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2. Multi-center study on overall clinical complexity of patients with prolonged disorders of consciousness of different etiologies

Author

Estraneo, A, Masotta, O, Bartolo, M, Pistoia, F, Perin, C, Marino, S, Lucca, L, Pingue, V, Casanova, E, Romoli, A, Gentile, S, Formisano, R, Salvi, G, Scarponi, F, De Tanti, A, Bongioanni, P, Rossato, E, Santangelo, A, Diana, A, Gambarin, M, Intiso, D, Antenucci, R, Premoselli, S, Bertoni, M, De Bellis, F, Estraneo A., Masotta O., Bartolo M., Pistoia F., Perin C., Marino S., Lucca L., Pingue V., Casanova E., Romoli A., Gentile S., Formisano R., Salvi G. P., Scarponi F., De Tanti A., Bongioanni P., Rossato E., Santangelo A., Diana A. R., Gambarin M., Intiso D., Antenucci R., Premoselli S., Bertoni M., De Bellis F., Estraneo, A, Masotta, O, Bartolo, M, Pistoia, F, Perin, C, Marino, S, Lucca, L, Pingue, V, Casanova, E, Romoli, A, Gentile, S, Formisano, R, Salvi, G, Scarponi, F, De Tanti, A, Bongioanni, P, Rossato, E, Santangelo, A, Diana, A, Gambarin, M, Intiso, D, Antenucci, R, Premoselli, S, Bertoni, M, De Bellis, F, Estraneo A., Masotta O., Bartolo M., Pistoia F., Perin C., Marino S., Lucca L., Pingue V., Casanova E., Romoli A., Gentile S., Formisano R., Salvi G. P., Scarponi F., De Tanti A., Bongioanni P., Rossato E., Santangelo A., Diana A. R., Gambarin M., Intiso D., Antenucci R., Premoselli S., Bertoni M., and De Bellis F.

Abstract

Aim: to assess overall clinical complexity of patients with acquired disorders of consciousness (DoC) in vegetative state/unresponsive wakefulness syndrome (VS/UWS) vs. minimally conscious state- MCS) and in different etiologies. Design: Multi-center cross-sectional observational study. Setting: 23 intensive neurorehabilitation units. Subjects: 264 patients with DoC in the post-acute phase: VS/UWS = 141, and MCS = 123 due to vascular (n = 125), traumatic (n = 83) or anoxic (n = 56) brain injury. Main Measures: Coma Recovery Scale-Revised, and Disability Rating Scale (DRS); presence of medical devices (e.g., for eating or breathing); occurrence and severity of medical complications. Results: patients in DoC, and particularly those in VS/UWS, showed severe overall clinical complexity. Anoxic patients had higher overall clinical complexity, lower level of responsiveness/consciousness, higher functional disability, and higher needs of medical devices. Vascular patients had worse premorbid clinical comorbidities. The two etiologies showed a comparable rate of MC, higher than that observed in traumatic etiology. Conclusion: overall clinical complexity is significantly higher in VS/UWS than in MCS, and in non-traumatic vs. traumatic etiology. These findings could explain the worse clinical evolution reported in anoxic and vascular etiologies and in VS/UWS patients and contribute to plan patient-tailored care and rehabilitation programmes.

Published
2021

3. Multi-center observational study on occurrence and related clinical factors of neurogenic heterotopic ossification in patients with disorders of consciousness

Author

Estraneo, A, Pascarella, A, Masotta, O, Bartolo, M, Pistoia, F, Perin, C, Marino, S, Lucca, L, Pingue, V, Casanova, E, Romoli, A, Gentile, S, Formisano, R, Salvi, G, Scarponi, F, De Tanti, A, Bongioanni, P, Rossato, E, Santangelo, A, Diana, A, Gambarin, M, Intiso, D, Antenucci, R, Premoselli, S, Bertoni, M, Trojano, L, Estraneo A., Pascarella A., Masotta O., Bartolo M., Pistoia F., Perin C., Marino S., Lucca L., Pingue V., Casanova E., Romoli A. M., Gentile S., Formisano R., Salvi G. P., Scarponi F., De Tanti A., Bongioanni P., Rossato E., Santangelo A., Diana A. R., Gambarin M., Intiso D., Antenucci R., Premoselli S., Bertoni M., Trojano L., Estraneo, A, Pascarella, A, Masotta, O, Bartolo, M, Pistoia, F, Perin, C, Marino, S, Lucca, L, Pingue, V, Casanova, E, Romoli, A, Gentile, S, Formisano, R, Salvi, G, Scarponi, F, De Tanti, A, Bongioanni, P, Rossato, E, Santangelo, A, Diana, A, Gambarin, M, Intiso, D, Antenucci, R, Premoselli, S, Bertoni, M, Trojano, L, Estraneo A., Pascarella A., Masotta O., Bartolo M., Pistoia F., Perin C., Marino S., Lucca L., Pingue V., Casanova E., Romoli A. M., Gentile S., Formisano R., Salvi G. P., Scarponi F., De Tanti A., Bongioanni P., Rossato E., Santangelo A., Diana A. R., Gambarin M., Intiso D., Antenucci R., Premoselli S., Bertoni M., and Trojano L.

Abstract

Aims: to assess occurrence and clinical correlates of neurogenic heterotopic ossifications (NHO) in patients with prolonged disorder of consciousness (DoC). Design: multi-center cross-sectional observational study. Setting: 23 intensive neurorehabilitation units. Subjects: 287 patients with prolonged disorder of consciousness (DoC; 150 in vegetative state, VS, and 128 in minimally conscious state, MCS) of different etiology (vascular = 125, traumatic = 83, anoxic = 56, others = 14). Main Measures: clinical evidence of NHO confirmed by standard radiological and/or sonographic evaluation; Coma Recovery Scale-Revised; Disability Rating Scale (DRS); Early Rehabilitation Barthel Index; presence of ventilator support, spasticity, bone fractures and paroxysmal sympathetic hyperactivity. Results: 31 patients (11.2%) presented NHO. Univariate analyses showed that NHO was associated with VS diagnosis, traumatic etiology, high DRS category and total score, and high occurrence of limb spasticity and bone fractures. A cluster-corrected binary logistic regression model (excluding spasticity available in a subset of patients) showed that only lower DRS total score and presence of bone fractures were independently associated with NHO. Conclusions: NHO are relatively frequent in patients with DoC, and are independently associated with functional disability, bone fractures and spasticity. These findings contribute to identifying patients with DoC prone to develop NHO and requiring special interventions to improve functional recovery.

Published
2021

4. A regional audit system for stillbirth: a way to better understand the phenomenon

Author

Po G., Monari F., Zanni F., Grandi G., Lupi C., Facchinetti F., Mancini L., Lugli L., Lanzoni C., Sgarbi L., Chiossi C., Ricchieri F., Roberta C., Contiero R., Garani G., Pedriali M., Rossi S., Fini S., Di Bartolo M., Radi D., Vancini A., Donati A., Guadalupi E., Righetti F., Salerno A., Cocchi G., Morandi R., Gabrielli L., Graziano C., Seri M., Caprara G., Mario S. N. C., Fantuz F., Ferlini F., Righi E., Silvestrini D., Foschi F., Fieni S., Frusca T., Ferretti A., Galli L., Magnani C., Silini E., Balduzzi L., Bellini M., Rodolfi A. M., Sgarabotto M. P., Fragni G., Comitini G., Bonasoni M. P., Fioroni L., Rozzi C., Tuzio A., Vito I., Mammoliti P., De Ambrosi E., Ricci M., Bandini A., Belosi C., Muratori C., Zago S., Turci A., Vitarelli M., Po G., Monari F., Zanni F., Grandi G., Lupi C., Facchinetti F., Mancini L., Lugli L., Lanzoni C., Sgarbi L., Chiossi C., Ricchieri F., Roberta C., Contiero R., Garani G., Pedriali M., Rossi S., Fini S., Di Bartolo M., Radi D., Vancini A., Donati A., Guadalupi E., Righetti F., Salerno A., Cocchi G., Morandi R., Gabrielli L., Graziano C., Seri M., Caprara G., Mario S.N.C., Fantuz F., Ferlini F., Righi E., Silvestrini D., Foschi F., Fieni S., Frusca T., Ferretti A., Galli L., Magnani C., Silini E., Balduzzi L., Bellini M., Rodolfi A.M., Sgarabotto M.P., Fragni G., Comitini G., Bonasoni M.P., Fioroni L., Rozzi C., Tuzio A., Vito I., Mammoliti P., De Ambrosi E., Ricci M., Bandini A., Belosi C., Muratori C., Zago S., Turci A., and Vitarelli M.

Subjects
Clinical audit, Multivariate analysis, Placenta Diseases, Perinatal Death, Eastern, Umbilical Cord, Africa, Northern, Pregnancy, Risk Factors, Cause of Death, Northern, Europe, Eastern, Pregnancy Complications, Infectious, Multivariate Analysi, Causes of death, Cause of death, Fetal Growth Retardation, Obstetrics, Placenta Disease, Infectious, Obstetrics and Gynecology, Stillbirth, Perinatal audit, Quality of care, Adult, Africa South of the Sahara, Clinical Audit, Female, Fetal Death, Fetal Diseases, Humans, India, Italy, Multivariate Analysis, Pregnancy Complications, Quality of Health Care, Pregnancy Complication, Europe, Gestation, Human, Research Article, medicine.medical_specialty, Reproductive medicine, Fetal Disease, Audit, lcsh:Gynecology and obstetrics, medicine, lcsh:RG1-991, Late Stillbirth, business.industry, Risk Factor, medicine.disease, Africa, Pregnancy Complications, Infectiou, business
Abstract

Background Implementation of high-quality national audits for perinatal mortality are needed to improve the registration of all perinatal deaths and the identification of the causes of death. This study aims to evaluate the implementation of a Regional Audit System for Stillbirth in Emilia-Romagna Region, Italy. Methods For each stillbirth (≥ 22 weeks of gestation, ≥ 500 g) occurred between January 1, 2014 to December 1, 2016 (n = 332), the same diagnostic workup was performed and a clinical record with data about mother and stillborn was completed. Every case was discussed in a multidisciplinary local audit to assess both the cause of death (ReCoDe classification) and the quality of care. Data were reviewed by the Regional Audit Group. Stillbirth rates, causes of death and the quality of care were established for each case. Results Total stillbirth rate was 3.09 per 1000 births (332/107,528). Late stillbirth rate was 2.3 per 1000 (251/107,087). Sixteen stillbirths were not registered by the Regional Birth Register. The most prevalent cause of death was placental disorder (33.3%), followed by fetal (17.6%), cord (14.2%) and maternal disorders (7.6%). Unexplained cases were 14%. Compared to local audits, the regional group attributed different causes of death in 17% of cases. At multivariate analysis, infections were associated with early stillbirths (OR 3.38, CI95% 1.62–7.03) and intrapartum cases (OR 6.64, CI95% 2.61–17.02). Placental disorders were related to growth restriction (OR 1.89, CI95% 1.06–3.36) and were more frequent before term (OR 1.86, CI95% 1.11–3.15). Stillbirths judged possibly/probably preventable with a different management (10.9%) occurred more frequently in non-Italian women and were mainly related to maternal disorders (OR 6.64, CI95% 2.61–17.02). Conclusions Regional Audit System for Stillbirth improves the registration of stillbirth and allows to define the causes of death. Moreover, sub-optimal care was recognized, allowing to identify populations which could benefit from preventive measures.

Published
2019
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5. La gestión sanitaria en la atención a la población indígena y afroperuana en la pandemia por la COVID-19.

Author

Segovia, G., Bartolo, M., Trujillo, O., Rivera, G., Monteza, B., Chara, M., Gonzales, K., Lazóriga, L., Segovia, G., Bartolo, M., Trujillo, O., Rivera, G., Monteza, B., Chara, M., Gonzales, K., and Lazóriga, L.

