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Liuzzi T, Bompard S, Raponi M, D’Arienzo F, Staccioli S, Napoli E, Diotallevi MF, Piga S, Giuliani R, Castelli E. Euterpe music therapy method for children with cerebral palsy. Front Neurol 2024; 15:1388712. [PMID: 38660092 PMCID: PMC11040093 DOI: 10.3389/fneur.2024.1388712] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction The main purpose of our study was to evaluate whether involvement in a personalized music therapy program (Euterpe method), could improve the condition of children with cerebral palsy and their parents, compared to a control group. It investigated whether it could positively affect children's sleep quality, temperament and quality of life, quality of family life, and parental stress. Methods A prospective single-center experimental study was conducted at "Bambino Gesù" Children's Hospital (Rome, Italy). All subjects involved attended an intensive rehabilitation program in the Neurorehabilitation Unit. In a group of patients (n = 25), a music therapy treatment was applied to evaluate the effect before and after the intervention. This group was also compared with a control group (n = 10) undergoing a standard protocol without music therapy. Results In the experimental group, the analysis shows statistically significant effects in the Disorders of initiating and maintaining sleep (p = 0.050) and the Sleep wake transition disorders (p = 0.026) factors, and the total score (p = 0.031) of Sleep Disturbances Scale for Children; the Positive emotionality scale (p = 0.013) of Italian Questionnaires of Temperament (QUIT); the Emotional Functioning (p = 0.029), Social Functioning (p = 0.012), Worry (p = 0.032), Daily Activities (p = 0.032), Total Score (p = 0.039) and Parent HRQL Summary Score (p = 0.035) dimensions of Pediatric Quality of Life for family. While in the control group, only the Attention scale of QUIT (p = 0.003) reaches statistical significance. Discussion Our study suggests that music therapy with the Euterpe Method has beneficial effects on fundamental aspects of the child's and his parents' lives, such as sleep, emotion control, and quality of family life.
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Affiliation(s)
- Tommaso Liuzzi
- Unit of Neurorehabilitation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Santa Cecilia Conservatory of Music, Rome, Italy
| | - Sarah Bompard
- Unit of Neurorehabilitation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Fiammetta D’Arienzo
- Unit of Neurorehabilitation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Euterpe APS Cultural Association, Rome, Italy
| | - Susanna Staccioli
- Unit of Neurorehabilitation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Eleonora Napoli
- Unit of Neurorehabilitation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Simone Piga
- Unit of Epidemiology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Enrico Castelli
- Unit of Neurorehabilitation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Gatto A, Capossela L, Conti G, Eftimiadi G, Ferretti S, Manni L, Curatola A, Graglia B, Di Sarno L, Calcagni ML, Di Giuda D, Cecere S, Romeo DM, Soligo M, Picconi E, Piastra M, Della Marca G, Staccioli S, Ruggiero A, Cocciolillo F, Pulitanò S, Chiaretti A. Intranasal human-recombinant NGF administration improves outcome in children with post-traumatic unresponsive wakefulness syndrome. Biol Direct 2023; 18:61. [PMID: 37789391 PMCID: PMC10546699 DOI: 10.1186/s13062-023-00418-1] [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: 07/27/2023] [Accepted: 09/26/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Severe traumatic brain injury (TBI) is one of the most dramatic events in pediatric age and, despite advanced neuro-intensive care, the survival rate of these patients remains low. Children suffering from severe TBI show long-term sequelae, more pronounced in behavioral, neurological and neuropsychological functions leading to, in the most severe cases, an unresponsive wakefulness syndrome (UWS). Currently, no effective treatments can restore neuronal loss or produce significant improvement in these patients. In experimental animal models, human- recombinant Nerve Growth Factor (hr-NGF) promotes neural recovery supporting neuronal growth, differentiation and survival of brain cells and up-regulating the neurogenesis-associated processes. Only a few studies reported the efficacy of intranasal hr-NGF administration in children with post- traumatic UWS. METHODS Children with the diagnosis of post-traumatic UWS were enrolled. These patients underwent a treatment with intranasal hr-NGF administration, at a total dose of 50 gamma/kg, three times a day for 7 consecutive days. The treatment schedule was performed for 4 cycles, at one month distance each. Neuroradiogical evaluation by Positron Emission Tomography scan (PET), Single Photon Emission Computed Tomography (SPECT), Electroencephalography (EEG), and Power Spectral Density (PSD) was determined before the treatment and one month after the end. Neurological assessment was also deepened by using modified Ashworth Scale, Gross Motor Function Measure, and Disability Rating Scale. RESULTS Three children with post-traumatic UWS were treated. hr-NGF administration improved functional (PET and SPECT) and electrophysiological (EEG and PSD) assessment. Also clinical conditions improved, mainly for the reduction of spasticity and with the acquisition of voluntary movements, facial mimicry, attention and verbal comprehension, ability to cry, cough reflex, oral motility, and feeding capacity, with a significant improvement of their neurological scores. No side effects were reported. CONCLUSION These promising results and the ease of administration of this treatment make it worthwhile to be investigated further, mainly in the early stages from severe TBI and in patients with better baseline neurological conditions, to explore more thoroughly the benefits of this new approach on neuronal function recovery after traumatic brain damage.
