37 results on '"Ferrara, Michela"'
Search Results
2. The role of SARS-COV-2 infection in promoting abnormal immune response and sepsis: A comparison between SARS-COV-2-related sepsis and sepsis from other causes
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Piccioni, Andrea, Franza, Laura, Rosa, Federico, Candelli, Marcello, Covino, Marcello, Ferrara, Michela, Volonnino, Gianpietro, Bertozzi, Giuseppe, Vittoria Zamponi, Maria, Maiese, Aniello, Savioli, Gabriele, Franceschi, Francesco, and La Russa, Raffaele more...
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- 2023
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3. Cervical spine injury: clinical and medico-legal overview
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Zanza, Christian, Tornatore, Gilda, Naturale, Cristina, Longhitano, Yaroslava, Saviano, Angela, Piccioni, Andrea, Maiese, Aniello, Ferrara, Michela, Volonnino, Gianpietro, Bertozzi, Giuseppe, Grassi, Roberta, Donati, Fabrizio, and Karaboue, Michele Ahmed Antonio more...
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- 2023
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4. Oxidative/Nitrosative Stress and Brain Involvement in Sepsis: A Relationship Supported by Immunohistochemistry.
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Bertozzi, Giuseppe, Ferrara, Michela, Calvano, Mariagrazia, Pascale, Natascha, and Di Fazio, Aldo
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SEPTIC shock ,NATURAL history ,HEALTH facilities ,GLUTATHIONE peroxidase ,VITAMIN E - Abstract
Background and Objectives: A large amount of recent evidence suggests that cellular inability to consume oxygen could play a notable part in promoting sepsis as a consequence of mitochondrial dysfunction and oxidative stress. The latter could, in fact, represent a fundamental stage in the evolution of the "natural history" of sepsis. Following a study previously conducted by the same working group on heart samples, the present research project aims to evaluate, through an immunohistochemical study, the existence and/or extent of oxidative stress in the brains of subjects who died due to sepsis and define, after reviewing the literature, its contribution to the septic process to support the use of medications aimed at correcting redox anomalies in the management of septic patients. Materials and Methods: 10 cases of subjects who died in healthcare facilities with ante-mortem clinical-laboratory signs that allowed the diagnosis of septic shock were selected as case studies, and 1 case of a subject who died immediately following a road traffic accident was used as a negative control. Samples of the cerebral cortex were then taken, fixed in formalin, and subjected to sections on which an immunohistochemical study was performed using anti-NOX-2, NT, iNOS, and 8-OHdG antibodies. Results: The results emerging from the present study demonstrate that despite a variable expressivity for the NT, iNOS, and NOX2 markers, the brain samples demonstrated univocal and high positivity for the 8-OHdG marker. Conclusions: This would allow us to hypothesize how, regardless of the mechanism of production of ROS and NOS (iNOS or NOX2 mediated) and the pathophysiological mechanisms that are triggered during sepsis, oxidative damage to DNA represents the event to which this whole process leads and, in fact, in the literature, is directly correlated to sepsis-dependent mortality. Neurons, conversely, appear to be more sensitive to oxidative stress because of a low number of protective or scavenger molecules (catalase, glutathione peroxidase, GSH, or vitamin E). Therefore, despite reduced production, the manifestation of the damage remains high. This evidence, together with that of the previous study, can only support the introduction of substances with an antioxidant function in the guidelines for the treatment of sepsis. [ABSTRACT FROM AUTHOR] more...
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- 2024
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5. Is It Still Time for Safety Walkaround? Pilot Project Proposing a New Model and a Review of the Methodology.
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Ferrara, Michela, Pascale, Natascha, Ciavarella, Mauro, Bertozzi, Giuseppe, Bellettieri, Angela Pia, and Di Fazio, Aldo
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PILOT projects ,HEALTH facilities ,PATIENT experience ,INDUSTRIAL management ,PHYSICIAN-patient relations ,SAFETY hats - Abstract
Background and Objectives: Healthcare facilities are complex systems due to the interaction between different factors (human, environmental, management, and technological). As complexity increases, it is known that the possibility of error increases; therefore, it becomes essential to be able to analyze the processes that occur within these contexts to prevent their occurrence, which is the task of risk management. For this purpose, in this feasibility study, we chose to evaluate the application of a new safety walkaround (SWA) model. Materials and Methods: A multidisciplinary working group made up of experts was established and then the subsequent phases of the activity were divided into three stages, namely the initial meeting, the operational phase, and the final meeting, to investigate knowledge regarding patient safety before and subsequently through visits to the department: the correct compilation of the medical record, adherence to evidence-based medicine (EBM) practices, the overall health and the degree of burnout of the various healthcare professionals, as well as the perception of empathy of staff by patients. Results: This working group chose to start this pilot project in the vascular surgery ward, demonstrating the ability of the tool used to capture the different aspects it set out to collect. In detail, the new version of SWA proposed in this work has made it possible to identify risk situations and system vulnerabilities that have allowed the introduction of corrective tools; detect adherence to existing company procedures, reschedule training on these specific topics after reviewing, and possibly update the same procedures; record the patient experience about the doctor–patient relationship and communication to hypothesize thematic courses on the subject; evaluate workers' perception of their health conditions about work, and above all reassure operators that their well-being is in the interest of the management of the healthcare company, which is maintained. Conclusions: Therefore, the outcome of the present study demonstrates the versatility and ever-present usefulness of the SWA tool. [ABSTRACT FROM AUTHOR] more...
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- 2024
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6. Oxidative Stress in Sepsis: A Focus on Cardiac Pathology.