Abstract

Objective: To determine the barriers in the management of health facilities that serve the indigenous and Afro-descendant population in Peru. Material and methods: A virtual survey on health management was designed for first level health care personnel in 89 health facilities (EESS) in 27 provinces during October and November 2021. Results: In 73% of the EESS, the personnel reported not knowing the plan against the third pandemic wave, 14.8% of the EESS reported not being trained in the management of COVID-19, in 22.7% of the EESS they met to coordinate how to face the third pandemic wave, in 83% of the EESS the personnel reported not having a budget for their plan against COVID-19. Conclusions: There are barriers in the vision, management and budget in EESS that serve indigenous and Afro-Peruvian populations, which would affect the effective execution of strategies for the control of the pandemic by COVID-19., Objetivo: Conocer las barreras en la gestión de los establecimientos de salud que atienden a población indígena y afrodescendiente del Perú. Material y métodos: Se diseñó una encuesta virtual en gestión sanitaria al personal del primer nivel de atención de 89 establecimientos de salud (EESS) de 27 provincias, durante los meses de octubre y noviembre del 2021. Resultados: En el 73 % de EESS, el personal refiere no conocer el plan contra la tercera ola pandémica, 14,8% de EESS el personal refiere no está capacitado en manejo de la COVID-19, en el 22,7% de EESS se reunieron para coordinar cómo enfrentar la tercera ola pandémica, en el 83% de EESS el personal refiere no contar con presupuesto para su plan contra la COVID-19. Conclusiones: Hay barreras en la visión, gestión y presupuesto en EESS que atienden poblaciones indígenas y afroperuano, lo que afectaría la ejecución eficaz de estrategias para el control de la pandemia por la COVID-19.

Published
2022

6. High intraoperative blood product requirements in liver transplantation: Risk factors and impact on the outcome

Author

Teofili, Luciana, Valentini, C. G., Aceto, Paola, Bartolo, M., Sollazzi, Liliana, Agnes, Salvatore, Gaspari, Rita, Avolio, Alfonso Wolfango, Teofili L. (ORCID:0000-0002-7214-1561), Aceto P. (ORCID:0000-0002-0228-0603), Sollazzi L. (ORCID:0000-0002-2973-6236), Agnes S. (ORCID:0000-0002-3341-4221), Gaspari R. (ORCID:0000-0003-0141-3686), Avolio A. W. (ORCID:0000-0003-2491-7625), Teofili, Luciana, Valentini, C. G., Aceto, Paola, Bartolo, M., Sollazzi, Liliana, Agnes, Salvatore, Gaspari, Rita, Avolio, Alfonso Wolfango, Teofili L. (ORCID:0000-0002-7214-1561), Aceto P. (ORCID:0000-0002-0228-0603), Sollazzi L. (ORCID:0000-0002-2973-6236), Agnes S. (ORCID:0000-0002-3341-4221), Gaspari R. (ORCID:0000-0003-0141-3686), and Avolio A. W. (ORCID:0000-0003-2491-7625)

Abstract

OBJECTIVE: Liver transplantation (LT) is associated with a significant bleeding and the high transfusion requirements (HTR) negatively affect the outcome of LT patients. Our primary aim was to identify potential predictors of intraoperative transfusion requirements. Secondarily, we investigated, the effect of transfusion requirements on different clinical outcomes, including short-term morbidity and mortality. PATIENTS AND METHODS: Data collected in 219 adult LT from a deceased donor, grouped according to HTR (defined as the need of 5 or more red blood cell units), were compared. RESULTS: We found that previous portal vein thromboses (p=0.0156), hemoglobin (Hb) (p<0.0001), International Normalized Ratio (INR) (p=0.0010) at transplant and veno-venous bypass (p=0.0048) independently predicted HTR. HTR was always associated with poorer outcomes, including higher simplified acute physiology II score at Intensive Care Unit admission (p=0.0005), higher rates of pulmonary infections (p=0.0015) and early rejection (p=0.0176), longer requirement of mechanical ventilation, (p<0.0001), more frequent need for hemodialysis after transplantation (p=0.0036), overall survival (p=0.0010) and rate of day-90 survival (p=0.0016). CONCLUSIONS: This study identified specific risk factors for HTR and confirmed the negative impact exerted by HTR on clinical outcomes, including recipient survival. Prospective investigations are worth to assess whether correcting pre-transplant Hb and INR levels may effectively reduce blood product need and improve prognosis.

Published
2022

7. Validation plan of bone marrow collection, processing and distribution using the failure mode and effect analysis methodology: a technical report

Author

Teofili, Luciana, Bianchi, M., Valentini, C. G., Bartolo, M., Orlando, Nicoletta, Sica, Simona, Teofili L. (ORCID:0000-0002-7214-1561), Orlando N., Sica S. (ORCID:0000-0003-2426-3465), Teofili, Luciana, Bianchi, M., Valentini, C. G., Bartolo, M., Orlando, Nicoletta, Sica, Simona, Teofili L. (ORCID:0000-0002-7214-1561), Orlando N., and Sica S. (ORCID:0000-0003-2426-3465)

Abstract

Background aims: Bone marrow (BM) is commonly used in the pediatric and adult setting as a source of hematopoietic stem cells (HSCs). The standards of the Joint Accreditation Committee of the International Society for Cell & Gene Therapy & European Society for Blood and Marrow Transplantation (JACIE) include specific requirements regarding BM collection, processing and distribution. To run this process, each transplant team develops a series of JACIE-compliant procedures, customizing them with regard to local settings and paths. Moreover, JACIE standards require that transplant teams validate and periodically revise their procedures to keep the entire process under control. In this article, the authors describe the methodology adopted in our center to fulfill the aforementioned JACIE requirements. Methods: The authors developed a validation plan based on the failure mode and effect analysis (FMEA) methodology. According to the FMEA approach, the authors carefully revised activities and procedures connected to BM collection, processing and distribution at our institution. The entire process was initially divided into five main phases (assessment of donor eligibility, perioperative autologous blood donation, preparation of BM collection kit, BM harvesting and BM processing and distribution), comprising 17 subphases and 22 activities. Results: For each activity, one or more failure modes were identified, for a total of 28 failure modes, and a risk priority number (RPN) was then assigned to each failure mode. Although many procedures were validated, others were subjected to substantial changes according to the RPN rating. Moreover, specific indicators were identified for subsequent monitoring to contain the risk of failure of steps emerging as critical at FMEA. Conclusions: This is the first study describing use of the FMEA methodology within an HSC transplant program. Shaping the risk analysis based on local experience may be a trustworthy tool for identifying

Published
2022

8. How to COVID-19 affected sleep talking episodes?

Author

Camaioni, M., Scarpelli, S., Alfonsi, V., Gorgoni, M., Calzolari, R., Bartolo, M., Mangiaruga, A., and Luigi De Gennaro

Subjects
parasomnia, sleep talking, dreaming
Published
2022

11. Being the Family Caregiver of a Patient With Dementia During the Coronavirus Disease 2019 Lockdown

Author

Zucca, M., Isella, V., Lorenzo, R. D., Marra, Camillo, Cagnin, A., Cupidi, C., Bonanni, L., Lagana, V., Rubino, E., Vanacore, N., Agosta, F., Caffarra, P., Sambati, R., Quaranta, Davide, Guglielmi, Valeria, Appollonio, I. M., Logroscino, G., Filippi, M., Tedeschi, G., Ferrarese, C., Rainero, I., Bruni, A. C., Gallo, E., Grassini, A., Marcinno, A., Roveta, F., Martino, P. D., Frangipane, F., Puccio, G., Colao, R., Mirabelli, M., Martellacci, N., Lino, F., Mozzetta, S., Busse, C., Camporese, G., Sacco, S., Lechiara, M. C., Carrarini, Claudia, Russo, M., Casalena, A., Sucapane, P., Tiraboschi, P., Caroppo, P., Redaelli, V., Fede, G. D., Coppa, D., Peluso, L., Insarda, P., Bartolo, M. D., Esposito, S., Iavarone, A., Orsini, A. V. M., Salvatore, E., Criscuolo, C., Sambati, L., Santoro, R., Gragnaniello, D., Pedriali, I., Ludovico, L., Chiari, A., Fabbo, A., Bevilacqua, P., Galli, C., Magarelli, S., Perini, M., Spalletta, G., Banaj, N., Porcari, D. E., Caruso, G., Cipollini, V., Casini, A. R., Ursini, F., Bruno, G., Rozzini, R., Brambilla, M., Magnani, G., Caso, F., Spinelli, E. G., Ramusino, M. C., Perini, G., Luzzi, S., Cacchio, G., Ciccola, A., Cionfrini, L., Giuli, C., Fabi, K., Guidi, M., Paci, C., Castellano, A., Petrucci, R., Accogli, M., Carapelle, E., Calabrese, G., Trevisi, G. N., Coluccia, B., Giuliano, A. V., Caggiula, M., Impagnatiello, V., Beretta, F., Milia, A., Pilia, G., Mascia, M. G., Putzu, V., Piccoli, T., Cuffaro, L., Monastero, R., Battaglia, A., Blandino, V., Lupo, F., Cumbo, E., Luca, A., Caravaglios, G., Vezzosi, A., Bessi, V., Tognoni, G., Calsolaro, V., Mossello, E., Amici, S., Trequattrini, A., Pezzuto, S., Mecocci, P., Fichera, G., Pradelli, S., Formilan, M., Coin, A., Togni, L. D., Sala, F., Nicolosi, V., Gallucci, M., Mazzarolo, A. P., Bergamelli, C., Zucca M., Isella V., Lorenzo R.D., Marra C., Cagnin A., Cupidi C., Bonanni L., Lagana V., Rubino E., Vanacore N., Agosta F., Caffarra P., Sambati R., Quaranta D., Guglielmi V., Appollonio I.M., Logroscino G., Filippi M., Tedeschi G., Ferrarese C., Rainero I., Bruni A.C., Gallo E., Grassini A., Marcinno A., Roveta F., Martino P.D., Frangipane F., Puccio G., Colao R., Mirabelli M., Martellacci N., Lino F., Mozzetta S., Busse C., Camporese G., Sacco S., Lechiara M.C., Carrarini C., Russo M., Casalena A., Sucapane P., Tiraboschi P., Caroppo P., Redaelli V., Fede G.D., Coppa D., Peluso L., Insarda P., Bartolo M.D., Esposito S., Iavarone A., Orsini A.V.M., Salvatore E., Criscuolo C., Sambati L., Santoro R., Gragnaniello D., Pedriali I., Ludovico L., Chiari A., Fabbo A., Bevilacqua P., Galli C., Magarelli S., Perini M., Spalletta G., Banaj N., Porcari D.E., Caruso G., Cipollini V., Casini A.R., Ursini F., Bruno G., Rozzini R., Brambilla M., Magnani G., Caso F., Spinelli E.G., Ramusino M.C., Perini G., Luzzi S., Cacchio G., Ciccola A., Cionfrini L., Giuli C., Fabi K., Guidi M., Paci C., Castellano A., Petrucci R., Accogli M., Carapelle E., Calabrese G., Trevisi G.N., Coluccia B., Giuliano A.V., Caggiula M., Impagnatiello V., Beretta F., Milia A., Pilia G., Mascia M.G., Putzu V., Piccoli T., Cuffaro L., Monastero R., Battaglia A., Blandino V., Lupo F., Cumbo E., Luca A., Caravaglios G., Vezzosi A., Bessi V., Tognoni G., Calsolaro V., Mossello E., Amici S., Trequattrini A., Pezzuto S., Mecocci P., Fichera G., Pradelli S., Formilan M., Coin A., Togni L.D., Sala F., Nicolosi V., Gallucci M., Mazzarolo A.P., Bergamelli C., Zucca, M, Isella, V, Di Lorenzo, R, Marra, C, Cagnin, A, Cupidi, C, Bonanni, L, Laganà, V, Rubino, E, Vanacore, N, Agosta, F, Caffarra, P, Sambati, R, Quaranta, D, Guglielmi, V, Appollonio, I, Logroscino, G, Filippi, M, Tedeschi, G, Ferrarese, C, Rainero, I, Bruni, A, Gallo, E, Grassini, A, Marcinnò, A, Roveta, F, De Martino, P, Frangipane, F, Puccio, G, Colao, R, Mirabelli, M, Martellacci, N, Lino, F, Mozzetta, S, Bussè, C, Camporese, G, Sacco, S, Lechiara, M, Carrarini, C, Russo, M, Casalena, A, Sucapane, P, Tiraboschi, P, Caroppo, P, Redaelli, V, Di Fede, G, Coppa, D, Peluso, L, Insarda, P, De Bartolo, M, Esposito, S, Iavarone, A, Orsini, A, Salvatore, E, Criscuolo, C, Sambati, L, Santoro, R, Gragnaniello, D, Pedriali, I, Ludovico, L, Chiari, A, Fabbo, A, Bevilacqua, P, Galli, C, Magarelli, S, Perini, M, Spalletta, G, Banaj, N, Porcari, D, Caruso, G, Cipollini, V, Casini, A, Ursini, F, Bruno, G, Rozzini, R, Brambilla, M, Magnani, G, Caso, F, Spinelli, E, Cotta Ramusino, M, Perini, G, Luzzi, S, Cacchiò, G, Ciccola, A, Cionfrini, L, Giuli, C, Fabi, K, Guidi, M, Paci, C, Castellano, A, Petrucci, R, Accogli, M, Carapelle, E, Calabrese, G, Trevisi, G, Coluccia, B, Vasquez Giuliano, A, Caggiula, M, Impagnatiello, V, Beretta, F, Milia, A, Pilia, G, Mascia, M, Putzu, V, Piccoli, T, Cuffaro, L, Monastero, R, Battaglia, A, Blandino, V, Lupo, F, Cumbo, E, Luca, A, Caravaglios, G, Vezzosi, A, Bessi, V, Tognoni, G, Calsolaro, V, Mossello, E, Amici, S, Trequattrini, A, Pezzuto, S, Mecocci, P, Fichera, G, Pradelli, S, Formilan, M, Coin, A, De Togni, L, Sala, F, Nicolosi, V, Gallucci, M, Mazzarolo, A, Bergamelli, C, Zucca, Milena, Isella, Valeria, Lorenzo, Raffaele Di, Marra, Camillo, Cagnin, Annachiara, Cupidi, Chiara, Bonanni, Laura, Laganà, Valentina, Rubino, Elisa, Vanacore, Nicola, Agosta, Federica, Caffarra, Paolo, Sambati, Renato, Quaranta, Davide, Guglielmi, Valeria, Appollonio, Ildebrando M., Logroscino, Giancarlo, Filippi, Massimo, Tedeschi, Gioacchino, Ferrarese, Carlo, Rainero, Innocenzo, and Bruni, Amalia C.

