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Rodolico A, Cutrufelli P, Di Francesco A, Aguglia A, Catania G, Concerto C, Cuomo A, Fagiolini A, Lanza G, Mineo L, Natale A, Rapisarda L, Petralia A, Signorelli MS, Aguglia E. Efficacy and safety of ketamine and esketamine for unipolar and bipolar depression: an overview of systematic reviews with meta-analysis. Front Psychiatry 2024; 15:1325399. [PMID: 38362031 PMCID: PMC10867194 DOI: 10.3389/fpsyt.2024.1325399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024] Open
Abstract
Background Unipolar and bipolar depression present treatment challenges, with patients sometimes showing limited or no response to standard medications. Ketamine and its enantiomer, esketamine, offer promising alternative treatments that can quickly relieve suicidal thoughts. This Overview of Reviews (OoR) analyzed and synthesized systematic reviews (SRs) with meta-analysis on randomized clinical trials (RCTs) involving ketamine in various formulations (intravenous, intramuscular, intranasal, subcutaneous) for patients with unipolar or bipolar depression. We evaluated the efficacy and safety of ketamine and esketamine in treating major depressive episodes across various forms, including unipolar, bipolar, treatment-resistant, and non-resistant depression, in patient populations with and without suicidal ideation, aiming to comprehensively assess their therapeutic potential and safety profile. Methods Following PRIOR guidelines, this OoR's protocol was registered on Implasy (ID:202150049). Searches in PubMed, Scopus, Cochrane Library, and Epistemonikos focused on English-language meta-analyses of RCTs of ketamine or esketamine, as monotherapy or add-on, evaluating outcomes like suicide risk, depressive symptoms, relapse, response rates, and side effects. We included studies involving both suicidal and non-suicidal patients; all routes and formulations of administration (intravenous, intramuscular, intranasal) were considered, as well as all available comparisons with control interventions. We excluded meta-analysis in which the intervention was used as anesthesia for electroconvulsive therapy or with a randomized ascending dose design. The selection, data extraction, and quality assessment of studies were carried out by pairs of reviewers in a blinded manner. Data on efficacy, acceptability, and tolerability were extracted. Results Our analysis included 26 SRs and 44 RCTs, with 3,316 subjects. The intervention is effective and well-tolerated, although the quality of the included SRs and original studies is poor, resulting in low certainty of evidence. Limitations This study is limited by poor-quality SRs and original studies, resulting in low certainty of the evidence. Additionally, insufficient available data prevents differentiation between the effects of ketamine and esketamine in unipolar and bipolar depression. Conclusion While ketamine and esketamine show promising therapeutic potential, the current evidence suffers from low study quality. Enhanced methodological rigor in future research will allow for a more informed application of these interventions within the treatment guidelines for unipolar and bipolar depression. Systematic review registration [https://inplasy.com/inplasy-2021-5-0049/], identifier (INPLASY202150049).
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Affiliation(s)
- Alessandro Rodolico
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Pierfelice Cutrufelli
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Antonio Di Francesco
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gaetano Catania
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
- University of Catania, Catania, Italy
| | - Carmen Concerto
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
| | - Ludovico Mineo
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Antimo Natale
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
- Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Laura Rapisarda
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Antonino Petralia
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
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Matera S, Filetti V, Rapisarda V, Kaźmierczak-Siedlecka K, Rapisarda L, Dounias G, Vecchio M, Musumeci G, Roggio F, Vitale E. Workplace health promotion: results of a combined multidisciplinary intervention over a long period - preliminary results. Eur Rev Med Pharmacol Sci 2023; 27:9346-9354. [PMID: 37843348 DOI: 10.26355/eurrev_202310_33962] [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] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Obesity is a multifactorial disease that is one of the major public health problems. It is the result of the interaction between behavioral, social and endocrine-metabolic components. Already in the 80s, it was highlighted by the World Health Organization (WHO) that the workplace is an ideal setting for introducing health promotion programs. The aim of the present study was to implement a health promotion program among healthcare workers (HCWs) operating in an Emergency Hospital in Southern Italy, combining diet, sports activity and motivational support over a 24-month period. PATIENTS AND METHODS Participants were HCWs operating in an Emergency Hospital in Southern Italy. The inclusion criteria were as follows: overweight or obesity, i.e., body mass index (BMI) >25 kg/m2, or waist circumference >102 cm (males), >88 cm (females); dyslipidemia without pharmacological treatment, i.e., total cholesterol >220 mg/dL, or high-density lipoprotein (HDL) cholesterol <35 mg/dL, or low-density lipoprotein cholesterol (LDL) >130 mg/dL, or triglycerides >200 mg/dL; fasting glucose levels >120 mg/dl and/or reduced tolerance to glucose or diabetes mellitus, without pharmacological treatment was determined through HbA1c. RESULTS The analysis was conducted on 36 participants. Follow-up was performed after twelve (T12) and twenty-four months (T24). The average systolic blood pressure (SBP) and diastolic blood pressure (DBP) values decreased during the time period. The average BMI of both male and female HCWs was significantly reduced from T0 to T12 and from T0 to T24. The triglyceride levels gradually decreased, but not significantly, from T0 to T24. The average blood glucose values decreased from T0 to T12 and from T12 to T24. The number of subjects who started to perform physical activity increased significantly between T0 and T12 and between T0 and T24. CONCLUSIONS The findings have led to a significant change in HCWs' lifestyles and body perceptions, as well as their ability to work.
