and shapes or different placements on the prosthesis. Similar high performances were obtained when they were asked to apply different levels of force in a random order on a dynamometer using LAM or LFM. In contrast, only the LAM strategy allowed the subjects to continuously modulate the grip pressure on the dynamometer. Furthermore, when long-lasting trains of stimulation were delivered, LFM strategy generated a very fast adaptation phenomenon in the subjects, which caused them to stop perceiving the restored sensations. Both encoding approaches were perceived as very different from the touch feelings of the healthy limb (natural). These results suggest that the choice of specific sensory feedback encodings can have an effect on user performance while grasping. In addition, our results invite the development of new approaches to provide more natural sensory feelings to the users, which could be addressed by a more biomimetic strategy in the future.
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Affiliation(s)
- G Valle
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - F M Petrini
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092, Zürich, Switzerland
| | - I Strauss
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - F Iberite
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - E D'Anna
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - G Granata
- Institute of Neurology, Catholic University of The Sacred Heart, Policlinic A. Gemelli Foundation, Roma, Italy
| | - M Controzzi
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - C Cipriani
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - T Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center, BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Freiburg, D-79110, Germany
| | - P M Rossini
- Institute of Neurology, Catholic University of The Sacred Heart, Policlinic A. Gemelli Foundation, Roma, Italy
| | - A Mazzoni
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S Raspopovic
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092, Zürich, Switzerland
| | - S Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
- Center for Neuroscience, Neurotechnology, and Bioelectronic Medicine and BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
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16
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Ronchi E, Granata G, Brivio M, Coradini D, Miodini P, Di Fronzo G. A Double-Labeling Assay for Simultaneous Estimation and Characterization of Estrogen and Progesterone Receptors using Radioiodinated Estradiol and Tritiated Org 2058. Tumori 2018; 72:251-7. [PMID: 3739005 DOI: 10.1177/030089168607200305] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Estrogen (ER) and progesterone receptors (PgR) appear to be a prerequisite to elicit a biologic response by a hormone-target organ. Current methodologies for analysis of these proteins (e.g., dextran-coated charcoal, DCC) in single-label assay (SLA) require relatively large amounts of tissue material, time and laboriousness. Therefore, we have developed for breast cancer tissue an improved dual-label assay (DLA) for simultaneous titration (by DCC) and/or characterization (by sedimentation properties) of ER and PgR on the same sample, using 125I-E2 and 3H-Org 2058 as tracers. The interaction of 125I-E2 with ER and plasma proteins in comparison to 3H-E2 was studied in terms of specificity, time course, affinity binding and sedimentation pattern. 125I-E2 bound the same molecular forms displayed by 3H-E2 (9 and 3S) but with lower titers (about 1.3-fold), irrespective of the technique used, and did not bind to sex hormone-binding globulin. Simultaneous detection of 125I and 3H was achieved by use of a gamma counter plus a beta counter sequentially. ER and PgR titrations with DCC in DLA were in good agreement with those obtained with SLA, in terms of titers and Ka values. An analogous result was obtained with sucrose density gradient (SDG) analysis. Both the DLA methods were highly reproducible (CV < 8.0 %). Between the rotors available for SDG, the vertical one was preferable because of the larger number of samples processed and of less purturbation of sedimenting receptor molecules. Furthermore, a biochemical application of the method is described. In conclusion, the DLA procedure, by simplifying ER and PgR estimation, makes it possible to study, even on small tumor biopsies, the molecular properties of these proteins in relation to the clinical response of the disease.
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Consoli GML, Granata G, Picciotto R, Blanco AR, Geraci C, Marino A, Nostro A. Design, synthesis and antibacterial evaluation of a polycationic calix[4]arene derivative alone and in combination with antibiotics. Medchemcomm 2018; 9:160-164. [PMID: 30108909 PMCID: PMC6072334 DOI: 10.1039/c7md00527j] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 12/01/2017] [Indexed: 12/14/2022]
Abstract
The growing antibiotic resistance phenomenon continues to stimulate the search for new compounds and strategies to combat bacterial infections. In this study, we designed and synthesized a new polycationic macrocyclic compound (2) bearing four N-methyldiethanol ammonium groups clustered and circularly organized by a calix[4]arene scaffold. The in vitro activity of compound 2, alone and in combination with known antibiotics (ofloxacin, chloramphenicol or tetracycline), was assessed against strains of Staphylococcus aureus (ATCC 6538 and methicillin-resistant isolate 15), S. epidermidis (ATCC 35984 and methicillin-resistant isolate 57), and Pseudomonas aeruginosa (ATCC 9027 and antibiotic-resistant isolate 1). Calix[4]arene derivative 2 showed significant antibacterial activity against ATCC and methicillin-resistant Gram positive Staphylococci, improved the stability of tetracycline in water, and in combination with antibiotics enhanced the antibiotic efficacy against Gram negative P. aeruginosa by an additive effect.