Subjects
Aging, medicine.medical_specialty, Cognitive Neuroscience, Population, Psychological intervention, Protective factor, Neurosciences. Biological psychiatry. Neuropsychiatry, burden, 03 medical and health sciences, stress, 0302 clinical medicine, stre, medicine, Dementia, caregiver, COVID-19, dementia, Psychiatry, education, Original Research, MED/26 - NEUROLOGIA, education.field_of_study, 030214 geriatrics, burden, caregiver, COVID-19, dementia, stress, Family caregivers, business.industry, medicine.disease, Mental health, Settore MED/26 - NEUROLOGIA, Anxiety, Caregiver stress, M-PSI/08 - PSICOLOGIA CLINICA, medicine.symptom, business, 030217 neurology & neurosurgery, Neuroscience, RC321-571
Abstract

Background: Family caregivers of patients with dementia are at high risk of stress and burden, and quarantine due to the coronavirus disease 2019 (COVID-19) pandemic may have increased the risk of psychological disturbances in this population. The current study was carried out during the national lockdown declared in March 2020 by the Italian government as a containment measure of the first wave of the coronavirus pandemic and is the first nationwide survey on the impact of COVID-19 lockdown on the mental health of dementia informal caregivers.Methods: Eighty-seven dementia centers evenly distributed on the Italian territory enrolled 4,710 caregiver–patient pairs. Caregivers underwent a telephone interview assessing classical symptoms of caregiver stress and concern for the consequences of COVID-19 infection on patient’s health. We calculated prevalence of symptoms and regressed them on various potential stress risk factors: caregivers’ sociodemographic characteristics and lifestyle, patients’ clinical features, and lockdown-related elements, like discontinuity in medical care.Results: Approximately 90% of caregivers reported at least one symptom of stress, and nearly 30% reported four or more symptoms. The most prevalent symptoms were concern for consequences of COVID-19 on patient’s health (75%) and anxiety (46%). The main risk factors for stress were identified as a conflicting relationship with the patient and discontinuity in assistance, but caregiver’s female sex, younger age, lower education, and cohabitation with the patient also had an impact. Availability of help from institutions or private individuals showed a protective effect against sense of abandonment but a detrimental effect on concern about the risk for the patient to contract COVID-19. The only protective factor was mild dementia severity, which was associated with a lower risk of feeling isolated and abandoned; type of dementia, on the other hand, did not affect stress risk.Conclusion: Our results demonstrate the large prevalence of stress in family caregivers of patients with dementia during the COVID-19 pandemic and have identified both caregivers and situations at a higher risk of stress, which should be taken into account in the planning of interventions in support of quarantined families and patients.

Published
2021

12. Urgent Measures for the Containment of the Coronavirus (Covid-19) Epidemic in the Neurorehabilitation/Rehabilitation Departments in the Phase of Maximum Expansion of the Epidemic

Author

Bartolo, M., Intiso, D., Lentino, C., Sandrini, G., Paolucci, S., Zampolini, M., Alfonsi, E., Antonucci, G., Baricich, A., Casu, G., Ciancarelli, I., Cisari, C., De Tanti, A., Estraneo, A., Ferraro, F., Gandolfi, M., Invernizzi, M., Iolascon, G., Martinuzzi, A., Morelli, D., Morone, G., Munari, D., Nordio, S., Picelli, A., Scarponi, F., Pingue, V., Solaro, C., Trompetto, C., Bartolo, M., Intiso, D., Lentino, C., Sandrini, G., Paolucci, S., Zampolini, M., Alfonsi, E., Antonucci, G., Baricich, A., Casu, G., Ciancarelli, I., Cisari, C., De Tanti, A., Estraneo, A., Ferraro, F., Gandolfi, M., Invernizzi, M., Iolascon, G., Martinuzzi, A., Morelli, D., Morone, G., Munari, D., Nordio, S., Picelli, A., Scarponi, F., Pingue, V., Solaro, C., and Trompetto, C.

Subjects
Settore M-PSI/02 - PSICOBIOLOGIA E PSICOLOGIA FISIOLOGICA, medicine.medical_treatment, Phase (combat), lcsh:RC346-429, epidemic, rehabilitation, 03 medical and health sciences, 0302 clinical medicine, Documentation, Intensive care, Health care, Pandemic, medicine, 030212 general & internal medicine, COVID-19, rehabilitation, neurorehabilitation, epidemic, infection, health care, organization, lcsh:Neurology. Diseases of the nervous system, Neurorehabilitation, neurorehabilitation, Rehabilitation, business.industry, COVID-19, health care, infection, organization, medicine.disease, Neurology, Perspective, Neurology (clinical), Medical emergency, business, Choking, 030217 neurology & neurosurgery
Abstract

COVID-19 has rapidly become a pandemic emergency, distressing health systems in each affected country. COVID-19 determines the need for healthcare in a large number of people in an extremely short time and, like a tsunami wave, overruns emergency, infectious diseases, and pneumology departments as well as intensive care units, choking healthcare services. Rehabilitation services are also affected by this epidemic which forces radical changes both in the organization and in the operating methods. In the absence of reference literature on this issue, this report aims to provide a background documentation to support physicians and healthcare personnel involved in neurorehabilitation and rehabilitation care.

Published
2020
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13. IMPLEMENTACI��N DE UNA ESTRATEGIA PARA LA GESTI��N ORGANIZACIONAL DEL COLECTIVO DE A��O ACAD��MICO UNIVERSITARIO

Author

Triana Hern��ndez, Bartolo M��ximo., Garc��a Bat��n, Jorge., and Alarc��n Ortiz, Rodolfo.

Abstract

Introducci��n: El colectivo de a��o acad��mico universitario (CAAU) es la instancia de direcci��n universitaria donde se concretan los objetivos institucionales y convergen los procesos sustantivos universitarios para conducir el proceso docente-educativo; sus funciones se orientan a la formaci��n integral del futuro profesional; sin embargo, existen dificultades en la concreci��n y articulaci��n coherente de sus acciones educativas. M��todos: Se utilizaron m��todos emp��ricos, te��ricos y estad��sticos-matem��ticos, se asumi�� la modelaci��n sist��mico estructural ��� funcional y la experimentaci��n para validar la hip��tesis planteada. Resultado: Se devel�� la l��gica te��rica-funcional de la gesti��n organizacional del CAAU con el objetivo de favorecer las influencias educativas en la formaci��n de los estudiantes, la cual se expres�� a trav��s de las relaciones e interacciones entre el proceso prescriptivo del contexto organizacional, el proyectivo de su estructura organizacional y el valorativo de la toma de decisiones colegiadas, lo cual permite alcanzar la sostenibilidad formativa en dicha gesti��n. Conclusiones: Con la implementaci��n de la estrategia propuesta se mejoraron los mecanismos de coordinaci��n para la materializaci��n de las acciones educativas que se generaban en los diferentes escenarios formativos del CAAU, con la din��mica y la actuaci��n arm��nica que propici�� el protagonismo estudiantil y las transformaciones progresivas de los estudiantes, lo que promovi�� el crecimiento, tanto individual como colectivo de estudiantes y profesores.

Published
2021
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14. Multiple identities, social connection and social activism: An explicative model in migrant and italian adolescents

Author

Bartolo M. G., Servidio R., Musso P., Palermiti A. L., Iannello N. M., Perucchini P., Costabile A., Bartolo, M. G., Servidio, R., Musso, P., Palermiti, A. L., Iannello, N. M., Perucchini, P., and Costabile, A.

Subjects
Immigrants, Multiple identities, PYD, Social activism, Social connection, Multiple identitie, Immigrant
Abstract

Positive Youth Development theoretical perspective posits that youth involvement in actions aiming to promote societal change (i.e. social activism) is a marker of their optimal growth. In particular, it claims that immigrant adolescents' engagement in initiatives that foster the progress of host communities is a clear evidence of their positive adjustment. From the PYD standpoint, it is necessary to identify individual and ecological factors that boost youth civic engagement. Among them, multiple social identities and connection seem to play a key role, particularly in those ambiguous contexts, such as the Italian one, in terms of immigration policies and inclusion of foreigners in civic participation. On the basis of these premises, the current study tested a model in which multiple social identities positively influence youth social activism through the mediating role of multiple social connection. This model has been hypothesized to be invariant for Italian and immigrant adolescents who grow up in the same, general developmental context, although they experience different life circumstances. Eighty-six immigrant adolescents (57% male; Mage=17.12, DS=1.73) and 114 Italian adolescents (52% male; Mage=16.68, DS=1.68) took part in the research. They were high school students and they were from southern Italy. Self-report questionnaires were administered including three measures of social identity (national, religious, ethnic/regional), three measures of social connection (perceived legitimacy of authorities, connection with Italian society and the religious group) and one measure of social activism. Data analysis provided for the estimation of alternative mediation models (total and partial) and the invariance between immigrant and Italian adolescents. Results suggest that multiple social connection fully mediate the relationship between multiple social identities and social activism in a sort of process that promotes positive civic engagement among both autochthonous and immigrant youths. Findings provide useful insights that might help in the planning of educational interventions that not only incite adolescents to explore they several social identities but also encourage them to feel part of larger communities and to promote societal change in a constructive way.