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Affiliation(s)
- S Matera
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Catania, Italy.
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Bono F, Rapisarda L, Bombardieri C, Gagliardi M, Procopio R, Demonte G, Tosto F, Bruno PA, Gambardella A, Annesi G. Neurological manifestations in patients and disease carriers in an Italian family with osteosclerosis. Neurol Sci 2023; 44:1393-1399. [PMID: 36481973 DOI: 10.1007/s10072-022-06541-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hereditary cranial hyperostosis is a rare disease never described in Italy, so the neurological manifestations in patients and carriers of the disease have been little studied. METHODS We describe the neurological and neuroimaging features of patients and carriers of the gene from a large Italian family with sclerosteosis. RESULTS In this family, genetic testing detected the homozygous p.Gln24X (c.70C > T) mutation of the SOST gene in the proband and a heterozygous mutation in 9 siblings. In homozygous adults, severe craniofacial hyperostosis was manifested by cranial neuropathy in childhood, chronic headache secondary to intracranial hypertension, and an obstructive sleep apnea syndrome in adults. In one of the adult patients, there was a compressible subcutaneous swelling in the occipital region caused by transosseous intracranial-extracranial occipital venous drainage, a compensation mechanism of obstructed venous drainage secondary to cranial hyperostosis. Mild cranial hyperostosis causing frequent headache and snoring was evident in the nine heterozygous subjects. CONCLUSIONS Multiple cranial neuropathies and headache in children, while severe chronic headache and sleep disturbances in adults, are the neurological manifestations of the first Italian family with osteosclerosis. It is reasonable to extend neurological and neuroimaging evaluation to gene carriers as well.
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Affiliation(s)
- Francesco Bono
- Headache Center, Neurology Unit A.O.U. Mater Domini, University Campus, Viale Europa, 88100, Catanzaro, Italy.
| | - Laura Rapisarda
- Headache Center, Neurology Unit A.O.U. Mater Domini, University Campus, Viale Europa, 88100, Catanzaro, Italy
| | | | - Monica Gagliardi
- Institute of Molecular Bioimaging and Physiology, N. R. C., Catanzaro, Italy
| | - Radha Procopio
- Institute of Molecular Bioimaging and Physiology, N. R. C., Catanzaro, Italy
| | - Giulio Demonte
- Headache Center, Neurology Unit A.O.U. Mater Domini, University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Federico Tosto
- Headache Center, Neurology Unit A.O.U. Mater Domini, University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Pietro A Bruno
- Headache Center, Neurology Unit A.O.U. Mater Domini, University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Antonio Gambardella
- Institute of Neurology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Grazia Annesi
- Institute of Molecular Bioimaging and Physiology, N. R. C., Catanzaro, Italy
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Barone S, Rapisarda L, Manzo L, Mechelli A, Pascarella A, Bruno P, Pasquale M, Trimboli M, Valentino P, Gambardella A. A case of neuromyelitis optica spectrum disorder (NMOSD) and acute myositis following SARS-CoV-2 infection. J Neurol Sci 2021. [PMCID: PMC8498504 DOI: 10.1016/j.jns.2021.119862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rapisarda L, Irace C, Nisticò R, Giugno A, Barone S, Parise M, Crasà M, Nicoli D, Gambardella A, Valentino P. PRECLINICAL MARKERS OF NEUROPATHIC DAMAGE IN TYPE 1 DIABETES MELLITUS. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rapisarda L, Gagliardi M, Bombardieri C, Procopio R, Demonte G, Tosto F, Gambardella A, Annesi G, Bono F. Headache and sleep-related breathing disorders among patients with sclerosteosis and disease carriers. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rapisarda L, Trimboli M, Fortunato F, De Martino A, Marsico O, Demonte G, Augimeri A, Labate A, Gambardella A. Facemask headache: a new nosographic entity among healthcare providers in COVID-19 era. Neurol Sci 2021; 42:1267-1276. [PMID: 33502666 PMCID: PMC7838234 DOI: 10.1007/s10072-021-05075-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/18/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND SARS-CoV-2 is a novel infectious agent causing coronavirus disease 2019, which has been declared as pandemic in March 2020. Personal protective equipment has been mandatory for healthcare workers in order to contain the outbreak of pandemic disease. Mild neurological disturbances such as headache have been related to the extensive utilization of facemask. This study aims to examine headache variations related to the intensive utilization of facemask among a cohort of healthcare professionals in a setting of low-medium risk of exposure to SARS-CoV-2. METHODS This is a cross-sectional study among healthcare providers from different hospital and clinics in Italy. Each participant completed a specifically designed self-administered questionnaire. Headache features and outcome measures' change from baseline were evaluated over a 4-month period, in which wearing facemask has become mandatory for Italian healthcare workers. RESULTS A total of 400 healthcare providers completed the questionnaire, 383 of them met the inclusion criteria. The majority were doctors, with a mean age of 33.4 ± 9.2 years old. Among 166/383 subjects, who were headache free at baseline, 44 (26.5%) developed de novo headache. Furthermore, 217/383 reported a previous diagnosis of primary headache disorder: 137 were affected by migraine and 80 had tension-type headache. A proportion (31.3%) of these primary headache sufferers experienced worsening of their pre-existing headache disorder, mainly for migraine frequency and attack mean duration. CONCLUSIONS Our data showed the appearance of de novo associated facemask headache in previous headache-free subjects and an exacerbation of pre-existing primary headache disorders, mostly experienced by people with migraine disease.
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Affiliation(s)
- Laura Rapisarda
- Institute of Neurology, Department of Medical and Surgical Sciences, AOU Mater Domini - Magna Græcia University, V.le Europa, 88100, Catanzaro, Italy
| | - Michele Trimboli
- Institute of Neurology, Department of Medical and Surgical Sciences, AOU Mater Domini - Magna Græcia University, V.le Europa, 88100, Catanzaro, Italy.
| | - Francesco Fortunato
- Institute of Neurology, Department of Medical and Surgical Sciences, AOU Mater Domini - Magna Græcia University, V.le Europa, 88100, Catanzaro, Italy
| | - Antonio De Martino
- Institute of Neurology, Department of Medical and Surgical Sciences, AOU Mater Domini - Magna Græcia University, V.le Europa, 88100, Catanzaro, Italy
| | - Oreste Marsico
- Institute of Neurology, Department of Medical and Surgical Sciences, AOU Mater Domini - Magna Græcia University, V.le Europa, 88100, Catanzaro, Italy
| | - Giulio Demonte
- Institute of Neurology, Department of Medical and Surgical Sciences, AOU Mater Domini - Magna Græcia University, V.le Europa, 88100, Catanzaro, Italy
| | | | - Angelo Labate
- Institute of Neurology, Department of Medical and Surgical Sciences, AOU Mater Domini - Magna Græcia University, V.le Europa, 88100, Catanzaro, Italy
| | - Antonio Gambardella