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Affiliation(s)
- G M L Consoli
- Institute of Biomolecular Chemistry , National Research Council (C.N.R.) , 95126 Catania , Italy .
| | - G Granata
- Institute of Biomolecular Chemistry , National Research Council (C.N.R.) , 95126 Catania , Italy .
| | - R Picciotto
- Laboratory of Photochemistry , Department of Drug Science , Viale Andrea Doria 6 , 95125 Catania , Italy
| | - A R Blanco
- Alfa Intes ITS S.r.l. , Casoria , 80026 Napoli , Italy
| | - C Geraci
- Institute of Biomolecular Chemistry , National Research Council (C.N.R.) , 95126 Catania , Italy .
| | - A Marino
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences , University of Messina , Polo Annunziata , Messina 98168 , Italy .
| | - A Nostro
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences , University of Messina , Polo Annunziata , Messina 98168 , Italy .
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Miraglia F, Vecchio F, Iorio RD, Granata G, Romanello R, Rossini P. P110 Transcranial direct current stimulation of the brain motor area generates a transient increase of small worldnessy in connectivity: An EEG graph theoretical analysis. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.233] [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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Erra C, Coraci D, De Franco P, Granata G, Padua L. Corrigendum to "Peripheral nerve tumors associated with Martin-Gruber anastomosis" [Clin. Neurophysiol. 126 (2015) 428-430]. Clin Neurophysiol 2016; 127:3385. [PMID: 27554246 DOI: 10.1016/j.clinph.2016.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- C Erra
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy.
| | - D Coraci
- Board of Physical Medicine and Rehabilitation, Department of Orthopedic Science, "Sapienza" University, Rome, Italy
| | | | - G Granata
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - L Padua
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy; Don Carlo Gnocchi Foundation, Milan, Italy
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Testani E, Granata G, Pazzaglia C, Padua L, Valeriani M. 69. Prolonged inhibitory effect of 1 Hz rTMS of the motor cortex on the nociceptive evoked potentials to contralateral hand stimulation. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Coraci D, Padua L, Erra C, Doneddu P, Granata G, Rossini P. 38. Prolonged phone-call posture as risk factor for developing ulnar nerve entrapment at elbow: A dynamic neurophysiological study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Testani E, Granata G, Pazzaglia C, Padua L, Valeriani. ID 156 – Prolonged inhibitory effect of 1 Hz rTMS of the motor cortex on the nociceptive evoked potentials to contralateral hand stimulation. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.388] [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: 10/22/2022]
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Padua L, Pazzaglia C, Coraci D, Lucchetta M, Paolasso I, Granata G, Cacciavillani M, Luigetti M, Manganelli F, Pareyson D, Briani C. ID 270 – Nerve ultrasound findings in cmt neuropathy. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.443] [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: 10/22/2022]
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Conti V, Leone MC, Casato M, Nicoli M, Granata G, Carlesimo M. High prevalence of gluten sensitivity in a cohort of patients with undifferentiated connective tissue disease. Eur Ann Allergy Clin Immunol 2015; 47:54-57. [PMID: 25781195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES The aim of this study was to investigate if co-morbid conditions as hepatitis C virus infection and celiac disease may be associated to undifferentiated connective tissue disease. METHODS We studied retrospectively and prospectively 52 patients with diagnosis of undifferentiated connective tissue disease, subdivided, according to Vaz criteria, in systemic lupus erythematosus, systemic sclerosis and Sjögren's syndrome-like subgroups. Serological markers of celiac disease as anti-gliadin, anti-endomysium and anti-tissue transglutaminase antibodies were investigated. An esophagogastroduodenoscopy with duodenal biopsy and histological examination was proposed to patients with positive celiac disease serology. In addition antibodies directed to hepatitis C virus and total IgA-antibodies were investigated. RESULTS Six patients (11,5%) were positive for celiac disease serological tests although two of them were asymptomatic. Four patients underwent an esophagogastroduodenoscopy, showing total or subtotal villous atrophy at duodenal biopsies. Hepatitis C virus serology was negative in all patients and none had IgA deficiency. 83% of celiac patients showed a scleroderma-like phenotype. We observed a statistically higher incidence of autoimmune symptoms in patients with gluten sensitivity. Fatigue and myalgia regressed early after the beginning of gluten-free diet. CONCLUSIONS In our cohort of patients the prevalence of celiac disease was higher than that reported in the general population. We believe that all patients with diagnosis of undifferentiated connective tissue disease, especially those with a systemic sclerosis-like presentation, should be investigated for celiac disease, even in absence of gastrointestinal symptoms. Gluten-free diet should be early recommended to all patients having undifferentiated connective tissue disease and gluten sensitivity.