Published
2020

15. Basics of brain tumor biology for clinicians

Author

Bartolo, M, Soffietti, R, Klein, M, Bartolo, M ( M ), Soffietti, R ( R ), Klein, M ( M ), Wirsching, H G, Weller, M, Bartolo, M, Soffietti, R, Klein, M, Bartolo, M ( M ), Soffietti, R ( R ), Klein, M ( M ), Wirsching, H G, and Weller, M

Published
2019

16. Identifying clinical complexity in patients affected by severe acquired brain injury in neurorehabilitation: A cross sectional survey

Author

Scarponi, F, Zampolini, M, Zucchella, C, Bargellesi, S, Fassio, C, Pistoia, F, Bartolo, M, Raggi, R, Beatrici, M, Macchetta, C, Cocchini, L, Benedetti, A, Bianconi, F, Bramanti, P, Marino, S, Corallo, F, Brambilla, M, Carboncini M, C, Spina, V, Cervigni, G, Cimenti, F, Previaio, C, Semerjian, M, Colombari, M, De Cicco, D, De Tanti, A, Iardella, L, Diverio, M, Grifoni, C, Carl, V, Pasqualone, E, Estraneo, A, Formisano, R, Ciurli M, P, Galardi, M, Santangelo, A, Giorgini, T, Biasutti, E, Iaia, V, Intiso, D, Lamberti, G, Antoniono, E, Lanfranchi, M, Lavezzi, S, Chiavaroli, R, Lucca L, F, Maggioni, G, Mancuso, M, Canova, S, Mandala, G, Melizza, G, Montis, A, Pilia, F, Mulè, C, Navarro, J, Lanzillotti, C, Perin, C, Petrozzino, S, Schierano, G, Battistini, A, Premoselli, S, Salvi, P, Simonini, M, Sara, M, Serafini, P, Fortuna, R, Sergio M, A, Volanti, P, Scarponi F., Zampolini M., Zucchella C., Bargellesi S., Fassio C., Pistoia F., Bartolo M, Raggi R, Beatrici M, Macchetta C, Cocchini L, Benedetti A, Bianconi F, Bramanti P, Marino S, Corallo F, Brambilla M, Carboncini M C., Spina V, Cervigni G, Cimenti F, Previaio C, Semerjian M, Colombari M, De Cicco D, De Tanti A, Iardella L, Diverio M), Grifoni C, Carl V, Pasqualone E, Estraneo A, Formisano R, Ciurli M P., Galardi M, Santangelo A, Giorgini T, Biasutti E, Iaia V, Intiso D, Lamberti G, Antoniono E, Lanfranchi M, Lavezzi S, Chiavaroli R, Lucca L F., Maggioni G, Mancuso M, Canova S, Mandala G, Melizza G, Montis A, Pilia F, Mulè C., Navarro J, Lanzillotti C, Perin C, Petrozzino S, Schierano G, Battistini A, Premoselli S, Salvi P, Simonini M, Sara M Pardo M, Serafini P, Fortuna R, Sergio M A., Volanti P, Scarponi, F, Zampolini, M, Zucchella, C, Bargellesi, S, Fassio, C, Pistoia, F, Bartolo, M, Raggi, R, Beatrici, M, Macchetta, C, Cocchini, L, Benedetti, A, Bianconi, F, Bramanti, P, Marino, S, Corallo, F, Brambilla, M, Carboncini M, C, Spina, V, Cervigni, G, Cimenti, F, Previaio, C, Semerjian, M, Colombari, M, De Cicco, D, De Tanti, A, Iardella, L, Diverio, M, Grifoni, C, Carl, V, Pasqualone, E, Estraneo, A, Formisano, R, Ciurli M, P, Galardi, M, Santangelo, A, Giorgini, T, Biasutti, E, Iaia, V, Intiso, D, Lamberti, G, Antoniono, E, Lanfranchi, M, Lavezzi, S, Chiavaroli, R, Lucca L, F, Maggioni, G, Mancuso, M, Canova, S, Mandala, G, Melizza, G, Montis, A, Pilia, F, Mulè, C, Navarro, J, Lanzillotti, C, Perin, C, Petrozzino, S, Schierano, G, Battistini, A, Premoselli, S, Salvi, P, Simonini, M, Sara, M, Serafini, P, Fortuna, R, Sergio M, A, Volanti, P, Scarponi F., Zampolini M., Zucchella C., Bargellesi S., Fassio C., Pistoia F., Bartolo M, Raggi R, Beatrici M, Macchetta C, Cocchini L, Benedetti A, Bianconi F, Bramanti P, Marino S, Corallo F, Brambilla M, Carboncini M C., Spina V, Cervigni G, Cimenti F, Previaio C, Semerjian M, Colombari M, De Cicco D, De Tanti A, Iardella L, Diverio M), Grifoni C, Carl V, Pasqualone E, Estraneo A, Formisano R, Ciurli M P., Galardi M, Santangelo A, Giorgini T, Biasutti E, Iaia V, Intiso D, Lamberti G, Antoniono E, Lanfranchi M, Lavezzi S, Chiavaroli R, Lucca L F., Maggioni G, Mancuso M, Canova S, Mandala G, Melizza G, Montis A, Pilia F, Mulè C., Navarro J, Lanzillotti C, Perin C, Petrozzino S, Schierano G, Battistini A, Premoselli S, Salvi P, Simonini M, Sara M Pardo M, Serafini P, Fortuna R, Sergio M A., and Volanti P

Abstract

BACKGROUND: Literature shows that occurrence of comorbidities in people with severe acquired brain injury (sABI) is a common problem in rehabilitation stay. Consequently, patients could require an increase of interventions for diagnosis and treatment of clinical conditions, with a reduction of the rehabilitative take in charge for both clinical and organizational aspects. AIM: The first aim was to evaluate the rate of clinical conditions of sABI patients at admission in rehabilitation and the types of rehabilitative interventions performed in the first week; second objective was to explore the impact of clinical conditions on real rehabilitative take in charge. DESIGN: Cross sectional study. SETTING: Inpatient rehabilitation centers. POPULATION: The study included data from 586 sABI patients. METHODS: Collected data regarded anamnestic information, functional status assessed by means of Glasgow Outcome Scale, Levels of cognitive functioning, Early Rehabilitation Barthel Index, comorbidities at admission and type of rehabilitative interventions carried out in first week of rehabilitation stay. Spearman correlation coefficients were applied to detect possible correlations between the number of treatments in first week and clinical variables; through a multiple regression analysis the effect of patient’s characteristics on rehabilitative take in charge was explored. RESULTS: Data from the sABI patients: mean age 55.1±17.1 years; etiology of sABI was vascular in 315 patients (53.8%), anoxic in 83 (14.2%), neoplastic in 17 (2.9%), infectious in 15 (2.6%), traumatic in 150 (25.6%); 6 subjects (1%) presented a mixed etiology. Need of cardiorespiratory monitoring, pressure sores, infections or presence of multi drug resistant bacteria were the most frequent comorbidities. Passive mobilization, sitting positioning, arousal/awareness stimulation, evaluation and management of dysphagia were the interventions most frequently carried out in the first week. The regression analysi

Published
2019

17. Identifying clinical complexity in patients affected by severe acquired brain injury in neurorehabilitation: a cross sectional survey

Author

Scarponi F., Zampolini M., Zucchella C., Bargellesi S., Fassio C., Pistoia F., Bartolo M, Raggi R, Beatrici M, Macchetta C, Cocchini L, Benedetti A, Bianconi F, Bramanti P, Marino S, Corallo F, Brambilla M, Carboncini M C., Spina V, Cervigni G, Cimenti F, Previaio C, Semerjian M, Colombari M, De Cicco D, De Tanti A, Iardella L, Diverio M), Grifoni C, Carl V, Pasqualone E, Estraneo A, Formisano R, Ciurli M P., Galardi M, Santangelo A, Giorgini T, Biasutti E, Iaia V, Intiso D, Lamberti G, Antoniono E, Lanfranchi M, Lavezzi S, Chiavaroli R, Lucca L F., Maggioni G, Mancuso M, Canova S, Mandala G, Melizza G, Montis A, Pilia F, Mulè C., Navarro J, Lanzillotti C, Perin C, Petrozzino S, Schierano G, Battistini A, Premoselli S, Salvi P, Simonini M, Sara M Pardo M, Serafini P, Fortuna R, Sergio M A., Volanti P, Scarponi, F, Zampolini, M, Zucchella, C, Bargellesi, S, Fassio, C, Pistoia, F, Bartolo, M, Raggi, R, Beatrici, M, Macchetta, C, Cocchini, L, Benedetti, A, Bianconi, F, Bramanti, P, Marino, S, Corallo, F, Brambilla, M, Carboncini M, C, Spina, V, Cervigni, G, Cimenti, F, Previaio, C, Semerjian, M, Colombari, M, De Cicco, D, De Tanti, A, Iardella, L, Diverio, M, Grifoni, C, Carl, V, Pasqualone, E, Estraneo, A, Formisano, R, Ciurli M, P, Galardi, M, Santangelo, A, Giorgini, T, Biasutti, E, Iaia, V, Intiso, D, Lamberti, G, Antoniono, E, Lanfranchi, M, Lavezzi, S, Chiavaroli, R, Lucca L, F, Maggioni, G, Mancuso, M, Canova, S, Mandala, G, Melizza, G, Montis, A, Pilia, F, Mulè, C, Navarro, J, Lanzillotti, C, Perin, C, Petrozzino, S, Schierano, G, Battistini, A, Premoselli, S, Salvi, P, Simonini, M, Sara, M, Serafini, P, Fortuna, R, Sergio M, A, and Volanti, P

Subjects
Patient admission, Male, 030506 rehabilitation, medicine.medical_specialty, Cross-sectional study, medicine.medical_treatment, Population, Glasgow Outcome Scale, Physical Therapy, Sports Therapy and Rehabilitation, Comorbidity, Brain injuries, Rehabilitation Centers, Brain injurie, Disability Evaluation, 03 medical and health sciences, 0302 clinical medicine, Acute care, medicine, Humans, education, Paroxysmal sympathetic hyperactivity, Acquired brain injury, Neurorehabilitation, Cross-Sectional Studie, Rehabilitation Center, Inpatients, Health Services Needs and Demand, education.field_of_study, Rehabilitation, business.industry, Neurological Rehabilitation, Middle Aged, medicine.disease, Brain Injuries, Cross-Sectional Studies, Female, Physical therapy, Inpatient, 0305 other medical science, business, 030217 neurology & neurosurgery, Human
Abstract

Background Literature shows that occurrence of comorbidities in people with severe acquired brain injury (sABI) is a common problem in rehabilitation stay. Consequently, patients could require an increase of interventions for diagnosis and treatment of clinical conditions, with a reduction of the rehabilitative take in charge for both clinical and organizational aspects. Aim The first aim was to evaluate the rate of clinical conditions of sABI patients at admission in rehabilitation and the types of rehabilitative interventions performed in the first week; second objective was to explore the impact of clinical conditions on real rehabilitative take in charge. Design Cross sectional study. Setting Inpatient rehabilitation centers. Population The study included data from 586 sABI patients. Methods Collected data regarded anamnestic information, functional status assessed by means of Glasgow Outcome Scale, Levels of cognitive functioning, Early Rehabilitation Barthel Index, comorbidities at admission and type of rehabilitative interventions carried out in first week of rehabilitation stay. Spearman correlation coefficients were applied to detect possible correlations between the number of treatments in first week and clinical variables; through a multiple regression analysis the effect of patient's characteristics on rehabilitative take in charge was explored. Results Data from the sABI patients: mean age 55.1±17.1 years; etiology of sABI was vascular in 315 patients (53.8%), anoxic in 83 (14.2%), neoplastic in 17 (2.9%), infectious in 15 (2.6%), traumatic in 150 (25.6%); 6 subjects (1%) presented a mixed etiology. Need of cardiorespiratory monitoring, pressure sores, infections or presence of multi drug resistant bacteria were the most frequent comorbidities. Passive mobilization, sitting positioning, arousal/awareness stimulation, evaluation and management of dysphagia were the interventions most frequently carried out in the first week. The regression analysis showed that severe neurological and clinical conditions, acute organ failure, cardio-respiratory instability and paroxysmal sympathetic hyperactivity significantly limit access to rehabilitative sessions. Conclusions In sABI patients clinical comorbidities requiring elevated care assistance are frequent at admission in rehabilitation from acute wards and may interfere with rehabilitative take in charge. Clinical rehabilitation impact The knowledge of clinical complexity of sABI patients may improve their care pathways, promoting early and appropriate transition from acute care to rehabilitation settings.