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Affiliation(s)
- Antonio Gatto
- Dipartimento di Pediatria, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Lavinia Capossela
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giorgio Conti
- Terapia Intensiva Pediatrica, Dipartimento di Scienze dell'Emergenza, Anestesiologiche e Rianimazione, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Gemma Eftimiadi
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Serena Ferretti
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Manni
- Istituto di Farmacologia Traslazionale, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy
| | - Antonietta Curatola
- Dipartimento di Pediatria, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Benedetta Graglia
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo Di Sarno
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Lucia Calcagni
- UOC di Medicina Nucleare, Fondazione Policlinico Universitario "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Di Giuda
- UOC di Medicina Nucleare, Fondazione Policlinico Universitario "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Cecere
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico Marco Romeo
- Unità di Neurologia Pediatrica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Marzia Soligo
- Istituto di Farmacologia Traslazionale, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy
| | - Enzo Picconi
- Terapia Intensiva Pediatrica, Dipartimento di Scienze dell'Emergenza, Anestesiologiche e Rianimazione, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Marco Piastra
- Terapia Intensiva Pediatrica, Dipartimento di Scienze dell'Emergenza, Anestesiologiche e Rianimazione, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Giacomo Della Marca
- Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Susanna Staccioli
- Dipartimento di Neuroriabilitazione Intensiva, Ospedale Pediatrico "Bambino Gesù", Rome, Italy
| | - Antonio Ruggiero
- Oncologia Pediatrica, Fondazione Policlinico Universitario A.Gemelli IRCCS - Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabrizio Cocciolillo
- UOC di Medicina Nucleare, Fondazione Policlinico Universitario "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Pulitanò
- Terapia Intensiva Pediatrica, Dipartimento di Scienze dell'Emergenza, Anestesiologiche e Rianimazione, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Antonio Chiaretti
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy.
- Department of Women's Health Sciences, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
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Curatola A, Graglia B, Granata G, Conti G, Capossela L, Manni L, Ferretti S, Di Giuda D, Romeo DM, Calcagni ML, Soligo M, Castelli E, Piastra M, Mantelli F, Marca GD, Staccioli S, Romeo T, Pani M, Cocciolillo F, Mancino A, Gatto A, Chiaretti A. Combined treatment of nerve growth factor and transcranical direct current stimulations to improve outcome in children with vegetative state after out-of-hospital cardiac arrest. Biol Direct 2023; 18:24. [PMID: 37165387 PMCID: PMC10170696 DOI: 10.1186/s13062-023-00379-5] [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] [Received: 03/22/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is one of the most dramatic events in pediatric age and, despite advanced neurointensive care, the survival rate remains low. Currently, no effective treatments can restore neuronal loss or produce significant improvement in these patients. Nerve Growth Factor (NGF) is a neurotrophin potentially able to counteract many of the deleterious effects triggered by OHCA. Transcranial Direct Current Stimulation (tDCS) has been reported to be neuroprotective in many neurological diseases, such as motor deficit and cognitive impairment. Children with the diagnosis of chronic vegetative state after OHCA were enrolled. These patients underwent a combined treatment of intranasal administration of human recombinant NGF (hr-NGF), at a total dose of 50 gamma/kg, and tDCS, in which current intensity was increased from zero to 2 mA from the first 5 s of stimulation and maintained constant for 20 min. The treatment schedule was performed twice, at one month distance each. Neuroradiogical evaluation with Positron Emission Tomography scan (PET), Single Photon Emission Computed Tomography (SPECT), Electroencephalography (EEG) and Power Spectral Density of the brain (PSD) was determined before the treatment and one month after the end. Neurological assessment was deepened by using modified Ashworth Scale, Gross Motor Function Measure, and Disability Rating Scale. RESULTS Three children with a chronic vegetative state secondary to OHCA were treated. The combined treatment with hr-NGF and tDCS improved functional (PET and SPECT) and electrophysiological (EEG and PSD) assessment. Also clinical conditions improved, mainly for the reduction of spasticity and with the acquisition of voluntary finger movements, improved facial mimicry and reaction to painful stimuli. No side effects were reported. CONCLUSIONS These promising preliminary results and the ease of administration of this treatment make it worthwhile to be investigated further, mainly in the early stages from OHCA and in patients with better baseline neurological conditions, in order to explore more thoroughly the benefits of this new approach on neuronal function recovery after OHCA.
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Affiliation(s)
- Antonietta Curatola
- Dipartimento di Pediatria, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Benedetta Graglia
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Granata
- Istituto di Neurologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Giorgio Conti
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e Rianimazione, Terapia Intensiva Pediatrica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Lavinia Capossela
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Manni
- Istituto di Farmacologia Traslazionale, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy
| | - Serena Ferretti
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Di Giuda
- UOC di Medicina Nucleare, Fondazione Policlinico Universitario "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico Marco Romeo
- Unità di Neurologia Pediatrica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Maria Lucia Calcagni
- UOC di Medicina Nucleare, Fondazione Policlinico Universitario "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marzia Soligo
- Istituto di Farmacologia Traslazionale, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy
| | - Enrico Castelli
- Dipartimento di Neuroriabilitazione Intensiva, Ospedale Pediatrico "Bambino Gesù", Rome, Italy
| | - Marco Piastra
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e Rianimazione, Terapia Intensiva Pediatrica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Flavio Mantelli
- Dompé Farmaceutici Spa, Via Campo di Pile, snc, L'Aquila, 67100, Italy
| | - Giacomo Della Marca
- Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Susanna Staccioli
- Dipartimento di Neuroriabilitazione Intensiva, Ospedale Pediatrico "Bambino Gesù", Rome, Italy
| | - Tiziana Romeo
- Dompé Farmaceutici Spa, Via Campo di Pile, snc, L'Aquila, 67100, Italy
| | - Marcello Pani
- Direttore Farmacia Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Fabrizio Cocciolillo
- UOC di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Aldo Mancino
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e Rianimazione, Terapia Intensiva Pediatrica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Antonio Gatto
- Dipartimento di Pediatria, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Antonio Chiaretti
- Dipartimento di Pediatria, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
- Dipartimento di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy.
