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Reina F, Salemi G, Capizzi M, Lo Cascio S, Marino A, Santangelo G, Santangelo A, Mineri M, Brighina F, Raieli V, Costa CA. Orofacial Migraine and Other Idiopathic Non-Dental Facial Pain Syndromes: A Clinical Survey of a Social Orofacial Patient Group. Int J Environ Res Public Health 2023; 20:6946. [PMID: 37887684 PMCID: PMC10606289 DOI: 10.3390/ijerph20206946] [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] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/08/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
Background: Orofacial pain syndromes (OFPs) are a heterogeneous group of syndromes mainly characterized by painful attacks localized in facial and oral structures. According to the International Classification of Orofacial Pain (ICOP), the last three groups (non-dental facial pain, NDFP) are cranial neuralgias, facial pain syndromes resembling primary headache syndromes, and idiopathic orofacial pain. These are often clinical challenges because the symptoms may be similar or common among different disorders. The diagnostic efforts often induce a complex diagnostic algorithm and lead to several imaging studies or specialized tests, which are not always necessary. The aim of this study was to describe the encountered difficulties by these patients during the diagnostic-therapeutic course. Methods: This study was based on the responses to a survey questionnaire, administered to an Italian Facebook Orofacial Patient Group, searching for pain characteristics and diagnostic-therapeutic care courses. The questionnaire was filled out by patients affected by orofacial pain, who were 18 years and older, using a free online tool available on tablets, smartphones, and computers. Results: The sample was composed of 320 subjects (244F/76M), subdivided by age range (18-35 ys: 17.2%; 36-55 ys: 55.0%; >55 ys 27.8%). Most of the patients were affected by OFP for more than 3 years The sample presented one OFP diagnosis in 60% of cases, more than one in 36.2% of cases, and 3.8% not classified. Trigeminal neuralgia is more represented, followed by cluster headaches and migraines. About 70% had no pain remission, showing persisting background pain (VAS median = 7); autonomic cranial signs during a pain attack ranged between 45 and 65%. About 70% of the subjects consulted at least two different specialists. Almost all received drug treatment, about 25% received four to nine drug treatments, 40% remained unsatisfied, and almost 50% received no pharmacological treatment, together with drug therapy. Conclusion: To the authors' knowledge, this is the first study on an OFP population not selected by a third-level specialized center. The authors believe this represents a realistic perspective of what orofacial pain subjects suffer during their diagnostic-therapeutic course and the medical approach often results in unsatisfactory outcomes.
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Affiliation(s)
- Federica Reina
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. “G D’Alessandro”, University of Palermo, 90100 Palermo, Italy; (F.R.); (M.C.); (S.L.C.); (A.M.)
| | - Giuseppe Salemi
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, 90100 Palermo, Italy; (G.S.); (F.B.)
| | - Mariarita Capizzi
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. “G D’Alessandro”, University of Palermo, 90100 Palermo, Italy; (F.R.); (M.C.); (S.L.C.); (A.M.)
| | - Salvatore Lo Cascio
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. “G D’Alessandro”, University of Palermo, 90100 Palermo, Italy; (F.R.); (M.C.); (S.L.C.); (A.M.)
| | - Antonio Marino
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. “G D’Alessandro”, University of Palermo, 90100 Palermo, Italy; (F.R.); (M.C.); (S.L.C.); (A.M.)
| | - Giuseppe Santangelo
- Child Neuropsychiatry Department, ISMEP—ARNAS Civico Palermo, via dei Benedettini 1, 90100 Palermo, Italy;
| | - Andrea Santangelo
- Pediatric Neurology, Pediatric Department, AOUP Santa Chiara Hospital, 56121 Pisa, Italy;
| | - Mirko Mineri
- Pain Management Department, Humanitas, 95045 Catania, Italy; (M.M.); (C.A.C.)
| | - Filippo Brighina
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, 90100 Palermo, Italy; (G.S.); (F.B.)
| | - Vincenzo Raieli
- Child Neuropsychiatry Department, ISMEP—ARNAS Civico Palermo, via dei Benedettini 1, 90100 Palermo, Italy;
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Mangano GD, Capizzi MR, Mantuano E, Veneziano L, Santangelo G, Quatrosi G, Nardello R, Raieli V. Familial hemiplegic migraine in pediatric patients: A genetic, clinical, and follow-up study. Headache 2023. [PMID: 37326332 DOI: 10.1111/head.14582] [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: 12/06/2022] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim of this study was to describe a cohort of pediatric patients with genetically confirmed familial hemiplegic migraine (FHM). The knowledge of genotype-phenotype correlations may suggest prognostic factors associated with severe phenotypes. BACKGROUND Hemiplegic migraine is a rare disease and data concerning the pediatric population are even more rare as they are often extrapolated from mixed cohorts. METHODS We selected patients who met International Classification of Headache Disorders, third edition criteria for FHM, who had a molecular diagnosis, and whose first attack occurred under the age of 18 years. RESULTS We enrolled nine patients (seven males and two females) first referred to our three centers. Three of the nine (33%) patients had calcium voltage-gated channel subunit alpha1 A (CACNA1A) mutations, five (55%) had ATPase Na+/K+ transporting subunit alpha 2 (ATP1A2) mutations, and one had both genetic mutations. The patients experienced at least one aura feature other than hemiplegia during the first attack. The mean (SD) duration of HM attacks in the sample was 11.3 (17.1) h; 3.8 (6.1) h in the ATP1A2 group, and 24.3 (23.5) h in the CACNA1A group. The mean (SD, range) duration of follow-up was 7.4 (2.2, 3-10) years. During the first year from the disorder's onset, only four patients had additional attacks. Over the course of follow-up, the attack frequency overall was 0.4 attacks/year without a difference between the two groups (CACNA1A and ATP1A2). CONCLUSION The study data show that most of our patients with early-onset FHM experienced infrequent and non-severe attacks, which improved over time. Furthermore, the clinical course revealed neither the appearance of novel neurological disorders or a deterioration of basic neurological or cognitive functioning.
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Affiliation(s)
- Giuseppe Donato Mangano
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| | - Maria Rita Capizzi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical, Specialities "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Elide Mantuano
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
| | - Liana Veneziano
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
| | - Giuseppe Santangelo
- Child Neuropsychiatry Department, P.O. Di Cristina, ARNAS Civico, Palermo, Italy
| | - Giuseppe Quatrosi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Rosaria Nardello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical, Specialities "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Department, P.O. Di Cristina, ARNAS Civico, Palermo, Italy
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Manzo ML, Reina F, Correnti E, D'Aiuto F, D'Agnano D, Santangelo A, Vetri L, Santangelo G, Maniscalco L, Tripi G, Sciruicchio V, Raieli V. Evolution of Pediatric Migraine Patients Admitted at an Emergency Department after a 10-Year Follow-Up. J Clin Med 2023; 12:jcm12072475. [PMID: 37048559 PMCID: PMC10095507 DOI: 10.3390/jcm12072475] [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: 02/01/2023] [Revised: 03/12/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Despite its high prevalence, the clinical course of pediatric migraine has not been fully understood, and previous studies present conflicting results. We present here the findings of a 10-year follow-up study involving children with severe migraine pain admitted to our emergency department. Furthermore, all studies were carried out on selected outpatient clinical case studies. Our aim was to evaluate a population of migraine children admitted to an emergency department because of increased severity or frequency of pain or even because of very anxious parents concerning their child's headache in order to describe their long-term outcomes, whether it differed from that of outpatient populations and to identify possible predictors of prognosis. METHODS We recruited 80 subjects with migraine headaches (mean age 8 years with a range of 4-14 years, 50% females), attending the baseline examination of a population admitted for a headache to the Emergency Department in the first half year of 2012. Of the 80 subjects, 48 (60%) were eligible for follow-up in 2022. We included in our study only patients diagnosed with migraine, according to the diagnostic criteria of the International Classification of Headache Disorders. All were contacted by telephone, and a semi-structured questionnaire was provided to them by email. The association between several possible prognostic factors (gender, familiar neurologic disorders, prenatal and perinatal disorders, social activities, sleep disorders, etc.) and the long-term persistence of migraine headaches were explored using logistic regression analysis. RESULTS Of 48 subjects with migraine headaches at baseline, 31 (65%) had persistent migraine, and 17 (35%) experienced remission. The preliminary results showed that the presence of neurologic disorders in parents (p < 0.01-odds ratio 9.34 (2.53-41.64) and sleep disorders (p < 0.01-odds ratio 13.18 (2.25-252.74) significantly predicted the 10-year persistence of migraine headaches, while the other considered predictors were found not to influence prognosis. CONCLUSIONS To our knowledge, this was the first study conducted on a selected pediatric population upon admission to the emergency room. Our study suggests that a population of pediatric migraine selected for admission to the emergency department also shows a favorable long-term prognosis, like the studies conducted in the outpatient sample. Familial neurological comorbidity and sleep disorders were unfavorable factors for predicting good outcomes.
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Affiliation(s)
- Maria Laura Manzo
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Federica Reina
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Edvige Correnti
- Child Neuropsychiatry Department, ISMEP-ARNAS Civico, 90100 Palermo, Italy
| | | | - Daniela D'Agnano
- Children Epilepsy and EEG Center, PO, San Paolo ASL, 70132 Bari, Italy
| | - Andrea Santangelo
- Pediatrics Department, AOUP Santa Chiara Hospital, 56126 Pisa, Italy
| | - Luigi Vetri
- Oasi Research Institute IRCCS, 94018 Troina, Italy
| | | | - Laura Maniscalco
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Gabriele Tripi
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | | | - Vincenzo Raieli
- Child Neuropsychiatry Department, ISMEP-ARNAS Civico, 90100 Palermo, Italy
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Correnti E, Lo Cascio S, Cernigliaro F, Rossi R, D'Agnano D, Grasso G, Pellegrino A, Lauria B, Santangelo A, Santangelo G, Tripi G, Versace A, Sciruicchio V, Raieli V. Idiopathic Non-Dental Facial Pain Syndromes in Italian Children: A Clinical Case Series. Life (Basel) 2023; 13:life13040861. [PMID: 37109390 PMCID: PMC10144764 DOI: 10.3390/life13040861] [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: 02/08/2023] [Revised: 03/08/2023] [Accepted: 03/19/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The orofacial pain syndromes (OFPs) are a heterogeneous group of syndromes characterized by painful attacks involving the orofacial structures. They may be summarily subdivided into two great categories: (1) orofacial pain mainly attributed to dental disorders such as dentoalveolar and myofascial orofacial pain or temporomandibular joint (TM) pain; (2) orofacial pain mainly attributed to non-dental pain as neuralgias, facial localization of primary headaches or idiopathic orofacial pain. The second group is uncommon, often described by single case reports, can often show overlapping symptoms with the first group, and represents a clinical challenge, carrying the risk of undervaluation and possibly invasive odontoiatric treatment. We aimed to describe a clinical pediatric series of non-dental orofacial pain and better to underline some topographic and clinical features associated with them. We retrospectively collected the data of children admitted to our headache centers (Bari, Palermo, Torino) from 2017 to 2021. Our inclusion criterion was the presence of non-dental orofacial pain following the topographic criteria of 3° International Classification of Headache Disorders (ICHD-3), and exclusion criteria included the pain syndromes attributed to the dental disorders and pain syndromes due to the secondary etiologies Results. Our sample comprised 43 subjects (23/20 M/F, in the range of ages 5-17). We classified them int: 23 primary headaches involving the facial territory during attacks, 2 facial trigeminal autonomic cephalalgias, 1 facial primary stabbing headache, 1 facial linear headache, 6 trochlear migraines, 1 orbital migraine 3 red ear syndrome and 6 atypical facial pain. All patients described debilitating pain for intensity (moderate/severe), 31 children had episodic attacks, and 12 had continuous pain. Almost all received drugs for acute treatment (less than 50% were satisfied), and some received non-pharmacological treatment associated with drug therapy Conclusion. Although rare OFP can occur in pediatric age, it can be debilitating if unrecognized and untreated, affecting the psychophysical well-being of young patients. We highlight the specific characteristics of the disorder for a more correct and earlier identification during the diagnostic process, already difficult in pediatric age, and to define the approach and possible treatment to prevent negative outcomes in adulthood.