Published
2019
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19. The Impact of COVID-19 Quarantine on Patients With Dementia and Family Caregivers: A Nation-Wide Survey

Author

Rainero, I, Bruni, A, Marra, C, Cagnin, A, Bonanni, L, Cupidi, C, Lagana, V, Rubino, E, Vacca, A, Di Lorenzo, R, Provero, P, Isella, V, Vanacore, N, Agosta, F, Appollonio, I, Caffarra, P, Busse, C, Sambati, R, Quaranta, D, Guglielmi, V, Logroscino, G, Filippi, M, Tedeschi, G, Ferrarese, C, Gallo, E, Grassini, A, Marcinnò, A, Roveta, F, De Martino, P, Frangipane, F, Puccio, G, Colao, R, Mirabelli, M, Terracciano, C, Lino, F, Mozzetta, S, Gazzola, G, Camporese, G, Sacco, S, Lechiara, M, Carrarini, C, Russo, M, Casa Lena, A, Sucapane, P, Tiraboschi, P, Caroppo, P, Redaelli, V, Di Fede, G, Coppa, D, Peluso, L, Insarda, P, De Bartolo, M, Esposito, S, Iavarone, A, Fuschillo, C, Salvatore, E, Criscuolo, C, Sambati, L, Santoro, R, Gragnaniello, D, Pedriali, I, Ludovico, L, Chiari, A, Fabbo, A, Bevilacqua, P, Galli, C, Magarelli, S, Spalletta, G, Banaj, N, Caruso, G, Porcari, E, Giubilei, F, Casini, A, Ursini, F, Bruno, G, Boffelli, S, Brambilla, M, Magnani, G, Caso, F, Spinelli, E, Sinforiani, E, Costa, A, Luzzi, S, Cacchiò, G, Perini, M, Angeloni, R, Giuli, C, Fabi, K, Guidi, M, Paci, C, Castellano, A, Carapelle, E, Petrucci, R, Accogli, M, Trevisi, G, Renna, S, Vasquez Giuliano, A, Da Re, F, Milia, A, Pilia, G, Mascia, M, Putzu, V, Piccoli, T, Cuffaro, L, Monastero, R, Battaglia, A, Blandino, V, Lupo, F, Cumbo, E, Luca, A, Caravaglios, G, Vezzosi, A, Bessi, V, Tognoni, G, Calsolaro, V, Lucarelli, G, Amici, S, Trequattrini, A, Pezzuto, S, Mecocci, P, Caironi, G, Boselli, B, Formilan, M, Coin, A, De Togni, L, Sala, F, Sandri, G, Gallucci, M, Mazzarolo, A, Bergamelli, C, Passoni, S, Bruni, AC, Lechiara, MC, Porcari, ED, Casini, AR, Spinelli, EG, Trevisi, GN, Mascia, MG, Mazzarolo, AP, Rainero, I, Bruni, A, Marra, C, Cagnin, A, Bonanni, L, Cupidi, C, Lagana, V, Rubino, E, Vacca, A, Di Lorenzo, R, Provero, P, Isella, V, Vanacore, N, Agosta, F, Appollonio, I, Caffarra, P, Busse, C, Sambati, R, Quaranta, D, Guglielmi, V, Logroscino, G, Filippi, M, Tedeschi, G, Ferrarese, C, Gallo, E, Grassini, A, Marcinnò, A, Roveta, F, De Martino, P, Frangipane, F, Puccio, G, Colao, R, Mirabelli, M, Terracciano, C, Lino, F, Mozzetta, S, Gazzola, G, Camporese, G, Sacco, S, Lechiara, M, Carrarini, C, Russo, M, Casa Lena, A, Sucapane, P, Tiraboschi, P, Caroppo, P, Redaelli, V, Di Fede, G, Coppa, D, Peluso, L, Insarda, P, De Bartolo, M, Esposito, S, Iavarone, A, Fuschillo, C, Salvatore, E, Criscuolo, C, Sambati, L, Santoro, R, Gragnaniello, D, Pedriali, I, Ludovico, L, Chiari, A, Fabbo, A, Bevilacqua, P, Galli, C, Magarelli, S, Spalletta, G, Banaj, N, Caruso, G, Porcari, E, Giubilei, F, Casini, A, Ursini, F, Bruno, G, Boffelli, S, Brambilla, M, Magnani, G, Caso, F, Spinelli, E, Sinforiani, E, Costa, A, Luzzi, S, Cacchiò, G, Perini, M, Angeloni, R, Giuli, C, Fabi, K, Guidi, M, Paci, C, Castellano, A, Carapelle, E, Petrucci, R, Accogli, M, Trevisi, G, Renna, S, Vasquez Giuliano, A, Da Re, F, Milia, A, Pilia, G, Mascia, M, Putzu, V, Piccoli, T, Cuffaro, L, Monastero, R, Battaglia, A, Blandino, V, Lupo, F, Cumbo, E, Luca, A, Caravaglios, G, Vezzosi, A, Bessi, V, Tognoni, G, Calsolaro, V, Lucarelli, G, Amici, S, Trequattrini, A, Pezzuto, S, Mecocci, P, Caironi, G, Boselli, B, Formilan, M, Coin, A, De Togni, L, Sala, F, Sandri, G, Gallucci, M, Mazzarolo, A, Bergamelli, C, Passoni, S, Bruni, AC, Lechiara, MC, Porcari, ED, Casini, AR, Spinelli, EG, Trevisi, GN, Mascia, MG, and Mazzarolo, AP

Abstract

Introduction: Previous studies showed that quarantine for pandemic diseases is associated with several psychological and medical effects. The consequences of quarantine for COVID-19 pandemic in patients with dementia are unknown. We investigated the clinical changes in patients with Alzheimer’s disease and other dementias, and evaluated caregivers’ distress during COVID-19 quarantine. Methods: The study involved 87 Italian Dementia Centers. Patients with Alzheimer’s Disease (AD), Dementia with Lewy Bodies (DLB), Frontotemporal Dementia (FTD), and Vascular Dementia (VD) were eligible for the study. Family caregivers of patients with dementia were interviewed by phone in April 2020, 45 days after quarantine declaration. Main outcomes were patients’ changes in cognitive, behavioral, and motor symptoms. Secondary outcomes were effects on caregivers’ psychological features. Results: 4913 patients (2934 females, 1979 males) fulfilled the inclusion criteria. Caregivers reported a worsening in cognitive functions in 55.1% of patients, mainly in subjects with DLB and AD. Aggravation of behavioral symptoms was observed in 51.9% of patients. In logistic regression analysis, previous physical independence was associated with both cognitive and behavioral worsening (odds ratio 1.85 [95% CI 1.42–2.39], 1.84 [95% CI 1.43–2.38], respectively). On the contrary, pandemic awareness was a protective factor for the worsening of cognitive and behavioral symptoms (odds ratio 0.74 [95% CI 0.65–0.85]; and 0.72 [95% CI 0.63–0.82], respectively). Approximately 25.9% of patients showed the onset of new behavioral symptoms. A worsening in motor function was reported by 36.7% of patients. Finally, caregivers reported a high increase in anxiety, depression, and distress. Conclusion: Our study shows that quarantine for COVID-19 is associated with an acute worsening of clinical symptoms in patients with dementia as well as increase of caregivers’ burden. Our findings emphasize the importance to imp

Published
2021

20. Being the Family Caregiver of a Patient With Dementia During the Coronavirus Disease 2019 Lockdown

Author

Zucca, M, Isella, V, Di Lorenzo, R, Marra, C, Cagnin, A, Cupidi, C, Bonanni, L, Laganà, V, Rubino, E, Vanacore, N, Agosta, F, Caffarra, P, Sambati, R, Quaranta, D, Guglielmi, V, Appollonio, I, Logroscino, G, Filippi, M, Tedeschi, G, Ferrarese, C, Rainero, I, Bruni, A, Gallo, E, Grassini, A, Marcinnò, A, Roveta, F, De Martino, P, Frangipane, F, Puccio, G, Colao, R, Mirabelli, M, Martellacci, N, Lino, F, Mozzetta, S, Bussè, C, Camporese, G, Sacco, S, Lechiara, M, Carrarini, C, Russo, M, Casalena, A, Sucapane, P, Tiraboschi, P, Caroppo, P, Redaelli, V, Di Fede, G, Coppa, D, Peluso, L, Insarda, P, De Bartolo, M, Esposito, S, Iavarone, A, Orsini, A, Salvatore, E, Criscuolo, C, Sambati, L, Santoro, R, Gragnaniello, D, Pedriali, I, Ludovico, L, Chiari, A, Fabbo, A, Bevilacqua, P, Galli, C, Magarelli, S, Perini, M, Spalletta, G, Banaj, N, Porcari, D, Caruso, G, Cipollini, V, Casini, A, Ursini, F, Bruno, G, Rozzini, R, Brambilla, M, Magnani, G, Caso, F, Spinelli, E, Cotta Ramusino, M, Perini, G, Luzzi, S, Cacchiò, G, Ciccola, A, Cionfrini, L, Giuli, C, Fabi, K, Guidi, M, Paci, C, Castellano, A, Petrucci, R, Accogli, M, Carapelle, E, Calabrese, G, Trevisi, G, Coluccia, B, Vasquez Giuliano, A, Caggiula, M, Impagnatiello, V, Beretta, F, Milia, A, Pilia, G, Mascia, M, Putzu, V, Piccoli, T, Cuffaro, L, Monastero, R, Battaglia, A, Blandino, V, Lupo, F, Cumbo, E, Luca, A, Caravaglios, G, Vezzosi, A, Bessi, V, Tognoni, G, Calsolaro, V, Mossello, E, Amici, S, Trequattrini, A, Pezzuto, S, Mecocci, P, Fichera, G, Pradelli, S, Formilan, M, Coin, A, De Togni, L, Sala, F, Nicolosi, V, Gallucci, M, Mazzarolo, A, Bergamelli, C, Bruni, AC, Lechiara, MC, Orsini, AVM, Porcari, DE, Casini, AR, Spinelli, EG, Trevisi, GN, Mascia, MG, Mazzarolo, AP, Zucca, M, Isella, V, Di Lorenzo, R, Marra, C, Cagnin, A, Cupidi, C, Bonanni, L, Laganà, V, Rubino, E, Vanacore, N, Agosta, F, Caffarra, P, Sambati, R, Quaranta, D, Guglielmi, V, Appollonio, I, Logroscino, G, Filippi, M, Tedeschi, G, Ferrarese, C, Rainero, I, Bruni, A, Gallo, E, Grassini, A, Marcinnò, A, Roveta, F, De Martino, P, Frangipane, F, Puccio, G, Colao, R, Mirabelli, M, Martellacci, N, Lino, F, Mozzetta, S, Bussè, C, Camporese, G, Sacco, S, Lechiara, M, Carrarini, C, Russo, M, Casalena, A, Sucapane, P, Tiraboschi, P, Caroppo, P, Redaelli, V, Di Fede, G, Coppa, D, Peluso, L, Insarda, P, De Bartolo, M, Esposito, S, Iavarone, A, Orsini, A, Salvatore, E, Criscuolo, C, Sambati, L, Santoro, R, Gragnaniello, D, Pedriali, I, Ludovico, L, Chiari, A, Fabbo, A, Bevilacqua, P, Galli, C, Magarelli, S, Perini, M, Spalletta, G, Banaj, N, Porcari, D, Caruso, G, Cipollini, V, Casini, A, Ursini, F, Bruno, G, Rozzini, R, Brambilla, M, Magnani, G, Caso, F, Spinelli, E, Cotta Ramusino, M, Perini, G, Luzzi, S, Cacchiò, G, Ciccola, A, Cionfrini, L, Giuli, C, Fabi, K, Guidi, M, Paci, C, Castellano, A, Petrucci, R, Accogli, M, Carapelle, E, Calabrese, G, Trevisi, G, Coluccia, B, Vasquez Giuliano, A, Caggiula, M, Impagnatiello, V, Beretta, F, Milia, A, Pilia, G, Mascia, M, Putzu, V, Piccoli, T, Cuffaro, L, Monastero, R, Battaglia, A, Blandino, V, Lupo, F, Cumbo, E, Luca, A, Caravaglios, G, Vezzosi, A, Bessi, V, Tognoni, G, Calsolaro, V, Mossello, E, Amici, S, Trequattrini, A, Pezzuto, S, Mecocci, P, Fichera, G, Pradelli, S, Formilan, M, Coin, A, De Togni, L, Sala, F, Nicolosi, V, Gallucci, M, Mazzarolo, A, Bergamelli, C, Bruni, AC, Lechiara, MC, Orsini, AVM, Porcari, DE, Casini, AR, Spinelli, EG, Trevisi, GN, Mascia, MG, and Mazzarolo, AP