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Bompard S, Liuzzi T, Staccioli S, D'Arienzo F, Khosravi S, Giuliani R, Castelli E. Home-based music therapy for children with developmental disorders during the COVID-19 pandemic. J Telemed Telecare 2023; 29:211-216. [PMID: 33412993 PMCID: PMC10015277 DOI: 10.1177/1357633x20981213] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 11/16/2022]
Abstract
INTRODUCTION During the COVID-19 pandemic, children with neurodevelopmental disabilities could not attend their usual rehabilitation therapies, with a consequent reduced support of developmental process and risk of worsening of their clinical conditions. METHODS We prospectively enrolled 14 children with developmental delay, who had already tried a personalised music therapy (Euterpe method). We included them in a 12-day programme of home-based music therapy. The children and their parents were investigated using the Sleep Disturbance Scale for Children and the Parent Stress Index-Short Form. RESULTS Fourteen children started the intervention, while only 12 children completed all the planned home sessions and assessments. We observed a significant improvement in children's sleep quality and a reduction of parental distress. DISCUSSION The significant improvements in parental distress and sleep quality must be considered important achievements for the quality of life of a child and their family. Home-based music therapy can provide a feasible approach to improving sleep and parent's stress for children with developmental disorders.
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Affiliation(s)
- Sarah Bompard
- Department of Neurorehabilitation, "Bambino Gesù" Children's Hospital, Rome, Italy
| | - Tommaso Liuzzi
- Department of Neurorehabilitation, "Bambino Gesù" Children's Hospital, Rome, Italy.,Santa Cecilia Conservatory of Music, Rome, Italy.,Euterpe Association, Rome, Italy
| | - Susanna Staccioli
- Department of Neurorehabilitation, "Bambino Gesù" Children's Hospital, Rome, Italy
| | - Fiammetta D'Arienzo
- Department of Neurorehabilitation, "Bambino Gesù" Children's Hospital, Rome, Italy.,Euterpe Association, Rome, Italy
| | - Sahereh Khosravi
- Department of Neurorehabilitation, "Bambino Gesù" Children's Hospital, Rome, Italy.,Euterpe Association, Rome, Italy
| | | | - Enrico Castelli
- Department of Neurorehabilitation, "Bambino Gesù" Children's Hospital, Rome, Italy
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Diamanti A, Capriati T, Mosca A, Trovato CM, Laureti F, Mazzoli B, Bolasco G, Caldaro T, De Peppo F, Staccioli S, Papa RE, Cerchiari A, De Angelis P, Maggiore G. Neurological impairment and malnutrition in children: The role of home enteral nutrition in real life. Front Nutr 2023; 10:1087603. [PMID: 37032763 PMCID: PMC10073451 DOI: 10.3389/fnut.2023.1087603] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/17/2023] [Indexed: 04/11/2023] Open
Abstract
Objective Recent decades have brought an increased survival of children with Neurologic Impairment (NI) but malnutrition and digestive comorbidity remain important challenges to face. We designed the present study to assess the course of nutritional status following standardized Home Enteral Nutrition (HEN) program and to evaluate impact of changing mode of feeding, as a part of overall multidisciplinary management, on digestive co-morbidity as Gastro-Esophageal Reflux Disease (GERD), Oropharyngeal Dysphagia (OPD), constipation and airway aspiration. Methods We performed a retrospective analysis on NI children entered into Institutional HEN program due to NI disorders between January 2011 and 2019. Demographic, anthropometric characteristics (BMI z-score and weight for age z-score) and symptoms (GERD, OPD constipation and airway aspiration) were collected at the enrolment and during the follow up. Results We enrolled 402 patients (median age: 39 months); overall survival was 97%. Nutritional status was significantly improved by HEN; in particular growth profile significantly changed within the first 2 years following HEN beginning; GERD and airways aspirations decreased after HEN beginning. Constipation and OPD remained unchanged over time. Conclusions Malnutrition and digestive complaints are distinctive features of NI children. Nutritional status improve after 2 years from the beginning of standardized nutritional interventions. Overall multidisciplinary care, including standardized HEN protocols, seems to also impact on GERD and airway aspirations, which can decrease over time. It is possible that constipation and OPD, unchanged over time, are more dependent on underlying diseases than on overall treatments.