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Affiliation(s)
- Edvige Correnti
- Child Neuropsychiatry Department, ISMEP, ARNAS Civico, 90100 Palermo, Italy
| | - Salvatore Lo Cascio
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Federica Cernigliaro
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Roberta Rossi
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Daniela D'Agnano
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Giulia Grasso
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Annamaria Pellegrino
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Barbara Lauria
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Andrea Santangelo
- Pediatrics Department, AOUP Santa Chiara Hospital, 56126 Pisa, Italy
| | | | - Gabriele Tripi
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Antonella Versace
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Vittorio Sciruicchio
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Department, ISMEP, ARNAS Civico, 90100 Palermo, Italy
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Orsini A, Foiadelli T, Sica A, Santangelo A, Carli N, Bonuccelli A, Consolini R, D’Elios S, Loddo N, Verrotti A, Di Cara G, Marra C, Califano M, Fetta A, Fabi M, Bergamoni S, Vignoli A, Battini R, Mosca M, Baldini C, Assanta N, Marchese P, Simonini G, Marrani E, Operto FF, Pastorino GMG, Savasta S, Santangelo G, Pedrinelli V, Massimetti G, Dell’Osso L, Peroni D, Cordelli DM, Corsi M, Carmassi C. Psychopathological Impact in Patients with History of Rheumatic Fever with or without Sydenham's Chorea: A Multicenter Prospective Study. Int J Environ Res Public Health 2022; 19:10586. [PMID: 36078300 PMCID: PMC9517806 DOI: 10.3390/ijerph191710586] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Sydenham's chorea (SC) is a post-streptococcal autoimmune disorder of the central nervous system, and it is a major criterium for the diagnosis of acute rheumatic fever (ARF). SC typically improves in 12-15 weeks, but patients can be affected for years by persistence and recurrencies of both neurological and neuropsychiatric symptoms. We enrolled 48 patients with a previous diagnosis of ARF, with or without SC, in a national multicenter prospective study, to evaluate the presence of neuropsychiatric symptoms several years after SC's onset. Our population was divided in a SC group (n = 21), consisting of patients who had SC, and a nSC group (n = 27), consisting of patients who had ARF without SC. Both groups were evaluated by the administration of 8 different neuropsychiatric tests. The Work and Social Adjustment Scale (WSAS) showed significantly (p = 0.021) higher alterations in the SC group than in the nSC group. Furthermore, 60.4% (n = 29) of the overall population experienced neuropsychiatric symptoms other than choreic movements at diagnosis and this finding was significantly more common (p = 0.00) in SC patients (95.2%) than in nSC patients (33.3%). The other neuropsychiatric tests also produced significant results, indicating that SC can exert a strong psychopathological impact on patients even years after its onset.
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Affiliation(s)
- Alessandro Orsini
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Thomas Foiadelli
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Attilio Sica
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Andrea Santangelo
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Niccolò Carli
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Alice Bonuccelli
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Rita Consolini
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Sofia D’Elios
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Nicolò Loddo
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of Perugia, 06123 Perugia, Italy
| | - Giuseppe Di Cara
- Department of Pediatrics, University of Perugia, 06123 Perugia, Italy
| | - Chiara Marra
- Child Neurology Unit, University of Bologna, 40126 Bologna, Italy
| | - Maria Califano
- Child Neurology Unit, University of Bologna, 40126 Bologna, Italy
| | - Anna Fetta
- Child Neurology Unit, University of Bologna, 40126 Bologna, Italy
| | - Marianna Fabi
- Child Neurology Unit, University of Bologna, 40126 Bologna, Italy
| | - Stefania Bergamoni
- Childhood and Adolescence Neurology and Psychiatry Unit, ASST GOM Niguarda, 20121 Milan, Italy
| | - Aglaia Vignoli
- Childhood and Adolescence Neurology and Psychiatry Unit, ASST GOM Niguarda, 20121 Milan, Italy
- Health Sciences Department, Università degli Studi di Milano, 20121 Milan, Italy
| | - Roberta Battini
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
- Department of Developmental Neuroscience, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, 56121 Pisa, Italy
| | - Marta Mosca
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Chiara Baldini
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Nadia Assanta
- Heart Hospital, G. Monasterio Tuscan Foundation, 54100 Massa, Italy
| | - Pietro Marchese
- Heart Hospital, G. Monasterio Tuscan Foundation, 54100 Massa, Italy
| | - Gabriele Simonini
- Pediatric Rheumatology, Meyer Children Hospital, University of Florence, 50134 Florence, Italy
| | - Edoardo Marrani
- Pediatric Rheumatology, Meyer Children Hospital, University of Florence, 50134 Florence, Italy
| | - Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy
| | - Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy
| | | | - Giuseppe Santangelo
- Child Neuropsychiatry Unit, ISMEP—P.O. Cristina—ARNAS Civico, Via dei Benedettini 1, 90100 Palermo, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Diego Peroni
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | | | - Martina Corsi
- Occupational Health Department, Azienda Ospedaliero Universitaria Pisana, Via Paradisa 2, 56124 Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
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Santangelo G, Bursi F, Toriello F, Tamagni ME, Fior G, Massironi L, Bertelli S, Fanin A, Gambini O, Carugo S, Benetti A. Echocardiographic changes in anorexia nervosa: a pathophysiological adaptation or a disease? Intern Emerg Med 2022; 17:777-787. [PMID: 34677790 DOI: 10.1007/s11739-021-02871-0] [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: 07/21/2021] [Accepted: 10/12/2021] [Indexed: 11/25/2022]
Abstract
Anorexia Nervosa is one of the most common form of eating disorders. Cardiac involvement occurs in approximately 80% of patients. Few reports focused on the association between body weight fluctuations and echocardiographic abnormalities, considering linear measurements. We describe echocardiographic and clinical features among male and female patients with anorexia nervosa and the effect of weight gain on these parameters. We performed a single center, retrospective study of patients followed at a dedicated multidisciplinary Unit. The study population consisted of 81 patients, mean age 25 ± 11 years, 94% female. Median body mass index was 14.4 kg/m2 (25th-75th percentile 12.7-15.6 kg/m2). Patients with body mass index below the median value had more often pericardial effusion, smaller left ventricular mass and left ventricular end-diastolic volume and thinner interventricular septum. However, when indexed to body surface area, left ventricular mass and volumes were within the normal range in 90% of population. Patients with pericardial effusion showed mitral valve abnormalities and lower values of white blood cells and platelets, although within normal limits. Presence of pericardial effusion was not related to inflammatory parameters or low plasma protein levels. In 39 patients who displayed weight gain during a median follow-up of 189 days (25th-75th percentile 47-471), increased left ventricular mass, interventricular septum thickness, white blood cells and platelet count and decreased pericardial effusion were observed. Patients with anorexia nervosa have a specific echocardiographic pattern which seems to be proportional to the body size, suggesting a pathophysiological adaptation to the lack of substrates.
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Affiliation(s)
- G Santangelo
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy.
| | - F Bursi
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - F Toriello
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - M E Tamagni
- Division of Internal Medicine, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - G Fior
- Division of Psychiatry, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - L Massironi
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - S Bertelli
- Division of Psychiatry, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - A Fanin
- Division of Internal Medicine, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - O Gambini
- Division of Psychiatry, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - S Carugo
- Division of Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A Benetti
- Division of Internal Medicine, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
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Valli F, Bursi F, Santangelo G, Toriello F, Rusconi I, Mondellini G, Vella A, Faggiano A, Persampieri S, Carugo S, Guazzi M. Sacubitril/Valsartan in heart failure with reduced ejection fraction: clinical and echocardiographic insights from a real world population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Following the PARADIGM trial, some studies have identified cardiac remodeling as major background for hard end point benefits of Sacubitril/Valsartan (S/V), but few adopted a well described definition in the literature.
Purpose
We aimed at a comprehensive evaluation of the effects of S/V on echo-derived measures of cardiac remodeling along with clinical and laboratory data over a medium-term follow-up pointing to a real-world HFrEF population.
Methods
This is a prospective observational study of HFrEF patients on optimal medical therapy (OMT) initiated with S/V at Heart Failure Clinic of our institute (January 2017-January 2020). In 62 HFrEF, echocardiographic, laboratory and clinical data were collected at baseline and over 10 (Q1-Q3 8–13) months after S/V initiation. Mean age was 68±12 years, 79% men. Left ventricular reverse remodeling (LVRR) was defined as: 1) an absolute increase in LVEF ≥10 points or a LVEF ≥50% at follow-up and 2) a relative decrease in indexed left ventricular end-diastolic diameter of at least 10% or an indexed left ventricular end-diastolic diameter ≤33 mm/m2.
Results
Compared to baseline, S/V promoted a significant improvement of LV ejection fraction (LVEF, from 30% to 37%; p<0,0001) with an absolute median increase in LVEF of 8 points. Parallel significant reductions in left ventricular and atrial volumes, lower mitral regurgitation degree and a better diastolic dysfunction along with clinical improvement (NYHA class and NT-proBNP values) were observed at follow up. sPAP (systolic Pulmonary Arterial Pressure) was significantly decreased at follow-up evaluation (37 mmHg vs 31 mmHg p=0,005) (Table 1). Overall, LVRR as defined above was observed in 30% of patients. Younger age (64 vs 74 years, p=0,007), a shorter duration of the disease (7 vs 23 months, p=0,009), and non ischaemic etiology (79% vs 33% p=0,003), along with a smaller baseline LAESVi (Left Atrial End Systolic Volume, 41 vs 48 ml/m2 p=0,012) were more common in patients with LVRR. sPAP and Right Ventricular (RV) function estimated by tricuspid annular plane systolic excursion (TAPSE) were significantly better in LVRR patients along with TAPSE/sPAP ratio (Table 2).
Conclusions
Our data point to a remarkable medium-term reverse remodeling effect by S/V in HFrEF. Findings reinforce the concept that the main benefits of S/V on hard end-points are mediated by its cardiac-related effects. Both a left and right reverse remodeling occur in HFrEF patients who start S/V in the most adaptable phase of the disease supporting an early administration.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Valli
- ASST Santi Paolo e Carlo, Milan, Italy
| | - F Bursi
- ASST Santi Paolo e Carlo, Milan, Italy
| | | | - F Toriello
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - I Rusconi
- ASST Santi Paolo e Carlo, Milan, Italy
| | | | - A.M Vella
- ASST Santi Paolo e Carlo, Milan, Italy
| | - A Faggiano
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - S Carugo
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Guazzi
- ASST Santi Paolo e Carlo, Milan, Italy
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8
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Casati M, Bursi F, Mondellini G, Santangelo G, Giustiniani A, Massironi L, Tarricone D, Carugo S, Guazzi M. Phenotyping the right heart according to left ventricular geometry patterns in severe HFrEF. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Right ventricular (RV) failure significantly impact on heart failure with reduced ejection fraction (HFrEF) prognosis. How and whether specific functional and geometrical phenotypes of the RV function adapt and combined with left ventricular (LV) geometry is unknown.
Purpose
To test the RV function across LV geometrical patterns looking at respective prognostic roles.
Methods
We retrospectively examined a population of patients homogenously diagnosed with chronic HFrEF (defined as LV ejection fraction (EF) less than 35%) and treated with optimal therapy (OT) and all implanted with ICD for primary prevention of sudden cardiac death. Patients were categorized by echocardiography according to remodeling pattern based on left ventricular mass index and relative wall thickness into four groups: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH) and eccentric hypertrophy (EH). RV parameters were: tricuspid annulus plane systolic excursion (TAPSE), TAPSE/pulmonary artery pressures (PAPs), RV basal diameter and fractional area change (FAC). Outcome variable was all-cause mortality, assessed with multivariable Cox proportional hazard (PH) models.
Results
Among 193 patients (age 66±11 years, 81% men, 74% with ischemic etiology of HF and EF 28±5%) 21% had NG, 3% had CR, 8% had CH, and 68% had EH. Distribution of RV echo parameters across LV remodeling groups is shown in table 1. Over a median follow-up time of 4 (1.9 – 6.1) years, 65 deaths occurred. In multivariable Cox PH models adjusted for age, LVEF, ischemic etiology and LV geometry, TAPSE, TAPSE/PAPs, RV basal diameter and FAC strongly and independently predicted the outcome variable [HR 0.92 (95% C.I. 0.86–0.98), HR 0.08 (95% C.I. 0.01–0.57), HR 1.87 (95% C.I. 1.29–2.71), HR 0.97 (95% C.I. 0.95–1.00), respectively all p-value <0.05].