- Institute of Neurology, Department of Medical and Surgical Sciences, AOU Mater Domini - Magna Græcia University, V.le Europa, 88100, Catanzaro, Italy
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Rapisarda L, Valentino P, Barone S, Torti C, La Gamba V, Fortunato F, Sammarra I, Gambardella A. Varicella zoster immunity loss in multiple sclerosis patient treated with ocrelizumab. Clin Immunol 2021; 223:108554. [DOI: 10.1016/j.clim.2020.108554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
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Chisari CG, Toro MD, Cimino V, Rejdak R, Luca M, Rapisarda L, Avitabile T, Posarelli C, Rejdak K, Reibaldi M, Zappia M, Patti F. Retinal Nerve Fiber Layer Thickness and Higher Relapse Frequency May Predict Poor Recovery after Optic Neuritis in MS Patients. J Clin Med 2019; 8:jcm8112022. [PMID: 31752357 PMCID: PMC6912390 DOI: 10.3390/jcm8112022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/15/2019] [Accepted: 11/16/2019] [Indexed: 12/16/2022] Open
Abstract
Optic neuritis (ON) is a common manifestation of multiple sclerosis (MS). Aiming to evaluate the retinal nerve fiber layer (RNFL) with optical coherence tomography (OCT), patients with relapsing-remitting (RR) MS experiencing ON were consecutively enrolled. RNFL, ganglion cell layer (GCL), foveal thickness, and macular volume were evaluated in both the ON and unaffected (nON) eye within six days from the relapse onset (T0) and after six months (T1). Ninety patients were enrolled. At T0, ON eyes showed a significantly increased RNFL when compared to the nON eyes (129.1 ± 19.5 vs. 100.5 ± 10.1, p < 0.001). At T1 versus T0, the ON eyes showed a thinner RNFL (129.1 ± 19.5 vs. 91.6 ± 20.2, p < 0.001) and a significantly decreased GCL (80.4 ± 8.8 vs. 73.8 ± 11.6; p < 0.005). No differences were found in the nON group in retinal parameters between T0 and T1. A multivariate logistic regression analysis showed that a higher number of relapses (not ON) and a greater swelling of RNFL at T0 were associated with poor recovery. The assessment of RNFL through OCT during and after ON could be used to predict persistent visual disability.
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Affiliation(s)
- Clara Grazia Chisari
- Department “GF. Ingrassia”; section of Neurosciences. University of Catania, 95123 Catania, Italy; (C.G.C.); (M.L.); (L.R.); (M.Z.); (F.P.)
| | - Mario Damiano Toro
- Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
- Eye Clinic, University of Catania, 95123 Catania, Italy; (T.A.); (M.R.)
- Correspondence: ; Tel.: +48-608047052; Fax: +48-815326149
| | - Vincenzo Cimino
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy;
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
| | - Maria Luca
- Department “GF. Ingrassia”; section of Neurosciences. University of Catania, 95123 Catania, Italy; (C.G.C.); (M.L.); (L.R.); (M.Z.); (F.P.)
| | - Laura Rapisarda
- Department “GF. Ingrassia”; section of Neurosciences. University of Catania, 95123 Catania, Italy; (C.G.C.); (M.L.); (L.R.); (M.Z.); (F.P.)
| | - Teresio Avitabile
- Eye Clinic, University of Catania, 95123 Catania, Italy; (T.A.); (M.R.)
| | - Chiara Posarelli
- Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy;
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, 20079 Lublin, Poland;
| | - Michele Reibaldi
- Eye Clinic, University of Catania, 95123 Catania, Italy; (T.A.); (M.R.)
| | - Mario Zappia
- Department “GF. Ingrassia”; section of Neurosciences. University of Catania, 95123 Catania, Italy; (C.G.C.); (M.L.); (L.R.); (M.Z.); (F.P.)
| | - Francesco Patti
- Department “GF. Ingrassia”; section of Neurosciences. University of Catania, 95123 Catania, Italy; (C.G.C.); (M.L.); (L.R.); (M.Z.); (F.P.)