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Bertozzi, Giuseppe, Ferrara, Michela, Di Fazio, Aldo, Maiese, Aniello, Delogu, Giuseppe, Di Fazio, Nicola, Tortorella, Vittoria, La Russa, Raffaele, and Fineschi, Vittorio
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OXIDATIVE stress , *SEPSIS , *MULTIPLE organ failure , *HEART cells , *PATHOLOGY , *HEART diseases - Abstract
This study aims to analyze post-mortem human cardiac specimens, to verify and evaluate the existence or extent of oxidative stress in subjects whose cause of death has been traced to sepsis, through immunohistological oxidative/nitrosative stress markers. Indeed, in the present study, i-NOS, NOX2, and nitrotyrosine markers were higher expressed in the septic death group when compared to the control group, associated with also a significant increase in 8-OHdG, highlighting the pivotal role of oxidative stress in septic etiopathogenesis. In particular, 70% of cardiomyocyte nuclei from septic death specimens showed positivity for 8-OHdG. Furthermore, intense and massive NOX2-positive myocyte immunoreaction was noticed in the septic group, as nitrotyrosine immunostaining intense reaction was found in the cardiac cells. These results demonstrated a correlation between oxidative and nitrosative stress imbalance and the pathophysiology of cardiac dysfunction documented in cases of sepsis. Therefore, subsequent studies will focus on the expression of oxidative stress markers in other organs and tissues, as well as on the involvement of the intracellular pattern of apoptosis, to better clarify the complex pathogenesis of multi-organ failure, leading to support the rationale for including therapies targeting redox abnormalities in the management of septic patients. [ABSTRACT FROM AUTHOR] more...
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- 2024
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7. Risk Management and Patient Safety in the Artificial Intelligence Era: A Systematic Review.
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Ferrara, Michela, Bertozzi, Giuseppe, Di Fazio, Nicola, Aquila, Isabella, Di Fazio, Aldo, Maiese, Aniello, Volonnino, Gianpietro, Frati, Paola, and La Russa, Raffaele
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PATIENT safety ,MEDICAL quality control ,MEDICAL errors ,ARTIFICIAL intelligence ,RISK management in business ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,ONLINE information services ,COMPARATIVE studies ,MACHINE learning ,MEDICAL practice ,MEDICAL incident reports - Abstract
Background: Healthcare systems represent complex organizations within which multiple factors (physical environment, human factor, technological devices, quality of care) interconnect to form a dense network whose imbalance is potentially able to compromise patient safety. In this scenario, the need for hospitals to expand reactive and proactive clinical risk management programs is easily understood, and artificial intelligence fits well in this context. This systematic review aims to investigate the state of the art regarding the impact of AI on clinical risk management processes. To simplify the analysis of the review outcomes and to motivate future standardized comparisons with any subsequent studies, the findings of the present review will be grouped according to the possibility of applying AI in the prevention of the different incident type groups as defined by the ICPS. Materials and Methods: On 3 November 2023, a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was carried out using the SCOPUS and Medline (via PubMed) databases. A total of 297 articles were identified. After the selection process, 36 articles were included in the present systematic review. Results and Discussion: The studies included in this review allowed for the identification of three main "incident type" domains: clinical process, healthcare-associated infection, and medication. Another relevant application of AI in clinical risk management concerns the topic of incident reporting. Conclusions: This review highlighted that AI can be applied transversely in various clinical contexts to enhance patient safety and facilitate the identification of errors. It appears to be a promising tool to improve clinical risk management, although its use requires human supervision and cannot completely replace human skills. To facilitate the analysis of the present review outcome and to enable comparison with future systematic reviews, it was deemed useful to refer to a pre-existing taxonomy for the identification of adverse events. However, the results of the present study highlighted the usefulness of AI not only for risk prevention in clinical practice, but also in improving the use of an essential risk identification tool, which is incident reporting. For this reason, the taxonomy of the areas of application of AI to clinical risk processes should include an additional class relating to risk identification and analysis tools. For this purpose, it was considered convenient to use ICPS classification. [ABSTRACT FROM AUTHOR] more...
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- 2024
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8. Functional neuroimaging and clinical features of drug naive patients with de novo Parkinson’s disease and probable RBD
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Arnaldi, Dario, Morbelli, Silvia, Brugnolo, Andrea, Girtler, Nicola, Picco, Agnese, Ferrara, Michela, Accardo, Jennifer, Buschiazzo, Ambra, de Carli, Fabrizio, Pagani, Marco, and Nobili, Flavio
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- 2016
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9. A multidisciplinary approach is mandatory to solve complex crimes: a case report
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Ferrara, Michela, Sessa, Francesco, Rendine, Marcello, Spagnolo, Lorenzo, De Simone, Stefania, Riezzo, Irene, Ricci, Pietrantonio, Pascale, Natascha, Salerno, Monica, Bertozzi, Giuseppe, and Maglietta, Francesca more...
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- 2019
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10. Nigro-caudate dopaminergic deafferentation: a marker of REM sleep behavior disorder?
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Arnaldi, Dario, De Carli, Fabrizio, Picco, Agnese, Ferrara, Michela, Accardo, Jennifer, Bossert, Irene, Famà, Francesco, Girtler, Nicola, Morbelli, Silvia, Sambuceti, Gianmario, and Nobili, Flavio
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- 2015
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11. Mapping brain morphological and functional conversion patterns in predementia late-onset bvFTD
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Morbelli, Silvia, Ferrara, Michela, Fiz, Francesco, Dessi, Barbara, Arnaldi, Dario, Picco, Agnese, Bossert, Irene, Buschiazzo, Ambra, Accardo, Jennifer, Picori, Lorena, Girtler, Nicola, Mandich, Paola, Pagani, Marco, Sambuceti, Gianmario, and Nobili, Flavio more...
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- 2016
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12. Parkinson’s Disease Sleep Scale 2: application in an Italian population
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Arnaldi, Dario, Cordano, Christian, De Carli, Fabrizio, Accardo, Jennifer, Ferrara, Michela, Picco, Agnese, Tamburini, Tiziano, Brugnolo, Andrea, Abbruzzese, Giovanni, and Nobili, Flavio
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- 2016
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13. Radionuclide brain imaging correlates of cognitive impairment in Parkinson's disease (PD)
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Nobili, Flavio, Morbelli, Silvia, Arnaldi, Dario, Ferrara, Michela, Campus, Claudio, Brugnolo, Andrea, Mazzei, Debora, Mehrdad, Naseri, Sambuceti, Gianmario, and Rodriguez, Guido
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- 2011
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14. Correlation between Doppler Velocities and Duplex Ultrasound Carotid Cross-sectional Percent Stenosis
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Rodriguez, Guido, Arnaldi, Dario, Campus, Claudio, Mazzei, Debora, Ferrara, Michela, Picco, Agnese, Famà, Francesco, Colombo, Barbara M., and Nobili, Flavio
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- 2011
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15. Plasma antioxidants and brain glucose metabolism in elderly subjects with cognitive complaints
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Picco, Agnese, Polidori, M. Cristina, Ferrara, Michela, Cecchetti, Roberta, Arnaldi, Dario, Baglioni, Mauro, Morbelli, Silvia, Bastiani, Patrizia, Bossert, Irene, Fiorucci, Giuliana, Brugnolo, Andrea, Dottorini, Massimo Eugenio, Nobili, Flavio, and Mecocci, Patrizia more...