Conclusion
In a homogeneously defined population of severe HFrEF outpatients receiving OT, the majority showed EH remodeling pattern, which did not predict the primary outcome. LV geometry did not further stratify patients in this high risk group. Conversely, RV dysfunction proved to be a strong predictor of mortality, independently of age, LV function and etiology of HF, regardless LV morphology.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Casati
- University of Milan, Cardiology, Milan, Italy
| | - F Bursi
- University of Milan, Cardiology, Milan, Italy
| | | | - G Santangelo
- ASST Santi Paolo e Carlo, Cardiology, Milan, Italy
| | | | - L Massironi
- ASST Santi Paolo e Carlo, Cardiology, Milan, Italy
| | | | - S Carugo
- University of Milan, Cardiology, Milan, Italy
| | - M Guazzi
- University of Milan, Cardiology, Milan, Italy
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9
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Vella AM, Bursi F, Santangelo G, Barbieri A, Toriello F, Valli F, Sansalone D, Carugo S, Guazzi M. Consequences on the right ventricular to pulmonary circulation coupling of COVID-19 infection. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Right Ventricular (RV) dysfunction and pulmonary hypertension (PH) are two very likely acute and long term targets of COVID-19 pneumonia, with a potential prognostic implications.
Purpose
To determine the COVID-19 pneumonia effects on the right ventricular to pulmonary circulation coupling through bedside echocardiography and extend its implications to prognostic assessment.
Methods
Single-centre study including consecutive subjects hospitalized for COVID-19 pneumonia who underwent a clinical indicated echocardiogram between March 2020 and December 2020. Extensive analysis of cardiac function was performed offline by an operator blinded to clinical data, laboratory findings and CT scans.
Results
133 patients were enrolled (mean age 69±12 years, 57% men), 38% of whom already had cardiac disease in their medical history. In-hospital mortality was 26% (35 pts), during a mean hospital stay of 26±16 days. Non survivors had higher pulmonary artery systolic pressure (PASP) and worse RV function, assessed with both standard parameters (i.e. TAPSE) and with the novel speckle tracking analysis by RV-Global Longitudinal Strain (RV-GLS) and RV-Free Wall Longitudinal Strain (RV-FWLS). The combination of these two variables in TAPSE/PASP ratio allows assessment of RV to pulmonary circulation (Pc) coupling and was strongly associated with in-hospital death (HR 0.73, 95% CI 0.59–0.89, p=0.003) and patients with TAPSE/PASP<0.57 mm/mmHg had a more than 4-fold increased risk of in-hospital death (HR 4.8, 95% CI 1.7–13.1, p=0.003). In patients where speckle tracking analysis was feasible, we examined RV-GLS/PASP and RV-FWLS/PASP and found that it was associated with in-hospital mortality. The best cut-offs for predicting in-hospital mortality was 0.51 for RV-GLS/PASP (94% sensitivity and 59% specificity) and 0.49 for RV-free wall LS (87% sensitivity and 70% specificity). At the multivariable analysis RV to Pc remained associated with in-hospital death after adjustments for age, PaO2/FiO2, LVEF, and severity of lung involvement at the CT.
Conclusions
Either PH and RV dysfunction predict in-hospital mortality in patients with COVID-19 pneumonia. The assessment of RV to Pc coupling, however, better describes the adaptive RV response to increased PASP and gives additional prognostic information in a population with a relevant prevalence of comorbidities.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A M Vella
- San Paolo University Hospital, Milano, Italy
| | - F Bursi
- San Paolo University Hospital, Milano, Italy
| | | | - A Barbieri
- Polyclinic Hospital of Modena, Modena, Italy
| | - F Toriello
- San Paolo University Hospital, Milano, Italy
| | - F Valli
- San Paolo University Hospital, Milano, Italy
| | - D Sansalone
- San Paolo University Hospital, Milano, Italy
| | - S Carugo
- Fondazione IRCCS Policlinico di Milano, Milano, Italy
| | - M Guazzi
- San Paolo University Hospital, Milano, Italy
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10
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Laura Manzo M, Galati C, Gallo C, Santangelo G, Marino A, Guccione F, Raieli V, Pitino R. ADEM post SARS-CoV-2 infection in a paediatric patient with fisher Evans syndrome. J Neurol Sci 2021. [PMCID: PMC8498500 DOI: 10.1016/j.jns.2021.119903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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11
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Capizzi M, Quatrosi G, Nocera GM, Guccione F, Vetri L, Nardello R, Santangelo A, Elia M, Mangano S, Brighina F, Santangelo G, Raieli V. Familiar hemiplegic migraine: A preliminary clinical and follow-up study in a pediatric sample. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Manzo ML, Galati C, Gallo C, Santangelo G, Marino A, Guccione F, Pitino R, Raieli V. ADEM post-Sars-CoV-2 infection in a pediatric patient with Fisher-Evans syndrome. Neurol Sci 2021; 42:4293-4296. [PMID: 33982145 PMCID: PMC8115868 DOI: 10.1007/s10072-021-05311-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/27/2021] [Accepted: 05/05/2021] [Indexed: 11/22/2022]
Abstract
Introduction Sars-CoV-2 is a single-strained RNA virus belonging to Coronaviridae’s family. In pediatric age, the majority of patients is asymptomatic; however, several neurological manifestations associated with Sars-CoV-2 infection have been detected in a percentage of cases ranging from 17.3 to 36.4%. Acute disseminated encephalomyelitis (ADEM) has been recently included among the potential complications of Sars-Cov2 infection. The available data regarding pediatric patient show only one case. Case report We present a case regarding a 6-year-old patient suffering from Fisher-Evans syndrome who was given sirolimus and thalidomide therapy. After 10 days since the first positive nasopharyngeal swab for Sars-CoV-2, in which he had no symptoms, he presented an episode of generalized tonic-clonic seizure with spontaneous resolution. The patient underwent MRI which showed the typical picture of acute disseminated encephalomyelitis. His clinical course was favorable, with a good response to cortisone therapy and a progressive improvement of the neuroradiological and electroencephalographic picture. Conclusions According to our knowledge, this is the second case of an acute disseminated encephalomyelitis following SARS-CoV-2 infection in a pediatric patient, characterized by monosymptomatic onset, in which the immunosuppressive therapy practiced for the Fisher-Evans syndrome has probably contributed to a favorable evolution of ADEM, in contrast to other case described in the literature.
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Affiliation(s)
- Maria Laura Manzo
- Child Neuropsychiatry School, University of Palermo, Piazzale delle Cliniche, 90100, Palermo, Italy.
| | - Cristina Galati
- Child Neuropsychiatry School, University of Palermo, Piazzale delle Cliniche, 90100, Palermo, Italy
| | - Cristina Gallo
- U.O.C Neuroradiology ARNAS Civico, Piazzale Nicola Leotta 4, 90100, Palermo, Italy
| | - Giuseppe Santangelo
- Child Neuropsychiatry Unit, ISMEP-P.O. Cristina-ARNAS Civico, Via Dei Benedettini 1, 90100, Palermo, Italy
| | - Antonio Marino
- Child Neuropsychiatry School, University of Palermo, Piazzale delle Cliniche, 90100, Palermo, Italy
| | - Fulvio Guccione
- Child Neuropsychiatry School, University of Palermo, Piazzale delle Cliniche, 90100, Palermo, Italy
| | - Renata Pitino
- Child Neuropsychiatry Unit, ISMEP-P.O. Cristina-ARNAS Civico, Via Dei Benedettini 1, 90100, Palermo, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Unit, ISMEP-P.O. Cristina-ARNAS Civico, Via Dei Benedettini 1, 90100, Palermo, Italy
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13
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De Falco N, Santangelo G, Chirico F, Cangiano A, Sommella MG, Cosenza A, Ronchi A, Accardo M, Pellino G, Parmeggiani D, Canonico S, De Falco M. Synchronous intrathyroidal parathyroid carcinoma and thyroid carcinoma: case report and review of the literature. BMC Endocr Disord 2021; 21:60. [PMID: 33827539 PMCID: PMC8028146 DOI: 10.1186/s12902-021-00724-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 03/25/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Parathyroid carcinoma is a rare endocrine malignancy, rarer when synchronous with a non medullary well differentiated thyroid carcinoma. Parathyroid carcinoma accounts of 0.005% of all malignant tumors and it is responsible for less than 1% of primary hyperparathyroidism. The intrathyroidal localization of a parathyroid gland is not frequent with a reported prevalence of 0.2%. Carcinoma of parathyroids with intrathyroidal localization represents an even rarer finding, reported in only 16 cases described in literature. The rare constellation of synchronous parathyroid and thyroid carcinomas has prompted us to report our experience and perform literature review. CASE PRESENTATION We herein report a case of a 63-years-old man with multinodular goiter and biochemical diagnosis of hyperparathyroidism. Total thyroidectomy with radio-guide technique using gamma probe after intraoperative sesta-MIBI administration and intraoperative PTH level was performed. The high radiation levels in the posterior thyroid lobe discovered an intrathyroidal parathyroid. Microscopic examination revealed a parathyroid main cell carcinoma at the posterior thyroidal left basal lobe, a classic papillary carcinoma at the same lobe and follicular variant of papillary carcinoma at the thyroidal right lobe. To the best of our knowledge, this is the first case documenting a synchronous multicentric non medullary thyroid carcinomas and intrathyroidal parathyroid carcinoma. CONCLUSIONS Our experience was reported and literature review underlining challenging difficulties in diagnostic workup and surgical management was carried out.
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Affiliation(s)
- Nadia De Falco
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Giuseppe Santangelo
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Fabrizio Chirico
- Maxillofacial Surgery Unit, Federico II University, Naples, Italy
| | - Angelo Cangiano
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Maria Giulia Sommella
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Angelo Cosenza
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Andrea Ronchi
- Division of Morphopathology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marina Accardo
- Division of Morphopathology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianluca Pellino
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Domenico Parmeggiani
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Silvestro Canonico
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Massimo De Falco
- General Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy.
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14
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Toriello F, Santangelo G, Bursi F, Epis E, Tamagni ME, Massironi L, Bertelli S, Benetti A, Cattaneo M, Carugo S. Echocardographic changes in anorexia nervosa: a pathophysiological adaptation or a disease? Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Anorexia nervosa (AN) is one of the most common form of eating disorders and it is a severe and potentially fatal disease with high rates of morbidity and mortality especially in the population aged 15-25 years. Cardiac involvement occurs in approximately 80% of patients with AN. Cardiovascular complications include changes in the autonomic regulation (increased vagal tone, bradycardia, orthostatic hypotension, syncope), arrhythmias, congestive heart failure and sudden death. Few reports have described, in small series, a variety of echocardiographic abnormalities including decreased cardiac mass, mitral valve prolapse, pericardial effusion and reduced left ventricular (LV) dimensions. No previous studies, however, examined if there is a change in these abnormalities with weight fluctuations.
Purpose
To describe echocardiographic findings among male and female patients with AN and to examine the effect of weight gain on clinical and echocardiographic parameters.
Methods
We performed a single center, retrospective, study of patients diagnosed with AN using the diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Clinical, laboratory and ECG-graphic data were obtained by reviewing each patient’s medical records. Echocardiographic parameters were measured off-line.
Results
The study population consisted of 81 patients, mean age 24.5 ± 11.6 years, 92.6% females. 75% showed an extreme AN degree. Mean body mass index (BMI) was 15.2 ± 2.1 kg/m2. Mean heart rate was 57.2 ± 12.7 beats per minute. Some patients showed right bundle branch block (7.4%) or prolonged QT interval (14.8%). Patients with BMI below the mean value had more often pericardial effusion, smaller LV mass and LV end-diastolic volume and thinner interventricular septum (all p < 0.05). However, when index to BSA, LV mass and volumes were within normal range in the 90% of the population. They also showed mitral valve abnormalities and low values of white blood cells and platelets. The presence of pericardial effusion was not related to inflammatory parameters or protein deficiency. For 39 patients echocardiographic exams at the highest and the lowest weight were available. With weight gain, there was an improvement in LV mass, interventricular septum thickness, pericardial effusion and an increase in white blood cells and platelet count.
