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Cioni M, Delle Piane M, Polino D, Rapetti D, Crippa M, Irmak EA, Van Aert S, Bals S, Pavan GM. Sampling Real-Time Atomic Dynamics in Metal Nanoparticles by Combining Experiments, Simulations, and Machine Learning. Adv Sci (Weinh) 2024:e2307261. [PMID: 38654692 DOI: 10.1002/advs.202307261] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/23/2024] [Indexed: 04/26/2024]
Abstract
Even at low temperatures, metal nanoparticles (NPs) possess atomic dynamics that are key for their properties but challenging to elucidate. Recent experimental advances allow obtaining atomic-resolution snapshots of the NPs in realistic regimes, but data acquisition limitations hinder the experimental reconstruction of the atomic dynamics present within them. Molecular simulations have the advantage that these allow directly tracking the motion of atoms over time. However, these typically start from ideal/perfect NP structures and, suffering from sampling limits, provide results that are often dependent on the initial/putative structure and remain purely indicative. Here, by combining state-of-the-art experimental and computational approaches, how it is possible to tackle the limitations of both approaches and resolve the atomistic dynamics present in metal NPs in realistic conditions is demonstrated. Annular dark-field scanning transmission electron microscopy enables the acquisition of ten high-resolution images of an Au NP at intervals of 0.6 s. These are used to reconstruct atomistic 3D models of the real NP used to run ten independent molecular dynamics simulations. Machine learning analyses of the simulation trajectories allow resolving the real-time atomic dynamics present within the NP. This provides a robust combined experimental/computational approach to characterize the structural dynamics of metal NPs in realistic conditions.
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Affiliation(s)
- Matteo Cioni
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, 10129, Italy
| | - Massimo Delle Piane
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, 10129, Italy
| | - Daniela Polino
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Polo Universitario Lugano, Campus Est, Via la Santa 1, Lugano-Viganello, 6962, Switzerland
| | - Daniele Rapetti
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, 10129, Italy
| | - Martina Crippa
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, 10129, Italy
| | - Ece Arslan Irmak
- EMAT and NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, Antwerp, 2020, Belgium
| | - Sandra Van Aert
- EMAT and NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, Antwerp, 2020, Belgium
| | - Sara Bals
- EMAT and NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, Antwerp, 2020, Belgium
| | - Giovanni M Pavan
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, 10129, Italy
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Polo Universitario Lugano, Campus Est, Via la Santa 1, Lugano-Viganello, 6962, Switzerland
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Cirnigliaro L, Pettinato F, Valle MS, Casabona A, Fiumara A, Vecchio M, Amico V, Rizzo R, Jaeken J, Barone R, Cioni M. Instrumented assessment of gait disturbance in PMM2-CDG adults: a feasibility analysis. Orphanet J Rare Dis 2024; 19:39. [PMID: 38308356 PMCID: PMC10837865 DOI: 10.1186/s13023-024-03027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 01/11/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Congenital disorders of glycosylation (CDG) are genetic diseases caused by impaired synthesis of glycan moieties linked to glycoconjugates. Phosphomannomutase 2 deficiency (PMM2-CDG), the most frequent CDG, is characterized by prominent neurological involvement. Gait disturbance is a major cause of functional disability in patients with PMM2-CDG. However, no specific gait assessment for PMM2-CDG is available. This study analyses gait-related parameters in PMM2-CDG patients using a standardized clinical assessment and instrumented gait analysis (IGA). RESULTS Seven adult patients with a molecular diagnosis of PMM2-CDG were followed-up from February 2021 to December 2022 and compared to a group of healthy control (HC) subjects, matched for age and sex. Standardized assessment of disease severity including ataxia and peripheral neuropathy along with isometric muscle strength and echo-biometry measurements at lower limbs were performed. IGA spatiotemporal parameters were obtained by means of a wearable sensor in basal conditions. PMM2-CDG patients displayed lower gait speed, stride length, cadence and symmetry index, compared to HC. Significant correlations were found among the used clinical scales and between disease severity (NCRS) scores and the gait speed measured by IGA. Variable reduction of knee extension strength and a significant decrease of lower limb muscle thickness with conserved echo intensity were found in PMM2-CDG compared to HC. CONCLUSIONS The study elucidates different components of gait disturbance in PMM2-CDG patients and shows advantages of using wearable sensor-based IGA in this frame. IGA parameters may potentially serve as quantitative measures for follow-up or outcome quantification in PMM2-CDG.
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Affiliation(s)
- Lara Cirnigliaro
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania - Policlinico, Via Santa Sofia, 78, 95123, Catania, Italy
| | - Fabio Pettinato
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania - Policlinico, Via Santa Sofia, 78, 95123, Catania, Italy
| | - Maria Stella Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Antonino Casabona
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Agata Fiumara
- Referral Centre for Inherited Metabolic Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Michele Vecchio
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123, Catania, Italy
- Rehabilitation Unit, AOU Policlinico-San Marco, 95123, Catania, Italy
| | - Valerio Amico
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Renata Rizzo
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania - Policlinico, Via Santa Sofia, 78, 95123, Catania, Italy
| | - Jaak Jaeken
- Department of Development and Regeneration, Centre for Metabolic Diseases, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Rita Barone
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania - Policlinico, Via Santa Sofia, 78, 95123, Catania, Italy.
- Reseach Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, Troina, Italy.
| | - Matteo Cioni
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
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Cioni M, Casabona A, Ferlito R, Pisasale M, Romeo DM, Messina G, Valle MS. Time course of surface electromyography during walking of children with spastic cerebral palsy treated with botulinum toxin type A and its rehabilitation implications. Clin Biomech (Bristol, Avon) 2024; 111:106147. [PMID: 37988778 DOI: 10.1016/j.clinbiomech.2023.106147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND The timing of the effects of botulinum toxin A on spastic muscles is not yet fully clarified. The goal of this study was to follow the temporal changes of surface electromyographic activity of lower limb muscles during walking, after a therapeutic dose of botulinum toxin A injected into the calf muscles of children with spastic cerebral palsy. METHODS A group of children with spastic equinus foot was administered botulinum toxin A into the gastrocnemius medialis and lateralis muscles. Surface electromyographic activity of the tibialis anterior, gastrocnemius medialis, rectus femoris and medial hamstrings, was recorded before botulinum toxin A injections and after 4, 8, and 16 weeks. Children walked on ground and on a treadmill at an incline of 0% and 12%. The area of electromyographic activity and the index of muscle co-contraction were calculated for specific segments of gait cycle. FINDINGS Botulinum toxin A did not modify the speed of gait on ground. ANOVA showed significant differences in electromyography during the stance phase segments with a maximum decrease between 4 and 8 weeks' post botulinum toxin A and a full recovery at 16 weeks. A significant co-contraction of rectus femoris/gastrocnemius medialis, between 0 and 20% and 35-50% of the gait cycle, was observed from the 4th to the 8th week post- botulinum toxin A for both treadmill settings. INTERPRETATION The temporal identification of deterioration/recovery of electromyographic activity as well as of muscle co-contractions, could be key elements in a rehabilitation program planning combined with botulinum toxin A.
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Affiliation(s)
- Matteo Cioni
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
| | - Antonino Casabona
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Rosario Ferlito
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; Department of Medicine and Health Science "Vincenzo Tiberio" University of Molise, Campobasso, Italy
| | - Mariangela Pisasale
- Casa di Cura Igea, Department of Neurorehabilitation Sciences, Milano, Italy
| | - Domenico Marco Romeo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Giulia Messina
- Pediatric Residency Program, Pediatric Unit, University Hospital Policlinico G. Rodolico - San Marco and University of Catania, Catania, Italy
| | - Maria Stella Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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Rapetti D, Delle Piane M, Cioni M, Polino D, Ferrando R, Pavan GM. Machine learning of atomic dynamics and statistical surface identities in gold nanoparticles. Commun Chem 2023; 6:143. [PMID: 37407706 DOI: 10.1038/s42004-023-00936-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/19/2023] [Indexed: 07/07/2023] Open
Abstract
It is known that metal nanoparticles (NPs) may be dynamic and atoms may move within them even at fairly low temperatures. Characterizing such complex dynamics is key for understanding NPs' properties in realistic regimes, but detailed information on, e.g., the stability, survival, and interconversion rates of the atomic environments (AEs) populating them are non-trivial to attain. In this study, we decode the intricate atomic dynamics of metal NPs by using a machine learning approach analyzing high-dimensional data obtained from molecular dynamics simulations. Using different-shape gold NPs as a representative example, an AEs' dictionary allows us to label step-by-step the individual atoms in the NPs, identifying the native and non-native AEs and populating them along the MD simulations at various temperatures. By tracking the emergence, annihilation, lifetime, and dynamic interconversion of the AEs, our approach permits estimating a "statistical equivalent identity" for metal NPs, providing a comprehensive picture of the intrinsic atomic dynamics that shape their properties.
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Affiliation(s)
- Daniele Rapetti
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129, Torino, Italy
| | - Massimo Delle Piane
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129, Torino, Italy
| | - Matteo Cioni
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129, Torino, Italy
| | - Daniela Polino
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Polo Universitario Lugano, Campus Est, Via la Santa 1, 6962, Lugano-Viganello, Switzerland
| | - Riccardo Ferrando
- Department of Physics, Università degli Studi di Genova, Via Dodecaneso 33, 16146, Genova, Italy
| | - Giovanni M Pavan
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129, Torino, Italy.
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Polo Universitario Lugano, Campus Est, Via la Santa 1, 6962, Lugano-Viganello, Switzerland.