Abstract

Background: Family caregivers of patients with dementia are at high risk of stress and burden, and quarantine due to the coronavirus disease 2019 (COVID-19) pandemic may have increased the risk of psychological disturbances in this population. The current study was carried out during the national lockdown declared in March 2020 by the Italian government as a containment measure of the first wave of the coronavirus pandemic and is the first nationwide survey on the impact of COVID-19 lockdown on the mental health of dementia informal caregivers. Methods: Eighty-seven dementia centers evenly distributed on the Italian territory enrolled 4,710 caregiver-patient pairs. Caregivers underwent a telephone interview assessing classical symptoms of caregiver stress and concern for the consequences of COVID-19 infection on patient's health. We calculated prevalence of symptoms and regressed them on various potential stress risk factors: caregivers' sociodemographic characteristics and lifestyle, patients' clinical features, and lockdown-related elements, like discontinuity in medical care. Results: Approximately 90% of caregivers reported at least one symptom of stress, and nearly 30% reported four or more symptoms. The most prevalent symptoms were concern for consequences of COVID-19 on patient's health (75%) and anxiety (46%). The main risk factors for stress were identified as a conflicting relationship with the patient and discontinuity in assistance, but caregiver's female sex, younger age, lower education, and cohabitation with the patient also had an impact. Availability of help from institutions or private individuals showed a protective effect against sense of abandonment but a detrimental effect on concern about the risk for the patient to contract COVID-19. The only protective factor was mild dementia severity, which was associated with a lower risk of feeling isolated and abandoned; type of dementia, on the other hand, did not affect stress risk. Conclusion: Our re

Published
2021

21. The Impact of COVID-19 Quarantine on Patients With Dementia and Family Caregivers: A Nation-Wide Survey

Author

Rainero, I., Bruni, A. C., Marra, Camillo, Cagnin, A., Bonanni, L., Cupidi, C., Lagana, V., Rubino, E., Vacca, A., Lorenzo, R. D., Provero, P., Isella, V., Vanacore, N., Agosta, F., Appollonio, I., Caffarra, P., Busse, C., Sambati, R., Quaranta, D., Guglielmi, Valeria, Logroscino, G., Filippi, M., Tedeschi, G., Ferrarese, C., Gallo, E., Grassini, A., Marcinno, A., Roveta, F., De Martino, P., Frangipane, F., Puccio, G., Colao, R., Mirabelli, M., Terracciano, C., Lino, F., Mozzetta, S., Gazzola, G., Camporese, G., Sacco, S., Lechiara, M. C., Carrarini, C., Russo, M., Casa Lena, A., Sucapane, P., Tiraboschi, P., Caroppo, P., Redaelli, V., Di Fede, G., Coppa, D., Peluso, L., Insarda, P., De Bartolo, M., Esposito, S., Iavarone, A., Fuschillo, C., Salvatore, E., Criscuolo, C., Sambati, L., Santoro, R., Gragnaniello, D., Pedriali, I., Ludovico, L., Chiari, A., Fabbo, A., Bevilacqua, P., Galli, C., Magarelli, S., Spalletta, G., Banaj, N., Caruso, G., Estela Porcari, D., Giubilei, F., Casini, A. R., Ursini, F., Bruno, G., Boffelli, S., Brambilla, M., Magnani, G., Caso, F., Spinelli, E. G., Sinforiani, E., Costa, A., Luzzi, S., Cacchio, G., Perini, M., Angeloni, R., Giuli, C., Fabi, K., Guidi, M., Paci, C., Castellano, A., Carapelle, E., Petrucci, R., Accogli, M., Nicoletta Trevisi, G., Renna, S., Giuliano, A. V., Da Re, F., Milia, A., Pilia, G., Mascia, M. G., Putzu, V., Piccoli, T., Cuffaro, L., Monastero, R., Battaglia, A., Blandino, V., Lupo, F., Cumbo, E., Luca, A., Caravaglios, G., Vezzosi, A., Bessi, V., Tognoni, G., Calsolaro, V., Lucarelli, G., Amici, S., Trequattrini, A., Pezzuto, S., Mecocci, P., Caironi, G., Boselli, B., Formilan, M., Coin, A., De Togni, L., Sala, F., Sandri, G., Gallucci, M., Mazzarolo, A. P., Bergamelli, C., Passoni, S., Marra C. (ORCID:0000-0003-3994-4044), Guglielmi V., Rainero, I., Bruni, A. C., Marra, Camillo, Cagnin, A., Bonanni, L., Cupidi, C., Lagana, V., Rubino, E., Vacca, A., Lorenzo, R. D., Provero, P., Isella, V., Vanacore, N., Agosta, F., Appollonio, I., Caffarra, P., Busse, C., Sambati, R., Quaranta, D., Guglielmi, Valeria, Logroscino, G., Filippi, M., Tedeschi, G., Ferrarese, C., Gallo, E., Grassini, A., Marcinno, A., Roveta, F., De Martino, P., Frangipane, F., Puccio, G., Colao, R., Mirabelli, M., Terracciano, C., Lino, F., Mozzetta, S., Gazzola, G., Camporese, G., Sacco, S., Lechiara, M. C., Carrarini, C., Russo, M., Casa Lena, A., Sucapane, P., Tiraboschi, P., Caroppo, P., Redaelli, V., Di Fede, G., Coppa, D., Peluso, L., Insarda, P., De Bartolo, M., Esposito, S., Iavarone, A., Fuschillo, C., Salvatore, E., Criscuolo, C., Sambati, L., Santoro, R., Gragnaniello, D., Pedriali, I., Ludovico, L., Chiari, A., Fabbo, A., Bevilacqua, P., Galli, C., Magarelli, S., Spalletta, G., Banaj, N., Caruso, G., Estela Porcari, D., Giubilei, F., Casini, A. R., Ursini, F., Bruno, G., Boffelli, S., Brambilla, M., Magnani, G., Caso, F., Spinelli, E. G., Sinforiani, E., Costa, A., Luzzi, S., Cacchio, G., Perini, M., Angeloni, R., Giuli, C., Fabi, K., Guidi, M., Paci, C., Castellano, A., Carapelle, E., Petrucci, R., Accogli, M., Nicoletta Trevisi, G., Renna, S., Giuliano, A. V., Da Re, F., Milia, A., Pilia, G., Mascia, M. G., Putzu, V., Piccoli, T., Cuffaro, L., Monastero, R., Battaglia, A., Blandino, V., Lupo, F., Cumbo, E., Luca, A., Caravaglios, G., Vezzosi, A., Bessi, V., Tognoni, G., Calsolaro, V., Lucarelli, G., Amici, S., Trequattrini, A., Pezzuto, S., Mecocci, P., Caironi, G., Boselli, B., Formilan, M., Coin, A., De Togni, L., Sala, F., Sandri, G., Gallucci, M., Mazzarolo, A. P., Bergamelli, C., Passoni, S., Marra C. (ORCID:0000-0003-3994-4044), and Guglielmi V.

Abstract

Introduction: Previous studies showed that quarantine for pandemic diseases is associated with several psychological and medical effects. The consequences of quarantine for COVID-19 pandemic in patients with dementia are unknown. We investigated the clinical changes in patients with Alzheimer’s disease and other dementias, and evaluated caregivers’ distress during COVID-19 quarantine. Methods: The study involved 87 Italian Dementia Centers. Patients with Alzheimer’s Disease (AD), Dementia with Lewy Bodies (DLB), Frontotemporal Dementia (FTD), and Vascular Dementia (VD) were eligible for the study. Family caregivers of patients with dementia were interviewed by phone in April 2020, 45 days after quarantine declaration. Main outcomes were patients’ changes in cognitive, behavioral, and motor symptoms. Secondary outcomes were effects on caregivers’ psychological features. Results: 4913 patients (2934 females, 1979 males) fulfilled the inclusion criteria. Caregivers reported a worsening in cognitive functions in 55.1% of patients, mainly in subjects with DLB and AD. Aggravation of behavioral symptoms was observed in 51.9% of patients. In logistic regression analysis, previous physical independence was associated with both cognitive and behavioral worsening (odds ratio 1.85 [95% CI 1.42–2.39], 1.84 [95% CI 1.43–2.38], respectively). On the contrary, pandemic awareness was a protective factor for the worsening of cognitive and behavioral symptoms (odds ratio 0.74 [95% CI 0.65–0.85]; and 0.72 [95% CI 0.63–0.82], respectively). Approximately 25.9% of patients showed the onset of new behavioral symptoms. A worsening in motor function was reported by 36.7% of patients. Finally, caregivers reported a high increase in anxiety, depression, and distress. Conclusion: Our study shows that quarantine for COVID-19 is associated with an acute worsening of clinical symptoms in patients with dementia as well as increase of caregivers’ burden. Our findings emphasize the importance to imp