Conclusions
Our study showed that patients with AN have a specific echocardiographic pattern which seems to be proportional to the body size, suggesting a pathophysiological adaptation to the lack of substrates, hypothesis confirmed by the regression with weight gain. It is possible that pericardic effusion fills the gap left by mass loss.
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Affiliation(s)
- F Toriello
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - G Santangelo
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - F Bursi
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - E Epis
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - ME Tamagni
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Internal Medicine, University of Milan, Milan, Italy
| | - L Massironi
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - S Bertelli
- ASST Santi Paolo e Carlo, Department of Mental Health, Milan, Italy
| | - A Benetti
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Internal Medicine, University of Milan, Milan, Italy
| | - M Cattaneo
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Internal Medicine, University of Milan, Milan, Italy
| | - S Carugo
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
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15
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Colombo L, Macheda A, Gentile D, Panizzardi F, Pierini S, Codazzi C, Meloni L, Bianchi F, Santangelo G. How to manage thromboembolic risk in patient with SARS-CoV-2-related disease in the Emergency Department: A case report of cardiogenic shock due to massive pulmonary embolism. Respir Med Case Rep 2020; 31:101185. [PMID: 32834988 PMCID: PMC7419271 DOI: 10.1016/j.rmcr.2020.101185] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/02/2020] [Accepted: 08/05/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Although the most known feature of SARS-CoV-2 associated infection is a mild to severe pneumonia, increasing evidence suggests the existence of an infection-associated risk of both arterial and venous thromboembolism (VTE), but the exact magnitude of this phenomenon is still unknown.Given that, it is important for the Emergency Physician to remember that a SARS-CoV-2 associated respiratory failure can be caused not only by the pulmonary parenchymal inflammation that characterizes the pneumonia, but also by an associated pulmonary thromboembolism. CASE REPORT A healthy 73-years old woman admitted to the ED for dyspnea, fever and thoracic pain. Cardiac ultrasound, electrocardiogram and clinical findings suggested a diagnosis of cardiogenic obstructive shock due to acute pulmonary embolism, successfully treated with thrombolysis. A CT angiography confirmed the pulmonary embolism (EP) diagnosis and showed bilateral pneumonia, caused by SARS-CoV-2 infection. CONCLUSION Considering the high prevalence of thromboembolic events in COVID-19 patients it is mandatory for the emergency physician to systematically evaluate signs of pulmonary thromboembolism, in order to perform the most patient-tailored therapy as soon as possible.
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Affiliation(s)
- L. Colombo
- Emergency Department, Ospedale San Paolo, Milano, Italy
| | - A. Macheda
- Emergency Department, Ospedale San Paolo, Milano, Italy
| | - D. Gentile
- Cardiology Department, Ospedale San Paolo, Milano, Italy
| | - F. Panizzardi
- Emergency Department, Ospedale San Paolo, Milano, Italy
| | - S. Pierini
- Emergency Department, Ospedale San Paolo, Milano, Italy
| | - C. Codazzi
- Emergency Department, Ospedale San Paolo, Milano, Italy
| | - L. Meloni
- Emergency Department, Ospedale San Paolo, Milano, Italy
| | - F. Bianchi
- Emergency Department, Ospedale San Paolo, Milano, Italy
| | - G. Santangelo
- Cardiology Department, Ospedale San Paolo, Milano, Italy
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16
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Raimo S, Trojano L, Gaita M, Spitaleri D, Santangelo G. Assessing apathy in multiple sclerosis: Validation of the dimensional apathy scale and comparison with apathy evaluation scale. Mult Scler Relat Disord 2019; 38:101870. [PMID: 31830701 DOI: 10.1016/j.msard.2019.101870] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 04/08/2019] [Revised: 10/09/2019] [Accepted: 11/24/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Apathy is a predictor of cognitive decline in the course of multiple sclerosis (MS). Early identification of apathetic patients is relevant in clinical settings. OBJECTIVE To assess applicability and psychometric properties of the self-rated version of the Dimensional Apathy Scale (DAS) in a large cohort of patients with MS and to compare its diagnosing accuracy with that of the Apathy Evaluation Scale (AES). METHODS One hundred and twenty-four patients underwent clinical interview based on diagnostic criteria for apathy, DAS, AES, and assessment of depression, global cognitive functioning, and non-verbal intelligence. RESULTS According to diagnostic criteria, apathy occurred in 33.4% of the patients. The DAS showed high consistency, and good convergent, discriminant and criterion validity. Factor analysis indicated a three-factor structure: executive, behavioural and emotional apathy. Unlike AES, no significant association between DAS score and severity of neurological disability (expressed by EDSS total score) was found, suggesting that the DAS might be less related to levels of disability. Receiver operating characteristics analyses, with clinical diagnostic criteria for apathy as the gold standard, revealed that a DAS score of 28/29 and an AES score of 35/36 were optimal cut-off values for identifying clinically relevant apathy. The two scales had similar diagnostic accuracy in the present sample. CONCLUSIONS The DAS is a valid and reliable multidimensional tool to assess apathy in MS, with diagnostic accuracy similar to that of the AES. However, the DAS score appears to be less strongly related to neurological disability.
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Affiliation(s)
- S Raimo
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy; Department of Psychology, University of Campania "Luigi Vanvitelli," Viale Ellittico, 31, Caserta 81100, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - L Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli," Viale Ellittico, 31, Caserta 81100, Italy
| | - M Gaita
- Department of Psychology, University of Campania "Luigi Vanvitelli," Viale Ellittico, 31, Caserta 81100, Italy
| | - D Spitaleri
- Neurology Unit "San Giuseppe Moscati," Hospital Avellino, Avellino, Italy
| | - G Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli," Viale Ellittico, 31, Caserta 81100, Italy.
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Abstract
Occult breast cancer is a carcinoma discovered by the presence of axillary lymph node metastases without the detection of the primary breast tumor. The incidence of this very rare pathology is 0.3%-1.0%. The limited number of these cases does not allow for the precise management of this rare pathology and often, the breast cancer manifestation can take many years to become obvious. We report the case of a 35-year-old woman who presented to our department for annual breast screening examination, without any symptoms. At the time of visit, there were two right and one left tumefactions; unfixed and palpable. Ultrasonography examination confirmed the lesions to be benign. One year later, a palpable hypoechoic axillary left lesion appeared: a lymph node with doubtful morphology. On cytological examination, a biopsy was performed for the axillary left mass which showed irregular masses of large malignant cells with pleomorphism and mitotic figures that suggested a carcinoma. The management of this case is suggestive for cancer of unknown primary syndrome.
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Affiliation(s)
| | - Giuseppe Santangelo
- Center of Diagnostic and Interventional Breast Imaging, Department of Simple Facility, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, FG, Italy
| | - Francesco Fiorentino
- Center of Diagnostic and Interventional Breast Imaging, Department of Simple Facility, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, FG, Italy
| | - Anna Simeone
- Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, FG, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia; Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza," San Giovanni Rotondo, FG, Italy
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Erro R, Picillo M, Amboni M, Savastano R, Scannapieco S, Cuoco S, Santangelo G, Vitale C, Pellecchia MT, Barone P. Comparing postural instability and gait disorder and akinetic‐rigid subtyping of Parkinson disease and their stability over time. Eur J Neurol 2019; 26:1212-1218. [DOI: 10.1111/ene.13968] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/04/2019] [Indexed: 01/19/2023]
Affiliation(s)
- R. Erro
- Center for Neurodegenerative Disease – CEMAND Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’ University of Salerno Baronissi (SA) Italy
| | - M. Picillo
- Center for Neurodegenerative Disease – CEMAND Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’ University of Salerno Baronissi (SA) Italy
| | - M. Amboni
- Center for Neurodegenerative Disease – CEMAND Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’ University of Salerno Baronissi (SA) Italy
- Institute of Diagnosis and Health IDC‐Hermitage Capodimonte Naples Italy
| | - R. Savastano
- Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona' SalernoItaly
| | - S. Scannapieco
- Center for Neurodegenerative Disease – CEMAND Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’ University of Salerno Baronissi (SA) Italy
| | - S. Cuoco
- Center for Neurodegenerative Disease – CEMAND Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’ University of Salerno Baronissi (SA) Italy
| | - G. Santangelo
- Department of Psychology University of Campania Luigi Vanvitelli CasertaItaly
| | - C. Vitale
- Institute of Diagnosis and Health IDC‐Hermitage Capodimonte Naples Italy
- Department of Motor Sciences and Wellness University ‘Parthenope’ Naples Italy
| | - M. T. Pellecchia
- Center for Neurodegenerative Disease – CEMAND Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’ University of Salerno Baronissi (SA) Italy
| | - P. Barone
- Center for Neurodegenerative Disease – CEMAND Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’ University of Salerno Baronissi (SA) Italy
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Brighina F, Raieli V, Messina LM, Santangelo G, Puma D, Drago F, Rocchitelli L, Vanadia F, Giglia G, Mangano S. Non-invasive Brain Stimulation in Pediatric Migraine: A Perspective From Evidence in Adult Migraine. Front Neurol 2019; 10:364. [PMID: 31031695 PMCID: PMC6473052 DOI: 10.3389/fneur.2019.00364] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 03/25/2019] [Indexed: 11/17/2022] Open
Abstract
Pediatric migraine remains still a challenge for the headache specialists as concerns both diagnostic and therapeutic aspects. The less ability of children to describe the exact features of their migraines and the lack of reliable biomarker for migraine contribute to complicate the diagnostic process. Therefore, there's need for new effective tools for supporting diagnostic and therapeutic approach in children with migraine. Recently, promising results have been obtained in adult headache by means of application of neurostimulation techniques both for investigating pathophysiological mechanisms and also for therapeutical applications. Non-invasive brain stimulation (NIBS) techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) indeed proved to be generally safe and showing also some evidence of efficacy particularly for the symptomatic treatment. On such basis, in the last years increasing interest is rising in scientific pediatric community to evaluate the potential of such approaches for treatment pediatric headaches, particularly in migraine, even if the evidence provided is still very poor. Here we present a perspective for application of TMS and tDCS technique in children migraine principally based on evidence coming by studies in adults.
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Affiliation(s)
- Filippo Brighina
- Dipartimento di Biomedicina, Neuroscienze and Diagnostica Avanzata (BiND), University of Palermo, Palermo, Italy
| | - Vincenzo Raieli
- ARNAS Ospedali Civico Di Cristina Benfratelli, Palermo, Italy
| | | | | | - Domenico Puma
- ARNAS Ospedali Civico Di Cristina Benfratelli, Palermo, Italy
| | - Flavia Drago
- ARNAS Ospedali Civico Di Cristina Benfratelli, Palermo, Italy
| | | | | | - Giuseppe Giglia
- Dipartimento di Biomedicina, Neuroscienze and Diagnostica Avanzata (BiND), University of Palermo, Palermo, Italy
| | - Salvatore Mangano
- Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University of Palermo, Palermo, Italy
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20
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Maggio MC, Mastrangelo G, Skabar A, Ventura A, Carrozzi M, Santangelo G, Vanadia F, Corsello G, Cimaz R. Atypical presentation of anti-N-methyl-D-aspartate receptor encephalitis: two case reports. J Med Case Rep 2017; 11:225. [PMID: 28810906 PMCID: PMC5558759 DOI: 10.1186/s13256-017-1388-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/13/2017] [Indexed: 02/06/2023] Open
Abstract
Background Anti-N-methyl-D-aspartate receptor encephalitis is a rare autoimmune disease characterized by severe neurological and psychiatric symptoms and a difficult diagnosis. The disease is often secondary to a neoplastic lesion, seldom diagnosed years later. Psychiatric symptoms are prevalent in adults; neurologic symptoms are more evident in children, who typically present primarily with neurological symptoms. To the best of our knowledge, the association with juvenile idiopathic arthritis has not been described. Case presentation We report the cases of two caucasian girls with an atypical presentation. The first patient was an 8-year-old girl with normal psychomotor development. Over a 4-month period she developed behavioral problems, speech impairment, and deterioration in academic skills. Within 8 months from the onset of symptoms, choreic movements gradually appeared. Hematological, neuroradiological, and neurophysiological examinations were negative; however, her symptoms worsened and treatment with prednisone was started. Although her choreic movements improved within 1 month, her neuropsychological and behavioral symptoms continued. Anti-N-methyl-D-aspartate receptor antibodies in cerebrospinal fluid and in blood were detected. Therapy with intravenously administered immunoglobulins was administered, without improvement of symptoms. After 2 months of steroid treatment, she suddenly started to pronounce some words with a progressive improvement in language and behavior. The second patient was a 14-year-old girl with classic anti-N-methyl-D-aspartate receptor encephalitis, treated successfully with intravenously administered immunoglobulins and methylprednisolone, followed by orally administered prednisone, who developed chronic arthritis of the hip. The arthritis was confirmed by magnetic resonance imaging and associated to antinuclear antigen antibody positivity. One year after the encephalitis presentation, an ovarian cystic mass was identified as a teratoma. The surgical resection of the mass was followed by the resolution of the psychotic spectrum and arthritis. Conclusions Anti-N-methyl-D-aspartate receptor encephalitis in pediatric patients can present initially with neuropsychological and behavioral symptoms. In the literature, the association of anti-N-methyl-D-aspartate receptor encephalitis with juvenile idiopathic arthritis is not yet described: to the best of our knowledge, this is the first case reported. The link to a neoplastic lesion can explain the favorable course of encephalitis and arthritis, after the surgical resection of the mass. Early diagnosis and treatment can improve the patient’s outcome.