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Cioni M, Polino D, Rapetti D, Pesce L, Delle Piane M, Pavan GM. Innate Dynamics and Identity Crisis of a Metal Surface Unveiled by Machine Learning of Atomic Environments. J Chem Phys 2023; 158:124701. [PMID: 37003771 DOI: 10.1063/5.0139010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Metals are traditionally considered hard matter. However, it is well known that their atomic lattices may become dynamic and undergo reconfigurations even well-below the melting temperature. The innate atomic dynamics of metals is directly related to their bulk and surface properties. Understanding their complex structural dynamics is thus important for many applications but is not easy. Here we report deep-potential molecular dynamics simulations allowing to resolve at atomic-resolution the complex dynamics of various types of copper (Cu) surfaces, used as an example, near the Hüttig (∼1/3 of melting) temperature.The development of a deep neural network potential trained on DFT calculations provides a dynamically-accurate force field that we use to simulate large atomistic models of different Cu surface types. A combination of high-dimensional structural descriptors and unsupervised machine learning allows identifying and tracking all the atomic environments (AEs) emerging in the surfaces at finite temperatures. We can directly observe how AEs that arenon-native in a specific (ideal) surface, but that are instead typical of other surface types, continuously emerge/disappear in that surface in relevant regimes in dynamic equilibrium with the native ones. Our analyses allow estimating the lifetime of all the AEs populating these Cu surfaces and to reconstruct their dynamic interconversions networks. This reveals the elusive identity of these metal surfaces, which preserve their identity only in part andin part transform into something else in relevant conditions. This also proposes a concept of "statistical identity" for metal surfaces, which is key for understanding their behaviors and properties.
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Affiliation(s)
- Matteo Cioni
- Polytechnic of Turin Department of Applied Science and Technology, Italy
| | - Daniela Polino
- University of Applied Sciences and Arts of Southern Switzerland Department of Innovative Technologies, Switzerland
| | - Daniele Rapetti
- Polytechnic of Turin Department of Applied Science and Technology, Italy
| | - Luca Pesce
- University of Applied Sciences and Arts of Southern Switzerland Department of Innovative Technologies, Switzerland
| | | | - Giovanni M. Pavan
- Department of Applied Science and Technology, Politecnico di Torino Dipartimento Scienza Applicata e Tecnologia, Italy
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Valle MS, Russo C, Casabona A, Crimi N, Crimi C, Colaianni V, Cioni M, Malaguarnera L. Anti-inflammatory role of vitamin D in muscle dysfunctions of patients with COPD: a comprehensive review. Minerva Med 2022:S0026-4806.22.07879-X. [PMID: 35332756 DOI: 10.23736/s0026-4806.22.07879-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Vitamin D deficiency is involved in the etiology of a broad range of diseases. Recently, some studies have shown a link between vitamin D and susceptibility to the onset of chronic obstructive pulmonary disease (COPD). COPD is characterized by chronic inflammation and irreversible airway obstruction. Systemic inflammation in COPD patients is associated with a decline in lung function. In addition, inflammation causes various extrapulmonary symptoms, including muscle deterioration that leads to reduced strength and fatigue endurance, especially in muscles of the lower limb. In COPD the pathophysiological changes related to the inflammatory state affect oxidant-antioxidant balance, which is one of the main mechanisms promoting the progression of this disease and exacerbations. Vitamin D exerts beneficial effects and exhibits anti-inflammatory actions. Vitamin D deficiency in COPD patients affects inflammation, oxidative stress and mitochondrial impairment and can generate the development of skeletal atrophy. This systematic review offers a better understanding of the molecular mechanisms linking vitamin D deficiency to COPD and muscle weakness, and aims to establish whether vitamin D supplementation could be useful to mitigate inflammation in COPD patients.
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Affiliation(s)
- Maria S Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Cristina Russo
- Section of Pathology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Antonino Casabona
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Nunzio Crimi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Claudia Crimi
- Respiratory Medicine Unit, Policlinico Vittorio Emanuele-San Marco, UniversityHospital, Catania, Italy
| | - Valeria Colaianni
- Section of Pathology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Matteo Cioni
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy.,Gait and Posture Analysis Laboratory, Policlinico Vittorio Emanuele-San Marco, University Hospital, Catania, Italy
| | - Lucia Malaguarnera
- Section of Pathology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy -
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Delle Piane M, Pesce L, Cioni M, Pavan GM. Reconstructing Reactivity in Dynamic Host-Guest Systems at Atomistic Resolution: Amide Hydrolysis Under Confinement in the Cavity of a Coordination Cage. Chem Sci 2022; 13:11232-11245. [PMID: 36320487 PMCID: PMC9517058 DOI: 10.1039/d2sc02000a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/28/2022] [Indexed: 11/21/2022] Open
Abstract
Spatial confinement is widely employed by nature to attain unique efficiency in controlling chemical reactions. Notable examples are enzymes, which selectively bind reactants and exquisitely regulate their conversion into products. In an attempt to mimic natural catalytic systems, supramolecular metal–organic cages capable of encapsulating guests in their cavity and of controlling/accelerating chemical reactions under confinement are attracting increasing interest. However, the complex nature of these systems, where reactants/products continuously exchange in-and-out of the host, makes it often difficult to elucidate the factors controlling the reactivity in dynamic regimes. As a case study, here we focus on a coordination cage that can encapsulate amide guests and enhance their hydrolysis by favoring their mechanical twisting towards reactive molecular configurations under confinement. We designed an advanced multiscale simulation approach that allows us to reconstruct the reactivity in such host–guest systems in dynamic regimes. In this way, we can characterize amide encapsulation/expulsion in/out of the cage cavity (thermodynamics and kinetics), coupling such host–guest dynamic equilibrium with characteristic hydrolysis reaction constants. All computed kinetic/thermodynamic data are then combined, obtaining a statistical estimation of reaction acceleration in the host–guest system that is found in optimal agreement with the available experimental trends. This shows how, to understand the key factors controlling accelerations/variations in the reaction under confinement, it is necessary to take into account all dynamic processes that occur as intimately entangled in such host–guest systems. This also provides us with a flexible computational framework, useful to build structure–dynamics–property relationships for a variety of reactive host–guest systems. Encapsulation of guests in metal–organic cages allows control over chemical reactivity. Focusing on the hydrolysis of amides, here we show an effective molecular simulation approach to reconstruct reactivity in host–guest systems in dynamic regimes.![]()
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Affiliation(s)
- Massimo Delle Piane
- Department of Applied Science and Technology, Politecnico di Torino Corso Duca degli Abruzzi 24 10129 Torino Italy
| | - Luca Pesce
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Polo Universitario Lugano Campus Est, Via la Santa 1 6962 Lugano-Viganello Switzerland
| | - Matteo Cioni
- Department of Applied Science and Technology, Politecnico di Torino Corso Duca degli Abruzzi 24 10129 Torino Italy
| | - Giovanni M Pavan
- Department of Applied Science and Technology, Politecnico di Torino Corso Duca degli Abruzzi 24 10129 Torino Italy
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Polo Universitario Lugano Campus Est, Via la Santa 1 6962 Lugano-Viganello Switzerland
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Chiaramonte R, Cioni M. Critical spatiotemporal gait parameters for individuals with dementia: A systematic review and meta-analysis. Hong Kong Physiother J 2021; 41:1-14. [PMID: 34054252 PMCID: PMC8158408 DOI: 10.1142/s101370252130001x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022] Open
Abstract
Instrumented gait analysis allows for the identification of walking parameters to predict cognitive decline and the worsening of dementia. The aim of this study was to perform a meta-analysis to better clarify which gait parameters are affected or modified with the progression of the dementia in a larger sample, as well as which gait assessment conditions (single-task or dual-task conditions) would be more sensitive to reflect the influence of dementia. Literature searches were conducted with the keywords "quantitative gait" OR "gait analysis" AND "dementia" AND "single-task" AND "dual-task," and for "quantitative gait" OR "gait analysis" AND "dementia" AND "fall risk" on PubMed, EMBASE, the Cochrane Library, Scopus, and Web of Science. The results were used to perform a systematic review focussing on instrumental quantitative assessment of the walking of patients with dementia, during both single and dual tasks. The search was performed independently by two authors (C. R. and C. M.) from January 2018 to April 2020 using the PICOS criteria. Nine publications met the inclusion criteria and were included in the systematic review. Our meta-analysis showed that during a single task, most of the spatiotemporal parameters of gait discriminated best between patients with dementia and healthy controls, including speed, cadence, stride length, stride time, stride time variability, and stance time. In dual tasks, only speed, stride length, and stride time variability discriminated between the two groups. In addition, compared with spatial parameters (e.g. stride length), some temporal gait parameters were more correlated to the risk of falls during the comfortable walking in a single task, such as cadence, stride time, stride time variability, and stance time. During a dual task, only the variability of stride time was associated with the risk of falls.
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Affiliation(s)
- Rita Chiaramonte
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- Department of Physical Medicine and Rehabilitation, ASP 7, Scicli Hospital, Ragusa, Italy
| | - Matteo Cioni
- Laboratory of Neurobiomechanics, Department of Biomedical and Biotechnological Sciences, Catania, Italy
- Gait and Posture Analysis Laboratory, AOU Policlinico Vittorio Emanuele, 95123 Catania, Italy
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Casabona A, Valle MS, Dominante C, Laudani L, Onesta MP, Cioni M. Effects of Functional Electrical Stimulation Cycling of Different Duration on Viscoelastic and Electromyographic Properties of the Knee in Patients with Spinal Cord Injury. Brain Sci 2020; 11:brainsci11010007. [PMID: 33374653 PMCID: PMC7822482 DOI: 10.3390/brainsci11010007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 12/31/2022] Open
Abstract
The benefits of functional electrical stimulation during cycling (FES-cycling) have been ascertained following spinal cord injury. The instrumented pendulum test was applied to chronic paraplegic patients to investigate the effects of FES-cycling of different duration (20-min vs. 40-min) on biomechanical and electromyographic characterization of knee mobility. Seven adults with post-traumatic paraplegia attended two FES-cycling sessions, a 20-min and a 40-min one, in a random order. Knee angular excursion, stiffness and viscosity were measured using the pendulum test before and after each session. Surface electromyographic activity was recorded from the rectus femoris (RF) and biceps femoris (BF) muscles. FES-cycling led to reduced excursion (p < 0.001) and increased stiffness (p = 0.005) of the knee, which was more evident after the 20-min than 40-min session. Noteworthy, biomechanical changes were associated with an increase of muscle activity and changes in latency of muscle activity only for 20-min, with anticipated response times for RF (p < 0.001) and delayed responses for BF (p = 0.033). These results indicate that significant functional changes in knee mobility can be achieved by FES-cycling for 20 min, as evaluated by the pendulum test in patients with chronic paraplegia. The observed muscle behaviour suggests modulatory effects of exercise on spinal network aimed to partially restore automatic neuronal processes.