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Sarica A, Curcio M, Rapisarda L, Cerasa A, Quattrone A, Bono F. Periventricular white matter changes in idiopathic intracranial hypertension. Ann Clin Transl Neurol 2019; 6:233-242. [PMID: 30847356 PMCID: PMC6389746 DOI: 10.1002/acn3.685] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/25/2018] [Accepted: 10/05/2018] [Indexed: 12/12/2022] Open
Abstract
Objective To evaluate whether increased cerebrospinal fluid (CSF) pressure causes alteration of periventricular white matter (WM) microstructure in patients with idiopathic intracranial hypertension (IIH). Methods In a prospective study, patients with refractory chronic headache with and without IIH performed a neuroimaging study including 3T MRI, 3D Phase Contrast MR venography, and diffusion tensor imaging (DTI) of the brain. Whole‐brain voxel‐wise comparisons of DTI abnormalities of WM were performed using tract‐based spatial statistics. A correlation analysis between DTI indices and CSF opening pressure, highest peak, and mean pressure was also performed in patients with IIH. Results We enrolled 62 consecutive patients with refractory chronic headaches. Thirty‐five patients with IIH, and 27 patients without increased intracranial pressure. DTI analysis revealed no fractional anisotropy changes, but decreased mean, axial, and radial diffusivity in body (IIHMD = 0.80 ± 0.04, non‐IIHMD = 0.84 ± 0.4, IIHAD = 1.67 ± 0.07, non‐IIHAD = 1.74 ± 0.05, IIHRD = 0.38 ± 0.04, non‐IIHRD = 0.42 ± 0.05 [mm2/sec × 10−3]) of corpus callosum, and in right superior corona radiata (IIHMD = 0.75 ± 0.04, non‐IIHMD = 0.79 ± 0.05, IIHAD = 1.19 ± 0.07, non‐IIHAD = 1.28 ± 0.09, IIHRD = 0.59 ± 0.03, non‐IIHRD = 0.53 ± 0.03 [mm2/sec × 10−3]) of 35 patients with IIH compared with 27 patients without increased intracranial pressure. DTI indices were negatively correlated with high CSF pressures (P < 0.05). After medical treatment, eight patients showed incremented MD in anterior corona radiata left and right and superior corona radiata right. Conclusions There is significant DTI alteration in periventricular WM microstructure of patients with IIH suggesting tissue compaction correlated with high CSF pressure. This periventricular WM change may be partially reversible after medical treatment.
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Affiliation(s)
- Alessia Sarica
- Department of Medical and Surgical Sciences Neuroscience Centre Magna Græcia University of Catanzaro Catanzaro Italy
| | - Maria Curcio
- Department of Medical and Surgical Sciences Center for Headache and Intracranial Pressure Disorders Institute of Neurology Magna Græcia University of Catanzaro Catanzaro Italy
| | - Laura Rapisarda
- Department of Medical and Surgical Sciences Center for Headache and Intracranial Pressure Disorders Institute of Neurology Magna Græcia University of Catanzaro Catanzaro Italy
| | - Antonio Cerasa
- Neuroimaging Research Unit Institute of Bioimaging and Molecular Physiology National Research Council Catanzaro Italy.,S. Anna Institute and Research in Advanced Neurorehabilitation Crotone Italy
| | - Aldo Quattrone
- Department of Medical and Surgical Sciences Neuroscience Centre Magna Græcia University of Catanzaro Catanzaro Italy.,Neuroimaging Research Unit Institute of Bioimaging and Molecular Physiology National Research Council Catanzaro Italy
| | - Francesco Bono
- Department of Medical and Surgical Sciences Center for Headache and Intracranial Pressure Disorders Institute of Neurology Magna Græcia University of Catanzaro Catanzaro Italy
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Bono F, Curcio M, Rapisarda L, Vescio B, Bombardieri C, Mangialavori D, Aguglia U, Quattrone A. Cerebrospinal Fluid Pressure-Related Features in Chronic Headache: A Prospective Study and Potential Diagnostic Implications. Front Neurol 2018; 9:1090. [PMID: 30619049 PMCID: PMC6305580 DOI: 10.3389/fneur.2018.01090] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 08/17/2018] [Accepted: 11/28/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: To identify the pressure-related features of isolated cerebrospinal fluid hypertension (ICH) in order to differentiate headache sufferers with ICH from those with primary headache disorder. Methods: In this prospective study, patients with refractory chronic headaches and suspected of having cerebrospinal fluid-pressure elevation without papilledema or sixth nerve palsy, together with controls, underwent 1-h lumbar cerebrospinal fluid pressure monitoring via a spinal puncture needle. Results: We recruited 148 consecutive headache patients and 16 controls. Lumbar cerebrospinal fluid pressure monitoring showed high pressure and abnormal pressure pulsations in 93 (63 %) patients with headache: 37 of these patients with the most abnormal pressure parameters (opening pressure above 250 mm H2O, mean pressure 301 mm H2O, mean peak pressure 398 mm H2O, and severe abnormal pressure pulsations) had the most severe headaches and associated symptoms (nocturnal headache, postural headache, transient visual obscuration); 56 patients with the less abnormal pressure parameters (opening pressure between 200 and 250 mm H2O, mean pressure 228 mm H2O, mean peak pressure 316 mm H2O, and abnormal pressure pulsations) had less severe headaches and associated symptoms. Conclusions: Nocturnal and postural headache, and abnormal pressure pulsations are the more common pressure-related features of ICH in patients with chronic headache. Abnormal pressure pulsations may be considered a marker of ICH in chronic headache.