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- 2014
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16. Learning from the Past to Improve the Future—Vaccine Hesitancy Determinants in the Italian Population: A Systematic Review.
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Ferrara, Michela, Bertozzi, Giuseppe, Volonnino, Gianpietro, Di Fazio, Aldo, Di Fazio, Nicola, Arcangeli, Mauro, La Russa, Raffaele, and Frati, Paola
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VACCINE hesitancy ,SCIENTIFIC literacy ,PUBLIC health education ,SOCIOCULTURAL factors ,COVID-19 vaccines ,MEDICAL literature - Abstract
WHO identifies vaccine hesitancy (VH) as one of the ten threats to global health. The authors bring to the international scientific community an Italian episode that offers the opportunity to renew the discussion on the extent of the VH matter. The purpose of this systematic review is to analyze the factors determining vaccine hesitancy in the Italian population, to understand its roots, and suggest potential strategies to mitigate it. A systematic review of the literature according to the PRISMA guidelines was carried out using the SCOPUS and Medline (via PubMed) databases, using the following strategy: (COVID-19 vaccines) AND (vaccination hesitancy) AND (Italy). After the selection process, 36 articles were included in this systematic review. The most frequently detected factors associated with VH in the Italian population can be grouped as vaccine-related factors, socio-cultural factors, and demographic factors. Currently, we are facing a gap between the population and science, governments, and institutions. To heal this breach, it is necessary to strengthen the trust of the population through the implementation of health communication and public education strategies, while scientific literacy must continue to support families and individuals in discerning evidence from opinions to recognize the real risks and balance them with the benefits. [ABSTRACT FROM AUTHOR] more...
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- 2023
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17. Proactive Risk Assessment through Failure Mode and Effect Analysis (FMEA) for Perioperative Management Model of Oral Anticoagulant Therapy: A Pilot Project.
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Micheletta, Fausta, Ferrara, Michela, Bertozzi, Giuseppe, Volonnino, Gianpietro, Nasso, Maria, and La Russa, Raffaele
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- 2022
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18. Brain perfusion correlates of cognitive and nigrostriatal functions in de novo Parkinson’s disease
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Nobili, Flavio, Arnaldi, Dario, Campus, Claudio, Ferrara, Michela, De Carli, Fabrizio, Brugnolo, Andrea, Dessi, Barbara, Girtler, Nicola, Morbelli, Silvia, Abruzzese, Giovanni, Sambuceti, Gianmario, and Rodriguez, Guido more...
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- 2011
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19. Liver Trauma: Management in the Emergency Setting and Medico-Legal Implications.
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Saviano, Angela, Ojetti, Veronica, Zanza, Christian, Franceschi, Francesco, Longhitano, Yaroslava, Martuscelli, Ermelinda, Maiese, Aniello, Volonnino, Gianpietro, Bertozzi, Giuseppe, Ferrara, Michela, and La Russa, Raffaele more...
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EMERGENCY management ,ABDOMINAL injuries ,BLUNT trauma ,EMERGENCY physicians ,LIVER ,LIVER surgery - Abstract
Traumatic abdominal injuries are life-threatening emergencies frequently seen in the Emergency Department (ED). The most common is liver trauma, which accounts for approximately 5% of all ED admissions for trauma. The management of blunt liver trauma has evolved significantly over the past few decades and, according to the injury's severity, it may require massive resuscitation, radiological procedures, endoscopy, or surgery. Patients admitted to the ED with blunt abdominal trauma require a multidisciplinary evaluation, including emergency physicians, surgeons, radiologists, and anesthetists, who must promptly identify the extent of the injury to prevent serious complications. In case of a patient's death, the execution of a forensic examination carried out with a multidisciplinary approach (radiological, macroscopic, and histological) is essential to understand the cause of death and to correlate the extent of the injuries to the possibility of survival to be able to manage any medico-legal disputes. This manuscript aims to collect the most up-to-date evidence regarding the management of hepatic trauma in the emergency room and to explore radiological findings and medico-legal implications. [ABSTRACT FROM AUTHOR] more...
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- 2022
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20. What predicts cognitive decline in de novo Parkinson's disease?
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Arnaldi, Dario, Campus, Claudio, Ferrara, Michela, Famà, Francesco, Picco, Agnese, De Carli, Fabrizio, Accardo, Jennifer, Brugnolo, Andrea, Sambuceti, Gianmario, Morbelli, Silvia, and Nobili, Flavio
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- 2012
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21. A repository based on a dynamically extensible data model supporting multidisciplinary research in neuroscience
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Corradi Luca, Porro Ivan, Schenone Andrea, Momeni Parastoo, Ferrari Raffaele, Nobili Flavio, Ferrara Michela, Arnulfo Gabriele, and Fato Marco M
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Neuroscience ,Data models ,Multidisciplinary studies ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Robust, extensible and distributed databases integrating clinical, imaging and molecular data represent a substantial challenge for modern neuroscience. It is even more difficult to provide extensible software environments able to effectively target the rapidly changing data requirements and structures of research experiments. There is an increasing request from the neuroscience community for software tools addressing technical challenges about: (i) supporting researchers in the medical field to carry out data analysis using integrated bioinformatics services and tools; (ii) handling multimodal/multiscale data and metadata, enabling the injection of several different data types according to structured schemas; (iii) providing high extensibility, in order to address different requirements deriving from a large variety of applications simply through a user runtime configuration. Methods A dynamically extensible data structure supporting collaborative multidisciplinary research projects in neuroscience has been defined and implemented. We have considered extensibility issues from two different points of view. First, the improvement of data flexibility has been taken into account. This has been done through the development of a methodology for the dynamic creation and use of data types and related metadata, based on the definition of “meta” data model. This way, users are not constrainted to a set of predefined data and the model can be easily extensible and applicable to different contexts. Second, users have been enabled to easily customize and extend the experimental procedures in order to track each step of acquisition or analysis. This has been achieved through a process-event data structure, a multipurpose taxonomic schema composed by two generic main objects: events and processes. Then, a repository has been built based on such data model and structure, and deployed on distributed resources thanks to a Grid-based approach. Finally, data integration aspects have been addressed by providing the repository application with an efficient dynamic interface designed to enable the user to both easily query the data depending on defined datatypes and view all the data of every patient in an integrated and simple way. Results The results of our work have been twofold. First, a dynamically extensible data model has been implemented and tested based on a “meta” data-model enabling users to define their own data types independently from the application context. This data model has allowed users to dynamically include additional data types without the need of rebuilding the underlying database. Then a complex process-event data structure has been built, based on this data model, describing patient-centered diagnostic processes and merging information from data and metadata. Second, a repository implementing such a data structure has been deployed on a distributed Data Grid in order to provide scalability both in terms of data input and data storage and to exploit distributed data and computational approaches in order to share resources more efficiently. Moreover, data managing has been made possible through a friendly web interface. The driving principle of not being forced to preconfigured data types has been satisfied. It is up to users to dynamically configure the data model for the given experiment or data acquisition program, thus making it potentially suitable for customized applications. Conclusions Based on such repository, data managing has been made possible through a friendly web interface. The driving principle of not being forced to preconfigured data types has been satisfied. It is up to users to dynamically configure the data model for the given experiment or data acquisition program, thus making it potentially suitable for customized applications. more...