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Affiliation(s)
- Antonino Casabona
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Maria Stella Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Correspondence:
| | - Claudio Dominante
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Luca Laudani
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK
| | | | - Matteo Cioni
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
- U.O.P.I. Gait and Posture Analysis Laboratory—A.O.U. Policlinico Vittorio Emanuele, 95123 Catania, Italy
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Mangano GR, Valle MS, Casabona A, Vagnini A, Cioni M. Age-Related Changes in Mobility Evaluated by the Timed Up and Go Test Instrumented through a Single Sensor. Sensors (Basel) 2020; 20:s20030719. [PMID: 32012930 PMCID: PMC7038469 DOI: 10.3390/s20030719] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 01/04/2023]
Abstract
Mobility across people with a large range of age was evaluated, for the first time, by using an instrumented timed up and go test (iTUG) based on signals acquired by a single wearable inertial sensor. Eighty healthy participants, from childhood to old age, performed the test, covering walking distances of 3 m and 7 m. Total time, temporal, and velocity parameters of linear and turning subcomponents of the test were quantified. While children, adults, and senior adults exhibited similar values for all the parameters, older adults showed increases in duration and reductions in velocity during the turning phases when compared with the other groups. an increase in velocity was observed during mid turning when the test was performed along the longer distance. Similarity across children, adults, and senior adults indicates that healthy individuals develop the abilities performed in the iTUG early, while the slowing down shown during the turning phases by the older adults may reflect the need to implement adaptive adjustments to face changes of direction. These results emphasize the idea that reducing equipment to a single sensor provides an appropriate quantification when the iTUG is used to investigate a broader age range or different levels of complexity.
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Affiliation(s)
- Giulia R.A. Mangano
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy (A.C.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Maria S. Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy (A.C.); (M.C.)
- Correspondence: ; Tel.: +39-095-7381328
| | - Antonino Casabona
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy (A.C.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | | | - Matteo Cioni
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy (A.C.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
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11
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Kalli F, Cioni M, Parodi A, Altosole T, Ferrera F, Barra G, De Palma R, Fenoglio D, Filaci G, Rongioletti F. Increased frequency of interleukin-4 and reduced frequency of interferon-γ and IL-17-producing CD4+ and CD8+ cells in scleromyxedema. J Eur Acad Dermatol Venereol 2020; 34:1092-1097. [PMID: 31912592 DOI: 10.1111/jdv.16136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 11/12/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known about the pathogenesis of scleromyxedema, a life-threatening fibromucinosis disease with immunological dysregulation. OBJECTIVES To investigate on T-cell phenotype, function and cytokine biology in search of new insights supporting the immunopathogenesis of the disease. METHODS We analysed the frequency of circulating lymphocyte subsets, the T-cell maturation stage, the generation of antigen-specific T-cell lines and T-cell cytokine secretion. RESULTS The analysis of T-cell maturation stage and the TCR spectratyping findings revealed that scleromyxedema patients showed clear immunological signs of long-lasting immune system activation and stimulation leading to a skewed T-cell repertoire. Moreover, these analyses showed that both CD4+ and CD8+ T cells from scleromyxedema patients have a profound deficiency (even after stimulation) relatively to the production of IFN-γ and IL17 with respect to healthy donor control cells, while they are massively skewed towards IL4 secretion after stimulation. CONCLUSIONS Our data indicate that a chronic Th2-skewed T-cell response against an unknown target antigen leading to abnormally high IL4 secretion, a pro-fibrotic cytokine, is a main immunological hallmark of scleromyxedema patients. These results, never reported before, may have a translational therapeutic value due to the availability of anti-IL4 agents such as dupilumab.
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Affiliation(s)
- F Kalli
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - M Cioni
- Section of Dermatology, DISSAL, University of Genoa, Genoa, Italy.,Section of Pathology, Department of Surgical and Morphological Sciences, University of Genoa, Genoa, Italy
| | - A Parodi
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - T Altosole
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - F Ferrera
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - G Barra
- Department of Precision Medicine, Università della Campania "L. Vanvitelli", Napoli, Italy
| | - R De Palma
- Institute of Protein Biochemistry, CNR, Napoli, Italy.,Department of Internal Medicine, University of Genoa- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - D Fenoglio
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.,Department of Internal Medicine, University of Genoa- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G Filaci
- Department of Internal Medicine and Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.,Bioterapy Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - F Rongioletti
- Section of Pathology, Department of Surgical and Morphological Sciences, University of Genoa, Genoa, Italy.,Department of Medical Science and Public Health, Unit of Dermatology, University of Cagliari, Cagliari, Italy
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12
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Valle MS, Lombardo L, Cioni M, Casabona A. Relationship between accuracy and complexity when learning underarm precision throwing. Eur J Sport Sci 2018; 18:1217-1225. [PMID: 29893184 DOI: 10.1080/17461391.2018.1484176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Learning precision ball throwing was mostly studied to explore the early rapid improvement of accuracy, with poor attention on possible adaptive processes occurring later when the rate of improvement is reduced. Here, we tried to demonstrate that the strategy to select angle, speed and height at ball release can be managed during the learning periods following the performance stabilization. To this aim, we used a multivariate linear model with angle, speed and height as predictors of changes in accuracy. Participants performed underarm throws of a tennis ball to hit a target on the floor, 3.42 m away. Two training sessions (S1, S2) and one retention test were executed. Performance accuracy increased over the S1 and stabilized during the S2, with a rate of changes along the throwing axis slower than along the orthogonal axis. However, both the axes contributed to the performance changes over the learning and consolidation time. A stable relationship between the accuracy and the release parameters was observed only during S2, with a good fraction of the performance variance explained by the combination of speed and height. All the variations were maintained during the retention test. Overall, accuracy improvements and reduction in throwing complexity at the ball release followed separate timing over the course of learning and consolidation.
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Affiliation(s)
- Maria Stella Valle
- a Neuro-Biomechanics Laboratory, Department of Biomedical and Biotechnological Sciences , University of Catania , Catania , Italy
| | - Luciano Lombardo
- a Neuro-Biomechanics Laboratory, Department of Biomedical and Biotechnological Sciences , University of Catania , Catania , Italy
| | - Matteo Cioni
- a Neuro-Biomechanics Laboratory, Department of Biomedical and Biotechnological Sciences , University of Catania , Catania , Italy.,b Physical Medicine and Rehabilitation Residency Program , University of Catania , Catania , Italy.,c Gait and Posture Laboratory , Policlinico-Vittorio Emanuele Hospital , Catania , Italy
| | - Antonino Casabona
- a Neuro-Biomechanics Laboratory, Department of Biomedical and Biotechnological Sciences , University of Catania , Catania , Italy.,b Physical Medicine and Rehabilitation Residency Program , University of Catania , Catania , Italy
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13
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Capecchi G, Baldassarri M, Ferranti S, Guidoni E, Cioni M, Nürnberg P, Mencarelli M, Renieri A, Grosso S. CKAP2L
mutation confirms the diagnosis of Filippi syndrome. Clin Genet 2018; 93:1109-1110. [DOI: 10.1111/cge.13188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 11/27/2022]
Affiliation(s)
- G. Capecchi
- Dipartimento di Medicina molecolare e dello sviluppo; Clinica Pediatrica; Siena Italy
| | - M. Baldassarri
- Medical Genetics; University of Siena; Siena Italy
- Genetica Medica; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - S. Ferranti
- Dipartimento di Medicina molecolare e dello sviluppo; Clinica Pediatrica; Siena Italy
| | - E. Guidoni
- Dipartimento di Medicina molecolare e dello sviluppo; Clinica Pediatrica; Siena Italy
| | - M. Cioni
- Dipartimento di Medicina molecolare e dello sviluppo; Clinica Pediatrica; Siena Italy
| | - P. Nürnberg
- Cologne Center for Genomics; University of Cologne; Cologne Germany
| | - M.A. Mencarelli
- Genetica Medica; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - A. Renieri
- Medical Genetics; University of Siena; Siena Italy
- Genetica Medica; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - S. Grosso
- Dipartimento di Medicina molecolare e dello sviluppo; Clinica Pediatrica; Siena Italy
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14
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Amata O, Scalisi E, Conti A, Umana G, Cioni M. Bardet-Biedl Syndrome Late Diagnosis with a Great Disability: A Case Report. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/35801.12372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Giovannelli E, Cioni M, Procacci P, Cardini G, Pagliai M, Volkov V, Chelli R. Binding Free Energies of Host–Guest Systems by Nonequilibrium Alchemical Simulations with Constrained Dynamics: Illustrative Calculations and Numerical Validation. J Chem Theory Comput 2017; 13:5887-5899. [DOI: 10.1021/acs.jctc.7b00595] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Edoardo Giovannelli
- Dipartimento
di Chimica, Università di Firenze, Via della Lastruccia 3, I-50019 Sesto Fiorentino, Italy
| | - Matteo Cioni
- Dipartimento
di Chimica, Università di Firenze, Via della Lastruccia 3, I-50019 Sesto Fiorentino, Italy
| | - Piero Procacci
- Dipartimento
di Chimica, Università di Firenze, Via della Lastruccia 3, I-50019 Sesto Fiorentino, Italy
| | - Gianni Cardini
- Dipartimento
di Chimica, Università di Firenze, Via della Lastruccia 3, I-50019 Sesto Fiorentino, Italy
| | - Marco Pagliai
- Dipartimento
di Chimica, Università di Firenze, Via della Lastruccia 3, I-50019 Sesto Fiorentino, Italy
| | - Victor Volkov
- Dipartimento
di Chimica, Università di Firenze, Via della Lastruccia 3, I-50019 Sesto Fiorentino, Italy
| | - Riccardo Chelli
- Interdisciplinary
Biomedical Research Center, School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, U.K
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16
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Guarneri A, Cioni M, Rongioletti F. High-dose intravenous immunoglobulin therapy for scleromyxoedema: a prospective open-label clinical trial using an objective score of clinical evaluation system. J Eur Acad Dermatol Venereol 2017; 31:1157-1160. [DOI: 10.1111/jdv.14244] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/03/2017] [Indexed: 12/01/2022]
Affiliation(s)
- A. Guarneri
- Section of Dermatology; DISSAL; University of Genoa and S. Martino University Hospital; Genoa Italy
| | - M. Cioni
- Section of Dermatology; DISSAL; University of Genoa and S. Martino University Hospital; Genoa Italy
| | - F. Rongioletti
- Unit of Dermatology; Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
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17
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Nocera A, Tagliamacco A, Cioni M, Innocente A, Fontana I, Barbano G, Carrea A, Ramondetta M, Sementa A, Basso S, Quartuccio G, Klersy C, Bertocchi M, Verrina E, Garibotto G, Ghiggeri GM, Cardillo M, Comoli P, Ginevri F. Kidney Intragraft Homing of De Novo Donor-Specific HLA Antibodies Is an Essential Step of Antibody-Mediated Damage but Not Per Se Predictive of Graft Loss. Am J Transplant 2017; 17:692-702. [PMID: 27501275 DOI: 10.1111/ajt.14000] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/07/2016] [Accepted: 08/02/2016] [Indexed: 01/25/2023]
Abstract
Donor-specific HLA antibody (DSA)-mediated graft injury is the major cause of kidney loss. Among DSA characteristics, graft homing has been suggested as an indicator of severe tissue damage. We analyzed the role of de novo DSA (dnDSA) graft homing on kidney transplantation outcome. Graft biopsy specimens and parallel sera from 48 nonsensitized pediatric kidney recipients were analyzed. Serum samples and eluates from graft biopsy specimens were tested for the presence of dnDSAs with flow bead technology. Intragraft dnDSAs (gDSAs) were never detected in the absence of serum dnDSAs (sDSAs), whereas in the presence of sDSAs, gDSAs were demonstrated in 72% of biopsy specimens. A significantly higher homing capability was expressed by class II sDSAs endowed with high mean fluorescence intensity and C3d- and/or C1q-fixing properties. In patients with available sequential biopsy specimens, we detected gDSAs before the appearance of antibody-mediated rejection. In sDSA-positive patients, gDSA positivity did not allow stratification for antibody-mediated graft lesions and graft loss. However, a consistent detection of skewed unique DSA specificities was observed over time within the graft, likely responsible for the damage. Our results indicate that gDSAs could represent an instrumental tool to identify, among sDSAs, clinically relevant antibody specificities requiring monitoring and possibly guiding patient management.