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Affiliation(s)
- Francesco Bono
- Center for Headache and Intracranial Pressure Disorders, Magna Græcia University, Catanzaro, Italy.,Institute of Neurology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Maria Curcio
- Center for Headache and Intracranial Pressure Disorders, Magna Græcia University, Catanzaro, Italy
| | - Laura Rapisarda
- Center for Headache and Intracranial Pressure Disorders, Magna Græcia University, Catanzaro, Italy
| | - Basilio Vescio
- Neurosciences Research Center, Magna Græcia University, Catanzaro, Italy
| | - Caterina Bombardieri
- Institute of Neuroradiology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Domenica Mangialavori
- Institute of Ophthalmology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Umberto Aguglia
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Aldo Quattrone
- Neurosciences Research Center, Magna Græcia University, Catanzaro, Italy
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Raggi A, Covelli V, Guastafierro E, Leonardi M, Scaratti C, Grazzi L, Bartolini M, Viticchi G, Cevoli S, Pierangeli G, Tedeschi G, Russo A, Barbanti P, Aurilia C, Lovati C, Giani L, Frediani F, Di Fiore P, Bono F, Rapisarda L, D'Amico D. Validation of a self-reported instrument to assess work-related difficulties in patients with migraine: the HEADWORK questionnaire. J Headache Pain 2018; 19:85. [PMID: 30203193 PMCID: PMC6131677 DOI: 10.1186/s10194-018-0914-7] [Citation(s) in RCA: 16] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/04/2018] [Indexed: 01/03/2023] Open
Abstract
Background The degree to which work-related difficulties are recognized in headache research is poor and often carried out with inadequate information such as “reduced ability to work as usual”, which do not capture at all the variety of difficulties and the factors that impact over them. The aim of this paper is to present the validation of the HEADWORK questionnaire, which addresses the amount and severity of difficulties in work-related tasks and the factors that impact over them. Methods We developed a set of items based on a previous literature review and patients’ focus groups and tested it on a wide set of patients with episodic and chronic migraine attending eight different Italian headache centers. HEADWORK factor structure was assessed with exploratory and confirmatory factor analysis; internal consistency and construct validity were addressed as well. Results The validation sample (N = 373) was mostly composed of patients with episodic migraine without aura (64.3%) and of females (81%). Factor analysis retrieved two different scales: “Work-related difficulties”, composed of eleven items which explain 67.1% of the total variance, and “Factors contributing to work difficulties”, composed of six items which explain 52.1% of the total variance. Both HEADWORK subscales have good measurement properties, with higher scores being associated to higher disability, lower quality of life, lower productivity, higher headache frequency and pain intensity. Conclusions HEADWORK is a 17-item, two-scale questionnaire addressing the impact of migraine on work-related difficulties in terms of difficulties in general or specific skills, and the factors contributing to these difficulties, defined as negative impact on work tasks. It can be used to address disability weights for the purpose of calculating the burden of migraine, and to assess the balance between therapeutic and side effects of medication on productivity. Electronic supplementary material The online version of this article (10.1186/s10194-018-0914-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | | | - Erika Guastafierro
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Scaratti
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Licia Grazzi
- Headache and Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marco Bartolini
- Clinica di Neurologia, Università Politecnica delle Marche, Ancona, Italy
| | - Giovanna Viticchi
- Clinica di Neurologia, Università Politecnica delle Marche, Ancona, Italy
| | - Sabina Cevoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Giulia Pierangeli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,DIBINEM - Alma Mater Studiorum, Università di Bologna, Bologna, Italy
| | - Gioacchino Tedeschi
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Russo
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Piero Barbanti
- Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences. IRCCS San Raffaele Pisana, Rome, Italy.,San Raffaele University, Rome, Italy
| | - Cinzia Aurilia
- Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences. IRCCS San Raffaele Pisana, Rome, Italy
| | - Carlo Lovati
- Neurology Unit, Headache Center, Ospedale L, Sacco University of Milan, Milan, Italy
| | - Luca Giani
- Neurology Unit, Headache Center, Ospedale L, Sacco University of Milan, Milan, Italy
| | - Fabio Frediani
- Neurological and Stroke Unit Department, Headache Center, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, Milan, Italy
