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Novak A, Schunert S, Carlsen R, Balestra P, Slaybaugh R, Martineau R. Multiscale thermal-hydraulic modeling of the pebble bed fluoride-salt-cooled high-temperature reactor. ANN NUCL ENERGY 2021. [DOI: 10.1016/j.anucene.2020.107968] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Novak AJ, Carlsen RW, Schunert S, Balestra P, Reger D, Slaybaugh RN, Martineau RC. Pronghorn: A Multidimensional Coarse-Mesh Application for Advanced Reactor Thermal Hydraulics. NUCL TECHNOL 2021. [DOI: 10.1080/00295450.2020.1825307] [Citation(s) in RCA: 6] [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] [Indexed: 10/22/2022]
Affiliation(s)
- A. J. Novak
- University of California Berkeley, Department of Nuclear Engineering, 3115 Etcheverry Hall, Berkeley, California 94720
| | | | - S. Schunert
- Idaho National Laboratory, Idaho Falls, Idaho
| | - P. Balestra
- Idaho National Laboratory, Idaho Falls, Idaho
| | - D. Reger
- Pennsylvania State University, Department of Nuclear Engineering, University Park, Pennsylvania
| | - R. N. Slaybaugh
- University of California Berkeley, Department of Nuclear Engineering, 3115 Etcheverry Hall, Berkeley, California 94720
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Balestra P, Parisi C, Alfonsi A, Rabiti C. Simulation of AER-DYN-002 and AER-DYN-003 Control Rod Ejection Benchmarks by RELAP5-3D/PHISICS Coupled Codes. NUCL TECHNOL 2017. [DOI: 10.13182/nt14-138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- P. Balestra
- UTFISST-SIMING Laboratory, ENEA, “Casaccia” Research Center, Rome, Italy
| | - C. Parisi
- UTFISST-SIMING Laboratory, ENEA, “Casaccia” Research Center, Rome, Italy
| | - A. Alfonsi
- Idaho National Laboratory, Idaho Falls, Idaho
| | - C. Rabiti
- Idaho National Laboratory, Idaho Falls, Idaho
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Balestra P, Parisi C, Giannetti F, Caruso G. Effects of cross sections library parameters on the OECD/NEA Oskarshamn-2 benchmark solution. ANN NUCL ENERGY 2015. [DOI: 10.1016/j.anucene.2015.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ferrera F, Rizzi M, Sprecacenere B, Balestra P, Sessarego M, Di Carlo A, Filaci G, Gabrielli A, Ravazzolo R, Indiveri F. AIRE gene polymorphisms in systemic sclerosis associated with autoimmune thyroiditis. Clin Immunol 2007; 122:13-7. [PMID: 17101293 DOI: 10.1016/j.clim.2006.09.013] [Citation(s) in RCA: 31] [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] [Received: 04/28/2006] [Revised: 09/27/2006] [Accepted: 09/28/2006] [Indexed: 10/23/2022]
Abstract
Mutations in the autoimmune regulator (AIRE) gene are responsible for autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). Systemic sclerosis (SSc) is a non-organ-specific autoimmune disease mainly characterized by cutaneous involvement, that is frequently associated with other autoimmune manifestations common to APECED. Nineteen SSc patients, 22 patients affected by SSc associated with autoimmune thyroiditis, and 100 healthy controls were analyzed. We identified 11 AIRE gene variants, one of which has never previously been described. Intronic polymorphism G11107A was significantly correlated to SSc/thyroiditis. Data show that variants of the AIRE gene might be correlated to different clinical manifestations in SSc patients.
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Affiliation(s)
- F Ferrera
- Centre of Excellence for Biomedical Research, University of Genoa, Viale Benedetto XV, 7 16132 Genoa, Italy.
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Bellone E, Balestra P, Ribizzi G, Schenone A, Zocchi G, Di Maria E, Ajmar F, Mandich P. An abnormal mRNA produced by a novel PMP22 splice site mutation associated with HNPP. J Neurol Neurosurg Psychiatry 2006; 77:538-40. [PMID: 16199442 PMCID: PMC2077485 DOI: 10.1136/jnnp.2005.075242] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant, demyelinating neuropathy. Point mutations in the PMP22 gene are a rare cause of HNPP. A novel PMP22 splice site mutation (c.179+1 G-->C) is reported in an HNPP family. By reverse transcriptase-polymerase chain reaction experiments, this mutation was shown to cause the synthesis of an abnormal mRNA in which a premature stop codon probably produces a truncated non-functional protein.