Published
2021

22. Behavioral and psychological effects of coronavirus disease-19 quarantine in patients with dementia

Author

Cagnin, A., Di Lorenzo, R., Marra, C., Bonanni, L., Cupidi, C., Lagana, V., Rubino, E., Vacca, A., Provero, P., Isella, V., Vanacore, N., Agosta, F., Appollonio, I., Caffarra, P., Pettenuzzo, I., Sambati, R., Quaranta, D., Guglielmi, V., Logroscino, G., Filippi, M., Tedeschi, G., Ferrarese, C., Rainero, I., Bruni, A. C., Gallo, E., Grassini, A., Marcinno, A., Roveta, F., De Martino, P., Frangipane, F., Puccio, G., Colao, R., Mirabelli, M., Martellacci, N., Lino, F., Mozzetta, S., Busse, C., Camporese, G., Sacco, S., Lechiara, M. C., Carrarini, C., Russo, M., Casalena, A., Sucapane, P., Tiraboschi, P., Caroppo, P., Redaelli, V., Di Fede, G., Coppa, D., Peluso, L., Insarda, P., De Bartolo, M., Esposito, S., Iavarone, A., Orsini, A. V. M., Salvatore, E., Criscuolo, C., Sambati, L., Santoro, R., Gragnaniello, D., Pedriali, I., Ludovico, L., Chiari, A., Fabbo, A., Bevilacqua, P., Galli, C., Magarelli, S., Perini, M., Spalletta, G., Banaj, N., Porcari, D. E., Caruso, G., Cipollini, V., Casini, A. R., Ursini, F., Bruno, G., Rozzini, R., Brambilla, M., Magnani, G., Caso, F., Spinelli, E. G., Ramusino, M. C., Perini, G., Luzzi, S., Cacchio, G., Angeloni, R., Giuli, C., Fabi, K., Guidi, M., Paci, C., Castellano, A., Carapelle, E., Petrucci, R., Accogli, M., Calabrese, G., Trevisi, G. N., Coluccia, B., Giuliano, A. V., Caggiula, M., Da Re, F., Milia, A., Pilia, G., Mascia, M. G., Putzu, V., Piccoli, T., Cuffaro, L., Monastero, R., Battaglia, A., Blandino, V., Lupo, F., Cumbo, E., Antonina, L., Caravaglios, G., Vezzosi, A., Bessi, V., Tognoni, G., Calsolaro, V., Mossello, E., Amici, S., Trequattrini, A., Pezzuto, S., Mecocci, P., Fichera, G., Pradelli, S., Formilan, M., Coin, A., Detogni, L., Sala, F., Sandri, G., Gallucci, M., Mazzarolo, A. P., Bergamelli, C., Marra C. (ORCID:0000-0003-3994-4044), Cagnin, A., Di Lorenzo, R., Marra, C., Bonanni, L., Cupidi, C., Lagana, V., Rubino, E., Vacca, A., Provero, P., Isella, V., Vanacore, N., Agosta, F., Appollonio, I., Caffarra, P., Pettenuzzo, I., Sambati, R., Quaranta, D., Guglielmi, V., Logroscino, G., Filippi, M., Tedeschi, G., Ferrarese, C., Rainero, I., Bruni, A. C., Gallo, E., Grassini, A., Marcinno, A., Roveta, F., De Martino, P., Frangipane, F., Puccio, G., Colao, R., Mirabelli, M., Martellacci, N., Lino, F., Mozzetta, S., Busse, C., Camporese, G., Sacco, S., Lechiara, M. C., Carrarini, C., Russo, M., Casalena, A., Sucapane, P., Tiraboschi, P., Caroppo, P., Redaelli, V., Di Fede, G., Coppa, D., Peluso, L., Insarda, P., De Bartolo, M., Esposito, S., Iavarone, A., Orsini, A. V. M., Salvatore, E., Criscuolo, C., Sambati, L., Santoro, R., Gragnaniello, D., Pedriali, I., Ludovico, L., Chiari, A., Fabbo, A., Bevilacqua, P., Galli, C., Magarelli, S., Perini, M., Spalletta, G., Banaj, N., Porcari, D. E., Caruso, G., Cipollini, V., Casini, A. R., Ursini, F., Bruno, G., Rozzini, R., Brambilla, M., Magnani, G., Caso, F., Spinelli, E. G., Ramusino, M. C., Perini, G., Luzzi, S., Cacchio, G., Angeloni, R., Giuli, C., Fabi, K., Guidi, M., Paci, C., Castellano, A., Carapelle, E., Petrucci, R., Accogli, M., Calabrese, G., Trevisi, G. N., Coluccia, B., Giuliano, A. V., Caggiula, M., Da Re, F., Milia, A., Pilia, G., Mascia, M. G., Putzu, V., Piccoli, T., Cuffaro, L., Monastero, R., Battaglia, A., Blandino, V., Lupo, F., Cumbo, E., Antonina, L., Caravaglios, G., Vezzosi, A., Bessi, V., Tognoni, G., Calsolaro, V., Mossello, E., Amici, S., Trequattrini, A., Pezzuto, S., Mecocci, P., Fichera, G., Pradelli, S., Formilan, M., Coin, A., Detogni, L., Sala, F., Sandri, G., Gallucci, M., Mazzarolo, A. P., Bergamelli, C., and Marra C. (ORCID:0000-0003-3994-4044)

Abstract

Background: In March 2020, the World Health Organization declared a global pandemic due to the novel coronavirus SARS-CoV-2 and several governments planned a national quarantine in order to control the virus spread. Acute psychological effects of quarantine in frail elderly subjects with special needs, such as patients with dementia, have been poorly investigated. The aim of this study was to assess modifications of neuropsychiatric symptoms during quarantine in patients with dementia and their caregivers. Methods: This is a sub-study of a multicenter nation-wide survey. A structured telephone interview was delivered to family caregivers of patients with diagnosis of Alzheimer disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VD), followed regularly at 87 Italian memory clinics. Variations in behavioral and psychological symptoms (BPSD) were collected after 1 month since quarantine declaration and associations with disease type, severity, gender, and caregiver’s stress burden were analyzed. Results: A total of 4,913 caregivers participated in the survey. Increased BPSD was reported in 59.6% of patients as worsening of preexisting symptoms (51.9%) or as new onset (26%), and requested drug modifications in 27.6% of these cases. Irritability, apathy, agitation, and anxiety were the most frequently reported worsening symptoms and sleep disorder and irritability the most frequent new symptoms. Profile of BPSD varied according to dementia type, disease severity, and patients’ gender. Anxiety and depression were associated with a diagnosis of AD (OR 1.35, CI: 1.12–1.62), mild to moderate disease severity and female gender. DLB was significantly associated with a higher risk of worsening hallucinations (OR 5.29, CI 3.66–7.64) and sleep disorder (OR 1.69, CI 1.25–2.29), FTD with wandering (OR 1.62, CI 1.12–2.35), and change of appetite (OR 1.52, CI 1.03–2.25). Stress-related symptoms were experienced by two-thirds of caregiv

Published
2020

25. How to understand it: Neuropsychological testing

Author

Zucchella, C, Federico, A, Martini, A, Tinazzi, M, Bartolo, M, and Tamburin, S

Subjects
BF
Abstract

Neuropsychological testing is a key diagnostic tool for assessing people with dementia and mild cognitive impairment, but can also help in other neurological conditions such as Parkinson’s disease, stroke, multiple sclerosis, traumatic brain injury and epilepsy. While cognitive screening tests offer gross information, detailed neuropsychological evaluation can provide data on different cognitive domains (visuospatial function, memory, attention, executive function, language and praxis) as well as neuropsychiatric and behavioural features. We should regard neuropsychological testing as an extension of the neurological examination applied to higher order cortical function, since each cognitive domain has an anatomical substrate. Ideally, neurologists should discuss the indications and results of neuropsychological assessment with a clinical neuropsychologist. This paper summarises the rationale, indications, main features, most common tests and pitfalls in neuropsychological evaluation.

Published
2018

26. Studio RCT sull’efficacia del training assistito da robot associato a riabilitazione convenzionale per il recupero funzionale dell’arto superiore negli esiti di ictus: protocollo clinico

Author

Mazzoleni, S., Bonaiuti, D., Aprile, I., Bartolo, M., Battini, E., Calabrò, R. S., Colombo, R., Del Felice, A., Filoni, S., Focacci, A., Franceschini, M., Gandolfi, M. L., Maggioni, G., Morone, G., Pignolo, L., Posteraro, F., Spagnuolo, C., Straudi, S., Taveggia, G., and Waldner, A.

Published
2017

27. Stimulus-induced dissociation of neuronal firing rates and local field potential gamma power and its relationship to the blood oxygen level-dependent signal in macaque primary visual cortex

Author

Bartolo, M J, Gieselmann, M A, Vuksanovic, V, Hunter, D, Sun, L, Chen, X, Delicato, L S, and Thiele, A

Subjects
Male, Neurons, V1, Brain Mapping, genetic structures, Cognitive Neuroscience, fMRI, Action Potentials, LFP, behavioral disciplines and activities, spiking, Magnetic Resonance Imaging, Electrophysiology, Oxygen, nervous system, Visual Perception, Animals, Humans, Macaca, cross-orientation inhibition, psychological phenomena and processes, Photic Stimulation, BOLD, Visual Cortex
Abstract

The functional magnetic resonance imaging (fMRI) blood oxygenation level-dependent (BOLD) signal is regularly used to assign neuronal activity to cognitive function. Recent analyses have shown that the local field potential (LFP) gamma power is a better predictor of the fMRI BOLD signal than spiking activity. However, LFP gamma power and spiking activity are usually correlated, clouding the analysis of the neural basis of the BOLD signal. We show that changes in LFP gamma power and spiking activity in the primary visual cortex (V1) of the awake primate can be dissociated by using grating and plaid pattern stimuli, which differentially engage surround suppression and cross-orientation inhibition/facilitation within and between cortical columns. Grating presentation yielded substantial V1 LFP gamma frequency oscillations and significant multi-unit activity. Plaid pattern presentation significantly reduced the LFP gamma power while increasing population multi-unit activity. The fMRI BOLD activity followed the LFP gamma power changes, not the multi-unit activity. Inference of neuronal activity from the fMRI BOLD signal thus requires detailed a priori knowledge of how different stimuli or tasks activate the cortical network.

Published
2011

28. Ancient coastal landscape of Protected Marine Area of Porto Cesareo (Le): recent researches

Author

Alfonso C., Scarano T., Mastronuzzi G., Calcagnile L., QUARTA, Gianluca, Di Bartolo M., AURIEMMA, Rita, Alfonso, C., Auriemma, Rita, Scarano, T., Mastronuzzi, G., Calcagnile, L., Quarta, Gianluca, and Di Bartolo, M.

Subjects
età romana, età medievale, variaizoni del livello del mare, Porto Cesareo (Le), archeologia dei paesaggi costieri, Ionio, Salento, relitti spiaggiati, necropoli, siti sommersi, geoarcheologia, età protostorica, insediamento età del Bronzo
Abstract

In the Protected Marine Area of Porto Cesareo (Lecce, Italy) various submerged and semi-submerged evidences have been highlighted/picked out by some recent notifications and preliminary surveys carried out by the Dipartimento di Beni Culturali – Università del Salento, in close collaboration with the Protected Marine Area: - a navis lapidaria wreck, with a cargo of monumental marble columns from Eubea (Greece), of the Roman Imperial age; - various scattered and decontextualized finds (amphorae, anchor stocks, pottery sherds); - a beached wreck, probably Medieval, at - 2 m.s.l. and 150 m from the coastline; - some submerged structures, located between the Scalo di Furno promontory and the opposite islet, at - 2.20 m.s.l; according to the building technique and the morphology, to the presence of Middle Bronze age ware, and mostly to the sea level relative rising values, we could identify them with the submerged part of the Bronze age Scalo di Furno settlement on the headland; - remains of structures (walls, buildings, burial areas) and finds of Roman age along the shoreline of T. Chianca headland and the close peninsula, partially submerged and eroded. The last three evidences allow us to hypothesize an ancient coastal landscape significantly different and a “dynamic” outline during the centuries.