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- 2012
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22. Homicide or car accident: The case of the 'guilty' fibre.
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De Simone, Stefania, Maglietta, Francesca, Ferrara, Michela, Spagnolo, Lorenzo, Ricci, Pietrantonio, De Carlo, Dania, Salerno, Monica, Sessa, Francesco, and Bertozzi, Giuseppe
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AUTOPSY ,CRIME ,CAUSES of death ,HOMICIDE ,INTERDISCIPLINARY research ,FORENSIC medicine ,POLICE ,TRAFFIC accidents - Abstract
Crime scene investigation should be carried out using a critical forensic approach by an expert team. This provides essential tools in the research and collection of evidence and samples which must be integrated with the autopsy and the police officers' investigations. This paper aims to highlight the importance of a multidisciplinary approach to crime scene investigation and describes a very interesting criminal case. As demonstrated by this case, the evidence obtained from the crime scene analysis sheds light on difficult cases, such as murders staged as suicides or accidents. [ABSTRACT FROM AUTHOR] more...
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- 2019
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23. Metabolic Correlates of Rey Auditory Verbal Learning Test in Elderly Subjects with Memory Complaints.
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Brugnolo, Andrea, Morbelli, Silvia, Arnaldi, Dario, De Carli, Fabrizio, Accardo, Jennifer, Bossert, Irene, Dessi, Barbara, Famà, Francesco, Ferrara, Michela, Girtler, Nicola, Picco, Agnese, Rodriguez, Guido, Sambuceti, Gianmario, and Nobili, Flavio more...
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REY Auditory Verbal Learning Test ,HEALTH of older people ,MEMORY ,MILD cognitive impairment ,COGNITION disorders ,DIAGNOSTIC imaging ,BIOCHEMISTRY - Abstract
We evaluated the brain metabolic correlates of main indexes of a widely used word list learning test, the Rey Auditory Verbal Memory Test (RAVLT), in a group of elderly subjects with memory complaints. Fifty-four subjects (age: 72.02 ± 7.45; Mini-Mental State Examination (MMSE) score: 28.9 ± 1.24) presenting at a memory clinic complaining of memory deficit, but not demented, and thirty controls (age: 71.87 ± 7.08; MMSE score: 29.1 ± 1.1) were included. Subjects with memory complaints included both patients with (amnestic mild cognitive impairment, aMCI) and without (subjective memory complaints, SMC) impairment on memory tests. All subjects underwent 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), analyzed with statistical parametric. Patients with aMCI but not those with SMC showed the expected posterior cingulate-precuneus and parietal hypometabolism as compared to controls. Correlation was determined for between four indexes of the RAVLT and brain metabolism. The results show a significant correlation between the delayed recall score and metabolism in posterior cingulate gyrus of both hemispheres and in left precuneus, as well as between a score of long-term percent retention and metabolism in left posterior cingulate gyrus, precuneus, and orbitofrontal areas. These correlations survived correction for age, education, and MMSE score. No correlation was found between immediate or total recall scores and glucose metabolism. These data show the relevant role of posterior cingulate-precuneus and orbitofrontal cortices in retention and retrieval of de-contextualized verbal memory material in a group of elderly subjects with memory complaints and shed light on the topography of synaptic dysfunction in these subjects, overlapping that found in the earliest stages of Alzheimer-type neurodegeneration. [ABSTRACT FROM AUTHOR] more...
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- 2014
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24. Seizures Can Precede Cognitive Symptoms in Late-Onset Alzheimer's Disease.
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Picco, Agnese, Archetti, Silvana, Ferrara, Michela, Arnaldi, Dario, Piccini, Alessandra, Serrati, Carlo, di Lorenzo, Diego, Morbelli, Silvia, and Nobili, Flavio
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ALZHEIMER'S disease ,MILD cognitive impairment ,AMYLOIDOSIS ,APOLIPOPROTEIN E ,NEURONS ,BIOMARKERS ,PRESENILINS - Abstract
This study describes late-onset Alzheimer's disease (LOAD) in the mild cognitive impairment (MCI) stage, debuting with seizures in a 72 year-old woman. Prodromal AD was consistently diagnosed with four among amyloidosis and neurodegeneration biomarkers about 1 year after onset of seizures. Genetic assessment demonstrated apolipoprotein E ℇ2/ℇ3 genotype and three intronic single nucleotide substitutions, two in presenilin 1 and one in amyloid-β protein precursor genes. This case of seizures at onset of LOAD with severe signs of brain amyloidosis and neurodegeneration but with just MCI leads to a re-appraisal of the intriguing relationship between AD pathology and neuron excitability in humans. [ABSTRACT FROM AUTHOR] more...