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Affiliation(s)
- E Bellone
- Department of Neurosciences, Ophthalmology and Genetics, Section of Medical Genetics, University of Genova, c/o DIMI-Viale Benedetto XV, 6, 16132 Genova, Italy.
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Di Maria E, Gulli R, Balestra P, Cassandrini D, Pigullo S, Doria-Lamba L, Bado M, Schenone A, Ajmar F, Mandich P, Bellone E. A novel mutation of GDAP1 associated with Charcot-Marie-Tooth disease in three Italian families: evidence for a founder effect. J Neurol Neurosurg Psychiatry 2004; 75:1495-8. [PMID: 15377708 PMCID: PMC1738732 DOI: 10.1136/jnnp.2003.028100] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Mutations in a gene encoding a novel protein of unknown function-the ganglioside-induced differentiation-associated protein 1 gene (GDAP1)-are associated with the autosomal recessive Charcot-Marie-Tooth disease type 4A (CMT4A). OBJECTIVE To investigate the role of GDAP1 mutations in causing autosomal recessive neuropathies in an Italian population. METHODS AND RESULTS 76 patients with severe early onset polyneuropathy and possible autosomal recessive inheritance were screened for mutations. A T>G transversion (c.347 T>G) at codon 116 (M116R) was detected in four affected subjects from three apparently unrelated families. All patients had early onset of disease with pronounced foot deformities and impaired walking. Neurophysiological studies showed an extremely variable expression. Sural nerve biopsies revealed signs of both de-remyelination and axonal impairment, the most prominent feature being a severe loss of larger fibres. Haplotype analysis of the GDAP1 locus demonstrated a common disease haplotype. CONCLUSIONS The association of the mutation with a common haplotype suggested a common ancestor.
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Affiliation(s)
- E Di Maria
- Department of Neuroscience, Ophthalmology and Genetics, Section of Medical Genetics, University of Genova, c/o DIMI - Viale Benedetto XV, 6 16132 Genova, Italy
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Tozzi V, Balestra P, Murri R, Galgani S, Bellagamba R, Narciso P, Antinori A, Giulianelli M, Tosi G, Fantoni M, Sampaolesi A, Noto P, Ippolito G, Wu AW. Neurocognitive impairment influences quality of life in HIV-infected patients receiving HAART. Int J STD AIDS 2004; 15:254-9. [PMID: 15075020 DOI: 10.1258/095646204773557794] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [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: 11/18/2022]
Abstract
The objective of the study was to determine the association of neurocognitive impairment with health-related quality of life (HRQoL) in patients receiving highly active antiretroviral therapy (HAART). Seventy subjects were cross-sectionally analysed with a standardized neuropsychological test battery and a questionnaire including an Italian translation of the MOS-HIV Health Survey. The presence of neurocognitive impairment was significantly associated with lower HRQoL scores: pain (P = 0.03), physical functioning (P = 0.01), role functioning (P = 0.01), social functioning (P = 0.029), mental health (P = 0.001), energy (P = 0.036), health distress (P = 0.002), cognitive functioning (P = 0.05), current health perception (P <0.001), physical health summary score (PHS) (P = 0.005), mental health summary score (MHS) (P = 0.002). Years of education (odds ratio [OR] 0.79; 95% confidence interval [CI] 0.65-0.96), PHS (OR 0.71; 95% CI 0.54-0.95) and MHS (OR 0.67; 95% CI 0.51-0.88) were also associated with cognitive impairment. Neurocognitive impairment in patients receiving HAART was associated with reduced HRQoL. Identifying cognitive impairment may provide motivation for additional treatment to help patients to compensate for deficits in functioning.
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Affiliation(s)
- V Tozzi
- Fourth Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani, Via Portuense 292, 00149 Rome, Italy.