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Affiliation(s)
- V Conti
- Department of Clinical Immunology, Sapienza University of Rome, Rome, Italy
| | - M C Leone
- Department of Clinical Immunology, Sapienza University of Rome, Rome, Italy
| | - M Casato
- Department of Clinical Immunology, Sapienza University of Rome, Rome, Italy
| | - M Nicoli
- Department of Clinical Immunology, Sapienza University of Rome, Rome, Italy
| | - G Granata
- Department of Clinical Immunology, Sapienza University of Rome, Rome, Italy
| | - M Carlesimo
- Department of Internal Medicine and Clinical Immunology, Sapienza University of Rome, Viale dell'Università 37, 00185 Rome, Italy, Phone: +39 06 499 72 090 Fax: +39 06 444 08 06 E-mail:
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Erra C, Coraci D, De Franco P, Granata G, Padua L. Peripheral nerve tumors associated with Martin–Gruber anastomosis. Clin Neurophysiol 2015; 126:428-30. [DOI: 10.1016/j.clinph.2014.05.019] [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] [Received: 12/11/2012] [Revised: 05/09/2014] [Accepted: 05/14/2014] [Indexed: 11/25/2022]
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Paolasso I, Hobson-Webb L, Briani C, Tsukamoto H, Coraci D, Erra C, Granata G, Padua L. 63. Multicenter protocol on the role of ultrasound in immune-mediated neuropathies. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lucchetta M, Padua L, Granata G, Luigetti M, Campagnolo M, Dalla Torre C, Coraci D, Sabatelli M, Briani C. Nerve ultrasound findings in neuropathy associated with anti-myelin-associated glycoprotein antibodies. Eur J Neurol 2014; 22:193-202. [PMID: 25174585 DOI: 10.1111/ene.12554] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 03/28/2014] [Accepted: 07/16/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE No systematic nerve ultrasound (US) studies on patients with neuropathy and anti-myelin-associated glycoprotein (anti-MAG) antibodies are available. PATIENTS AND METHODS Twenty-eight patients (18 men, 10 women, mean age 69.2 ± 10.9 years; mean disease duration 6.9 years) with anti-MAG neuropathy underwent nerve US. Echotexture, nerve cross-sectional area (CSA) and intra-nerve and inter-nerve CSA variability were assessed. The frequency (number of nerves with enlarged CSA, 'enlarged nerves sum score') and distribution (proximal versus distal, arms versus legs, symmetry) of US abnormalities were considered. Controls included two groups: four patients with immunoglobulin M (IgM) paraproteinaemic neuropathy without anti-MAG antibodies and five with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with IgM paraprotein. RESULTS In all, 26/28 patients had increased CSA (23 with at least one nerve outside entrapment sites). Intra-nerve CSA variability was abnormal in 21/28 patients (in 14 for increased nerve CSA outside entrapment sites). Inter-nerve CSA variability was abnormal in 16 patients (of whom half for CSA increase out of entrapment sites). The enlarged nerves sum score in anti-MAG neuropathy patients was greater than in MAG-negative paraproteinaemic neuropathies and lower than in CIDP. Intra-nerve variability appeared instead similar in anti-MAG and controls. No correlation was found between US findings and Inflammatory Neuropathy Cause and Treatment Group (INCAT) disability score or disease duration. DISCUSSION Amongst the different measures to assess the US pattern (symmetry/asymmetry, proximal/distal distribution and sum score), the enlarged nerves sum score was the most useful for differentiating the three groups of patients with demyelinating neuropathies and may contribute to diagnosis in a typical cases.