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Affiliation(s)
- Maria Cristina Maggio
- Department Pro.Sa:M.I. "G. D'Alessandro" ARNAS, University of Palermo, Palermo, Italy.
| | - Greta Mastrangelo
- Department of Rheumatology, Meyer Children's Hospital, Florence, Italy
| | - Aldo Skabar
- Department of Advanced Diagnostic and Clinical Trials, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Alessandro Ventura
- Department of Advanced Diagnostic and Clinical Trials, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Marco Carrozzi
- Department of Advanced Diagnostic and Clinical Trials, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giuseppe Santangelo
- Unit of Paediatric Neuropsychiatry, Children Hospital "G. Di Cristina", ARNAS, Palermo, Italy
| | - Francesca Vanadia
- Unit of Paediatric Neuropsychiatry, Children Hospital "G. Di Cristina", ARNAS, Palermo, Italy
| | - Giovanni Corsello
- Department Pro.Sa:M.I. "G. D'Alessandro" ARNAS, University of Palermo, Palermo, Italy
| | - Rolando Cimaz
- Department of Rheumatology, Meyer Children's Hospital, Florence, Italy
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Gervasi F, D'Amelio L, Trizzino A, Ferraro F, Russo D, Santangelo G, Cardella F, Trizzino A, Marco FD, Farruggia P. Cerebral Stroke in a Teenage Girl with Paroxysmal Nocturnal Hemoglobinuria. Hematol Rep 2017. [PMID: 28626543 PMCID: PMC5472347 DOI: 10.4081/hr.2017.7012] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We report a case of paroxysmal nocturnal hemoglobinuria (PNH) in a 14 year-old girl presenting a cerebral arterial thrombosis. The initial diagnosis was carential anemia due to menarche following identification of slight macrocytic anemia, leucopenia and mild thrombocytopenia at routine blood analysis. The child was eventually referred to a children's hospital after the onset of progressive fatigue, anorexia and paleness. Severe anemia (hemoglobin 6 g/dL) with negative Coombs test, mild leucopenia (white blood cells 4.9×109/L) and thrombocytopenia (platelets 97×109/L) and high values of lactate dehydrogenase (2855 U/L) were identified; a packed red cells transfusion was administered. Her condition worsened and she subsequently presented complete right hemiplegia, aphasia and coma; magnetic resonance imaging revealed a massive ischemic lesion. A diagnosis of PNH was eventually made following high sensitivity flow cytometry, which identified a PNH clone (CD66b negative equal to 93.7% of granulocytes). Fast recovery from neurologic and hematological problems occurred in response to anticoagulant therapy and intravenous therapy with eculizumab. We are convinced that PNH should be included in the differential diagnosis of children presenting with cytopenia.
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Affiliation(s)
- Francesco Gervasi
- Specialistic Oncology Laboratory Unit, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Lucia D'Amelio
- Specialistic Oncology Laboratory Unit, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Antonino Trizzino
- Pediatric Hematology and Oncology Unit, Oncology Department, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Fabrizia Ferraro
- Pediatric Hematology and Oncology Unit, Oncology Department, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Delia Russo
- Pediatric Hematology and Oncology Unit, Oncology Department, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Giuseppe Santangelo
- Pediatric Neurology and Psychiatric Unit, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Francesca Cardella
- Department of Pediatrics, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Angela Trizzino
- Pediatric Hematology and Oncology Unit, Oncology Department, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Floriana Di Marco
- Pediatric Hematology and Oncology Unit, Oncology Department, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Piero Farruggia
- Pediatric Hematology and Oncology Unit, Oncology Department, ARNAS Hospitals Civico, Di Cristina e Benfratelli, Palermo, Italy
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22
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Rossi A, Scordamaglia E, Bellingeri M, Gnone G, Nuti S, Salvioli F, Manfredi P, Santangelo G. Demography of the bottlenose dolphin Tursiops truncatus (Mammalia: Delphinidae) in the Eastern Ligurian Sea (NW Mediterranean): quantification of female reproductive parameters. The European Zoological Journal 2017. [DOI: 10.1080/24750263.2017.1334839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- A. Rossi
- Department of Biology, University of Pisa, Italy
| | - E. Scordamaglia
- Department of Biology, University of Pisa, Italy
- Acquario di Genova, Area Porto Antico, Italy
| | | | - G. Gnone
- Acquario di Genova, Area Porto Antico, Italy
| | - S. Nuti
- CE.TU.S./O.T.C., Villa Borbone, Italy
| | | | - P. Manfredi
- Department of Economics and Management, University of Pisa, Italy
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Cattaneo-Vietti R, Bo M, Cannas R, Cau A, Follesa C, Meliadò E, Russo GF, Sandulli R, Santangelo G, Bavestrello G. An overexploited Italian treasure: past and present distribution and exploitation of the precious red coral Corallium rubrum (L., 1758) (Cnidaria: Anthozoa). ACTA ACUST UNITED AC 2016. [DOI: 10.1080/11250003.2016.1255788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - M. Bo
- DiSTAV, Università di Genova, Genova, Italy
| | - R. Cannas
- DiSVA, Università di Cagliari, Cagliari, Italy
| | - A. Cau
- DiSVA, Università di Cagliari, Cagliari, Italy
| | - C. Follesa
- DiSVA, Università di Cagliari, Cagliari, Italy
| | - E. Meliadò
- DiSTAV, Università di Genova, Genova, Italy
| | - G. F. Russo
- DiST, Università di Napoli Parthenope, Centro Direzionale, Napoli, Italy
| | - R. Sandulli
- DiST, Università di Napoli Parthenope, Centro Direzionale, Napoli, Italy
| | - G. Santangelo
- Department of Biology, Università di Pisa, Pisa, Italy
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24
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Santangelo G, Sacco R, Siciliano M, Bisecco A, Muzzo G, Docimo R, De Stefano M, Bonavita S, Lavorgna L, Tedeschi G, Trojano L, Gallo A. Anxiety in Multiple Sclerosis: psychometric properties of the State-Trait Anxiety Inventory. Acta Neurol Scand 2016; 134:458-466. [PMID: 27219913 DOI: 10.1111/ane.12564] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [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: 01/11/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aims of the present study were to examine psychometric properties of the Spielberger State-Trait Anxiety Inventory (STAI-Y-1 and STAI-Y-2, respectively) in a Multiple Sclerosis (MS) population and to identify a cut-off score to detect those MS patients with high level of state and/or trait anxiety who could be more vulnerable to development of depression and/or cognitive defects. MATERIAL AND METHODS The STAI-Y-1 and STAI-Y-2 was completed by a group of patients (n = 175) affected by MS and a group of healthy subjects (n = 150) matched for age, educational level, and gender. In MS patients internal consistency, divergent and discriminant validities were evaluated. Construct validity was examined by exploratory factor analysis for each scale. RESULTS There was no missing data, no floor or ceiling effects for both scales. The two scales showed high internal consistency, good divergent, and Known-groups validities. To identify high levels of state and trait anxiety in a patient with MS, we proposed three gender specific screening cut-off values (1, 1.5, 2 SD) for the STAI-Y-1 and the STAI-Y-2. CONCLUSIONS The findings showed that the STAI-Y-1 and the STAI-Y-2 are a valid tool for clinical use in MS patients and can be useful to measure the severity of anxiety and to identify those patients with high anxiety to introduce them in specific non-pharmacological intervention.
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Affiliation(s)
- G. Santangelo
- Department of Psychology; Second University of Naples; Caserta Italy
- IDC-Hermitage-Capodimonte; Naples Italy
| | - R. Sacco
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - M. Siciliano
- Department of Psychology; Second University of Naples; Caserta Italy
| | - A. Bisecco
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - G. Muzzo
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - R. Docimo
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - M. De Stefano
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - S. Bonavita
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Lavorgna
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - G. Tedeschi
- IDC-Hermitage-Capodimonte; Naples Italy
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Trojano
- Department of Psychology; Second University of Naples; Caserta Italy
- Salvatore Maugeri Foundation; Scientific Institute of Telese; Telese Terme Italy
| | - A. Gallo
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
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25
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Camarda RM, Avarello R, Bivona B, Cammalleri RT, Cuccia F, Rocca DL, Raieli V, Raimondo D, Rossetti M, Santangelo G. Migraine Headaches in a High School Student Population. Cephalalgia 2016. [DOI: 10.1177/0333102491011s1152] [Citation(s) in RCA: 1] [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: 11/16/2022]
Affiliation(s)
- Rosolino M. Camarda
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Rosa Avarello
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Biagio Bivona
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Rober To Cammalleri
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Francesco Cuccia
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Donatella La Rocca
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Vincenzo Raieli
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Domenico Raimondo
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Marisa Rossetti
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
| | - Giuseppe Santangelo
- Institute of Neuropsychiatry -School of Medicine and Dentistry -University of Palermo-via Gaetano La Loggia no1 -90129 Palermo -ITALY
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26
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Erro R, Picillo M, Vitale C, Amboni M, Moccia M, Santangelo G, Pellecchia MT, Barone P. The non-motor side of the honeymoon period of Parkinson's disease and its relationship with quality of life: a 4-year longitudinal study. Eur J Neurol 2016; 23:1673-1679. [DOI: 10.1111/ene.13106] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/09/2016] [Indexed: 01/16/2023]
Affiliation(s)
- R. Erro
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; London UK
- Department of Neuroscience, Biomedicine and Movement Science; University of Verona; Verona Italy
| | - M. Picillo
- Department of Medicine and Surgery; Center for Neurodegenerative diseases (CEMAND), Neuroscience Section; University of Salerno; Baronissi (SA) Italy
| | - C. Vitale
- University Parthenope; Naples Italy
- IDC-Hermitage-Capodimonte; Naples Italy
| | - M. Amboni
- IDC-Hermitage-Capodimonte; Naples Italy
| | - M. Moccia
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences; University of Naples Federico II; Naples Italy
| | - G. Santangelo
- Department of Psychology, Second University of Naples; Caserta Italy
| | - M. T. Pellecchia
- Department of Medicine and Surgery; Center for Neurodegenerative diseases (CEMAND), Neuroscience Section; University of Salerno; Baronissi (SA) Italy
| | - P. Barone
- Department of Medicine and Surgery; Center for Neurodegenerative diseases (CEMAND), Neuroscience Section; University of Salerno; Baronissi (SA) Italy
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27
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Pellino G, Marcellinaro R, Candilio G, De Fatico GS, Guadagno E, Campione S, Santangelo G, Reginelli A, Sciaudone G, Riegler G, Canonico S, Selvaggi F. The experience of a referral centre and literature overview of GIST and carcinoid tumours in inflammatory bowel diseases. Int J Surg 2016; 28 Suppl 1:S133-41. [DOI: 10.1016/j.ijsu.2015.12.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 04/28/2015] [Accepted: 05/15/2015] [Indexed: 02/06/2023]
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Santangelo G, Accardo M, De Vita F, Del Giudice S, Gallucci F, Fabozzi A, De Falco M. Malignant transformation in non-recurrent peritoneal cystic mesothelioma Our experience and review of the literature. Ann Ital Chir 2016; 87:S2239253X16023343. [PMID: 27031307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM Cystic peritoneal mesothelioma is commonly regarded as a benign neoplasm at its first manifestation. It can only seldom show malignant transformation, and only after repeated postoperative recurrences. MATERIAL OF STUDY We hereby represent a unique case of peritoneal cystic mesothelioma, malignant since its first presentation. We observed a 73 year-old man presenting with intermittent abdominal pain and periumbilical swelling. At surgery, we found an extensive, oval-shaped, multi-lobed cystic formation that was surgically removed. RESULTS Histopathology was consistent with a malignant peritoneal cystic mesothelioma. In agreement with oncologists, we decided not to give any further therapy because of the few possibilities offered by systemic chemotherapy and the paucity of published data from the literature. We planned periodical follow-up including US scan every six and CTscan every 12 months. DISCUSSION Several cases of malignant transformation occurring after repeated recurrences of peritoneal mesothelioma have been reported. To our knowledge, this is the first case showing "ab initio" histological features of malignancy, typical of an active, proliferating and infiltrating lesion. In addition, advanced age and male gender of our patient are extremely peculiar CONCLUSION Our observation suggests the possibility, although very rare, that peritoneal cystic mesothelioma may present as malignant since its first manifestation. KEY WORDS Peritoneal cystic mesothelioma.