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Bellone E, Balestra P, Di Maria E, Pigullo S, Gulli R, Ajmar F, Mandich P. Screening for mutations in the lipopolysaccharide-induced tumor necrosis factor-alpha factor (litaf) gene in italian patients with charcot-marie-tooth disease. J Peripher Nerv Syst 2004. [DOI: 10.1111/j.1085-9489.2004.009209aa.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bellone E, Di Maria E, Gulli R, Balestra P, Cassandrini D, Bado M, Doria L, Schenone A, Ajmar F, Mandich P. Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 65. J Peripher Nerv Syst 2003. [DOI: 10.1046/j.1529-8027.2003.00065.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bellone E, Di Maria E, Balestra P, Cassandrini D, Ribizzi G, Schenone A, Ajmar F, Mandich P. Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 64. J Peripher Nerv Syst 2003. [DOI: 10.1046/j.1529-8027.2003.00064.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Musso M, Balestra P, Bellone E, Di Maria E, Cassandrini D, Ajmar F, Mandich P. THE CONNEXIN 32 NERVE-SPECIFIC PROMOTER IS DIRECTLY ACTIVATED BY Egr2/Krox20 IN HeLa CELLS. J Peripher Nerv Syst 2002. [DOI: 10.1046/j.1529-8027.2002.7011_29.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cassandrini D, Balestra P, Manganelli F, Santoro L, Ajmar F, Mandich P, Bellone E. A NOVEL MYELIN PROTEIN ZERO MUTATION ASSOCIATED WITH CHARCOT-MARIE-TOOTH TYPE II DISEASE. J Peripher Nerv Syst 2002. [DOI: 10.1046/j.1529-8027.2002.7011_9.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bellone E, Cassandrini D, Di Maria E, Balestra P, Grandis M, Mancardi GL, Schenone A, Ajmar F, Mandich P. Novel MPZ Mutation In A Sporadic CMT Patient. J Peripher Nerv Syst 2001. [DOI: 10.1046/j.1529-8027.2001.01007-3.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- E Bellone
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
| | - D Cassandrini
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
| | - E Di Maria
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
| | - P Balestra
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
| | - M Grandis
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
| | - GL Mancardi
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
| | - A Schenone
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
| | - F Ajmar
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
| | - P. Mandich
- Department of Neurological Sciences and Vision and Service of Medical Genetics, University of Genova
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Musso M, Balestra P, Bellone E, Cassandrini D, Di Maria E, Lamba Doria L, Grandis M, Mancardi GL, Schenone A, Levi G, Ajmar F, Mandich P. The D355V Mutation Decreases EGR2 Binding To An Element Within The CX32 Promoter. J Peripher Nerv Syst 2001. [DOI: 10.1046/j.1529-8027.2001.01007-37.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- M Musso
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - P Balestra
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - E Bellone
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - D Cassandrini
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - E Di Maria
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - L Lamba Doria
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - M Grandis
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - GL Mancardi
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - A Schenone
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - G Levi
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - F Ajmar
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
| | - P. Mandich
- Service of Medical Genetics and Dept. of Neurological Sciences and Vision, University of Genova
- Laboratory of Molecular Morphogenesis, IST, Genova
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Narciso P, Galgani S, Del Grosso B, De Marco M, De Santis A, Balestra P, Ciapparoni V, Tozzi V. Acute disseminated encephalomyelitis as manifestation of primary HIV infection. Neurology 2001; 57:1493-6. [PMID: 11673598 DOI: 10.1212/wnl.57.8.1493] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [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: 11/15/2022] Open
Abstract
The authors report a 27-year-old woman with clinical, MRI, virologic, and CSF findings consistent with acute disseminated encephalomyelitis as a manifestation of primary HIV infection. Improvements in the clinical and MRI findings and a reduction in HIV RNA levels, both in plasma and in the CSF, were observed during highly active antiretroviral therapy.
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Affiliation(s)
- P Narciso
- Fourth Clinical Division, National Institute for Infectious Diseases I.R.C.C.S. Lazzaro Spallanzani, Rome, Italy.