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Affiliation(s)
- A Nocera
- Transplant Immunology Research Laboratory at Clinical Nephrology Unit, Department of Internal Medicine (DIMI), University of Genova, Genova, Italy
| | - A Tagliamacco
- Transplant Immunology Research Laboratory at Clinical Nephrology Unit, Department of Internal Medicine (DIMI), University of Genova, Genova, Italy
| | - M Cioni
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - A Innocente
- Transplantation Immunology, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - I Fontana
- Kidney Transplant Surgery Unit, IRCCS Azienda Ospedaliera Universitaria S. Martino-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - G Barbano
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - A Carrea
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - M Ramondetta
- Transplantation Immunology, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - A Sementa
- Pathology Unit, Istituto G. Gaslini, Genova, Italy
| | - S Basso
- Pediatric Hematology/Oncology, Fondazione Policlinico S. Matteo, Pavia, Italy
| | - G Quartuccio
- Pediatric Hematology/Oncology, Fondazione Policlinico S. Matteo, Pavia, Italy
| | - C Klersy
- Biometry and Statistics Service, Fondazione Policlinico S. Matteo, Pavia, Italy
| | - M Bertocchi
- Kidney Transplant Surgery Unit, IRCCS Azienda Ospedaliera Universitaria S. Martino-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - E Verrina
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - G Garibotto
- Nephrology Unit, Department of Internal Medicine, University of Genova, Genova, Italy
| | - G M Ghiggeri
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - M Cardillo
- Transplantation Immunology, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - P Comoli
- Pediatric Hematology/Oncology, Fondazione Policlinico S. Matteo, Pavia, Italy
| | - F Ginevri
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
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18
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Piatti PM, Cioni M, Magistro A, Villa V, Crippa VG, Galluccio E, Fontana B, Spadoni S, Bosi E, Monti LD, Alfieri O. Basal insulin therapy is associated with beneficial effects on postoperative infective complications, independently from circulating glucose levels in patients admitted for cardiac surgery. J Clin Transl Endocrinol 2017; 7:47-53. [PMID: 29067250 PMCID: PMC5651296 DOI: 10.1016/j.jcte.2017.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/23/2017] [Accepted: 01/31/2017] [Indexed: 02/07/2023]
Abstract
The effect of insulin per se on infective complications during cardiac surgery was evaluated. Eight hundred twelve patients were included. Insulin therapy decreased infections independently from glycemic levels. Basal + premeal insulin therapy is well tolerated without severe hypoglycemia cases.
Background Although hyperglycemia is a strong predictor of postoperative infective complications (PIC), little is known about the effect of basal insulin therapy (BIT) per se on PIC. Aim To evaluate if there is an association between BIT, independent of glucose levels, and a possible improvement of PIC during the perioperative cardiosurgery period (PCP). Methods In 812 patients admitted for cardiac intervention and treated with a continuous intravenous insulin infusion (CIII) for hyperglycemic levels (>130 mg/dl), a retrospective analysis was performed during the PCP (January 2009–December 2011). Upon transfer to the cardiac surgery division, if fasting glucose was ≥130 mg/dl, a basal + premeal insulin therapy was initiated (121 patients, group 1); for <130 mg/dl, a premeal insulin alone was initiated (691 patients, group 2). Findings Compared with group 2, group 1 showed reductions in PIC (2.48% vs 7.96%, p < 0.049; odds ratio: 0.294; 95% CI: 0.110–0.780), C-Reactive Protein (p < 0.05) and white blood cell (p < 0.05) levels despite glucose levels and CIII that were higher during the first two days after surgery (179.8 ± 25.3 vs 169.5 ± 10.6 mg/dl, p < 0.01; 0.046 ± 0.008 vs 0.037 ± 0.015 U/kg/h, p < 0.05, respectively). Normal glucose levels were achieved in both groups from day 3 before the discharge. The mean length of hospital duration was 18% lower in group 1 than in group 2 (7.21 ± 05.08 vs 8.76 ± 9.08 days, p < 0.007), providing a significant impact on public health costs. Conclusions Basal + preprandial insulin therapy was associated with a lower frequency of PIC than preprandial insulin therapy alone, suggesting a beneficial effect of basal insulin therapy on post-surgery outcome.
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Affiliation(s)
- P M Piatti
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - M Cioni
- Cardio-Surgery Division, IRCCS San Raffaele Institute, Milan, Italy
| | - A Magistro
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - V Villa
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - V G Crippa
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - E Galluccio
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - B Fontana
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - S Spadoni
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - E Bosi
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.,Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - L D Monti
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - O Alfieri
- Cardio-Surgery Division, IRCCS San Raffaele Institute, Milan, Italy
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19
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Comoli P, Cioni M, Tagliamacco A, Quartuccio G, Innocente A, Fontana I, Trivelli A, Magnasco A, Nocco A, Klersy C, Rubert L, Ramondetta M, Zecca M, Garibotto G, Ghiggeri GM, Cardillo M, Nocera A, Ginevri F. Acquisition of C3d-Binding Activity by De Novo Donor-Specific HLA Antibodies Correlates With Graft Loss in Nonsensitized Pediatric Kidney Recipients. Am J Transplant 2016; 16:2106-16. [PMID: 26725780 DOI: 10.1111/ajt.13700] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [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: 08/14/2015] [Revised: 12/23/2015] [Accepted: 12/28/2015] [Indexed: 01/25/2023]
Abstract
Alloantibody-mediated graft injury is a major cause of kidney dysfunction and loss. The complement-binding ability of de novo donor-specific antibodies (dnDSAs) has been suggested as a prognostic tool to stratify patients for clinical risk. In this study, we analyzed posttransplant kinetics of complement-fixing dnDSAs and their role in antibody-mediated rejection development and graft loss. A total of 114 pediatric nonsensitized recipients of first kidney allograft were periodically monitored for dnDSAs using flow bead assays, followed by C3d and C1q assay in case of positivity. Overall, 39 patients developed dnDSAs, which were C1q(+) and C3d(+) in 25 and nine patients, respectively. At follow-up, progressive acquisition over time of dnDSA C1q and C3d binding ability, within the same antigenic specificity, was observed, paralleled by an increase in mean fluorescence intensity that correlated with clinical outcome. C3d-fixing dnDSAs were better fit to stratify graft loss risk when the different dnDSA categories were evaluated in combined models because the 10-year graft survival probability was lower in patients with C3d-binding dnDSA than in those without dnDSAs or with C1q(+) /C3d(-) or non-complement-binding dnDSAs (40% vs. 94%, 100%, and 100%, respectively). Based on the kinetics profile, we favor dnDSA removal or modulation at first confirmed positivity, with treatment intensification guided by dnDSA biological characteristics.
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Affiliation(s)
- P Comoli
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - M Cioni
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - A Tagliamacco
- Clinical Nephrology Unit and Transplant Immunology Research Laboratory, Department of Internal Medicine - DIMI, University of Genova, Genova, Italy
| | - G Quartuccio
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - A Innocente
- Transplantation Immunology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - I Fontana
- Vascular and Endovascular Unit and Kidney Transplant Surgery Unit, University of Genova, IRCCS San Martino University Hospital IST, Genova, Italy
| | - A Trivelli
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - A Magnasco
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - A Nocco
- Transplantation Immunology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - C Klersy
- Biometry and Statistics Service, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - L Rubert
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - M Ramondetta
- Transplantation Immunology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - M Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - G Garibotto
- Clinical Nephrology Unit and Transplant Immunology Research Laboratory, Department of Internal Medicine - DIMI, University of Genova, Genova, Italy
| | - G M Ghiggeri
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
| | - M Cardillo
- Transplantation Immunology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - A Nocera
- Clinical Nephrology Unit and Transplant Immunology Research Laboratory, Department of Internal Medicine - DIMI, University of Genova, Genova, Italy
| | - F Ginevri
- Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Genova, Italy
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20
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Casabona A, Leonardi G, Aimola E, La Grua G, Polizzi CM, Cioni M, Valle MS. Specificity of foot configuration during bipedal stance in ballet dancers. Gait Posture 2016; 46:91-7. [PMID: 27131184 DOI: 10.1016/j.gaitpost.2016.02.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/10/2016] [Accepted: 02/26/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIM Learning highly specialized upright postures may be of benefit for more common as well as for novel stances. In this study, we asked whether this generalization occurs with foot configurations previously trained or depends on a generic increase in balance difficulty. We also explored the possibility that the benefit may concern not only the level of postural performance but also the structural organization of the upright standing. METHODS Ten elite professional ballet dancers were compared to ten untrained subjects, measuring the motion of the center of pressure (COP) across a set of five stances with different foot configurations. The balance stability was measured computing the area, the sway path, and the root mean square of the COP motion, whereas the structure of the postural control was assessed by compute approximate entropy, fractal dimension and the mean power frequency. The foot position included common and challenging stances, with the level of difficulty changed across the configurations. Among these conditions, only one foot configuration was familiar to the dancers. RESULTS Statistically significant differences between the two groups, for all the parameters, were observed only for the stance with the foot position familiar to the dancers. Stability and structural parameters exhibited comparable differences. CONCLUSIONS We concluded that the benefit from classical ballet is limited to a specific foot configuration, regardless of the level of stance difficulty or the component of postural control.