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Affiliation(s)
- Antonella Diamanti
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- *Correspondence: Antonella Diamanti
| | - Teresa Capriati
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Antonella Mosca
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Chiara Maria Trovato
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Francesca Laureti
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Bianca Mazzoli
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giulia Bolasco
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Tamara Caldaro
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Francesco De Peppo
- Unit of Palidoro Pediatric Surgery, Department of Specialized Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Susanna Staccioli
- Department of Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Raffaele Edo Papa
- Pediatrics Unit, University Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonella Cerchiari
- Department of Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Paola De Angelis
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giuseppe Maggiore
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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Lovardi E, De Ioris MA, Lettori D, Geremia C, Staccioli S, Bella GD, Scrocca R, Scarselli A, Aversa M, De Peppo F, Campana A, Castelli E. Glycopyrrolate for drooling in children with medical complexity under three years of age. Ital J Pediatr 2022; 48:2. [PMID: 34998418 PMCID: PMC8742944 DOI: 10.1186/s13052-021-01195-1] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/23/2021] [Indexed: 11/18/2022] Open
Abstract
Background The aim of the study is to determine that Glycopirrolate is safe and effective in decreasing drooling in children with medical complexity under 3 years of age. Medical treatment is based on anticholinergic drugs as transdermal scopolamine, benzotropine and GLY. GLY (Glycopyrronium bromide) is a synthetic quaternary ammonium anticholinergic agent with poor blood–brain barrier penetration and consequently has limited central effects. Actually, the oral GLY formulation was approved by the United States Food and Drug Administration (FDA) to treat drooling in children aged 3–16 years. Five studies reported on GLY use for the treatment of drooling in children with cerebral palsy and other conditions with neurological impairment; four are prospective studies while one a retrospective review. Methods this is a case report of eighteen children (sex ratio 11/8, median age 17 months, range 2–36 months) under three years of age, followed by a multidisciplinary team at the Bambino Gesù Children Hospital. The median follow-up was of 31.5 months (range 1–69 months). Response to treatment was assessed according to the Drooling Impact Scale administered at time 0 and after 1 month. All patients have an important neurological impairment: nine patients have a cerebral palsy (Gross Motor Function Classification System class V) and nine a genetic/malformative syndrome. Twelve patients have a tracheostomy and two need mechanical ventilation. Gastrostomy is present in 16 out of 18 patients. All patients received Glycopirrolate. The median starting daily dose was 0.065 mg/kg/die (range 0.02–0.21 mg/kg/die) three times a day. The drooling impact scale was administered at time O and after 1 month. Results Four out 18 patients stopped treatment for adverse event, lack of efficacy or parental decision. The mean Drooling Impact Scale at time 0 was 89 (range 81–100) and after 1 month 61(range 43–78); the difference was statistically significant (P < 0.001). The overall response to treatment was 94%. Conclusions This is the first study to determine the safety and effectiveness of Glycopyrrolate in decreasing drooling in a specific subset of patients. No major side effects were observed. Further comparative studies are needed to confirm our results.
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Affiliation(s)
- Eleonora Lovardi
- Neurorehabilitation Unit, Department of Neurosciences, Bambino Gesù Children Hospital, IRCCS, Rome, Italy. .,Child Neuropsychiatric Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
| | | | - Donatella Lettori
- Neurorehabilitation Unit, Department of Neurosciences, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | | | - Susanna Staccioli
- Neurorehabilitation Unit, Department of Neurosciences, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Gessica Della Bella
- Neurorehabilitation Unit, Department of Neurosciences, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | | | | | - Marcella Aversa
- Intensive Care Unit, Department of Anesthesia and Intensive Care, Rome, Italy
| | - Francesco De Peppo
- Department of Pediatric Surgery and Transplantation Center, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Andrea Campana
- Pediatrics, University Department of Pediatrics, Rome, Italy
| | - Enrico Castelli
- Neurorehabilitation Unit, Department of Neurosciences, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
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Perulli M, Cicala G, Turrini I, Musto E, Quintiliani M, Gambardella ML, Pulitanò SM, Bompard S, Staccioli S, Carmillo L, Di Sante G, Ria F, Veredice C, Contaldo I, Battaglia D. Fighting autoinflammation in FIRES: The role of interleukins and early immunomodulation. Epilepsy Behav Rep 2022; 18:100531. [PMID: 35356746 PMCID: PMC8958320 DOI: 10.1016/j.ebr.2022.100531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 01/11/2023] Open
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Ricci D, Lucibello S, Orazi L, Gallini F, Staccioli S, Serrao F, Olivieri G, Quintiliani M, Sivo S, Rossi V, Leone D, Ferrantini G, Romeo DM, Frezza S, Amorelli GM, Molle F, Vento G, Lepore D, Mercuri E. Early visual and neuro-development in preterm infants with and without retinopathy. Early Hum Dev 2020; 148:105134. [PMID: 32688300 DOI: 10.1016/j.earlhumdev.2020.105134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) is often associated with visual impairment and multiple developmental disabilities. AIMS As most of the previous studies include infants with brain lesions, that can determine visual impairment per se, a cohort of low neurological risk preterm infants without ROP and with various degree of severity of ROP was assessed in order to establish visual and neurodevelopmental outcome. STUDY DESIGN Preterm infants born at <31 weeks gestation, without major brain lesions, underwent visual function assessment at 1 year corrected age and neurodevelopmental assessment at 2 years corrected age. SUBJECTS One hundred and five infants were included in the study: 42 infants did not develop ROP, 7 reached stage 1 in zone 2 ROP, 37 reached prethreshold (untreated) type 2 ROP. The remaining 19 infants were classified as type 1 ROP. OUTCOME MEASURES Visual function (including fixing, tracking, visual acuity, visual field, attention at distance and nystagmus) were assessed at 12 months corrected age and Griffiths Scales at 2 years corrected age. RESULTS The severity of ROP was strongly correlated (p < 0.001) with both visual function at 1 year and neurodevelopment at 2 years. Similarly, the presence of nystagmus was also strongly correlated with visual and neurodevelopmental sequelae. CONCLUSIONS Infants with no or milder retinopathy showed normal visual function at 1 year and neurodevelopment at 2 years. Infants who underwent treatment more frequently showed abnormal results on several aspects of visual function. Presence of nystagmus appeared to increase the risk for abnormal visual function and neurodevelopmental outcome.