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Affiliation(s)
- M Lucchetta
- Department of Neurosciences, SNPSRR, University of Padova, Padova, Italy
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De Franco P, Erra C, Granata G, Coraci D, Padua R, Padua L. Sonographic diagnosis of anatomical variations associated with carpal tunnel syndrome. J Clin Ultrasound 2014; 42:371-374. [PMID: 24302518 DOI: 10.1002/jcu.22118] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 06/26/2013] [Accepted: 10/09/2013] [Indexed: 06/02/2023]
Abstract
Bifid median nerve is an anatomic variation that occurs in about 18% of patients with symptoms suggestive of carpal tunnel syndrome and in about 15% of symptom-free subjects. Reversed palmaris longus is a rare anatomic muscular variation. The simultaneous presence of a bifid median nerve and a reversed palmaris longus has been very rarely described, usually during surgical exploration or in cadavers. We present two cases where ultrasound showed the presence of both abnormalities, allowing a correct diagnosis and influencing the treatment plan.
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Affiliation(s)
- P De Franco
- Department of Neuroscience, Institute of Neurology, Catholic University, Rome, Italy
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Erra C, De Franco P, Coraci D, Granata G, Paolasso I, Padua L. P624: Ultrasound evidence of concomitant traumatic nerve lesions far from the trauma site. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50718-3] [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: 10/25/2022]
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Micera S, Raspospovic S, Capogrosso M, Carpaneto J, Granata G, Oddo C, Cipriani C, Stieglitz T, Schuettler M, Navarro X, Raffo L, Barbaro M, Rossini P. P190: NEurocontrolled BIdirectional Artificial upper limb and hand prosthesiS (NEBIAS). Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50328-8] [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: 10/25/2022]
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Ferilli M, Fasano A, Iodice F, Granata G, Pilato F, Rossini P. P347: Paired associative stimulation-25ms in stroke patients. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50462-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bianchi M, Granata G, Coraci D, Padua L. Fibular nerve neurotmesis secondary to knee trauma: A diagnosis requiring nerve ultrasound. Clin Neurophysiol 2014; 125:858-859. [DOI: 10.1016/j.clinph.2013.06.189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 06/28/2013] [Accepted: 06/30/2013] [Indexed: 11/17/2022]
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Padua L, Paolasso I, Pazzaglia C, Granata G, Lucchetta M, Erra C, Coraci D, De Franco P, Briani C. High ultrasound variability in chronic immune-mediated neuropathies. Review of the literature and personal observations. Rev Neurol (Paris) 2013; 169:984-90. [DOI: 10.1016/j.neurol.2013.07.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 07/26/2013] [Accepted: 07/26/2013] [Indexed: 12/12/2022]
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Paolasso I, Briani C, Tsukamoto H, Coraci D, Erra C, Franco PD, Granata G, Padua L. 150. Proposal for a multicenter protocol on the role of ultrasound in immune-mediated neuropathies. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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35
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Erra C, Lauria A, Granata G, Coraci D, Briani C, Padua L. 154. Evolution of ultrasound abnormalities in multifocal motor neuropathy: Series of five cases. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Franco PD, Coraci D, Tsukamoto H, Paolasso I, Granata G, Padua L. 41. Ultrasound diagnosis of Meralgia Paresthetica: Review of literature and presentation of 8 cases. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Padua L, Granata G, Sabatelli M, Inghilleri M, Lucchetta M, Luigetti M, Coraci D, Martinoli C, Briani C. Heterogeneity of root and nerve ultrasound pattern in CIDP patients. Clin Neurophysiol 2013; 125:160-5. [PMID: 24099922 DOI: 10.1016/j.clinph.2013.07.023] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [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: 04/02/2013] [Revised: 06/25/2013] [Accepted: 07/20/2013] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The few published ultrasound (US) studies on chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) report diffusely increased cross-sectional area (CSA) of nerves. The data are, however, heterogeneous and correlations with clinical history or disease severity are lacking. METHODS Thirty-four patients with CIDP underwent US nerve evaluation by two neurologists blinded to clinical data. US nerve pattern for each patient was defined by a third neurologist blinded to clinical data. Three US classes were identified based on CSA and echogenicity: large nerves with hypoechoic nerves/fascicles (class 1); large nerves with heterogeneous hypo- and hyperechoic fascicles (class 2); normal size nerve but abnormal hyperechoic array (class 3). RESULTS In all patients, US nerve changes were observed: in most of the cases, enlarged nerves or nerve segments were observed. The three 'classes' of US nerve changes significantly correlated (R: 0.68, p<0.001) with disease duration, but not with age or Inflammatory Neuropathy Cause and Treatment (INCAT) disability score. CONCLUSIONS US may be of adjunctive diagnostic value in CIDP assessment. Nerve morphological changes may mirror the underlying pathophysiological mechanisms and seem to correlate with disease duration. SIGNIFICANCE These results offer the possibility of exploring the use of US to assess CIDP disease activity and treatment.