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Affiliation(s)
- Antonino Casabona
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy; Physical Medicine and Rehabilitation Residency Program, University of Catania, Catania, Italy.
| | - Giuseppa Leonardi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Ettore Aimola
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Giovanni La Grua
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Cristina Maria Polizzi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Matteo Cioni
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy; Physical Medicine and Rehabilitation Residency Program, University of Catania, Catania, Italy
| | - Maria Stella Valle
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy
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Cioni M, Leboeuf C, Comoli P, Ginevri F, Hirsch HH. Characterization of Immunodominant BK Polyomavirus 9mer Epitope T Cell Responses. Am J Transplant 2016; 16:1193-206. [PMID: 26663765 PMCID: PMC5067673 DOI: 10.1111/ajt.13598] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/30/2015] [Accepted: 10/18/2015] [Indexed: 01/25/2023]
Abstract
Uncontrolled BK polyomavirus (BKPyV) replication in kidney transplant recipients (KTRs) causes polyomavirus-associated nephropathy and allograft loss. Reducing immunosuppression is associated with clearing viremia and nephropathy and increasing BKPyV-specific T cell responses in most patients; however, current immunoassays have limited sensitivity, target mostly CD4(+) T cells, and largely fail to predict onset and clearance of BKPyV replication. To characterize BKPyV-specific CD8(+) T cells, bioinformatics were used to predict 9mer epitopes in the early viral gene region (EVGR) presented by 14 common HLAs in Europe and North America. Thirty-nine EVGR epitopes were experimentally confirmed by interferon-γ enzyme-linked immunospot assays in at least 30% of BKPyV IgG-seropositive healthy participants. Most 9mers clustered in domains, and some were presented by more than one HLA class I, as typically seen for immunodominant epitopes. Specific T cell binding using MHC class I streptamers was demonstrated for 21 of 39 (54%) epitopes. In a prospective cohort of 118 pediatric KTRs, 19 patients protected or recovering from BKPyV viremia were experimentally tested, and 13 epitopes were validated. Single HLA mismatches were not associated with viremia, suggesting that failing immune control likely involves multiple factors including maintenance immunosuppression. Combining BKPyV load and T cell assays using immunodominant epitopes may help in evaluating risk and reducing immunosuppression and may lead to safe adoptive T cell transfer.
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Affiliation(s)
- M. Cioni
- Transplantation and Clinical VirologyDepartment Biomedicine (Haus Petersplatz)University of BaselBaselSwitzerland
| | - C. Leboeuf
- Transplantation and Clinical VirologyDepartment Biomedicine (Haus Petersplatz)University of BaselBaselSwitzerland
| | - P. Comoli
- Pediatric Hematology/OncologyFondazione IRCCS Policlinico S. MatteoPaviaItaly
| | - F. Ginevri
- Nephrology, Dialysis and Transplantation UnitIRCCS G. Gaslini InstituteGenovaItaly
| | - H. H. Hirsch
- Transplantation and Clinical VirologyDepartment Biomedicine (Haus Petersplatz)University of BaselBaselSwitzerland,Division of Infection DiagnosticsDepartment Biomedicine (Haus Petersplatz)University of BaselBaselSwitzerland,Infectious Diseases and Hospital EpidemiologyUniversity Hospital BaselBaselSwitzerland
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Abstract
Upright stance on a balance board is a skill requiring complex rearrangement of the postural control. Despite the large use of these boards in training the standing posture, a comprehensive analysis of the learning process underlying the control of these devices is lacking. In this paper learning to maintain a stable stance on a multiaxial oscillating board was studied by analyzing performance changes over short and long periods. Healthy participants were asked to keep the board orientation as horizontal as possible for 20 sec, performing two sessions of 8 trials separated by 15-min pause. Memory consolidation was tested one week later. Amplitude and variability of the oscillations around horizontal plane and area and sway path of the board displacement decreased rapidly over the first session. The performance was stable during the second session, and retained after 1 week. A similar behavior was observed in the anterior-posterior and medial-lateral directions for amplitude and variability parameters, with less stable balance in the anterior-posterior direction. Approximate entropy and mean power frequency, assessing temporal dynamics and frequency content of oscillations, changed only in the anterior-posterior direction during the retention test. Overall, the ability to stand on a balance board is rapidly acquired, and retained for long time. The asymmetric stability between anterior-posterior and medial-lateral directions replicates a structure observed in other standing stances, suggesting a possible transfer from previous postural experiences. Conversely, changes in the temporal dynamics and the frequency content could be associated with new postural strategies developed later during memory consolidation.
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Affiliation(s)
- Maria Stella Valle
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy
| | - Antonino Casabona
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy
- Physical Medicine and Rehabilitation Residency Program, University of Catania, Catania, Italy
| | - Carlo Cavallaro
- Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy
- Physical Medicine and Rehabilitation Residency Program, University of Catania, Catania, Italy
| | - Gabriele Castorina
- Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy
| | - Matteo Cioni
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy
- Physical Medicine and Rehabilitation Residency Program, University of Catania, Catania, Italy
- * E-mail:
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Bertelli R, Bonanni A, Di Donato A, Cioni M, Ravani P, Ghiggeri GM. Regulatory T cells and minimal change nephropathy: in the midst of a complex network. Clin Exp Immunol 2015; 183:166-74. [PMID: 26147676 DOI: 10.1111/cei.12675] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2015] [Indexed: 12/16/2022] Open
Abstract
Minimal change nephrosis (MCN) is an important cause of morbidity in children. In spite of successful therapies having been developed in the last three decades, most aspects related to pathogenesis still remain poorly defined. Evolution in basic immunology and results deriving from animal models of the disease suggest a complex interaction of factors and cells starting from activation of innate immunity and continuing with antigen presentation. Oxidants, CD80 and CD40/CD40L have probably a relevant role at the start. Studies in animal models and in human beings also suggest the possibility that the same molecules (i.e. CD80, CD40) are expressed by podocytes under inflammatory stimuli, representing a direct potential mechanism for proteinuria. B and T cells could play a relevant role this contest. Implication of B cells is suggested indirectly by studies utilizing anti-CD20 monoclonal antibodies as the main therapy. The role of regulatory T cells (Tregs ) is supported mainly by results in animal models of nephrotic syndrome (i.e. adriamycin, puromycin, lipopolysaccharide), showing a protective effect of direct Treg infusion or stimulation by interleukin 2 (IL-2). Limited studies have also shown reduced amounts of circulating Tregs in patients with active MCN cells. The route from bench to bedside would be reduced if results from animal models were confirmed in human pathology. The expansion of Tregs with recombinant IL-2 and new anti-CD20 monoclonal antibodies is the beginning. Blocking antigen-presenting cells with cytotoxic T lymphocyte antigen (CTLA-4)-Ig fusion molecules inhibiting CD80 and/or with blockers of CD40-CD40 ligand interaction represent potential new approaches. The hope is that evolution in therapies of MCN could fill a gap lasting 30 years.
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Affiliation(s)
- R Bertelli
- Laboratory on Physiopathology of Uremia, Children's Hospital, Genoa, Italy.,Division of Nephrology, Dialysis, Transplantation, Giannina Gaslini Children's Hospital, Genoa, Italy
| | - A Bonanni
- Laboratory on Physiopathology of Uremia, Children's Hospital, Genoa, Italy.,Division of Nephrology, Dialysis, Transplantation, Giannina Gaslini Children's Hospital, Genoa, Italy
| | - A Di Donato
- Laboratory on Physiopathology of Uremia, Children's Hospital, Genoa, Italy.,Division of Nephrology, Dialysis, Transplantation, Giannina Gaslini Children's Hospital, Genoa, Italy
| | - M Cioni
- Laboratory on Physiopathology of Uremia, Children's Hospital, Genoa, Italy.,Division of Nephrology, Dialysis, Transplantation, Giannina Gaslini Children's Hospital, Genoa, Italy
| | - P Ravani
- Division of Nephrology, University of Calgary, Calgary, Canada
| | - G M Ghiggeri
- Laboratory on Physiopathology of Uremia, Children's Hospital, Genoa, Italy.,Division of Nephrology, Dialysis, Transplantation, Giannina Gaslini Children's Hospital, Genoa, Italy
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Cioni M, Amata O, Seminara M, Marano P, Palermo F, Corallo V, Brugliera L. Responsiveness to sensory cues using the Timed Up and Go test in patients with Parkinson’s disease: A prospective cohort study. J Rehabil Med 2015; 47:824-9. [DOI: 10.2340/16501977-2003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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De Bonis M, Taramasso M, Lapenna E, Denti P, Canna GL, Pappalardo F, Cioni M, Alfieri O. 142 * MITRACLIP THERAPY AND SURGICAL EDGE-TO-EDGE REPAIR IN PATIENTS WITH SEVERE LEFT VENTRICULAR DYSFUNCTION AND SECONDARY MITRAL REGURGITATION: MID-TERM RESULTS OF A SINGLE-CENTRE EXPERIENCE. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Taramasso M, Denti P, Buzzatti N, Cioni M, La Canna G, Colombo A, Alfieri O, Maisano F. 180 * MITRACLIP THERAPY IN HIGH-RISK AND ELDERLY PATIENTS WITH DEGENERATIVE MITRAL REGURGITATION: MID-TERM CLINICAL AND ECHOCARDIOGRAPHIC OUTCOMES IN A SINGLE-CENTRE EXPERIENCE. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Ajello S, Latib A, Candreva A, Buzzatti N, Cioni M, Guidotti A, Colombo A, La Canna G, Alfieri O, Maisano F. Outcome of patients referred for MitraClip: treated vs. untreated high-risk candidates in a single center experience. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Casabona A, Valle MS, Pisasale M, Pantò MR, Cioni M. Functional assessments of the knee joint biomechanics by using pendulum test in adults with Down syndrome. J Appl Physiol (1985) 2012; 113:1747-55. [PMID: 22995394 PMCID: PMC3544505 DOI: 10.1152/japplphysiol.00960.2012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [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: 08/03/2012] [Accepted: 09/18/2012] [Indexed: 11/22/2022] Open
Abstract
In this study, we assessed kinematics and viscoelastic features of knee joint in adults with Down syndrome (DS) by means of the Wartenberg pendulum test. This test allows the measuring of the kinematics of the knee joint during passive pendular motion of leg under the influence of gravity. In addition, by a combination of kinematic and anthropometric data, pendulum test provides estimates of joint viscoelastic properties by computing damping and stiffness coefficients. To monitor the occurrences of muscle activation, the surface electromyogram (EMG) of muscle rectus femoris was recorded. The experimental protocol was performed in a group of 10 adults with DS compared with 10 control adults without DS. Joint motion amplitude, velocity, and acceleration of the leg during the first knee flexion significantly decreased in persons with DS with respect to those without DS. This behavior was associated with the activation of rectus femoris in subjects with DS that resulted in increasing of joint resistance shortly after the onset of the first leg flexion. The EMG bursts mostly occurred between 50 and 150 ms from the leg flexion onset. During the remaining cycles of pendular motion, persons with DS exhibited passive leg oscillations with low tonic EMG activity and reduced damping coefficient compared with control subjects. These results suggest that adults with DS might perform preprogrammed contractions to increase joint resistance and compensate for inherent joint instability occurring for quick and unpredictable perturbations. The reduction of damping coefficients observed during passive oscillations could be a predictor of muscle hypotonia.