| | - Paola Di Fiore
- Neurological and Stroke Unit Department, Headache Center, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, Milan, Italy
| | - Francesco Bono
- Headache Center, Institute of Neurology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Laura Rapisarda
- Headache Center, Institute of Neurology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Domenico D'Amico
- Headache and Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Pinzone MR, Zanghì AM, Rapisarda L, D'Agata V, Benanti F, Spartà D, Nunnari G, Cacopardo B. Cirrhotic patients are still at risk of developing hepatocellular carcinoma despite Interferon-induced sustained virological response. Eur Rev Med Pharmacol Sci 2014; 18:11-15. [PMID: 25535185] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Hepatitis C virus (HCV) infection is a common cause of chronic liver disease and hepatocellular carcinoma (HCC). The prevalence of HCC significantly declines among patients achieving a sustained virological response (SVR) after antiviral therapy with pegylated(PEG)-interferon (IFN) and ribavirin. However, up to 5% of patients with SVR may develop HCC. PATIENTS AND METHODS We investigated the epidemiological, clinical, biochemical and virological characteristics of a small cohort of patients with chronic hepatitis C (CHC) who developed HCC after being successfully treated with PEG-IFN-α and ribavirin. RESULTS Between September 2000 and January 2003, 598 patients with CHC underwent a complete course of treatment with PEG-IFN-α and ribavirin; 221 out of 598 (37%) patients obtained a SVR. Throughout the 10-year post-treatment follow up, 13 of 221 ( 5.8% ) SVR patients developed HCC. All 13 patients were male and were affected with Child A liver cirrhosis; in addition, at baseline they were significantly older (p < 0.05) and had higher alpha-fetoprotein levels (p < 0.05) in comparison with those who did not develop HCC. Nine patients (69.3%) developed HCC within the first 3 years after antiviral treatment completion, one patient (7.7%) between 3 and 5 years and 3 subjects (23%) between 5 and 10 years; 12 of 13 had a solitary lesion with a mean diameter of 2.5± 0.5 cm. Eleven cases (84.6%) underwent surgical resection, one (7.7%) received liver transplantation, one (7.7%) received palliative care. CONCLUSIONS The risk of developing HCC after achieving SVR persists in patients with HCV-related cirrhosis. As a consequence, these patients should continue to undergo long-term surveillance for HCC, in order to early detect and treat it.
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Affiliation(s)
- M R Pinzone
- Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Italy.
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Marioni CF, Rapisarda L, Butelli S. [Drug addiction and hepatitis C: does a correlation exist between the laboratory and clinical pictures?]. Recenti Prog Med 1992; 83:690-1. [PMID: 1337387] [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] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The prevalence of anti-HCV antibodies reaches 90% positive among intravenous drug addicts. The authors evaluate the possibility of relating laboratory findings to clinical evolution of hepatitis C. Besides, a comparison between first generation anti-HCV system ELISA and the newer RIBA detection system showed no significant difference.
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Marioni CF, Rapisarda L, Lussetti M, Perseghin P. [Prevalence of liver damage in alcoholics and drug addicts]. Recenti Prog Med 1991; 82:577-80. [PMID: 1763228] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The behaviour of drug addicts and alcoholics leads to the cooperation of risk factors concerning the development of chronic hepatitis, liver cirrhosis and hepatocarcinoma. The authors evaluate the prevalence of infections from B, C and Delta virus among a group of 40 intravenous drug users and 40 alcoholics affering to a territorial centre for drug dependence located in Valtellina (Italy). The prevalence of at least one serum marker of virus B, C or Delta hepatitis results to be 85% among drug addicts and 17% among alcoholics. The prevalence of Anti-HCV in alcoholics results to be much lower than found in former works. For what concerns the hepatitis B virus, 68% of the drug addicts and 10% of the alcoholics had at least one positive serum marker. The hepatitis B seronegative patients underwent vaccination with a recombinant-DNA vaccine. Those affected by chronic C hepatitis have been treated with alpha-recombinant interferon. All of the patients underwent health education, psychotherapy and drug-addiction therapy for a period of 8 months. These strategies in prevention and therapy aim to the reduction over the years of the incidence of chronic hepatitis liver cirrhosis and hepatocarcinoma among intravenous drug users and alcoholics.
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Affiliation(s)
- C F Marioni
- Nucleo operativo per le Tossicodipendenze e l'Alcolismo, USSL 24, Bormio
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