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- 2011
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25. Frontal Variant Alzheimer Disease or Frontotemporal Lobe Degeneration With Incidental Amyloidosis?
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Scialò, Carlo, Ferrara, Michela, Accardo, Jennifer, Morbelli, Silvia, Picco, Agnese, Arnaldi, Dario, Brugnolo, Andrea, Girtler, Nicola, and Nobili, Flavio
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The article presents a case study of 68-year-old woman, a retired school teacher presented with multidomain cognitive impairment which is associated with behavioral symptoms. Topics mentioned include the diagnosis of frontotemporal lobe degeneration (FTLD) or frontal variant Alzheimer Disease (FvAD) with incidental amyloidosis, the focus on the results of F-fluorodeoxyglucose positron emission tomography (FDG-PET) and F-florbetapir PET, and the difficulty of differentiating FvAD from FTLD. more...
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- 2016
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26. Sudden Cardiac Death and Ex-Situ Post-Mortem Cardiac Magnetic Resonance Imaging: A Morphological Study Based on Diagnostic Correlation Methodology.
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Bertozzi, Giuseppe, Cafarelli, Francesco Pio, Ferrara, Michela, Di Fazio, Nicola, Guglielmi, Giuseppe, Cipolloni, Luigi, Manetti, Federico, La Russa, Raffaele, and Fineschi, Vittorio
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CARDIAC magnetic resonance imaging ,CARDIAC arrest ,MAGNETIC resonance imaging ,FORENSIC pathology ,DIAGNOSTIC imaging ,IMPLANTABLE cardioverter-defibrillators - Abstract
During the last years, post-mortem imaging has gradually been assumed within research in the field of forensic pathology. This role appears to be clearly and simply applied in the trauma field with the use of conventional radiography or Post Mortem Computed Tomography (PMCT). Recently, particular attention was paid to cardiovascular imaging using Post Mortem Magnetic Resonance Imaging (PMMRI). The present experimental study aims to: (i) confirm the efficacy of a Post Mortem Cardiac Resonance Imaging (PMCRI) study protocol for the study of human hearts collected during the autopsy; (ii) apply the defined protocol on subjects who died of "SCD (sudden cardiac death)", to identify alterations that could guide subsequent sampling. Two hearts of healthy subjects (A: male 22 years; B: female 26 years), who died from causes other than SCD were collected and compared to hearts that belonged to SCD individuals (C: male, 47 years old; D: female, 44 years old; E: male; 72 years old). The exams were performed on a 1.5 T scanner (Philips Intera Achieva, Best, the Netherlands) on hearts collected during autopsy and after a 30-day formalin fixation. Two readers analyzed the obtained images blindly and after randomization. From the comparison between the data from imaging and the macroscopic and histological investigations carried out, the present study proved the effectiveness of a PMMRI protocol to study ex-situ hearts. Moreover, it suggested the following semeiology in post-mortem SCD cases: the hyperintense area with indistinct margins in the Short Tau Inversion Recovery (STIR) sequence was linked to edema or area of pathological fibers, whereas the hypointense area in the T2-FFE sequences was linked to fibrosis. PMMRI can provide a valuable benefit to post-mortem investigations, helping to distinctly improve the success rate of histological sampling and investigations, which remains the gold standard in the diagnosis of sudden death. [ABSTRACT FROM AUTHOR] more...
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- 2022
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27. Dog-bite-related attacks: A new forensic approach.
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Iarussi, Fabrizio, Cipolloni, Luigi, Bertozzi, Giuseppe, Sasso, Luigi, Ferrara, Michela, Salerno, Monica, Rubino, Giuseppe Tommaso Roberto, Maglietta, Francesca, Dinisi, Armida, Albano, Davide, Iarussi, Valerio, Pomara, Cristoforo, and Sessa, Francesco more...
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DOG bites , *DOG attacks , *HEALTH risk assessment , *FORENSIC pathology , *SHORT tandem repeat analysis , *DNA analysis , *BITES & stings , *SALIVA , *DNA fingerprinting , *ANIMAL experimentation , *GENETIC techniques , *FORENSIC medicine , *GENEALOGY , *DOGS - Abstract
Dog attacks today represent a health hazard considering that prevention strategies have not always been successful. The identification of the dog that attacked the victim is necessary, considering the civil or criminal consequences for the animal's owner. An accurate scene analysis must be performed collecting a series of important information. Forensic investigations in dog attacks involve different methods, such as the evaluating of the canine Short Tandem Repeat (STR) typing in saliva traces on wounds or bite mark analysis, however, these techniques cannot always be applied. The effort to find new methods to identify the dog that attacked the victim represents a very interesting field for the forensic community. This study aims to propose an innovative approach, based on the identification of the victim's profile in the dog's mouth, using a buccal swab on the suspected aggressor dog, to find the victim's genetic profile. In addition, a further goal of this study is to determine the persistence time of hexogen DNA in the dog's mouth to define a timeframe for performing this particular technique. For this purpose, ten different dogs were used to aggressively bite a bovine sample (reference sample) to simulate the victim. For each dog two buccal swabs were taken at different time intervals: 30', 45', 60', 90', 120', 150', 180' and 240'. The typing of the swabs provided an interpretable profile after 45' while traces of bovine profile were found until 150' after the dog attack simulation. These results could be improved using the human identification kit, which is more sensitive. In the light of this experimental study, the forensic community should consider using this approach in real casework studies with the aim of collecting new data, validating this technique for forensic use. [ABSTRACT FROM AUTHOR] more...
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- 2020
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28. Glymphatic System a Window on TBI Pathophysiology: A Systematic Review.