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Affiliation(s)
- Daniela Ricci
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy; National Centre of Services and Research for Prevention of Blindness and Rehabilitation of Visually Impaired, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy
| | - Simona Lucibello
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Lorenzo Orazi
- National Centre of Services and Research for Prevention of Blindness and Rehabilitation of Visually Impaired, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy; Institute of Ophthalmology, Catholic University, Fondazione Policlinico A. Gemelli, Largo A. Gemelli 8, Rome, Italy
| | - Francesca Gallini
- Division of Neonatology, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Susanna Staccioli
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy; Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS Via Torre di Palidoro, Rome, Italy
| | - Francesca Serrao
- Division of Neonatology, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Giorgia Olivieri
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Michela Quintiliani
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Serena Sivo
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Valeria Rossi
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Daniela Leone
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Gloria Ferrantini
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Domenico M Romeo
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Simonetta Frezza
- Division of Neonatology, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Giulia Maria Amorelli
- Institute of Ophthalmology, Catholic University, Fondazione Policlinico A. Gemelli, Largo A. Gemelli 8, Rome, Italy
| | - Fernando Molle
- Institute of Ophthalmology, Catholic University, Fondazione Policlinico A. Gemelli, Largo A. Gemelli 8, Rome, Italy; Institute of Ophthalmology, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy
| | - Giovanni Vento
- Division of Neonatology, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Domenico Lepore
- Institute of Ophthalmology, Catholic University, Fondazione Policlinico A. Gemelli, Largo A. Gemelli 8, Rome, Italy; Institute of Ophthalmology, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy
| | - Eugenio Mercuri
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy; Pediatric Neurology Unit, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy.
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9
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Chiaretti A, Conti G, Falsini B, Buonsenso D, Crasti M, Manni L, Soligo M, Fantacci C, Genovese O, Calcagni ML, Di Giuda D, Mattoli MV, Cocciolillo F, Ferrara P, Ruggiero A, Staccioli S, Colafati GS, Riccardi R. Intranasal Nerve Growth Factor administration improves cerebral functions in a child with severe traumatic brain injury: A case report. Brain Inj 2017; 31:1538-1547. [PMID: 28972396 DOI: 10.1080/02699052.2017.1376760] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Antonio Chiaretti
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giorgio Conti
- Pediatric Intensive Care Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Benedetto Falsini
- Institute of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Danilo Buonsenso
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Crasti
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Manni
- Institute of Translational Pharmacology, CNR, Rome, Italy
| | - Marzia Soligo
- Institute of Translational Pharmacology, CNR, Rome, Italy
| | - Claudia Fantacci
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Orazio Genovese
- Pediatric Intensive Care Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Lucia Calcagni
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Di Giuda
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Fabrizio Cocciolillo
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Pietro Ferrara
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Ruggiero
- Pediatric Oncology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Susanna Staccioli
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children’s Hospital, Rome, Italy
| | | | - Riccardo Riccardi
- Pediatric Oncology, Università Cattolica del Sacro Cuore, Rome, Italy
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10
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Cefalo MG, De Ioris MA, Cacchione A, Longo D, Staccioli S, Arcioni F, Bernardi B, Mastronuzzi A. Wernicke encephalopathy in pediatric neuro-oncology: presentation of 2 cases and review of literature. J Child Neurol 2014; 29:NP181-5. [PMID: 24293308 DOI: 10.1177/0883073813510355] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Wernicke encephalopathy represents a well-known entity characterized by a set of cognitive and neurologic alterations. Wernicke encephalopathy is rare and under-recognized in childhood and may be fatal. Few cases have been documented in pediatric oncology. We report on 2 Wernicke encephalopathy cases that occurred in children having a brain tumor. The diagnosis of Wernicke encephalopathy was suggested by clinical manifestations associated with the typical radiologic findings and a laboratory evidence of thiamine deficiency. No large series have been published to support the evidence that pediatric malignancies represent a demonstrated factor of increased risk to develop a Wernicke encephalopathy. Moreover, the diagnosis may be even more difficult in brain tumors, considering the overlapping symptoms and the risk of encephalopathy related to both the disease and the treatment. Wernicke encephalopathy should be considered in all children with cancer presenting a neurologic deterioration, mainly in brain tumors. An early diagnosis is imperative for a prompt therapy that might prevent or minimize the irreversible brain damage related to this condition.