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Sacco R, Santangelo G, Stamenova S, Bisecco A, Bonavita S, Lavorgna L, Trojano L, D'Ambrosio A, Tedeschi G, Gallo A. Psychometric properties and validity of Beck Depression Inventory II in multiple sclerosis. Eur J Neurol 2016; 23:744-50. [DOI: 10.1111/ene.12932] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 11/04/2015] [Indexed: 01/03/2023]
Affiliation(s)
- R. Sacco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - G. Santangelo
- Department of Psychology; Second University of Naples; Caserta Italy
| | - S. Stamenova
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
- Multiprofile Hospital for Active Treatment in Neurology and Psychiatry ‘St. Naum’; Sofia Bulgaria
| | - A. Bisecco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - S. Bonavita
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Lavorgna
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Trojano
- Department of Psychology; Second University of Naples; Caserta Italy
- Salvatore Maugeri Foundation; Scientific Institute of Telese; Telese Terme (BN) Italy
| | - A. D'Ambrosio
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - G. Tedeschi
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
- Neurological Institute for Diagnosis and Care ‘Hermitage Capodimonte’; Naples Italy
| | - A. Gallo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
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Santangelo G, Pellino G, De Falco N, Colella G, D'Amato S, Maglione MG, De Luca R, Canonico S, De Falco M. Prevalence, diagnosis and management of ectopic thyroid glands. Int J Surg 2015; 28 Suppl 1:S1-6. [PMID: 26708843 DOI: 10.1016/j.ijsu.2015.12.043] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [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: 04/06/2015] [Revised: 04/25/2015] [Accepted: 05/10/2015] [Indexed: 12/13/2022]
Abstract
Ectopic thyroid tissue (ETT) is an uncommon entity that may be found anywhere along the line of the obliterated thyroglossal duct, usually from the tongue to the diaphragm. We performed a retrospective analysis of patients undergoing surgical treatment for thyroid disease between January 2000 and December 2013, seeking for ETT All patients with prior neck surgery or trauma were excluded. The clinic-pathologic features, prevalence and diagnosis of the lesions were collected and analyzed. Out of 3092 included patients, 28 ETT were identified (0.9%). The anatomical site of ETT was as follows: lateral cervical in 6 (21.4%), along the thyroglossal duct in 6 (21.4%), mediastinal in 5 (17.9%), lingual in 5 (17.9%), sublingual in 3 (10.7%), and submandibular in 3 (10.7%). Histopathology revealed 27 benign lesions and 1 (3.6%) papillary carcinoma. ETT is found in less than 1% of patients receiving thyroid surgery. Diagnosis of ETT requires clinical imaging. Surgery is a prudent choice due to the potential of malignant evolution of ETT.
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Affiliation(s)
- Giuseppe Santangelo
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Gianluca Pellino
- Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Nadia De Falco
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Giuseppe Colella
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Salvatore D'Amato
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - M Grazia Maglione
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Roberto De Luca
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Silvestro Canonico
- Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Massimo De Falco
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
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Sartori S, Nosadini M, Cesaroni E, Falsaperla R, Capovilla G, Beccaria F, Mancardi MM, Santangelo G, Giunta L, Boniver C, Cantalupo G, Cappellari A, Costa P, Dalla Bernardina B, Dilena R, Natali Sora MG, Pelizza MF, Pruna D, Serino D, Vanadia F, Vigevano F, Zamponi N, Zanus C, Toldo I, Suppiej A. Paediatric anti-N-methyl-D-aspartate receptor encephalitis: The first Italian multicenter case series. Eur J Paediatr Neurol 2015; 19:453-63. [PMID: 25792293 DOI: 10.1016/j.ejpn.2015.02.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [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: 11/07/2014] [Revised: 02/17/2015] [Accepted: 02/20/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Given the rarity of this condition, especially in children, there is a paucity of large reported paediatric case series of anti-N-methyl-d-aspartate receptor encephalitis. METHODS To contribute to define the features of this condition, we describe retrospectively a new nationwide case series of 20 children (50% females), referred by 13 Italian centres. RESULTS Mean age at onset was 8 years (range 3-17). Prodromal symptoms were reported in 31.6%; onset was with neurological symptoms in 70%, and with behavioural/psychiatric disturbances in 30%. Most patients developed a severe clinical picture (90%), and 41% experienced medical complications; children 12-18 years old seemed to be more severe and symptomatic than younger patients. All children received first-line immune therapy; second-line treatment was administered to 45%. Relapses occurred in 15%. At last follow-up (mean 23.9 months, range 5-82), 85% patients had mRS 0-1; this rate was higher among older patients, and in those receiving first immune therapy within 1 month. CONCLUSIONS Our case series confirms a symptomatologic core of paediatric anti-N-methyl-d-aspartate receptor encephalitis, even though displaying some distinctive features that may be explained by a specific genetic background or by the limited number of patients. The growing incidence of this condition, the relative age-dependent variability of its manifestations, the availability of immunotherapy and the possible better outcome with early treatment impose a high index of clinical suspicion be maintained. In the absence of data suggesting other specific etiologies, paediatricians should consider this diagnosis for children presenting with neurological and/or behavioural or psychiatric disturbances, regardless of age and gender.
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Affiliation(s)
- Stefano Sartori
- Paediatric Neurology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy.
| | - Margherita Nosadini
- Paediatric Neurology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy.
| | - Elisabetta Cesaroni
- Child Neuropsychiatry Unit, Polytechnic University of the Marche, Ancona, Italy.
| | - Raffaele Falsaperla
- Paediatric Acute and Emergency Operative Unit and Department, Policlinico Vittorio Emanuele University Hospital, University of Catania, Italy.
| | - Giuseppe Capovilla
- Department of Child Neuropsychiatry, Epilepsy Center, C. Poma Hospital, Mantua, Italy.
| | - Francesca Beccaria
- Department of Child Neuropsychiatry, Epilepsy Center, C. Poma Hospital, Mantua, Italy.
| | - Maria Margherita Mancardi
- Unit of Child Neuropsychiatry, Head-Neck and Neuroscience Department, Giannina Gaslini Institute, Genoa, Italy.
| | - Giuseppe Santangelo
- Child and Adolescent Neuropsychiatry Unit, Department of Paediatrics, ARNAS Civico - Di Cristina, Palermo, Italy.
| | - Leandra Giunta
- Paediatric Acute and Emergency Operative Unit and Department, Policlinico Vittorio Emanuele University Hospital, University of Catania, Italy.
| | - Clementina Boniver
- Paediatric Neurophysiology Unit, Department of Paediatrics, University of Padua, Italy.
| | - Gaetano Cantalupo
- Child Neuropsychiatry, Department of Life and Reproduction Sciences, University of Verona, Italy.
| | - Alberto Cappellari
- Child Neuropsychiatry, Department of Life and Reproduction Sciences, University of Verona, Italy.
| | - Paola Costa
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
| | | | - Robertino Dilena
- Unit of Clinical Neurophysiology, Department of Neurological Sciences, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | - Maria Federica Pelizza
- Paediatric Neurology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy.
| | - Dario Pruna
- Child Neurology and Psychiatry Dept, Pediatric Hospital, Cagliari, Italy.
| | - Domenico Serino
- Neurology Unit, Bambino Gesù Children's Hospital, Rome, Italy.
| | - Francesca Vanadia
- Child and Adolescent Neuropsychiatry Unit, Department of Paediatrics, ARNAS Civico - Di Cristina, Palermo, Italy.
| | | | - Nelia Zamponi
- Child Neuropsychiatry Unit, Polytechnic University of the Marche, Ancona, Italy.
| | - Caterina Zanus
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
| | - Irene Toldo
- Paediatric Neurology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy.
| | - Agnese Suppiej
- Paediatric Neurology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy.
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Raieli V, Pitino R, Giordano G, Spitalieri C, Consolo F, Puma D, Santangelo G, Vanadia F, D'Amelio M. Migraine in a pediatric population: a clinical study in children younger than 7 years of age. Dev Med Child Neurol 2015; 57:585-8. [PMID: 25586426 DOI: 10.1111/dmcn.12679] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 01/17/2023]
Abstract
AIM Migraines in children younger than 7 years of age have received limited attention in the published literature. The aim of this study is to describe the characteristics of migraine phenotypes in children younger than 7 years, and to compare them with migraines in children older than 7 years of age. METHOD We reviewed all standard clinical files, collected over 4 years, related to children with a diagnosis of primary headache. We included all children younger than 7 years diagnosed with migraine in our study. RESULTS A total of 374 children (188 males, 186 females) were affected by migraine with/without aura: 40 of these patients (10.7%; 20 males, 20 females; mean age 5y 7mo, SD 1y 2mo) where younger than 7 years old. The frequencies of the main migraine features in the younger age group were similar to those of children older than 7 years, with the exception of a shorter duration of migraine and reduced frequency of attacks. INTERPRETATION In children younger than 7 years of age, the clinical phenotype of migraine is similar to that seen in older children. We propose that there is a general genetic migraine susceptibility that, in the presence of activating environmental factors, may induce typical attacks of migraine in individuals already predisposed to migraine attacks. Therefore, different modules induce different clinical features within the different age groups, but there is no difference in the frequencies of clinical phenotypes between the two age groups.
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Affiliation(s)
- Vincenzo Raieli
- Child Neuropsychiatry Unit, Di Cristina Hospital ARNAS Civico, Palermo, Italy
| | - Renata Pitino
- Child Neuropsychiatry School, University of Palermo, Palermo, Italy
| | | | | | - Flavia Consolo
- Child Neuropsychiatry Unit, Di Cristina Hospital ARNAS Civico, Palermo, Italy
| | - Domenico Puma
- Child Neuropsychiatry Unit, Di Cristina Hospital ARNAS Civico, Palermo, Italy
| | - Giuseppe Santangelo
- Child Neuropsychiatry Unit, Di Cristina Hospital ARNAS Civico, Palermo, Italy
| | - Francesca Vanadia
- Child Neuropsychiatry Unit, Di Cristina Hospital ARNAS Civico, Palermo, Italy
| | - Marco D'Amelio
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
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Barone P, Santangelo G, Morgante L, Onofrj M, Meco G, Abbruzzese G, Bonuccelli U, Cossu G, Pezzoli G, Stanzione P, Lopiano L, Antonini A, Tinazzi M. A randomized clinical trial to evaluate the effects of rasagiline on depressive symptoms in non-demented Parkinson's disease patients. Eur J Neurol 2015; 22:1184-91. [PMID: 25962410 PMCID: PMC4676931 DOI: 10.1111/ene.12724] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [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: 11/24/2014] [Accepted: 02/26/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE Depressed mood is a common psychiatric problem associated with Parkinson's disease (PD), and studies have suggested a benefit of rasagiline treatment. METHODS ACCORDO (see the ) was a 12-week, double-blind, placebo-controlled trial to evaluate the effects of rasagiline 1 mg/day on depressive symptoms and cognition in non-demented PD patients with depressive symptoms. The primary efficacy variable was the change from baseline to week 12 in depressive symptoms measured by the Beck Depression Inventory (BDI-IA) total score. Secondary outcomes included change from baseline to week 12 in cognitive function as assessed by a comprehensive neuropsychological battery; Parkinson's disease quality of life questionnaire (PDQ-39) scores; Apathy Scale scores; and Unified Parkinson's Disease Rating Scale (UPDRS) subscores. RESULTS One hundred and twenty-three patients were randomized. At week 12 there was no significant difference between groups for the reduction in total BDI-IA score (primary efficacy variable). However, analysis at week 4 did show a significant difference in favour of rasagiline (marginal means difference ± SE: rasagiline -5.46 ± 0.73 vs. placebo -3.22 ± 0.67; P = 0.026). There were no significant differences between groups on any cognitive test. Rasagiline significantly improved UPDRS Parts I (P = 0.03) and II (P = 0.003) scores versus placebo at week 12. Post hoc analyses showed the statistical superiority of rasagiline versus placebo in the UPDRS Part I depression item (P = 0.04) and PDQ-39 mobility (P = 0.007) and cognition domains (P = 0.026). CONCLUSIONS Treatment with rasagiline did not have significant effects versus placebo on depressive symptoms or cognition in PD patients with moderate depressive symptoms. Although limited by lack of correction for multiple comparisons, post hoc analyses signalled some improvement in patient-rated cognitive and depression outcomes.