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Affiliation(s)
- Antonino Casabona
- Gait Analysis Laboratory, Physical Medicine and Rehabilitation Residency Program, University of Catania, Catania, Italy
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29
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Ginevri F, Nocera A, Comoli P, Innocente A, Cioni M, Parodi A, Fontana I, Magnasco A, Nocco A, Tagliamacco A, Sementa A, Ceriolo P, Ghio L, Zecca M, Cardillo M, Garibotto G, Ghiggeri GM, Poli F. Posttransplant de novo donor-specific hla antibodies identify pediatric kidney recipients at risk for late antibody-mediated rejection. Am J Transplant 2012; 12:3355-62. [PMID: 22959074 DOI: 10.1111/j.1600-6143.2012.04251.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The emerging role of humoral immunity in the pathogenesis of chronic allograft damage has prompted research aimed at assessing the role of anti-HLA antibody (Ab) monitoring as a tool to predict allograft outcome. Data on the natural history of allografts in children developing de novo Ab after transplantation are limited. Utilizing sera collected pretransplant, and serially posttransplant, we retrospectively evaluated 82 consecutive primary pediatric kidney recipients, without pretransplant donor-specific antibodies (DSA), for de novo Ab occurrence, and compared results with clinical-pathologic data. At 4.3-year follow up, 19 patients (23%) developed de novo DSA whereas 24 had de novo non-DSA (NDSA, 29%). DSA appeared at a median time of 24 months after transplantation and were mostly directed to HLA-DQ antigens. Among the 82 patients, eight developed late/chronic active C4d+ antibody-mediated rejection (AMR), and four C4d-negative AMR. Late AMR correlated with DSA (p < 0.01), whose development preceded AMR by 1-year median time. Patients with DSA had a median serum creatinine of 1.44 mg/dL at follow up, significantly higher than NDSA and Ab-negative patients (p < 0.005). In our pediatric cohort, DSA identify patients at risk of renal dysfunction, AMR and graft loss; treatment started at Ab emergence might prevent AMR occurrence and/or progression to graft failure.
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Affiliation(s)
- F Ginevri
- Pediatric Nephrology, Istituto G. Gaslini, Genova, Italy.
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Buchanan GL, Chieffo A, Montorfano M, Maisano F, Latib A, Cioni M, Figini F, Carlino M, Covello RD, Franco A, Gerli C, Grimaldi A, La Canna G, Spagnolo P, Alfieri O, Colombo A. 040 Outcomes following transcatheter aortic valve implantation comparing Edwards SAPIEN with Medtronic CoreValve ReValving system devices: results from the Milan registry. Heart 2012. [DOI: 10.1136/heartjnl-2012-301877b.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Maisano F, Taramasso M, Cioni M, Buzzatti N, Denti P, Colombo A, Alfieri O. Review of the MitraClip clinical evidence. Minerva Cardioangiol 2012; 60:85-93. [PMID: 22322576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
MitraClip system is the only catheter-based device for percutaneous mitral valve repair available for clinical use, after receipt of the CE Mark in 2008, while it is currently under review for FDA approval in the US. To date, over 3500 MitraClip implants have been performed worldwide, mainly in high risk surgical patients. The aim of this review is to review all the current evidences of the MitraClip therapy in an aim to define its clinical role in the treatment of mitral regurgitation (MR).
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Affiliation(s)
- F Maisano
- Cardiothoracic Department, San Raffaele Hospital, Milan, Italy.
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Balduzzi A, Lucchini G, Hirsch HH, Basso S, Cioni M, Rovelli A, Zincone A, Grimaldi M, Corti P, Bonanomi S, Biondi A, Locatelli F, Biagi E, Comoli P. Polyomavirus JC-targeted T-cell therapy for progressive multiple leukoencephalopathy in a hematopoietic cell transplantation recipient. Bone Marrow Transplant 2010; 46:987-92. [PMID: 20921942 DOI: 10.1038/bmt.2010.221] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Progressive multifocal leukoencephalopathy (PML) associated with polyomavirus JC (JCV) infection has been reported to be usually fatal in allogeneic hematopoietic SCT (HSCT) recipients. We present the case of a 19-year-old HSCT patient diagnosed with JCV-associated PML after prolonged immunosuppression for severe GVHD. No short-term neurological improvement was observed after antiviral treatment and discontinuation of immunosuppressive therapy. Donor-derived JCV Ag-specific CTLs were generated in vitro after stimulation with 15-mer peptides derived from VP1 and large T viral proteins. After adoptive CTL infusion, virus-specific cytotoxic cells were shown in the peripheral blood, JCV-DNA was cleared in the cerebrospinal fluid and the patient showed remarkable improvement. Adoptive T-lymphocyte therapy with JCV-specific CTLs was feasible and had no side effects. This case suggests that adoptive transfer of JCV-targeted CTLs may contribute to restore JCV-specific immune competence and control PML in transplanted patients.
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Affiliation(s)
- A Balduzzi
- Clinica Pediatrica Università degli Studi di Milano Bicocca, Ospedale San Gerardo, Monza, Italy.
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Romeo DM, Cioni M, Distefano A, Battaglia LR, Costanzo L, Ricci D, De Sanctis R, Romeo MG, Mazzone D, Mercuri E. Quality of life in parents of children with cerebral palsy: is it influenced by the child's behaviour? Neuropediatrics 2010; 41:121-6. [PMID: 20859830 DOI: 10.1055/s-0030-1262841] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [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: 10/19/2022]
Abstract
The aims of the present study were: to examine the quality of life (QOL) of parents of children with cerebral palsy (CP) and to establish the possible effect of behaviour problems on their QOL. One-hundred children with CP, aged between 4 and 10 years, and both their parents were included in the study. Both parents completed the WHOQOL-BREF, to assess their QOL. A sample of 60 parents of healthy children was used as control group. The primary caregiver also completed the CHILD BEHAVIOUR CHECKLIST (CBCL). Parents of children with CP showed lower scores on physical and psychological domains than the control group on QOL. In the psychological domain the mothers of children with hemiplegia had the lowest scores. The mothers reported lower scores than the fathers for the physical domain in the group of children with diplegia and quadriplegia and for the psychological domain in the group of children with hemiplegia. Children with hemiplegia showed externalizing scores at CBCL higher than the other groups, that could explain the poorer QOL scores of their mothers. In conclusions our results provide useful information on the QOL in families with different forms of CP, useful in planning interventions for the family of children with CP.
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Affiliation(s)
- D M Romeo
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, Catania, Italy
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Bertelli R, Trivelli A, Magnasco A, Cioni M, Bodria M, Carrea A, Montobbio G, Barbano G, Ghiggeri GM. Failure of regulation results in an amplified oxidation burst by neutrophils in children with primary nephrotic syndrome. Clin Exp Immunol 2010; 161:151-8. [PMID: 20491793 DOI: 10.1111/j.1365-2249.2010.04160.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The mechanism responsible for proteinuria in non-genetic idiopathic nephrotic syndrome (iNS) is unknown. Animal models suggest an effect of free radicals on podocytes, and indirect evidence in humans confirm this implication. We determined the oxidative burst by blood CD15+ polymorphonucleates (PMN) utilizing the 5-(and-6)-carboxy-2',7'-dichlorofluorescin diacetate (DCF-DA) fluorescence assay in 38 children with iNS. Results were compared with PMN from normal subjects and patients with renal pathologies considered traditionally to be models of oxidative stress [six anti-neutrophil cytoplasmic autoantibody (ANCA) vasculitis, seven post-infectious glomerulonephritis]. Radicals of oxygen (ROS) production was finally determined in a patient with immunodeficiency, polyendocrinopathy, enteropathy X-linked (IPEX) and in seven iNS children after treatment with Rituximab. Results demonstrated a 10-fold increase of ROS production by resting PMN in iNS compared to normal PMN. When PMN were separated from other cells, ROS increased significantly in all conditions while a near-normal production was restored by adding autologous cells and/or supernatants in controls, vasculitis and post-infectious glomerulonephritis but not in iNS. Results indicated that the oxidative burst was regulated by soluble factors and that this regulatory circuit was altered in iNS. PMN obtained from a child with IPEX produced 100 times more ROS during exacerbation of clinical symptoms and restored to a near normal-level in remission. Rituximab decreased ROS production by 60%. In conclusion, our study shows that oxidant production is increased in iNS for an imbalance between PMN and other blood cells. Regulatory T cells (Tregs) and CD20 are probably involved in this regulation. Overall, our observations reinforce the concept that oxidants deriving from PMN are implicated in iNS.