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Ferrara M, Bertozzi G, Volonnino G, Di Fazio N, Frati P, Cipolloni L, La Russa R, and Fineschi V
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- Brain metabolism, Humans, Lymphatic System metabolism, Neuroglia metabolism, Brain Injuries metabolism, Glymphatic System metabolism
- Abstract
Background: In recent years, the attention of the scientific world has focused on a clearance system of brain waste metabolites, called the glymphatic system, based on its similarity to the lymphatic system in peripheral tissue and the relevant role of the AQP4 glial channels and described for the first time in 2012. Consequently, numerous studies focused on its role in organ damage in cases of neuropathologies, including TBI., Methods: To evaluate the role that the glymphatic system has in the pathogenesis of TBI, on 23 March 2022, a systematic review of the literature according to PRISMA guidelines was carried out using the SCOPUS and Medline (via PubMed) databases, resulting in 12 articles after the selection process., Discussion and Conclusion: The present review demonstrated that an alteration of AQP4 is associated with the accumulation of substances S100b, GFAP, and NSE, known markers of TBI in the forensic field. In addition, the alteration of the functionality of AQP4 favors edema, which, as already described, constitutes alterations of secondary brain injuries. Moreover, specific areas of the brain were demonstrated to be prone to alterations of the glymphatic pathway, suggesting their involvement in post-TBI damage. Therefore, further studies are mandatory. In this regard, a study protocol on cadavers is also proposed, based on the analyzed evidence. more...
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- 2022
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29. COVID-19 and H1N1-09: A Systematic Review of Two Pandemics with a Focus on the Lung at Autopsy.
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Bertozzi G, Ferrara M, Maiese A, Di Fazio N, Delogu G, Frati P, La Russa R, and Fineschi V
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- Autopsy, Humans, Lung pathology, Pandemics, Quality of Life, COVID-19 epidemiology, Influenza A Virus, H1N1 Subtype, Influenza, Human epidemiology
- Abstract
Background: The purpose of this manuscript is to provide a comparative overview of the two global pandemics: the first on June 11th 2009 due to influenza A H1N1 (H1N1-09); the second and current pandemic caused by coronavirus 2019 (COVID-19) on March 11th 2020, focusing on how autopsy can contribute to the definition of cellular pathology, to clinical pathology and, more generally, to public health., Methods: A systematic literature search selection was conducted on PubMed database on June 5, 2021, with this search strategy: (COVID-19) AND (H1N1 influenza) showing 101 results. The following inclusion criteria were selected: English language; published in a scholarly peer-reviewed journal; full-length articles were further elected. To further refine the research was to focus on the type of manuscript: review, systematic review, and meta-analysis. A critical appraisal of the collected studies was conducted, analyzing titles and abstracts, excluding the following topics: treatment, public health measures and perception of the general population or healthcare personnel about their quality of life. According to these procedures, 54 eligible studies were included in the present review., Results: Histopathological findings play a key role in understanding the pathophysiological mechanisms of diseases and, thus possible therapeutic approaches. The evidence on the thrombo-inflammatory mechanism underlying COVID-19 is growing to a much greater magnitude than the diffuse alveolar damage in common with H1N1-09; our study appears to be in line with these results. The prevailing scientific thinking to explain the morbidity and mortality of COVID-19 patients is that it elicits an exuberant immune reaction characterized by dysregulated cytokine production, known as a "cytokine storm"., Conclusions: The histological and immunohistochemical pattern demonstrated similarities and differences between the infectious manifestations of the two pathogens, which justify empirical therapeutic approaches, in the first phase of the COVID-19 pandemic. Therefore, the previous pandemic should have taught us to promote a culture of clinical and forensic autopsies in order to provide timely evidence from integration among autopsy and clinical data for early adopting adequate therapies., Competing Interests: The authors declare no conflict of interest. RLR is serving as the guest editor of this journal. VF is serving as the editorial board member of this journal. We declare that RLR and VF had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to GP., (© 2022 The Author(s). Published by IMR Press.) more...
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- 2022
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30. Proactive Risk Assessment Through Failure Mode and Effect Analysis (FMEA) for Haemodialysis Facilities: A Pilot Project.
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La Russa R, Fazio V, Ferrara M, Di Fazio N, Viola RV, Piras G, Ciano G, Micheletta F, and Frati P
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- Humans, Pilot Projects, Renal Dialysis, Risk Assessment, Risk Management methods, Healthcare Failure Mode and Effect Analysis
- Abstract
Haemodialysis (HD) is one of the methods for renal replacement therapy in the management of advanced chronic kidney disease through an osmosis process that allows purification of blood in the dialysis machine. The complexity of the dialytic procedure often requires the presence of a multi-specialist, multi-disciplinary team. The dialysis process is an important target for clinical risk management. Failure Mode and Effect Analysis (FMEA) is a proactive technique, considered a purposeful and dynamic tool for clinical risk management. FMEA is noted in five phases that allow a preliminary assessment of a definite process through identification and classification of risk priorities. This study represents the first of a two-phase project where FMEA is applied to HD in the setting of San Feliciano Hospital. The dialysis center performs ~12,000 dialysis sessions per year. The dialysis process is divided into different stages. A total of 31 failure modes were identified in the whole dialysis stages; more than 2/3 of the failure modes were related to the only connecting of the patient to the dialysis machine. The first phase of the study clearly remarked that the most critical step of the dialytic process is represented by the connection between the patient and the machine, as expected. Indeed, in order to have the dialysis set up, an arteriovenous fistula must be surgically created prior to the procedure and it is one of the most important issues in the HD process because of the necessity of a constant revision of it. FMEA application to HD is a useful tool, easy to be implemented and it is likely to nimbly reveal the practical and potential solutions to the critical steps of the procedure., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 La Russa, Fazio, Ferrara, Di Fazio, Viola, Piras, Ciano, Micheletta and Frati.) more...
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- 2022
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31. Penetrating cardiac injuries: literature review and analysis of the forensic approach.
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Ferrara M, Baldari B, Vittorio S, Bertozzi G, Cipolloni L, and De Simone S
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- Humans, Retrospective Studies, Heart Injuries surgery, Suicide, Wounds, Penetrating surgery
- Abstract
Penetrating cardiac injuries represent an increasingly frequent type of trauma in clinical and autopsy practice. The present study aims to review the specialist literature of the last decade (2010-2020) to assess whether the main features of these lesions have changed compared to previous years. The following characteristics were considered: sex, age, cardiac structure involved, execution or not of surgery and postoperative survival, hemodynamic stability, circumstances and mechanism of production, injury and cause of death. Furthermore, the authors propose a practical appraisal of penetrating heart injury in which death was due to a delay in rescue. In line with the data obtained from the practical case, the review showed that compared to the past, the differences concern especially the mortality rate. This paper highlights that the forensic pathologist who approaches a case of transcardiac injury must consider that the circumstances of death are not always attributable to accidental events, attacks or suicides, but may also be due to clinical malpractice or failure to rescue., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s). Published by IMR Press.) more...