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Affiliation(s)
- P Barone
- University of Salerno, Baronissi, Italy
| | | | | | - M Onofrj
- University of Chieti-Pescara, Chieti, Italy
| | - G Meco
- 'Sapienza' University of Rome, Rome, Italy
| | | | | | | | | | | | | | - A Antonini
- IRCCS Ospedale San Camillo, Venice, Italy
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Pellecchia MT, Picillo M, Santangelo G, Longo K, Moccia M, Erro R, Amboni M, Vitale C, Vicidomini C, Salvatore M, Barone P, Pappatà S. Cognitive performances and DAT imaging in early Parkinson's disease with mild cognitive impairment: a preliminary study. Acta Neurol Scand 2015; 131:275-81. [PMID: 25644029 DOI: 10.1111/ane.12365] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Mild cognitive impairment (MCI) is a common feature in Parkinson's disease (PD). We performed an exploratory study to investigate dopaminergic nigrostriatal innervation and its cognitive correlates in early untreated PD patients with MCI as compared to cognitively intact patients. PATIENTS AND METHODS A consecutive series of 34-de-novo, drug-naïve patients with PD were enrolled. They underwent [123-I] FP-CIT SPECT and comprehensive neuropsychological battery. MCI was identified in 15 of 34 patients with PD. RESULTS The two groups did not show any statistically significant difference in age, sex, disease duration, education, lateralization, and H&Y and Hospital Anxiety and Depression Scale scores. Logistic regression analysis showed that UPDRS-III was weakly associated with MCI (P = 0.034). Partial correlation analysis controlling for UPDRS-III and age suggested that in PD patients with MCI reduced V3″ values in the more affected caudate were correlated with reduced performances in frontal assessment battery, Trail Making Test: part B minus Part A and copy task of the Rey-Osterrieth complex figure test. Reduced V3″ values in the more and less affected putamen were significantly related with reduced performance in frontal assessment battery and in copy task of Rey-Osterrieth complex figure test, respectively. No correlation was found between neuropsychological scores and DAT availability in PD patients without MCI. CONCLUSIONS Although preliminary, our results suggest that striatal dopamine depletion may contribute to some cognitive deficit in early never treated PD patients with MCI.
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Affiliation(s)
- M. T. Pellecchia
- Center for Neurodegenerative Diseases; University of Salerno; Salerno Italy
| | - M. Picillo
- Department of Neurological Sciences; University Federico II; Naples Italy
| | - G. Santangelo
- Department of Psychology; Neuropsychology Laboratory; Second University of Naples; Caserta Italy
- IDC Hermitage-Capodimonte; Naples Italy
| | - K. Longo
- IDC Hermitage-Capodimonte; Naples Italy
| | - M. Moccia
- Department of Neurological Sciences; University Federico II; Naples Italy
| | - R. Erro
- Department of Neurological Sciences; University Federico II; Naples Italy
| | - M. Amboni
- IDC Hermitage-Capodimonte; Naples Italy
| | - C. Vitale
- IDC Hermitage-Capodimonte; Naples Italy
- University Parthenope; Naples Italy
| | - C. Vicidomini
- Institute of Biostructure and Bioimaging; CNR; Naples Italy
| | - M. Salvatore
- Department of Advanced Biomedical Sciences; University Federico II; Naples Italy
| | - P. Barone
- Department of Neurological Sciences; University Federico II; Naples Italy
| | - S. Pappatà
- Institute of Biostructure and Bioimaging; CNR; Naples Italy
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Nisini B, Santangelo G, Giannini T, Antoniucci S, Cabrit S, Codella C, Davis CJ, Eislöffel J, Kristensen L, Herczeg G, Neufeld D, van Dishoeck EF. [O I] 63μm JETS IN CLASS 0 SOURCES DETECTED BYHERSCHEL. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/801/2/121] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Raieli V, Trapolino D, Giordano G, Spitaleri C, Consolo F, Santangelo G, Buffa D, Vanadia F, D'Amelio M. Juvenile Migraine and Allodynia: Results of a Retrospective Study. Headache 2015; 55:413-8. [DOI: 10.1111/head.12530] [Citation(s) in RCA: 13] [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] [Accepted: 12/16/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Vincenzo Raieli
- Child Neuropsychiatry Unit; Di Cristina Hospital; ARNAS CIVICO; Palermo Italy
| | - Davide Trapolino
- Child Neuropsychiatry School; University of Palermo; Palermo Italy
| | | | - Chiara Spitaleri
- Child Neuropsychiatry School; University of Palermo; Palermo Italy
| | - Flavia Consolo
- Child Neuropsychiatry Unit; Di Cristina Hospital; ARNAS CIVICO; Palermo Italy
| | - Giuseppe Santangelo
- Child Neuropsychiatry Unit; Di Cristina Hospital; ARNAS CIVICO; Palermo Italy
| | - Daniela Buffa
- Child Neuropsychiatry Unit; Di Cristina Hospital; ARNAS CIVICO; Palermo Italy
| | - Francesca Vanadia
- Child Neuropsychiatry Unit; Di Cristina Hospital; ARNAS CIVICO; Palermo Italy
| | - Marco D'Amelio
- Department of Experimental Biomedicine and Clinical Neurosciences; University of Palermo; Palermo Italy
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Moccia M, Picillo M, Erro R, Longo K, Amboni M, Santangelo G, Palladino R, Allocca R, Caporale O, Triassi M, Pellecchia MT, Barone P, Vitale C. Increased bilirubin levels in de novo Parkinson's disease. Eur J Neurol 2015; 22:954-9. [PMID: 25740378 DOI: 10.1111/ene.12688] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 12/29/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Oxidative stress is a central pathogenic mechanism of Parkinson's disease (PD), and the heme oxygenase (HO) bilirubin pathway is one of the main mammalian antioxidative defences. Indeed, there is growing evidence of HO-bilirubin upregulation from early phases of PD. Our aim was to investigate bilirubin as a possible biomarker of PD diagnosis and progression. METHODS A cross-sectional case-control study was performed to evaluate differences in bilirubin levels between newly diagnosed, drug-naïve PD subjects and controls. Afterwards, PD subjects were included in a 2-year longitudinal study to evaluate disease progression in relation to baseline bilirubin levels. RESULTS Seventy-five de novo PD subjects were selected and matched with 75 controls by propensity score. Analysis of variance showed higher bilirubin levels in PD patients compared with controls (P < 0.001). Linear regression analysis failed to show a relationship between bilirubin and Unified Parkinson's Disease Rating Scale (UPDRS) part III (P = 0.283) at baseline evaluation. At 2-year follow-up, indirect relationships between bilirubin levels and UPDRS part III (P = 0.028) and between bilirubin levels and levodopa-equivalent daily dosage (P = 0.012) were found. CONCLUSIONS Parkinson's disease subjects showed higher levels of bilirubin compared with controls. Bilirubin increase might be due to HO overexpression as a compensatory response to oxidative stress occurring from early stages of PD.
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Affiliation(s)
- M Moccia
- Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
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Raieli V, Giordano G, Spitaleri C, Consolo F, Buffa D, Santangelo G, Savettieri G, Vanadia F, D'Amelio M. Migraine and cranial autonomic symptoms in children and adolescents: a clinical study. J Child Neurol 2015; 30:182-6. [PMID: 24846900 DOI: 10.1177/0883073814535494] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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
The frequency of cranial autonomic symptoms in children affected by primary headaches is uncertain. The aim of our study was to estimate the frequency of symptoms in pediatric headaches and correlate it with main migraine characteristics. A questionnaire investigating the presence of cranial autonomic symptoms was administered to all children with primary headache for 2 years. A total of 230 children with primary headache (105 males, 125 females) were included. Two hundred two children were affected by migraine and 28 (12.2%) by other primary headaches. Cranial autonomic symptoms were significantly complained by migraineurs (55% vs. 17.8%) (P < .001) and by children with higher frequency of migraine attacks (odds ratio = 2.6, confidence interval = 1.4-4.7, P = .001). Our findings show that cranial autonomic symptoms are rather common during pediatric migraine attacks. The association between cranial autonomic symptoms and higher frequency of attacks might suggest the role of the trigeminal-autonomic reflex in migraine pathophysiology.
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Affiliation(s)
- V Raieli
- Child Neuropsychiatry Unit, Di Cristina Hospital -ARNAS CIVICO Palermo, Palermo, Italy
| | - G Giordano
- Child Neuropsychiatry School, University of Palermo, Palermo, Italy
| | - C Spitaleri
- Child Neuropsychiatry School, University of Palermo, Palermo, Italy
| | - F Consolo
- Child Neuropsychiatry Unit, Di Cristina Hospital -ARNAS CIVICO Palermo, Palermo, Italy
| | - D Buffa
- Child Neuropsychiatry Unit, Di Cristina Hospital -ARNAS CIVICO Palermo, Palermo, Italy
| | - G Santangelo
- Child Neuropsychiatry Unit, Di Cristina Hospital -ARNAS CIVICO Palermo, Palermo, Italy
| | - G Savettieri
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - F Vanadia
- Child Neuropsychiatry Unit, Di Cristina Hospital -ARNAS CIVICO Palermo, Palermo, Italy
| | - M D'Amelio
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
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Pitino R, Raieli V, Consolo F, La Franca G, Puma D, Santangelo G, Vanadia F. EHMTI-0115. Migraine under 7 years: a clinical study. J Headache Pain 2014. [PMCID: PMC4180916 DOI: 10.1186/1129-2377-15-s1-b25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Santangelo G, Del Giudice S, Gallucci F, Parmeggiani U, De Falco M. Cancer of the thyroid gland in geriatric age: A single center retrospective study with a 10-year post-operative follow-up. Int J Surg 2014; 12 Suppl 2:S103-S107. [DOI: 10.1016/j.ijsu.2014.08.368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/15/2014] [Indexed: 11/28/2022]
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41
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Moccia M, Picillo M, Erro R, Vitale C, Longo K, Amboni M, Santangelo G, Palladino R, Capo G, Orefice G, Barone P, Pellecchia MT. Presence and progression of non-motor symptoms in relation to uric acid inde novoParkinson's disease. Eur J Neurol 2014; 22:93-8. [DOI: 10.1111/ene.12533] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 06/09/2014] [Indexed: 12/25/2022]
Affiliation(s)
- M. Moccia
- Department of Neuroscience, Reproductive Science and Odontostomatology; Federico II University; Naples Italy
| | - M. Picillo
- Neuroscience Section; Department of Medicine; Center for Neurodegenerative Diseases (CEMAND); University of Salerno; Salerno Italy
| | - R. Erro
- Sobell Department of Motor Neuroscience and Movement Disorders; University College London (UCL) Institute of Neurology; London UK
- Department of Neurological and Movement Sciences; University of Verona; Policlinico Borgo Roma; Verona Italy
| | - C. Vitale
- IDC Hermitage Capodimonte; Naples Italy
- Department of Motor Sciences; University Parthenope; Naples Italy
| | - K. Longo
- IDC Hermitage Capodimonte; Naples Italy
| | - M. Amboni
- IDC Hermitage Capodimonte; Naples Italy
| | - G. Santangelo
- Neuropsychology Laboratory; Department of Psychology; Second University of Naples; Caserta Italy
| | - R. Palladino
- Department of Primary Care and Public Health; Imperial College; London UK
- Department of Public Health; Federico II University; Naples Italy
| | - G. Capo
- AOU San Giovanni di Dio e Ruggi d'Aragona; Salerno Italy
| | - G. Orefice
- Department of Neuroscience, Reproductive Science and Odontostomatology; Federico II University; Naples Italy
| | - P. Barone
- Neuroscience Section; Department of Medicine; Center for Neurodegenerative Diseases (CEMAND); University of Salerno; Salerno Italy
| | - M. T. Pellecchia
- Neuroscience Section; Department of Medicine; Center for Neurodegenerative Diseases (CEMAND); University of Salerno; Salerno Italy
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De Falco M, Santangelo G, Del Giudice S, Gallucci F, Parmeggiani U. Double probe intraoperative neuromonitoring with a standardized method in thyroid surgery. Int J Surg 2014; 12 Suppl 1:S140-4. [DOI: 10.1016/j.ijsu.2014.05.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/03/2014] [Indexed: 12/15/2022]
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Santangelo G, Vitale C, Trojano L, Picillo M, Moccia M, Pisano G, Pezzella D, Cuoco S, Erro R, Longo K, Pellecchia MT, Amboni M, De Rosa A, De Michele G, Barone P. Relationship between apathy and cognitive dysfunctions in de novo untreated Parkinson's disease: a prospective longitudinal study. Eur J Neurol 2014; 22:253-60. [PMID: 24848193 DOI: 10.1111/ene.12467] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [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: 11/23/2013] [Accepted: 03/26/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Apathy may be either a symptom of major depression or a behavioral disturbance occurring in concomitance with depression or alone in Parkinson's disease (PD). The aim of the present study was to determine the progression of cognitive impairment in drug-naïve untreated PD patients with or without clinically significant apathy. METHODS Sixty-two PD patients with a disease duration <2 years and without history of present or past therapy with pro-dopaminergic agents were included and underwent the Apathy Evaluation Scale (S-AES), a clinical interview based on diagnostic criteria for apathy and a comprehensive neuropsychological battery to assess memory, frontal functions and visuospatial functions. Two years after the first assessment, all patients were re-evaluated on the S-AES, a clinical interview and neuropsychological tests. RESULTS According to the cut-off value of the S-AES and diagnostic criteria for apathy, eight patients experienced apathy at both baseline and follow-up (A+A+), nine patients had apathy only at follow-up (A-A+), 37 patients never experienced apathy (A-A-) and eight patients showed apathy at the baseline only (A+A-). Cognitive performance significantly declined in all four groups. At both baseline and follow-up A+A+ performed worse than A-A- on visuospatial and frontal tests; A-A+ had lower scores than A-A- on the interference task of the Stroop test (IT-ST). Regression analysis showed that poor performance on the IT-ST at baseline was the only independent predictor of onset of apathy at follow-up. CONCLUSIONS The results indicated a relationship between apathy and dysexecutive syndrome in early PD. Reduced scores on the IT-ST may predict development of apathy in PD patients.