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Affiliation(s)
- L Padua
- Institute of Neurology, Catholic University, Rome, Italy; Don Carlo Gnocchi Onlus Foundation, Rome, Italy.
| | - G Granata
- Institute of Neurology, Catholic University, Rome, Italy
| | - M Sabatelli
- Institute of Neurology, Catholic University, Rome, Italy
| | - M Inghilleri
- Institute of Neurology, "Sapienza" University of Rome, Rome, Italy
| | - M Lucchetta
- Department of Neurosciences, University of Padua, Padua, Italy
| | - M Luigetti
- Institute of Neurology, Catholic University, Rome, Italy
| | - D Coraci
- Don Carlo Gnocchi Onlus Foundation, Rome, Italy
| | - C Martinoli
- Radiology Institute, "R" - DICMI, University of Genoa, Genoa, Italy
| | - C Briani
- Department of Neurosciences, University of Padua, Padua, Italy
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Tsukamoto H, Coraci D, Paolasso I, Granata G, Padua L, Sonoo M. Sonographic evaluation of neuromas in patients with limb amputation. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Binda D, Vanhoutte E, Cavaletti G, Cornblath D, Postma T, Frigeni B, Alberti P, Bruna J, Velasco R, Argyriou A, Kalofonos H, Psimaras D, Ricard D, Pace A, Galiè E, Briani C, Dalla Torre C, Lalisang R, Boogerd W, Brandsma D, Koeppen S, Hense J, Storey D, Kerrigan S, Schenone A, Fabbri S, Rossi E, Valsecchi M, Faber C, Merkies I, Galimberti S, Lanzani F, Mattavelli L, Piatti M, Bidoli P, Cazzaniga M, Cortinovis D, Lucchetta M, Campagnolo M, Bakkers M, Brouwer B, Boogerd W, Grant R, Reni L, Piras B, Pessino A, Padua L, Granata G, Leandri M, Ghignotti I, Plasmati R, Pastorelli F, Heimans J, Eurelings M, Meijer R, Grisold W, Lindeck Pozza E, Mazzeo A, Toscano A, Russo M, Tomasello C, Altavilla G, Penas Prado M, Dominguez Gonzalez C, Dorsey S. Rasch-built Overall Disability Scale for patients with chemotherapy-induced peripheral neuropathy (CIPN-R-ODS). Eur J Cancer 2013; 49:2910-8. [DOI: 10.1016/j.ejca.2013.04.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/03/2013] [Accepted: 04/05/2013] [Indexed: 10/26/2022]
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Granata G, Padua L, Celletti C, Castori M, Saraceni V, Camerota F. Entrapment neuropathies and polyneuropathies in joint hypermobility syndrome/Ehlers–Danlos syndrome. Clin Neurophysiol 2013; 124:1689-94. [DOI: 10.1016/j.clinph.2012.12.051] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 12/04/2012] [Accepted: 12/19/2012] [Indexed: 11/25/2022]
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42
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Padua L, Di Pasquale A, Liotta G, Granata G, Pazzaglia C, Erra C, Briani C, Coraci D, De Franco P, Antonini G, Martinoli C. Ultrasound as a useful tool in the diagnosis and management of traumatic nerve lesions. Clin Neurophysiol 2013; 124:1237-43. [DOI: 10.1016/j.clinph.2012.10.024] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 10/02/2012] [Accepted: 10/29/2012] [Indexed: 11/25/2022]
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Cavaletti G, Cornblath DR, Merkies ISJ, Postma TJ, Rossi E, Frigeni B, Alberti P, Bruna J, Velasco R, Argyriou AA, Kalofonos HP, Psimaras D, Ricard D, Pace A, Galiè E, Briani C, Dalla Torre C, Faber CG, Lalisang RI, Boogerd W, Brandsma D, Koeppen S, Hense J, Storey D, Kerrigan S, Schenone A, Fabbri S, Valsecchi MG, Mazzeo A, Pace A, Pessino A, Schenone A, Toscano A, Argyriou AA, Brouwer B, Frigeni B, Piras B, Briani C, Dalla Torre C, Dominguez Gonzalez C, Faber CG, Tomasello C, Binda D, Brandsma D, Cortinovis D, Psimaras D, Ricard D, Storey D, Cornblath DR, Galiè E, Lindeck Pozza E, Rossi E, Vanhoutte EK, Lanzani F, Pastorelli F, Altavilla G, Cavaletti G, Granata G, Kalofonos HP, Ghignotti I, Merkies ISJ, Bruna J, Hense J, Heimans JJ, Mattavelli L, Padua L, Reni L, Bakkers M, Boogerd M, Campagnolo M, Cazzaniga M, Eurelings M, Leandri M, Lucchetta M, Penas Prado M, Russo M, Valsecchi MG, Piatti ML, Alberti P, Bidoli P, Grant R, Plasmati R, Velasco R, Lalisang RI, Meijer RJ, Fabbri S, Dorsey SG, Galimberti S, Kerrigan S, Koeppen S, Postma TJ, Boogerd W, Grisold W. The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings. Ann Oncol 2013; 24:454-462. [PMID: 22910842 PMCID: PMC3551481 DOI: 10.1093/annonc/mds329] [Citation(s) in RCA: 208] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 06/05/2012] [Accepted: 07/09/2012] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and dose-limiting complication of cancer treatment. Thus far, the impact of CIPN has not been studied in a systematic clinimetric manner. The objective of the study was to select outcome measures for CIPN evaluation and to establish their validity and reproducibility in a cross-sectional multicenter study. PATIENTS AND METHODS After literature review and a consensus meeting among experts, face/content validity were obtained for the following selected scales: the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), the Total Neuropathy Score clinical version (TNSc), the modified Inflammatory Neuropathy Cause and Treatment (INCAT) group sensory sumscore (mISS), the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and CIPN20 quality-of-life measures. A total of 281 patients with stable CIPN were examined. Validity (correlation) and reliability studies were carried out. RESULTS Good inter-/intra-observer scores were obtained for the TNSc, mISS, and NCI-CTC sensory/motor subscales. Test-retest values were also good for the EORTC QLQ-C30 and CIPN20. Acceptable validity scores were obtained through the correlation among the measures. CONCLUSION Good validity and reliability scores were demonstrated for the set of selected impairment and quality-of-life outcome measures in CIPN. Future studies are planned to investigate the responsiveness aspects of these measures.
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Affiliation(s)
- G Cavaletti
- Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Monza, Italy.
| | - D R Cornblath
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - I S J Merkies
- Department of Neurology, Spaarne Hospital, Hoofddorp/Maastricht, University Medical Center, Maastricht
| | - T J Postma
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - E Rossi
- Center of Biostatistics for Clinical Epidemiology, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Monza, Italy
| | - B Frigeni
- Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Monza, Italy
| | - P Alberti
- Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Monza, Italy
| | - J Bruna
- Unit of Neuro-Oncology, Department of Neurology, University Hospital of Bellvitge, L'Hospitalet, Spain
| | - R Velasco
- Unit of Neuro-Oncology, Department of Neurology, University Hospital of Bellvitge, L'Hospitalet, Spain
| | - A A Argyriou
- Division of Clinical Oncology, Department of Medicine, University Hospital of Patras, Patras, Greece
| | - H P Kalofonos
- Division of Clinical Oncology, Department of Medicine, University Hospital of Patras, Patras, Greece
| | - D Psimaras
- Service de Neurologie Mazarin, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris
| | - D Ricard
- Service de Neurologie, Hôpital du Val-de-Grâce, Service de Santé des Armées, Paris, France
| | - A Pace
- Neurology Unit, National Cancer Institute Regina Elena, Rome
| | - E Galiè
- Neurology Unit, National Cancer Institute Regina Elena, Rome
| | - C Briani
- Department of Neurosciences, University of Padova, Padova, Italy
| | - C Dalla Torre
- Department of Neurosciences, University of Padova, Padova, Italy
| | - C G Faber
- Department of Neurology, Spaarne Hospital, Hoofddorp/Maastricht, University Medical Center, Maastricht
| | - R I Lalisang
- Division of Medical Oncology, Department of Internal Medicine, GROW-School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
| | - W Boogerd
- Department of Neuro-oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D Brandsma
- Department of Neuro-oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Koeppen
- Department of Neurology and West German Cancer Center, University of Essen, Essen, Germany
| | - J Hense
- Department of Neurology and West German Cancer Center, University of Essen, Essen, Germany
| | - D Storey
- Edinburgh Centre for Neuro-Oncology and Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK
| | - S Kerrigan
- Edinburgh Centre for Neuro-Oncology and Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK
| | - A Schenone
- Department of Neurosciences, Ophthalmology and Genetic, Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | - S Fabbri