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Affiliation(s)
| | | | | | - Daniela Longo
- Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Susanna Staccioli
- Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Francesco Arcioni
- University of Perugia, S.M. Misericordia University Hospital, Perugia, Rome, Italy
| | - Bruno Bernardi
- Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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11
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Boman KK, Hornquist L, Rickardsson J, Lannering B, Gustafsson G, Pitchford N, Davis E, Walker D, Hoang DH, Pagnier A, Cousin E, Guichardet K, Schiff I, Dubois-Teklali F, Krainik A, Lazar MB, Resnik K, Olsson IT, Perrin S, Burtscher IB, Lundgren J, Kahn A, Johanson A, Korzeniewska J, Dembowska-Baginska B, Perek-Polnik M, Walsh K, Gioia A, Wells E, Packer R, de Speville ED, Dufour C, Bolle S, Giraudat K, Longaud A, Kieffer V, Grill J, Puget S, Valteau-Couanet D, Hetz-Pannier L, Noulhiane M, Chieffo D, Tamburrini G, Caldarelli M, Di Rocco C, Margelisch K, Studer M, Steinlin M, Leibundgut K, Heinks T, Longaud-Vales A, Chevignard M, Dufour C, Grill J, Pujet S, Sainte-Rose C, Valteau-Couanet D, Dellatolas G, Kahalley L, Grosshans D, Paulino A, Ris MD, Chintagumpala M, Okcu F, Moore B, Stancel H, Minard C, Guffey D, Mahajan A, Herrington B, Raiker J, Manning E, Criddle J, Karlson C, Guerry W, Finlay J, Sands S, Dockstader C, Skocic J, Bouffet E, Laughlin S, Tabori U, Mabbott D, Moxon-Emre I, Scantlebury N, Taylor MD, Bouffet E, Malkin D, Laughlin S, Law N, Kumabe T, Leonard J, Rubin J, Jung S, Kim SK, Gupta N, Weiss W, Faria C, Vibhakar R, Spiegler B, Janzen L, Liu F, Decker L, Mabbott D, Lemiere J, Vercruysse T, Haers M, Vandenabeele K, Geuens S, Jacobs S, Van Gool S, Riggs L, Piscione J, Bouffet E, Timmons B, Laughlin S, Cunningham T, Bartels U, Skocic J, Liu F, Mabbott D, Riggs L, Bouffet E, Chakravarty M, Laughlin S, Laperriere N, Liu F, Skocic J, Pipitone J, Strother D, Hukin J, Fryer C, McConnell D, Mabbott D, Secco DE, Cappelletti S, Gentile S, Chieffo D, Cacchione A, Del Bufalo F, Staccioli S, Spagnoli A, Messina R, Carai A, Marras CE, Mastronuzzi A, Brinkman T, Armstrong G, Kimberg C, Gajjar A, Srivastava DK, Robison L, Hudson M, Krull K, Hardy K, Hostetter S, Hwang E, Walsh K, Leiss U, Bemmer A, Pletschko T, Grafeneder J, Schwarzinger A, Deimann P, Slavc I, Batchelder P, Wilkening G, Hankinson T, Foreman N, Handler M. NEUROPSYCHOLOGY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou076] [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: 11/12/2022] Open
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12
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Brinkman T, Liu W, Armstrong G, Gajjar A, Merchant T, Kimberg C, Kun L, Srivastava DK, Gurney J, Robison L, Hudson M, Krull K, Rubens J, Lulla RR, Lai JS, Fangusaro J, Wolfe K, Madan-Swain A, Reddy A, Hunter G, Banos J, Kana R, Resch A, von Hoff K, von Buren AO, Friedrich C, Treulieb W, Lindow C, Kwiecien R, Ottensmeier H, Rutkowski S, Armstrong CL, Phillips PC, Lustig RA, Stamos C, Li Y, Belasco J, Minturn JE, Fisher MJ, Heinks-Maldonado T, Wingeier K, Lory V, Schafer C, Studer M, Steinlin M, Leibundgut K, de Ruiter M, Schouten N, Greidanus J, Grootenhuis M, Oosterlaan J, A ALV, Grill J, Puget S, Sainte-Rose C, Dufour C, Kieffer V, Dellatolas G, -Shkedi EB, Ben Arush MW, Kaplinsky H, Ash S, Goshen Y, Yaniv I, Cohen IJ, Levy JM, Tello T, Lu X, Gao D, Wilkening G, Donson A, Foreman N, Liu A, Korzeniewska J, Baginska BD, Perek D, Staccioli S, Chieffo D, Petrarca M, Moxon-Emre I, Taylor M, Bouffet E, Malkin D, Hawkins C, Scantlebury N, Mabbott D, Cunningham T, Bouffet E, Scantlebury N, Piscione J, Igoe D, Orfus M, Bartels U, Laughlin S, Tabori U, Mabbott D, Hardy K, Carlson-Green B, Conklin H, Dockstader C, Bouffet E, Wang F, Mabbott D, Bostan S, Dockstader C, Scantlebury N, Bouffet E, Liu F, Wang F, Mabbott D, Zou P, Li Y, Conklin HM, Mulhern RK, Butler RW, Ogg RJ, Diver T, Manley P, Kieran M, Chordas C, Liptak C, Delaney B, Brand S, Rey-Casserly C. NEUROPSYCHOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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13
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Ricci D, Cesarini L, Gallini F, Serrao F, Leone D, Baranello G, Cota F, Pane M, Brogna C, De Rose P, Vasco G, Alfieri P, Staccioli S, Romeo DM, Tinelli F, Molle F, Lepore D, Baldascino A, Ramenghi LA, Torrioli MG, Romagnoli C, Cowan F, Atkinson J, Cioni G, Mercuri E. Cortical visual function in preterm infants in the first year. J Pediatr 2010; 156:550-5. [PMID: 20056237 DOI: 10.1016/j.jpeds.2009.10.042] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [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] [Received: 07/06/2009] [Revised: 09/15/2009] [Accepted: 10/30/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess visual function in low-risk preterm infants at 3, 5, and 12 months corrected age to determine whether the maturation of visual function in the first year is similar to that reported in term-born infants. STUDY DESIGN Seventy-five low-risk infants (25.0-30.9 weeks gestation) underwent ophthalmological examinations and a battery of tests (fix and follow, visual fields, acuity, attention at distance, and fixation shift) designed to assess various aspects of visual function at 3, 5, and 12 months corrected age. RESULTS The results were comparable with normative data from term-born infants in all tests but fixation shift, suggesting that maturation of most aspects of visual function is not significantly affected by preterm birth. In contrast, >25% of preterm infants failed the fixation shift test at 3 months, with a higher percentage of failing at 5 and 12 months. CONCLUSIONS There is a specific profile of early visual behavior in low-risk preterm infants, with a high percentage of infants failing a test that specifically assesses visual attention and provides a measure of cortical processing.