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Tozzi V, Balestra P, Galgani S, Narciso P, Sampaolesi A, Antinori A, Giulianelli M, Serraino D, Ippolito G. Changes in neurocognitive performance in a cohort of patients treated with HAART for 3 years. J Acquir Immune Defic Syndr 2001; 28:19-27. [PMID: 11579273 DOI: 10.1097/00042560-200109010-00004] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe changes in HIV-associated neurocognitive impairment in patients treated with highly active antiretroviral therapy (HAART) for at least 3 years. METHODS Prospective, observational study of comprehensive neuropsychologic (NP) testing, neurologic examination, and laboratory measures before HAART and after 6, 15 and 45 months of HAART, on 28 consecutive patients seen in our department since April 1996. RESULTS At baseline, 16 patients were neurocognitively impaired and 12 were not. Among the 16 impaired patients, 5 patients failed to meet the criteria for impairment after 6 months and 9 patients after both 15 and 45 months of HAART, respectively. Statistically significant improvements ( p < or =.01) were seen in two of six measures exploring the concentration and speed of mental processing, two of three measures exploring mental flexibility, in one of five measures exploring memory, and in two of two measures exploring fine motor functions. Unimpaired study subjects performed better than impaired ones in 10 of 17 measures at baseline, in eight of 17 after 6 months, in six of 17 after 15 months, and in seven of 17 after 45 months of HAART. CONCLUSIONS During the course of HAART, patients experienced a positive and sustained improvement in their neurocognitive performance. However, the presence of 7 of 16 (43.7%) patients with neurocognitive impairment, and the persistence of statistically significant differences in the neurocognitive performance between impaired and unimpaired patients after more than 3 years of HAART, suggests that ongoing HIV-related neurologic damage can occur even during potent antiretroviral treatment.
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Affiliation(s)
- V Tozzi
- Fourth Division of Infectious Diseases, I.R.C.C.S. Lazzaro Spallanzani, Rome, Italy
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Musso M, Balestra P, Bellone E, Cassandrini D, Di Maria E, Doria LL, Grandis M, Mancardi GL, Schenone A, Levi G, Ajmar F, Mandich P. The D355V mutation decreases EGR2 binding to an element within the Cx32 promoter. Neurobiol Dis 2001; 8:700-6. [PMID: 11493034 DOI: 10.1006/nbdi.2001.0397] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mutations in the early growth response 2 (EGR2) gene are associated with some forms of Charcot--Marie--Tooth disease (CMT) and other demyelinating neuropathies. These mutations modify the EGR2 binding to specific DNA sequences suggesting a role in the transcriptional control of myelination-specific genes. Here we show that the D355V mutation, associated with a CMT case combining axonal and demyelinating abnormalities, reduces three times the affinity of EGR2 to its consensus sequence and ten times its affinity to a sequence in the human Cx32 promoter. These findings could indicate that this EGR2 mutation leads to the development of CMT1 through the transcriptional deregulation of Cx32 gene.
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Affiliation(s)
- M Musso
- Department of Neurological Sciences and Vision, University of Genova, Viale Benedetto XV, 6-16132 Genova, Italy
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Di Maria E, Bellone E, Cassandrini D, Nobbio L, Balestra P, Bordo D, Grandis M, Schenone A, Ajmar F, Mandich P. Myelin Protein Zero Mutations In Inherited Neuropathies: The Recurrent Thr124Met IS Associated With A Distinct Phenotype. J Peripher Nerv Syst 2001. [DOI: 10.1046/j.1529-8027.2001.01007-21.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- E Di Maria
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - E Bellone
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - D Cassandrini
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - L Nobbio
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - P Balestra
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - D Bordo
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - M Grandis
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - A Schenone
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - F Ajmar
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
| | - P. Mandich
- Dept. of Oncology, Biology and Genetics, University of Genova
- Dept. of Neurological Sciences and Vision
- Istituto Nazionale per la Ricerca sul Cancro (c/o CBA), Genova
- Service of Medical Genetics, Ospedale San Martino, Genova
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Tozzi V, Balestra P, Galgani S, Narciso P, Ferri F, Sebastiani G, D'Amato C, Affricano C, Pigorini F, Pau FM, De Felici A, Benedetto A. Positive and sustained effects of highly active antiretroviral therapy on HIV-1-associated neurocognitive impairment. AIDS 1999; 13:1889-97. [PMID: 10513647 DOI: 10.1097/00002030-199910010-00011] [Citation(s) in RCA: 147] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine whether highly active antiretroviral therapy (HAART) is effective in HIV-associated neurocognitive impairment. DESIGN An open label, prospective, observational study. METHODS Since April 1996, 116 patients with advanced HIV infection, reverse transcriptase inhibitor (nRTI) experienced but protease inhibitor (PI) naive, were screened for the presence of neurocognitive impairment. Ninety patients with confounding neurological illness, opportunistic infections or drug abuse were excluded. The remaining 26 patients underwent comprehensive neuropsychological testing, and laboratory measures before, after 6 and after 15 months of treatment with one PI plus two nRTI. RESULTS The prevalence of neurocognitive impairment decreased from 80.8% (baseline) to 50.0% (P<0.05) (sixth month) and to 21.7% (P<0.001) (15th month). Among the functions explored, the impairment of concentration and speed of mental processing decreased from 65.4 to 21.7% (P<0.01) and of memory impairment from 50 to 8.7% (P<0.01). Comparing baseline with the sixth and 15th month raw scores, a statistically significant improvement was seen in measures exploring concentration and speed of mental processing (P<0.05), mental flexibility (P<0.05), memory (P<0.05), fine motor functions (P<0.05) and visuospatial and constructional abilities (P<0.01). After 6 months of HAART patients with a normal neuropsychological examination had lower mean plasma viraemia (2.95 versus 3.97 log copies/ml, P<0.05) and greater mean log plasma HIV RNA changes from baseline (-1.84 versus -0.83 log copies/ml, P<0.05) than neuropsychologically impaired subjects. CONCLUSION HAART produces a positive and sustained effect on neurocognitive impairment in HIV-infected patients. A reduction of plasma viral load was associated with the regression of neuropsychological test abnormalities.