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- 2022
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32. The Role of miRNAs as New Molecular Biomarkers for Dating the Age of Wound Production: A Systematic Review.
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De Simone S, Giacani E, Bosco MA, Vittorio S, Ferrara M, Bertozzi G, Cipolloni L, and La Russa R
- Abstract
Background: The timing of wounds production is a significant issue in forensic pathology. Although various methods have been evaluated, obtaining an accurate dating of lesions is still a challenge. The pathologist uses many parameters to value wound age, such as histological and immunohistochemical. In recent years, there have been many studies regarding the use of miRNAs in wound-age estimation; indeed, miRNAs have multiple potential uses in forensic pathology., Scope: This review aims to verify the efficacy and feasibility of miRNAs as a tool for determining the timing of lesions., Materials and Methods: The authors conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed was used as a search engine to find articles published between January, 1st 2016 and October, 1st 2021, to evaluate the current state of the art regarding wound-age estimation., Results: A total of 256 articles were collected; after screening according to PRISMA guidelines, the systematic review included 8 articles. The studies included in this review were all Original articles evaluating the use of biomarkers for wound-age determination., Discussion and Conclusion: The literature review showed that analysis of miRNA is an innovative field of study with significant potentiality in forensic pathology. There are few studies, and almost all of them are at an early stage. The challenge is to understand how to standardize the samples' selection to obtain reliable experimental data. This observation represents a necessary prerequisite to planning further clinical trials., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer AM declared a shared affiliation, with no collaboration, with one of the authors SV to the handling editor at the time of the review., (Copyright © 2022 De Simone, Giacani, Bosco, Vittorio, Ferrara, Bertozzi, Cipolloni and La Russa.) more...
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- 2022
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33. Traumatic Brain Injury and Gut Brain Axis: The Disruption of an Alliance.
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Ferrara M, Bertozzi G, Zanza C, Longhitano Y, Piccolella F, Lauritano CE, Volonnino G, Manetti AC, Maiese A, and La Russa R
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- Animals, Humans, Brain-Gut Axis, Brain, Anxiety, Gastrointestinal Microbiome, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic pathology
- Abstract
Background: Traumatic brain injury (TBI) can be considered a "silent epidemic", causing morbidity, disability, and mortality in all age cohorts. Therefore, a greater understanding of the underlying pathophysiological intricate mechanisms and interactions with other organs and systems is necessary to intervene not only in the treatment but also in the prevention of complications. In this complex of reciprocal interactions, the complex brain-gut axis has captured a growing interest., Scope: The purpose of this manuscript is to examine and systematize existing evidence regarding the pathophysiological processes that occur following TBI and the influences exerted on these by the brain-gut axis., Literature Review: A systematic review of the literature was conducted according to the PRISMA methodology. On the 8th of October 2021, two independent databases were searched: PubMed and Scopus. Following the inclusion and exclusion criteria selected, 24 (12 from PubMed and 12 from Scopus) eligible manuscripts were included in the present review. Moreover, references from the selected articles were also updated following the criteria mentioned above, yielding 91 included manuscripts., Discussion: Published evidence suggests that the brain and gut are mutually influenced through four main pathways: microbiota, inflammatory, nervous, and endocrine., Conclusion: These pathways are bidirectional and interact with each other. However, the studies conducted so far mainly involve animals. An autopsy methodological approach to corpses affected by traumatic brain injury or intestinal pathology could represent the keystone for future studies to clarify the complex pathophysiological processes underlying the interaction between these two main systems., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.) more...
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- 2022
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34. Wound Vitality in Decomposed Bodies: New Frontiers Through Immunohistochemistry.
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Bertozzi G, Ferrara M, La Russa R, Pollice G, Gurgoglione G, Frisoni P, Alfieri L, De Simone S, Neri M, and Cipolloni L
- Abstract
Background: The question about wound vitality and the estimation of wound age of production are two of the classic investigation fields of forensic sciences. To answer this, the techniques most frequently used in research studies are immunohistochemistry (IHC), molecular biology, and biochemistry. Despite the great data on the literature about the usefulness of IHC in forensic pathology, there is always a request for further studies, especially on tissues altered by putrefactive phenomena. In fact, the degradation of the tissues is intended as the main limiting factor to the use of this technique. Scope: The aim of this pilot study was to evaluate the immunohistochemical behavior of samples collected from decomposed bodies (in different putrefaction phases) and to relate these findings to wound vitality and postmortem interval. Materials and Methods: Samples of skin and soft tissues were collected during autopsies, which were executed on decomposed bodies, whose cause of death was concluded to be traumatic. An immunohistochemical study was performed using antibodies against CD15, CD45, IL-15, tryptase, and glycophorin-A MMPs (endopeptidases involved in degrading extracellular matrix proteins: MMP-9 and MMP-2). An immunohistochemistry (IHC) reaction was evaluated according to a qualitative method as the following legend: (0): not expressed, (+): isolated and disseminated expression, (++): expression in groups or widespread foci, and (+++): widespread expression. Results: Most of the tested markers (tryptase, glycophorin, IL15, CD 15, CD 45, and MMP9) showed to be highly expressed in the tissue of putrefied skin for 15 days. Discussion and Conclusion: Although certainly inconclusive, this experimental application demonstrated that a nonexclusive but combined use of multiple antibodies is appropriate to verify wound vitality in decomposed bodies. Among them, GPA exhibited major reliability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Bertozzi, Ferrara, La Russa, Pollice, Gurgoglione, Frisoni, Alfieri, De Simone, Neri and Cipolloni.) more...
- Published
- 2021
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35. Sphingomyelin as a myelin biomarker in CSF of acquired demyelinating neuropathies.