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Affiliation(s)
- Daniela Ricci
- Paediatric Neurology Unit, Catholic University, Rome, Italy
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14
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Barca L, Cappelli FR, Di Giulio P, Staccioli S, Castelli E. Outpatient assessment of neurovisual functions in children with Cerebral Palsy. Res Dev Disabil 2010; 31:488-495. [PMID: 19963340 DOI: 10.1016/j.ridd.2009.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Accepted: 10/27/2009] [Indexed: 05/28/2023]
Abstract
This study examined the feasibility of the Atkinson Battery for Child Development for Examining Functional Vision (Atkinson, Anker, Rae, et al., 2002) to evaluate neurovisual functions of children with neurodevelopmental disorders in outpatient setting. A total of 90 patients underwent a comprehensive evaluation. Among these, a group of 33 children with Cerebral Palsy (CP), mean age 6 years, with different types of CP (26% diplegic, 37% hemiplegic and 37% tetraplegic) were selected to constitute the cohort of the study. Visual sensory measures as well as higher level visual functions were considered. Overall, 73% patients had impairments at the assessment protocol, the majority of which presenting difficulties on both visuoperceptual and visuospatial tasks (79%). Subgroups of participants presented similar profiles of impairments with spared basic visuocognitive abilities and limitations in visuoperceptual and visuospatial domains. The Atkinson's battery proved to be valuable for evaluation in outpatient setting and follow-up testing. Some limitations emerged. For the definition of personalized and detailed rehabilitation programs a breakdown of the different components of vision and subsequent in-depth evaluation are needed.
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Affiliation(s)
- Laura Barca
- Paediatric Rehabilitation Division, Children's Hospital Bambino Gesù, Italy.
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15
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Carlesimo B, Cigna E, Fino P, Rusciani A, Tariciotti F, Staccioli S. Antibiotic therapy of transaxillary augmentation mammoplasty. In Vivo 2009; 23:357-362. [PMID: 19414427] [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: 05/27/2023]
Abstract
BACKGROUND Capsular contracture is the most common complication and the main cause of dissatisfaction after augmentation mammoplasty, for both the patient and the plastic surgeon. The formation of fibrous tissue around the prosthesis alters the form or the consistency of the implant, thus modifying the breast shape, its contour and its softness. The initial satisfaction with the achieved aesthetical result is then transformed into great dissatisfaction, due to the presence of a shapeless and undesired mass. PATIENTS AND METHODS The following study considered data collected between 1998 and 2007. Sixty-seven female patients (aged between 35 and 53 years) who suffered from mammary hypotrophy and had undergone submuscular augmentation mammoplasty were enrolled. All the implanted prostheses were round and texturized, with a volume of 250 cm3 to 450 cm3. The patients underwent pre-, intra- and postoperative antibiotic therapy in order to prevent clinical and subclinical infection of the implants. RESULTS The follow-up ranged from a period of two to nine years. All patients were examined during the first antibiotic administration and again subsequently, after 1, 3, 6 and 12 months, to evaluate the results in terms of capsular contracture. Of all patients, 90% presented a degree I Baker's classification, the remaining 10% a degree II. Not one of the patients treated showed grade III or IV capsular contracture nor was there any need to remove the prosthesis during the examination period. CONCLUSION It is clear that a main role in capsular contracture is played by the infectious process, with the activation of specific inflammatory cells. Interfering with the infectious process can prevent fibrotic reaction evolving into capsular contracture. Although the process causing capsular contracture is multifactorial, our study showed a favourable response can be achieved when using antibiotic therapy associated with the transaxillary approach.
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Affiliation(s)
- B Carlesimo
- Department of Plastic and Reconstructive Surgery, University of Rome La Sapienza, Policlinico Umberto I, Viale del Policlinico, 155, 00161-Rome, Italy
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16
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Alfieri P, Cesarini L, Zampino G, Pantaleoni F, Selicorni A, Salerni A, Vasta I, Cerutti M, Dickmann A, Colitto F, Staccioli S, Leoni C, Ricci D, Brogna C, Tartaglia M, Mercuri E. Visual function in Noonan and LEOPARD syndrome. Neuropediatrics 2008; 39:335-40. [PMID: 19568997 DOI: 10.1055/s-0029-1216354] [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: 10/20/2022]
Abstract
The aim of the study was to assess various aspects of visual and visuoperceptual function in patients with Noonan syndrome (NS) or LEOPARD syndrome (LS) with mutations affecting the PTPN11, SOS1 and RAF1 genes. Twenty-four patients were assessed with a battery of tests assessing visual function including ophthalmological and orthoptic evaluation and age appropriate behavioural visual tests, including measures of crowding acuity (Cambridge crowding cards), and stereopsis (TNO test). Twenty-one subjects were also assessed with the visuo-motor integration (VMI) test. Twenty of the 24 patients (83%) had abnormalities of visual function on at least one of the tests used to assess visual function or on ophthalmological examination, and 7 of 21 (33%) also had abnormalities on VMI. Ocular movements and stereopsis were most frequently abnormal (50% and 79%, respectively). Our results suggest that visual and visuoperceptual abilities are commonly impaired in patients with Noonan and LEOPARD syndrome and they are probably related to a multifactorial etiology.