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Affiliation(s)
- R Bertelli
- Division of Nephrology and Laboratory on Pathophysiology of Uremia, Istituto Giannina Gaslini IRCCS, Genova, Italy
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Cioni M, Pisasale M, Abela S, Belfiore T, Micale M. Physiological Electromyographic Activation Patterns of Trunk Muscles During Walking. ACTA ACUST UNITED AC 2010. [DOI: 10.2174/1874943701003010136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Esquenazi A, Cioni M, H. Mayer N. Assessment of Muscle Overactivity and Spasticity with Dynamic Polyelectromyography and Motion Analysis. ACTA ACUST UNITED AC 2010. [DOI: 10.2174/1874943701003010143] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Esquenazi A, Cioni M, Kim S, Mayer NH, Vachranukunkiet T. Poster 36: Botulinum Toxin Type-A (BoNT-A) Treatment Interventions in Stroke, Traumatic Brain Injury and Adults with Cerebral Palsy Related Muscle Overactivity: A Six-Year Retrospective Review. PM R 2009. [DOI: 10.1016/j.pmrj.2009.08.053] [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: 11/30/2022]
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Romeo DMM, Cioni M, Scoto M, Palermo F, Pizzardi A, Sorge A, Romeo MG. Development of the forward parachute reaction and the age of walking in near term infants: a longitudinal observational study. BMC Pediatr 2009; 9:13. [PMID: 19220886 PMCID: PMC2653025 DOI: 10.1186/1471-2431-9-13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Accepted: 02/16/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Near term infants are a main part of preterms. They are at higher risk for mortality and morbidity than term infants and could show a quite different development of tone and reflexes from them. The aim of the present study was to describe longitudinally, in a large sample of healthy near term infants, the development of the forward parachute reaction (FPR) and its correlation with the age of acquisition of independent walking. METHODS The assessment of FPR (as absent, incomplete or complete) was performed at 3, 6, 9, 12 months of corrected age in 484 infants, with a gestational age between 35.0 and 36.9 weeks. The age of acquisition of independent walking was monitored until its appearance. A correlation analysis was done between the age of walking and the acquisition of a complete or incomplete FPR, using the Spearman Rank correlation. The Mann-Withney U test was used to identify significant gestational age differences for the age of FPR appearance. RESULTS Most of infants had a two-step development pattern. In fact, they showed at first an incomplete and then a complete FPR, which was observed more frequently at 9 months. An incomplete FPR only, without a successive maturation to a complete FPR, was present in the 21% of the whole sample. Infants with a complete FPR walked at a median age of 13 months, whereas those with an incomplete FPR only walked at a median age of 14 months. CONCLUSION We identified two groups within our sample of near term infants. The first group showed a progressive maturation of FPR, whereas the second one was characterised by the inability to get a complete pattern, within the one year observation's period. Furthermore, we observed a trend toward a delayed acquisition of independent walking in the latter group of infants.
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Affiliation(s)
- Domenico M M Romeo
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, Catania, Italy.
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Abstract
The prognostic value of the single items of a standardised neurological examination, the Hammersmith Infant Neurologic Examination (HINE), was explored longitudinally in 658 infants at 3, 6, 9 and 12 months post-term age. ROC curves were built based on the presence/absence of cerebral palsy at 2 years of age. Global HINE scores showed very high prediction (ROC curve areas above 0.9) at all ages. The items with the highest predictive value were always movement quality and quantity. In the first semester, among the most predictive items were those assessing tone, while beyond that time they were reflexes and reactions. Our results show that the high predictive value of the HINE across the first year of life is granted by the successful combination of different groups of items for each age-period. This should be recognised in clinical practice when assessing the significance of individual neurological profiles.
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Affiliation(s)
- A Pizzardi
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, Catania, Italy
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Romeo DMM, Guzzetta A, Scoto M, Cioni M, Patusi P, Mazzone D, Romeo MG. Early neurologic assessment in preterm-infants: integration of traditional neurologic examination and observation of general movements. Eur J Paediatr Neurol 2008; 12:183-9. [PMID: 17881261 DOI: 10.1016/j.ejpn.2007.07.008] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Revised: 07/24/2007] [Accepted: 07/26/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the possible additional benefit in terms of prognostic accuracy of an integrated application of a traditional scorable method of neurologic examination and the Prechtl's method of qualitative assessment of general movements (GMs) in a large population of 903 consecutive preterm infants. STUDY DESIGN Infants were enrolled from the Intensive Care Unit of the University of Catania. Inclusion criteria were a gestational age below 37 weeks and the absence of genetic disorders. All infants underwent serial ultrasound and at 3 months performed both the GMs assessment and the Hammersmith Infant Neurologic Examination (HINE). Outcome was assessed at 2 years by the Touwen neurologic examination and the Clinical Adaptive Test/Clinical, Linguistic and Auditory Milestone Scale. RESULTS The integration of the two methods was shown to be more effective than the single assessments in predicting neurologic outcome. The additional benefit of combining the two approaches was particularly clear for the discrimination between unilateral and bilateral cerebral palsy. CONCLUSIONS The integrated use of a scorable neurological examination and Prechtl's assessment of GMs can improve early prediction of neurodevelopmental outcome in preterm infants and should complement other clinical and instrumental exams in follow-up programs.
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Romeo DMM, Cioni M, Scoto M, Mazzone L, Palermo F, Romeo MG. Neuromotor development in infants with cerebral palsy investigated by the Hammersmith Infant Neurological Examination during the first year of age. Eur J Paediatr Neurol 2008; 12:24-31. [PMID: 17604195 DOI: 10.1016/j.ejpn.2007.05.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Revised: 04/28/2007] [Accepted: 05/20/2007] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Hammersmith Infant Neurological Examination (HINE) is a simple and scorable method for assessing infants between 2 and 24 months of age. AIMS The purpose of this retrospective study was firstly, to evaluate the neuromotor development of infants with cerebral palsy (CP) by the HINE, during the first year of age; secondly, to correlate the scoring of this neurological tool with levels of the Gross Motor Function Classification System (GMFCS). METHODS A cohort of 70 infants with a diagnosis of CP at 2 years of age was evaluated by the HINE at 3, 6, 9 and 12 months of corrected age and by GMFCS at 2 years of age. RESULTS The main results indicate that at 3-6 months, infants with quadriplegia (IV and V levels of GMFCS) and those with severe diplegia (III level) scored below 40, whereas those with mild or moderate diplegia (I-II level) and hemiplegia (I-II level) mainly scored between 40-60. Interestingly, the 26% of infants with hemiplegia scored > or =67 at 12 months. We observed a strong (r=-0.82) and significant (p<0.0001) negative correlation between the scores of the neurological examination and the levels of GMFCS. CONCLUSIONS Our results point out that the HINE can give additional information about neuromotor development of infants with CP from 3-6 months of age, strictly related to the gross motor functional abilities at 2 years of age.
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Affiliation(s)
- Domenico M M Romeo
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, Italy
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Ginevri F, Azzi A, Hirsch HH, Basso S, Fontana I, Cioni M, Bodaghi S, Salotti V, Rinieri A, Botti G, Perfumo F, Locatelli F, Comoli P. Prospective monitoring of polyomavirus BK replication and impact of pre-emptive intervention in pediatric kidney recipients. Am J Transplant 2007; 7:2727-35. [PMID: 17908275 DOI: 10.1111/j.1600-6143.2007.01984.x] [Citation(s) in RCA: 195] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Polyoma BK virus (BKV)-associated nephropathy (PVAN) is a relevant cause of poor renal allograft survival. In a prospective analysis, we monitored BKV DNA in blood and urine samples from 62 consecutive pediatric kidney recipients. In patients with BKV replication, we analyzed the impact of reduction of maintenance immunosuppression on viral load kinetics and PVAN in patients with BKV replication. BKV-specific immunity was concomitantly evaluated on blood samples of viremic patients, by measuring the frequency of BKV-specific interferon-gamma-producing and cytotoxic T cells, and BKV IgG antibody levels. At a median follow-up of 24 months, BK viruria was observed in 39 of 62 patients, while BK viremia developed in 13 patients (21%). In all viremic patients, immunosuppression reduction resulted in the clearance of viremia, and prevented development of PVAN, without increasing the rate of acute rejection or causing graft dysfunction. As a consequence of immunosuppression adjustment, an expansion of BKV-specific cellular immunity was observed that coincided with viral clearance. We conclude that treating pediatric kidney transplant patients pre-emptively with immunosuppression reduction guided by BKV DNA in blood is safe and effective to prevent onset of PVAN. BKV-specific cellular immunity may be useful to guide this intervention.
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Affiliation(s)
- F Ginevri
- Pediatric Nephrology Unit, G. Gaslini Institute, Genova, Italy.
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Romeo DMM, Cioni M, Guzzetta A, Scoto M, Conversano M, Palermo F, Romeo MG, Mercuri E. Application of a scorable neurological examination to near-term infants: longitudinal data. Neuropediatrics 2007; 38:233-8. [PMID: 18330837 DOI: 10.1055/s-2007-1004520] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to follow the evolution of neurological findings in a cohort of near-term infants born between 35 and 37 weeks. A total of 448 infants born between 35 and 36.9 weeks gestational age with normal cranial ultrasonograms or only minor abnormalities, were studied using the Hammersmith Infant Neurological Examination, at 6, 9 and 12 months (corrected for prematurity). Our results showed that while some items such as cranial nerve and movements showed minimal changes over time, other items mainly related to "tone", "posture" and "reflexes" showed progressive maturation. There was no significant difference between the infants born at 35 and 36 weeks gestation. When compared to term infants assessed at the same age intervals, our cohort showed a wider variability of scores. Mean and 10 (th) percentile for global scores were lower than those reported for term infants suggesting that when assessing infants born at 35 and 36 weeks the optimality scores used for infants born full-term should not be used as normative data. Our results, providing longitudinal data in near-term infants without brain lesions, can be used as a reference in both clinical and research setting to monitor early neurological signs in those children.