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Affiliation(s)
- G Santangelo
- Department of Psychology, Second University of Naples, Caserta, Italy; IDC-Hermitage-Capodimonte, Naples, Italy
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Picillo M, Barone P, Pellecchia MT, Santangelo G, Kano O, Ikeda K, Iwasaki Y. Evolution of mild cognitive impairment in Parkinson disease. Neurology 2014; 82:1384. [DOI: 10.1212/wnl.0000000000000234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Giannini I, Pecorella G, Pennisi D, Santangelo G, Digennaro R, Latorre F, Giuliani G, Altomare DF. Control of post-hemorrhoidectomy symptoms and wound healing by Triclosan: a randomized, double-blind, controlled trial. MINERVA CHIR 2014; 69:75-82. [PMID: 24847894] [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: 06/03/2023]
Abstract
AIM Milligan-Morgan hemorrhoidectomy (MM) is still the most common treatment for grades III and IV hemorrhoids despite prolonged post-operative anal pain and wound healing. This multicenter, double blind, randomized, controlled trial was designed to assess the safety and the efficacy of anal wound cleansing with Triclosan (Proctocid®) in the control of symptoms and healing time after MM. METHODS A total of 113 patients with grades III and IV hemorrhoids, undergoing open hemorroidectomy by diathermy or Ligasure vessel sealing device, were randomly assigned to Triclosan or sodium hypochlorite solution. All patients received analgesics and a fiber-rich diet after hemorrhoidectomy. Postoperative anal pain, bleeding and/or secretion and itch were assessed 7, 14 and 21 days after hemorrhoidectomy by a Visual Analogue Scale (VAS) and the day of complete re-epithelialization of anal wounds was recorded. RESULTS Fifty-five patients were randomized for Triclosan treatment and 58 for the control drug. The two groups were comparable for demographics, severity of hemorrhoids and technique used for the hemorrhoidectomy. The comparison of days to get complete anal wound healing shows a trend of significance (P=0.05) for the Triclosan group. Bleeding and/or secretion, anal pain and itch were significantly better (P=0.003; P<0.0001 and P=0.01, respectively). CONCLUSION Triclosan solution for the treatment of post-hemorrhoidectomy wounds is safe and improves the control of post-operative symptoms and wound healing time compared to sodium hypochlorite.
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Affiliation(s)
- I Giannini
- Department of Emergency and Organ Transplantation University of Bari, Bari, Italy -
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Picillo M, Iavarone A, Pellecchia M, Amboni M, Erro R, Moccia M, Vitale C, Longo K, Santangelo G, Spina E, Scannapieco S, Orefice G, Barone P. Validation of an Italian version of the 40-item University of Pennsylvania Smell Identification Test that is physician administered: Our experience on one hundred and thirty-eight healthy subjects. Clin Otolaryngol 2014; 39:53-7. [DOI: 10.1111/coa.12212] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 11/29/2022]
Affiliation(s)
- M. Picillo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology; University Federico II; Naples Italy
| | - A. Iavarone
- Neurological and Stroke Unit; CTO Hospital; AORN Ospedale dei Colli; Naples Italy
| | - M.T. Pellecchia
- Center for Neurodegenerative Diseases (CEMAND); Department of Medicine and Surgery; University of Salerno; Salerno Italy
| | - M. Amboni
- Center for Neurodegenerative Diseases (CEMAND); Department of Medicine and Surgery; University of Salerno; Salerno Italy
- IDC Hermitage-Capodimonte; Naples Italy
| | - R. Erro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology; University Federico II; Naples Italy
| | - M. Moccia
- Department of Neuroscience, Reproductive Sciences and Odontostomatology; University Federico II; Naples Italy
| | - C. Vitale
- IDC Hermitage-Capodimonte; Naples Italy
- University “Parthenope”; Naples Italy
| | - K. Longo
- IDC Hermitage-Capodimonte; Naples Italy
| | - G. Santangelo
- Neuropsychology Laboratory; Department of Psychology; Second University of Naples; Caserta Italy
| | - E. Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology; University Federico II; Naples Italy
| | - S. Scannapieco
- Center for Neurodegenerative Diseases (CEMAND); Department of Medicine and Surgery; University of Salerno; Salerno Italy
| | - G. Orefice
- Department of Neuroscience, Reproductive Sciences and Odontostomatology; University Federico II; Naples Italy
| | - P. Barone
- Center for Neurodegenerative Diseases (CEMAND); Department of Medicine and Surgery; University of Salerno; Salerno Italy
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Farruggia P, D'Angelo P, La Rosa M, Scibetta N, Santangelo G, Lo Bello A, Duner E, Randi ML, Putti MC, Santoro A. MPL W515L mutation in pediatric essential thrombocythemia. Pediatr Blood Cancer 2013; 60:E52-4. [PMID: 23441089 DOI: 10.1002/pbc.24500] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 10/08/2012] [Accepted: 01/21/2013] [Indexed: 11/10/2022]
Abstract
Essential thrombocythemia (ET) is extremely rare in the pediatric population. In most patients no molecular abnormality can be found, with about 40% of pediatric patients harboring a JAK2 V617F mutation. Another recurrent mutation, involving a W to L or K transversion at MPL codon 515, has been reported in about 3-8% of adult ET patients. Herein we describe this mutation in a pediatric patient.
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Affiliation(s)
- Piero Farruggia
- Oncology Department, Pediatric Hematology and Oncology Unit, ARNAS Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy
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Affiliation(s)
- N. Ricci
- a Istituto di Zoologia ed Anatomia Comparata dell'Università di Pisa
- b Istituto di Zoologia dell'Università di Camerino
| | - G. Santangelo
- a Istituto di Zoologia ed Anatomia Comparata dell'Università di Pisa
- b Istituto di Zoologia dell'Università di Camerino
| | - P. Luporini
- a Istituto di Zoologia ed Anatomia Comparata dell'Università di Pisa
- b Istituto di Zoologia dell'Università di Camerino
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Santangelo G, Vitale C, Trojano L, Angrisano MG, Picillo M, Errico D, Agosti V, Grossi D, Barone P. Subthreshold depression and subjective cognitive complaints in Parkinson's disease. Eur J Neurol 2013; 21:541-4. [PMID: 23790130 DOI: 10.1111/ene.12219] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 05/16/2013] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE Subthreshold depression (SubD) is characterized by clinically relevant depressive symptoms not meeting criteria for major depression. The possible association of SubD with subjective cognitive complaints and/or objective cognitive impairments was investigated in a sample of consecutive, non-demented Parkinson's disease (PD) outpatients. METHODS Amongst 115 patients, SubD was identified in 30 patients, major depression in 33; 36 patients were classified as non-depressed. Enrolled patients were administered tests and questionnaires validated in PD for assessing objective and subjective cognitive dysfunctions. RESULTS On objective cognitive measures SubD patients did not differ from non-depressed patients, whereas depressed patients achieved significantly lower scores than the other two groups. SubD and depressed patients reported more cognitive complaints than non-depressed patients. CONCLUSIONS SubD is a non-motor aspect of PD that is not related to objective cognitive deficits but is associated with subjective cognitive complaints, thus impacting on patients' well-being.
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Affiliation(s)
- G Santangelo
- Department of Psychology, Second University of Naples, Caserta, Italy; IDC Hermitage-Capodimonte, Naples, Italy
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50
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Pellecchia MT, Santangelo G, Picillo M, Pivonello R, Longo K, Pivonello C, Vitale C, Amboni M, De Rosa A, Moccia M, Erro R, De Michele G, Santoro L, Colao A, Barone P. Insulin-like growth factor-1 predicts cognitive functions at 2-year follow-up in early, drug-naïve Parkinson's disease. Eur J Neurol 2013; 21:802-7. [DOI: 10.1111/ene.12137] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 02/14/2013] [Indexed: 11/30/2022]
Affiliation(s)
- M. T. Pellecchia
- Center for Neurodegenerative Diseases, University of Salerno; Salerno Italy
| | - G. Santangelo
- Department of Psychology; Neuropsychology Laboratory, Second University of Naples; Caserta Italy
- IDC Hermitage-Capodimonte; Naples Italy
| | - M. Picillo
- Department of Neurological Sciences; Federico II University; Naples Italy
| | - R. Pivonello
- Department of Molecular and Clinical Endocrinology and Oncology; Federico II University; Naples Italy
| | - K. Longo
- IDC Hermitage-Capodimonte; Naples Italy
| | - C. Pivonello
- Department of Molecular and Clinical Endocrinology and Oncology; Federico II University; Naples Italy
| | - C. Vitale
- IDC Hermitage-Capodimonte; Naples Italy
- University of Naples Parthenope; Naples Italy
| | - M. Amboni
- IDC Hermitage-Capodimonte; Naples Italy
| | - A. De Rosa
- Department of Neurological Sciences; Federico II University; Naples Italy
| | - M. Moccia
- Department of Neurological Sciences; Federico II University; Naples Italy
| | - R. Erro
- Department of Neurological Sciences; Federico II University; Naples Italy
| | - G. De Michele
- Department of Neurological Sciences; Federico II University; Naples Italy
| | - L. Santoro
- Department of Neurological Sciences; Federico II University; Naples Italy
| | - A. Colao
- Department of Molecular and Clinical Endocrinology and Oncology; Federico II University; Naples Italy
| | - P. Barone
- Center for Neurodegenerative Diseases, University of Salerno; Salerno Italy
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