- Department of Neurosciences, Ophthalmology and Genetic, Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | - M G Valsecchi
- Center of Biostatistics for Clinical Epidemiology, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Monza, Italy
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Briani C, Campagnolo M, Lucchetta M, Cacciavillani M, Dalla Torre C, Granata G, Bergamo F, Lonardi S, Zagonel V, Cavaletti G, Ermani M, Padua L. Ultrasound assessment of oxaliplatin-induced neuropathy and correlations with neurophysiologic findings. Eur J Neurol 2012; 20:188-92. [PMID: 22943629 DOI: 10.1111/j.1468-1331.2012.03852.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 06/25/2012] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Chemotherapy-induced peripheral neuropathy is a major adverse effect of oxaliplatin (OXL) treatment. Whereas neurophysiologic study is commonly used to assess the occurrence and severity of polyneuropathies, ultrasound (US) analysis of the peripheral nerves, an emerging technique in the study of peripheral nerve diseases, has never been used in chemotherapy-induced peripheral neuropathy. PATIENTS AND METHODS Fifteen patients (four women; 11 men; mean age, 60.1 ± 10.6 years; median, 62; range, 37-75) with colorectal cancer treated with OXL-based treatment have been clinically and neurophysiologically evaluated before and after OXL therapy. At the end of chemotherapy, all patients underwent also nerve US study at four limbs, and the findings correlated with clinical and neurophysiologic measures. RESULTS Clinical and neurophysiological evaluation showed that 13 of 15 (86.7%) patients developed sensory axonal neuropathy, 10 of whom severe (two or more sensory nerve action potential amplitude absent and the other amplitudes decreased of ≥50%). Nerve US did not reveal decreased cross-sectional area (CSA), a reported finding in axonal neuropathies. Instead increased CSA at entrapment sites (median nerve at wrist and ulnar nerve at elbow) was found in 09/15 (60%) of patients. DISCUSSION Sensory axonal neuropathy is a very common complication of OXL therapy, affecting almost 90% of patients. US findings of enlargement of median and ulnar nerves, mostly at entrapment sites, in patients with no history or symptoms of neuropathies at recruitment, and no neurophysiologic evidence of entrapment, may be expression of increased, OXL-induced, nerve susceptibility to mechanical damage. An ongoing prospective study will help clarify these findings.
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Affiliation(s)
- C Briani
- Department of Neurosciences, University of Padova, Padova, Italy
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Granata G, Padua L, Rossi F, De Franco P, Erra C, Rossi V. P1.6 Bulbocavernosus reflex: normative data. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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De Franco P, Granata G, Coraci D, Erra C, Padua L. P17.15 US of bifid median nerve and reverse palmaris longus muscle in patients with carpal tunnel syndrome: a case report. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60482-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Padua L, Stålberg E, Caliandro P, Muscogiuri G, Pazzaglia C, Sorice G, Granata G, Salomone E, Pontecorvi A, Giaccari A. P5.2 Diagnosis of early myelin involvement in diabetes as first sign of polyneuropathy: single fiber conduction velocity test. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lucchetta M, Briani C, Pazzaglia C, Granata G, Padua L. W12.4 POEMS syndrome: inside neuropathy. The ultrasound picture. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60127-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Erra C, Granata G, De Franco P, Coraci D, Padua L. P17.17 Usefulness of ultrasonography in a diagnosis of an unusual ulnar nerve entrapment after olecranon fracture. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60484-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Padua L, Liotta G, Di Pasquale A, Granata G, Pazzaglia C, Caliandro P, Martinoli C. W12.3 Contribution of ultrasound in the assessment of nerve diseases. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60126-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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