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Affiliation(s)
- D M M Romeo
- Department of Paediatrics, University of Catania, Catania, Italy
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Cioni M, Iero I, Tornatore G, Cocilovo A, Belfiore A, Ferri R. Gait patterns of a patient with myoclonus of a lower limb, when OFF and ON treatment with antiepileptic drugs. Neurol Sci 2007; 28:100-3. [PMID: 17464474 DOI: 10.1007/s10072-007-0795-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Accepted: 03/20/2007] [Indexed: 11/25/2022]
Abstract
We describe kinematics, kinetics and electromyographic patterns of a patient with spinal myoclonus of the left lower limb, during walking. Gait analysis was performed when the patient was OFF and ON his treatment with antiepileptic drugs. When OFF, we mainly observed clonic bursts and out-of-phase activations of m. tibialis anterior and m. rectus femoris, with increased hip flexion, reduction of knee flexion during swing and excessive ankle dorsal flexion. Furthermore, large oscillations of knee moment of force and power during stance phase were also observed. These abnormal patterns markedly recovered when ON drugs.
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Affiliation(s)
- M Cioni
- Department of Experimental and Clinical Pharmacology, Medical School, University of Catania, V.le A. Doria 6, I-95125 Catania, Italy.
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Cioni M, Esquenazi A, Hirai B. Effects of Botulinum Toxin-A on Gait Velocity, Step Length, and Base of Support of Patients with Dynamic Equinovarus Foot. Am J Phys Med Rehabil 2006; 85:600-6. [PMID: 16788391 DOI: 10.1097/01.phm.0000223216.50068.bc] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to identify if botulinum toxin type A is a drug able to modify walking velocity, step length, and width of the base of support of adult patients with dynamic equinovarus foot deformity resulting from upper motor neuron syndrome. DESIGN This retrospective study analyzed data from 20 patients' files selected from 448 consecutive charts. The main inclusion criteria were the presence of dynamic equinovarus foot deformity due to upper motor neuron syndrome, age between 20 and 80 yrs, evaluation of temporospatial parameters of gait by the Gait Mat II before and 4 wks after botulinum toxin type A injection to the calf muscles, and the ability to walk barefoot, unassisted, and without braces. For data analysis, based on walking velocity, we divided the patients into two groups, slow walking velocity (0.18-0.49 m/sec) and medium walking velocity (0.50-0.99 m/sec). RESULTS Width of the base of support was significantly reduced after botulinum toxin type A treatment, both for the affected (P < 0.005) and the unaffected limbs (P < 0.002), in the group of subjects walking at medium velocity. Walking velocity or step length of either group of patients was not significantly modified by botulinum toxin type A treatment. CONCLUSIONS Based on this study, a significant effect of botulinum toxin type A on width of the base of support is evident and seems to be the result of a better position of the affected foot during the stance phase of locomotion leading to increased body stability and consequent reduction of width of the base of support of the unaffected limb. No change was evident in step length or walking velocity for this patient population.
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Affiliation(s)
- Matteo Cioni
- Department of Experimental and Clinical Pharmacology, Medical School, University of Catania, Catania, Italy
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Lombardo SA, Leanza G, Meli C, Lombardo ME, Mazzone L, Vincenti I, Cioni M. Maternal exposure to the antiepileptic drug vigabatrin affects postnatal development in the rat. Neurol Sci 2005; 26:89-94. [PMID: 15995825 DOI: 10.1007/s10072-005-0441-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Accepted: 04/14/2005] [Indexed: 11/24/2022]
Abstract
The objective was to investigate, in the rat, the effects of maternal exposure to vigabatrin (VGB) on the postnatal motor-cognitive behaviour of the offspring. We used an experimental evaluator-blind, placebo-controlled study in the rat. Ten pregnant rats were divided into five groups and treated with different doses of VGB (250, 500, 750, 1000 mg/kg/day) or placebo from gestation day (GD) 6 to GD10. After delivery, 56 pups (40 pups prenatally exposed to VGB and 16 pups exposed to placebo) were evaluated for motor-cognitive behaviour throughout postpartum day 40. At the end of testing sessions the animals were sacrificed and brain tissues processed for biochemical analysis of GABA levels. Body weight of pups and young rats whose mothers were treated with a dose of 750 mg/kg/day were significantly lower both at birth and during the whole postnatal life with respect to the control groups. Young rats of this group exhibited impaired performance in both the open-field and water maze tasks. Brain GABA contents were dramatically increased in this group of rats. No other significant nutritional, biochemical or behavioural changes were observed after treatments with doses of VGB lower than 750 mg/kg/day. The exposure to a dose of 1000 mg/kg caused abortion. Maternal exposure to VGB at relatively high doses (750 mg/kg/day) is likely to cause some important changes of the nutritional status during the pre- and postnatal life. Thus, the biochemical and cognitive abnormalities observed in this study could be related to some disturbances of brain development induced by malnutrition and/or to a disturbance of neuronal programming of the gabaergic system.
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Affiliation(s)
- S A Lombardo
- Department of Experimental and Clinical Pharmacology, Chair of Neuropsychopharmacology, School of Medicine, University of Catania, Viale A. Doria 6, I-95125 Catania, Italy
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Grosso S, Pucci L, Di Bartolo RM, Gobbi G, Bartalini G, Anichini C, Scarinci R, Balestri M, Farnetani MA, Cioni M, Morgese G, Balestri P. Chromosome 18 aberrations and epilepsy: a review. Am J Med Genet A 2005; 134A:88-94. [PMID: 15690352 DOI: 10.1002/ajmg.a.30575] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Epilepsy is commonly observed in patients with chromosomal aberrations. We evaluated epilepsy and electroencephalographic (EEG) features in a group of patients carrying aberrations of chromosome 18. Fourteen patients were recruited: five with an 18p deletion syndrome (18pDS); six with an 18q deletion syndrome (18qDS); two with trisomy 18p syndrome; and one with a 45,XY,t(17-18) (cen-q11.2) karyotype. Patients with 18pDS had neither epilepsy nor EEG anomalies; four patients with 18qDS had epilepsy with partial seizures occurring during infancy or early childhood. Partial seizures were also present in both patients with trisomy 18p. By contrast, mixed seizures were observed in the patient carrying a translocation between chromosomes 17 and 18. Our data and a re-evaluation of the literature suggest that epilepsy is infrequent in patients with 18pDS. Conversely, partial seizures and focal EEG anomalies may be observed in those with patients with 18qDS. Our observations suggest that the haplo-insufficiency of genes located on the long arm of chromosome 18 is more likely to be associated with epilepsy, than is haplo-insufficiency of genes located on the short arm. While further EEG/clinical investigations are needed to validate these observations, this study indicates a possible relationship between chromosome 18 genes and epilepsy.
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Affiliation(s)
- S Grosso
- Department of Pediatrics, University of Siena, Siena, Italy
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Grosso S, Galimberti D, Farnetani MA, Cioni M, Mostardini R, Vivarelli R, Di Bartolo RM, Bernardoni E, Berardi R, Morgese G, Balestri P. Efficacy and safety of topiramate in infants according to epilepsy syndromes. Seizure 2005; 14:183-9. [PMID: 15797353 DOI: 10.1016/j.seizure.2005.01.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Studies of the efficacy of topiramate (TPM) in infants and young children are few. Here we report an open, prospective, and pragmatic study of effectiveness of TPM in terms of epilepsy syndromes, in children aged less than 2 years. The median follow-up period was 11 months. We enrolled 59 children in the study: 22 affected by localization-related epilepsy (LRE), 23 by generalized epilepsy, six by Dravet's syndrome, and eight with unclassifiable epilepsy. TPM was effective (responders showed a decrease of more than 50% in seizure frequency) in 47% of patients, including 13% who were seizure-free at the last visit. TPM was more effective in localization-related epilepsy (48% of responders) than in generalized epilepsy (32% of responders). In the latter group, 19 patients suffered from infantile spasms. Four of six patients with cryptogenic infantile spasms became seizure-free. Of the 13 patients with symptomatic infantile spasms, only one was seizure-free. Results were poor for patients with Dravet's syndrome. In general, TPM was well tolerated. The most frequently reported adverse effects were drowsiness, irritability, hyperthermia, and anorexia. The present study concludes that TPM is effective for a broad range of seizures in infants and young children and represents a valid therapeutic option in this population.
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Affiliation(s)
- S Grosso
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Via M. Bracci, Le Scotte 53100, Siena, Italy
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Abstract
The biomechanical characteristics of the ankle during gait of 17 participants with Down syndrome, ages 8 to 36 years, were investigated. Ten volunteers without disabilities of comparable anthropometric parameters were the control group. A 3-dimensional gait analysis was performed using an optoelectronic system equipped with a force platform. Participants with Down syndrome showed significant decreases of plantar-flexor moments and of A1 and A2 joint powers. Furthermore, correlation between kinetic and temporal spatial parameters was markedly reduced or weak in comparison to the control group. These results point out a hypofunctioning of ankle, probably due to hypotonia and ligament laxity.
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Affiliation(s)
- M Cioni
- Institute for Research and Care on Mental Retardation and Brain Aging, Troina, Enna, Italy.
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Atlante M, Dionisi B, Cioni M, Di Ruzza D, Sedati P, Mariani L. Sarcoma botryoides of the uterine cervix in a young woman: a case report. EUR J GYNAECOL ONCOL 2001; 21:504-6. [PMID: 11198044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Among the rhabdomyosarcomas, which represent an uncommon neoplasm of mesoderm origin comprising about 1% of all female genital malignancies, sarcoma botryoides (SB) is an embrional variant usually found in the vagina of infants and young children under 16 years of age. The onset of SB from the uterine cervix is very rare with a peak incidence in the second decade; only a few cases have been published in the international literature so far. The authors report a case of embryonal rhabdomyosarcoma of the uterine cervix which occurred in a young woman treated by radical surgery, followed by adjuvant chemotherapy and radiotherapy.
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Affiliation(s)
- M Atlante
- Gynecologic Oncology Dept., Regina Elena National Cancer Institute, Rome, Italy
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