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Affiliation(s)
- V Tozzi
- Department of Infectious Diseases, IRCCS Lazzaro Spallanzani, Rome, Italy
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Galgani S, Balestra P, Narciso P, Tozzi V, Sette P, Pau F, Visco G. Nimodipine plus zidovudine versus zidovudine alone in the treatment of HIV-1-associated cognitive deficits. AIDS 1997; 11:1520-1. [PMID: 9342076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Tozzi V, Narciso P, Galgani S, Sette P, Balestra P, Gerace C, Pau FM, Pigorini F, Volpini V, Camporiondo MP. Effects of zidovudine in 30 patients with mild to end-stage AIDS dementia complex. AIDS 1993; 7:683-92. [PMID: 8318176 DOI: 10.1097/00002030-199305000-00012] [Citation(s) in RCA: 57] [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: 01/29/2023]
Abstract
OBJECTIVE Zidovudine (ZDV) is an inhibitor of HIV replication that may have a beneficial effect on patients with AIDS dementia complex (ADC). However, little is known about the association between long-term ZDV treatment and severity of ADC, ZDV dose or clinical and laboratory response to therapy. DESIGN An open study on ZDV administration in 30 consecutive patients with ADC. SETTING An infectious diseases hospital. PATIENTS Thirty consecutive patients followed-up for 12 months. INTERVENTIONS Three oral ZDV doses were used: 1000 mg (nine patients), 750 mg (eight patients) and 500 mg (13 patients) per day, depending on haematological status. MAIN OUTCOME MEASURES Clinical and neurological examinations, neuropsychological evaluations, high-field brain magnetic resonance imaging (MRI) and 99mTc-HM-PAO single photon emission computerized tomography (SPECT). RESULTS A favourable clinical response, defined as reversal to a less severe ADC stage (Price and Brew's criteria), was observed after 1, 3, 6, 9 and 12 months in 15, 22, 25, 19 and 14 patients, respectively. Neither severity of ADC at entry nor ZDV dose correlated with response to treatment. Seven patients died during the 12-month follow-up. The only factor associated with longer survival was ADC severity at entry (12-month survival, 0.94 and 0.53, in patients in stages 1 or 2 and in stages 3 or 4, respectively; P < 0.01). After 6-12 months of ZDV treatment six patients who initially responded to therapy showed a relapse in initial ADC stage, and two patients a less severe neurological deterioration. Neuropsychological evaluations showed significant improvement in the Wisconsin Card-Sorting test (P = 0.006 for categories, P = 0.029 for perseverative errors), which is particularly sensitive to cognitive and frontal-lobe type functions. Brain MRI revealed a reduction of the extent of white matter lesions in six out of 13 patients, who also showed clinical improvement. SPECT scanning revealed a reduction in the extent of uptake defects concomitant with clinical response in nine out of 14 patients. CONCLUSIONS ZDV is effective in most patients with mild to end-stage ADC, although the benefit is sometimes only transient; several relapses and deaths occurred after the sixth month of treatment.
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Affiliation(s)
- V Tozzi
- Ospedale L. Spallanzani for Infectious Diseases, Rome, Italy
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