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Affiliation(s)
- P Alfieri
- Pediatric Neurology Unit, Catholic University, Rome, Italy
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17
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Pane M, Staccioli S, Messina S, D'Amico A, Pelliccioni M, Mazzone ES, Cuttini M, Alfieri P, Battini R, Main M, Muntoni F, Bertini E, Villanova M, Mercuri E. Daily salbutamol in young patients with SMA type II. Neuromuscul Disord 2008; 18:536-40. [PMID: 18579379 DOI: 10.1016/j.nmd.2008.05.004] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2008] [Revised: 05/05/2008] [Accepted: 05/12/2008] [Indexed: 11/15/2022]
Abstract
The aim of this open pilot study was to establish the profile of tolerability and clinical response of salbutamol (albuterol) in a cohort of young children affected by type II spinal muscular atrophy (SMA). Twenty-three children between 30 months and 6 years of age were treated with salbutamol (2 mg three times a day) for 1 year. All children were longitudinally assessed using the Hammersmith motor functional scale 6 months before treatment started (T0), at baseline (T1) and 6 and 12 months later. There was no significant change in function between T0 and T1 assessments, but the functional scores recorded after 6 and 12 months of treatment were significantly higher than those recorded at baseline (p=0.006). Our results suggest that salbutamol may be beneficial to SMA patients without producing any major side effect. Larger prospective randomized, double-blind, placebo controlled trials are needed to confirm these preliminary findings.
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Affiliation(s)
- Marika Pane
- Department of Paediatric Neurology, Catholic University, Policlinico Gemelli Largo Gemelli, 00168 Rome, Italy
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18
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Lettori D, Battaglia D, Sacco A, Veredice C, Chieffo D, Massimi L, Tartaglione T, Chiricozzi F, Staccioli S, Mittica A, Di Rocco C, Guzzetta F. Early hemispherectomy in catastrophic epilepsy. Seizure 2008; 17:49-63. [PMID: 17689988 DOI: 10.1016/j.seizure.2007.06.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 04/23/2007] [Accepted: 06/18/2007] [Indexed: 11/26/2022] Open
Abstract
The authors report their experience about a neuro-cognitive and epileptic long-term follow-up of children with catastrophic epilepsy treated with hemispherectomy in the first 5 years of life. Nineteen children with resistant epilepsy that significantly interfered with their neuro-cognitive development underwent hemispherectomy within 5 years of life (mean: 2 years, 3 months; range: 5 months to 5 years). All patients were assessed before surgery and after, at least at the end of the follow-up (mean: 6 years and 6 months; range: 2-11 years and 2 months) with a full clinical examination including motor ability and functional status evaluation as well as behaviour observation, neuroimaging and an ictal/interictal prolonged scalp video-EEG. A seizure-free outcome was obtained in 73.7% of patients. Gross motility generally improved and cognitive competence did not worsen, with an evident progress in two cases. Consistently with previous reports, evolution was worse in cortical dysplasia than in progressive or acquired vascular cerebropathies. The excellent epileptic outcome and the lack of developmental deterioration in comparison with other more aged series seem to suggest a possible better evolution in earlier surgery treatment. To confirm this suggestion, however, further experience with larger series is needed.
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Affiliation(s)
- D Lettori
- Child Neurology and Psychiatry, Catholic University, Rome, Italy
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19
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Battaglia D, Acquafondata C, Lettori D, Tartaglione T, Donvito V, Staccioli S, Mittica A, Guzzetta F. Observation of continuous spike-waves during slow sleep in children with myelomeningocele. Childs Nerv Syst 2004; 20:462-7. [PMID: 15173953 DOI: 10.1007/s00381-004-0956-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2003] [Indexed: 10/26/2022]
Abstract
CASES Two patients with myelomeningoceles (MMC) and shunt-treated hydrocephalus are reported. At 5 and 7 years respectively, when they began presenting mental deterioration and behavioural disorders, sleep EEG showed continuous spike-waves during slow sleep (CSWS). DISCUSSION These are the first cases of CSWS described in patients with MMC. The mechanisms of CSWS are considered. The role of hydrocephalus and the thalamic injuries found in one of the patients is discussed in detail. The usefulness of monitoring sleep EEG in patients with hydrocephalus or thalamic lesions is stressed, considering the effects of CSWS on the cognitive competencies and the soft or subclinical course that epilepsy complicated with CSWS may follow.
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Affiliation(s)
- D Battaglia
- Department of Medical and Surgical Paediatrics and Developmental Neurosciences, Catholic University, Largo A. Gemelli 8, 00168 Rome, Italy
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