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Capodivento G, Visigalli D, Garnero M, Fancellu R, Ferrara MD, Basit A, Hamid Z, Pastore VP, Garibaldi S, Armirotti A, Mancardi G, Serrati C, Capello E, Schenone A, and Nobbio L
- Subjects
- Animals, Chromatography, Liquid, Cross-Sectional Studies, Demyelinating Diseases cerebrospinal fluid, Demyelinating Diseases metabolism, Diagnosis, Differential, Disease Models, Animal, Humans, Peripheral Nervous System Diseases cerebrospinal fluid, Peripheral Nervous System Diseases metabolism, Rats, Retrospective Studies, Tandem Mass Spectrometry, Biomarkers cerebrospinal fluid, Demyelinating Diseases diagnosis, Peripheral Nervous System Diseases diagnosis, Sphingomyelins cerebrospinal fluid
- Abstract
Fast, accurate and reliable methods to quantify the amount of myelin still lack, both in humans and experimental models. The overall objective of the present study was to demonstrate that sphingomyelin (SM) in the cerebrospinal fluid (CSF) of patients affected by demyelinating neuropathies is a myelin biomarker. We found that SM levels mirror both peripheral myelination during development and small myelin rearrangements in experimental models. As in acquired demyelinating peripheral neuropathies myelin breakdown occurs, SM amount in the CSF of these patients might detect the myelin loss. Indeed, quantification of SM in 262 neurological patients showed a significant increase in patients with peripheral demyelination (p = 3.81 * 10 - 8) compared to subjects affected by non-demyelinating disorders. Interestingly, SM alone was able to distinguish demyelinating from axonal neuropathies and differs from the principal CSF indexes, confirming the novelty of this potential CSF index. In conclusion, SM is a specific and sensitive biomarker to monitor myelin pathology in the CSF of peripheral neuropathies. Most importantly, SM assay is simple, fast, inexpensive, and promising to be used in clinical practice and drug development. more...
- Published
- 2017
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36. The Role of the Serotonergic System in REM Sleep Behavior Disorder.
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Arnaldi D, Famà F, De Carli F, Morbelli S, Ferrara M, Picco A, Accardo J, Primavera A, Sambuceti G, and Nobili F
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- Aged, Aged, 80 and over, Corpus Striatum metabolism, Dopamine metabolism, Dopamine Plasma Membrane Transport Proteins metabolism, Female, Humans, Male, Middle Aged, Polysomnography, Prospective Studies, Serotonin Plasma Membrane Transport Proteins metabolism, Tomography, Emission-Computed, Single-Photon, Tropanes, Video Recording, REM Sleep Behavior Disorder physiopathology, Serotonin physiology
- Abstract
Study Objectives: REM sleep behavior disorder (RBD) can be induced by antidepressants, especially serotonin reuptake inhibitors (SSRI), thus a role of the serotonergic system in the pathogenesis of RBD has been proposed. However, the serotonergic system integrity in idiopathic RBD (iRBD) is still unknown. We aimed to study brain stem serotonergic system integrity, by means of (123)I-FP-CIT-SPECT, in a group of iRBD patients as compared to normal subjects., Design: Single-center, prospective observational study., Setting: University hospital., Patients or Participants: Twenty iRBD outpatients and 23 age-matched normal controls., Measurements and Results: The diagnosis of RBD was determined clinically and confirmed by means of overnight, laboratory-based video-polysomnography. Both iRBD patients and normal subjects underwent (123)I-FP-CIT-SPECT as a marker of dopamine transporter (DAT) at basal ganglia level and of serotonin transporter (SERT) at brainstem and thalamus levels. (123)I-FP-CIT-SPECT images were analyzed and compared between iRBD patients and controls by means of both region of interest analysis at basal ganglia, midbrain, pons and thalamus levels, and voxel-based analysis, taking into account age and the use of SSRI as confounding factors. No difference in (123)I-FP-CIT-SPECT specific to nondisplaceable binding ratios (SBR) values was found between iRBD and normal subjects at brainstem and thalamus levels while iRBD patients showed lower SBR values in all basal ganglia nuclei (P < 0.0001) compared to controls., Conclusions: These results suggest that the serotonergic system is not directly involved in RBD pathogenesis while confirming nigro-striatal dopaminergic deafferentation in iRBD., (© 2015 Associated Professional Sleep Societies, LLC.) more...
- Published
- 2015
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37. Screening of Early and Late Onset Alzheimer's Disease Genetic Risk Factors in a Cohort of Dementia Patients from Liguria, Italy.
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Ferrari R, Ferrara M, Alinani A, Sutton RB, Famà F, Picco A, Rodriguez G, Nobili F, and Momeni P
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- Age of Onset, Aged, Aged, 80 and over, Cognitive Dysfunction genetics, Cohort Studies, Female, Genetic Association Studies, Genotype, Humans, Italy, Male, Middle Aged, Risk Factors, Alzheimer Disease genetics, Dementia genetics, Genetic Predisposition to Disease genetics
- Abstract
Cohorts from a defined geographical area enable ad hoc genotype-phenotype correlation studies providing novel and unique insight into disease. We analysed genetic risk factors associated with early and late onset Alzheimer's disease (EOAD and LOAD) in a population from Liguria (northern Italy), as part of an ongoing longitudinal study. We screened 37 AD, 8 mild cognitive impairment (MCI), 3 AD and CVD (cerebrovascular disease), 3 MCI and CVD, 8 frontotemporal dementia (FTD) and 2 progressive supranuclear palsy (PSP) patients, and 28 normal controls (NCs).We sequenced PSEN1, PSEN2 and APP (EOAD risk factors), as well as MAPT, GRN and TARDBP for all cases and NCs, and analysed the APOE, CLU, CR1 and PICALM genotypes as well as the MAPT and ACE haplotypes (LOAD risk factors) for the AD (n = 37) and AD + MCI (n = 45) cases and NCs (n = 28).We identified variants in PSEN1, PSEN2 and TARDBP across a range of phenotypes (AD, AD and CVD, FTD and PSP), suggesting that screening of all known candidate genes of Alzheimer's and non-Alzheimer's forms of dementias in all dementia cases might be warranted. The analysis of the LOAD risk factors revealed no association with AD or AD + MCI status after Bonferroni correction. Lack of association with APOE is supported by previous studies in the Italian population. Our data also evidenced: 1) a potentially protective haplotype at the PSEN2 locus; 2) a nominal association with the GWAS-risk allele A for rs3818361 in CR1 and; 3) a threefold prevalence of AD in the female population compared to men.Our results will need to be further assessed and confirmed in larger cohorts from this area. more...
- Published
- 2015
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