Published
2012

30. Early rehabilitation for severe acquired brain injury in intensive care unit: Multicenter observational study

Author

Bartolo, M, Bargellesi, S, Castioni, C, Bonaiuti, D, Antenucci, R, Benedetti, A, Capuzzo, V, Gamna, F, Radeschi, G, Citerio, G, Colombo, C, Del Casale, L, Recubini, E, Toska, S, Zanello, M, D'Aurizio, C, Spina, T, Del Gaudio, A, Di Rienzo, F, Intiso, D, Dallocchio, G, Felisatti, G, Lavezzi, S, Zoppellari, R, Gariboldi, V, Lorini, L, Melizza, G, Molinero, G, Mandalà, G, Pignataro, A, Montis, A, Napoleone, A, Pilia, F, Pisu, M, Semerjian, M, Pagliaro, G, Nardin, L, Scarponi, F, Zampolini, M, Zava, R, Massetti, M, Piccolini, C, Aloj, F, Antonelli, S, Zucchella, C, Lorini, F, Zucchella, C., LORINI, FERDINANDO LUCA, CITERIO, GIUSEPPE, Bartolo, M, Bargellesi, S, Castioni, C, Bonaiuti, D, Antenucci, R, Benedetti, A, Capuzzo, V, Gamna, F, Radeschi, G, Citerio, G, Colombo, C, Del Casale, L, Recubini, E, Toska, S, Zanello, M, D'Aurizio, C, Spina, T, Del Gaudio, A, Di Rienzo, F, Intiso, D, Dallocchio, G, Felisatti, G, Lavezzi, S, Zoppellari, R, Gariboldi, V, Lorini, L, Melizza, G, Molinero, G, Mandalà, G, Pignataro, A, Montis, A, Napoleone, A, Pilia, F, Pisu, M, Semerjian, M, Pagliaro, G, Nardin, L, Scarponi, F, Zampolini, M, Zava, R, Massetti, M, Piccolini, C, Aloj, F, Antonelli, S, Zucchella, C, Lorini, F, Zucchella, C., LORINI, FERDINANDO LUCA, and CITERIO, GIUSEPPE

Abstract

Background: The increased survival after a severe acquired brain injury (sABI) raise the problem of making most effective the treatments in Intensive Care Unit (ICU)/Neurointensive Care Unit (NICU), also integrating rehabilitation care. Despite previous studies reported that early mobilization in ICU was effective in preventing complications and reducing hospital stay, few studies addressed the rehabilitative management of sABI patients in ICU/NICU. Aim: To collect clinical and functional data about the early rehabilitative management of sABI patients during ICU/NICU stay. Design. Prospective, observational, multicenter study. Setting: Fourteen facilities supplied by intensive neurorehabilitation units and ICU/NICUs. Population : Consecutive sABI patients admitted to ICU/NICU. Methods: Patients were evaluated at admission and then every 3-5 days. Clinical, functional and rehabilitative data, including Glasgow Coma Scale (GCS), Disability Rating Scale (DRS), The Rancho Los Amigos Levels of Cognitive Functioning Scale (LCF), Early Rehabilitation Barthel Index (ERBI), Glasgow Outcome scale (GOS) and Functional Independence Measure (FIM) were collected. Results : One hundred and two patients (F/M 44/58) were enrolled. The mean duration of ICU stay was 24.7±13.9 days and the first rehabilitative evaluation occurred after 8.7±8.8 days. Regular postural changes and multijoint mobilization were prescribed in 63.7% and 64.7% cases, respectively. The mean session duration was 38±11.5 minutes. Swallowing evaluation was performed in 14.7% patients, psychological support was provided to 12.7% of patients' caregivers, while 17.6% received a psycho-educational intervention, and 28.4% were involved in interdisciplinary team meetings. The main discharge destinations were Severe Acquired Brain Injury rehabilitation units for 43.7%, intensive neurorehabilitation units for 20.7%. Conclusions: Data showed that early rehabilitation was not diffusely performed in sABI subjects in ICU/NICU

Published
2016

31. Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) (2016) Pharmacological and non-pharmacological strategies in the integrated treatment of pain in neurorehabilitation. Evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

Author

Tamburin, S., Lacerenza, M. R., Castelnuovo, Gianluca, Agostini, M., Paolucci, S., Bartolo, M., Bonazza, S., Federico, A., Formaglio, F., Giusti, Emanuele Maria, Manzoni, G. M., Mezzarobba, S., Pietrabissa, Giada, Polli, A., Turolla, A., Sandrini, G., Castelnuovo G. (ORCID:0000-0003-2633-9822), Giusti E. M. (ORCID:0000-0001-5767-8785), Pietrabissa G. (ORCID:0000-0002-5911-5748), Tamburin, S., Lacerenza, M. R., Castelnuovo, Gianluca, Agostini, M., Paolucci, S., Bartolo, M., Bonazza, S., Federico, A., Formaglio, F., Giusti, Emanuele Maria, Manzoni, G. M., Mezzarobba, S., Pietrabissa, Giada, Polli, A., Turolla, A., Sandrini, G., Castelnuovo G. (ORCID:0000-0003-2633-9822), Giusti E. M. (ORCID:0000-0001-5767-8785), and Pietrabissa G. (ORCID:0000-0002-5911-5748)

Abstract

The interplay between pain and neurorehabilitation is very complex, in that pain may be a target for treatment, but can also have negative effects on neurorehabilitation procedures. Moreover, side effects of drugs, which are currently used to treat pain, may negatively influence rehabilitation outcomes. Because of the lack of guidelines or consensus, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) was aimed to answer some open questions on the treatment of pain in this setting. To this aim, we collected evidence on the pharmacological and non-pharmacological strategies and their role in the integrated approach to pain. Despite the lack of studies in patients undergoing neurorehabilitation, current guidelines on the pharmacological treatment of nociceptive and neuropathic pain may be applied in this setting. Non-pharmacological strategies include physical therapy, invasive procedures, psychological treatments and psychotherapy, which together with pharmacological therapies play a key role in the integrated approach to pain. The ICCPN recommendations offer information to ameliorate the current treatment of pain in neurorehabilitation, and to design future studies to answer the still open questions on this topic.

Published
2016

32. Time for a Consensus Conference on pain in neurorehabilitation

Author

Sandrini, Giorgio, Tamburin, Stefano, Paolucci, Stefano, Boldrini, Paolo, Saraceni, Vincenzo M, Smania, Nicola, Agostini, M, Alfonsi, E, Aloisi, Am, Alvisi, E, Aprile, I, Armando, M, Avenali, M, Azicnuda, E, Barale, F, Bartolo, M, Bergamaschi, R, Berlangieri, M, Berlincioni, V, Berliocchi, L, Berra, E, Berto, G, Bonadiman, S, Bonazza, S, Bressi, F, Brugnera, A, Brunelli, S, Buzzi, Mg, Cacciatori, C, Calvo, A, Cantarella, C, Caraceni, At, Carone, R, Carraro, E, Casale, R, Castellazzi, P, Castelnuovo, G, Castino, A, Cella, M, Cerbo, R, Chiò, A, Ciotti, C, Cisari, C, Coraci, D, Dalla Toffola, E, Defazio, G, De Icco, R, Del Carro, U, Dell’Isola, A, De Tanti, A, D’Ippolito, M, Fazzi, E, Federico, A, Ferrari, A, Ferrari, S, Ferraro, F, Formaglio, F, Formisano, R, Franzoni, S, Gajofatto, F, Gandolfi, M, Gardella, B, Geppetti, P, Giammò, A, Gimigliano, R, Giusti, Em, Greco, E, Ieraci, V, Invernizzi, M, Jacopetti, M, Jedrychowska, I, Lacerenza, M, La Cesa, S, Lobba, D, Magrinelli, F, Mandrini, S, Manera, U, Manzoni, Gm, Marchettini, P, Marchioni, E, Mariotto, S, Martinuzzi, A, Masciullo, M, Mezzarobba, S, Miotti, D, Modenese, A, Molinari, M, Monaco, S, Morone, G, Nappi, R, Negrini, S, Pace, A, Padua, L, Pagliano, E, Palmerini, V, Paolucci, S, Pazzaglia, C, Pecchioli, C, Pietrabissa, G, Picelli, A, Polli, A, Porro, Ca, Porru, D, Romano, M, Roncari, L, Rosa, R, Saccavini, M, Sacerdote, P, Sandrini, G, Saviola, D, Schenone, A, Schweiger, V, Scivoletto, G, Smania, N, Solaro, C, Spallone, V, Springhetti, I, Tamburin, S, Tassorelli, C, Tinazzi, M, Togni, R, Torre, M, Torta, R, Traballesi, M, Trabucco, E, Tramontano, M, Truini, A, Tugnoli, V, Turolla, A, Valeriani, M, Vallies, G, Verzini, E, Vottero, M, Mario, P., Castelnuovo G (ORCID:0000-0003-2633-9822), Giusti EM (ORCID:0000-0001-5767-8785), Padua L (ORCID:0000-0003-2570-9326), Pietrabissa G (ORCID:0000-0002-5911-5748), Sandrini, Giorgio, Tamburin, Stefano, Paolucci, Stefano, Boldrini, Paolo, Saraceni, Vincenzo M, Smania, Nicola, Agostini, M, Alfonsi, E, Aloisi, Am, Alvisi, E, Aprile, I, Armando, M, Avenali, M, Azicnuda, E, Barale, F, Bartolo, M, Bergamaschi, R, Berlangieri, M, Berlincioni, V, Berliocchi, L, Berra, E, Berto, G, Bonadiman, S, Bonazza, S, Bressi, F, Brugnera, A, Brunelli, S, Buzzi, Mg, Cacciatori, C, Calvo, A, Cantarella, C, Caraceni, At, Carone, R, Carraro, E, Casale, R, Castellazzi, P, Castelnuovo, G, Castino, A, Cella, M, Cerbo, R, Chiò, A, Ciotti, C, Cisari, C, Coraci, D, Dalla Toffola, E, Defazio, G, De Icco, R, Del Carro, U, Dell’Isola, A, De Tanti, A, D’Ippolito, M, Fazzi, E, Federico, A, Ferrari, A, Ferrari, S, Ferraro, F, Formaglio, F, Formisano, R, Franzoni, S, Gajofatto, F, Gandolfi, M, Gardella, B, Geppetti, P, Giammò, A, Gimigliano, R, Giusti, Em, Greco, E, Ieraci, V, Invernizzi, M, Jacopetti, M, Jedrychowska, I, Lacerenza, M, La Cesa, S, Lobba, D, Magrinelli, F, Mandrini, S, Manera, U, Manzoni, Gm, Marchettini, P, Marchioni, E, Mariotto, S, Martinuzzi, A, Masciullo, M, Mezzarobba, S, Miotti, D, Modenese, A, Molinari, M, Monaco, S, Morone, G, Nappi, R, Negrini, S, Pace, A, Padua, L, Pagliano, E, Palmerini, V, Paolucci, S, Pazzaglia, C, Pecchioli, C, Pietrabissa, G, Picelli, A, Polli, A, Porro, Ca, Porru, D, Romano, M, Roncari, L, Rosa, R, Saccavini, M, Sacerdote, P, Sandrini, G, Saviola, D, Schenone, A, Schweiger, V, Scivoletto, G, Smania, N, Solaro, C, Spallone, V, Springhetti, I, Tamburin, S, Tassorelli, C, Tinazzi, M, Togni, R, Torre, M, Torta, R, Traballesi, M, Trabucco, E, Tramontano, M, Truini, A, Tugnoli, V, Turolla, A, Valeriani, M, Vallies, G, Verzini, E, Vottero, M, Mario, P., Castelnuovo G (ORCID:0000-0003-2633-9822), Giusti EM (ORCID:0000-0001-5767-8785), Padua L (ORCID:0000-0003-2570-9326), and Pietrabissa G (ORCID:0000-0002-5911-5748)

Abstract

Time for a Consensus Conference on pain in neurorehabilitation.

Published
2016

33. Neuroriabilitazione

Author

Bartolo, M, Serrao, Mariano, and Pierelli, Francesco

Published
2012

36. Non-recurrent inferior laryngeal nerves and sympathetic-inferior laryngeal anastomotic branches: 6 years' personal experience

Author

Calzolari, F, Misso, Claudia, Monacelli, M, Lucchini, R, Sanguinetti, A, D'Ajello, Fabio, Vannucci, Jacopo, Galasso, Valentina, Bartolo, M, Ragusa, Mark, and Avenia, Nicola

Subjects
Humans, Laryngeal Nerves, Abnormalities, Multiple
Abstract

The incidence and possible association of inferior laryngeal nerve and sympathetic anastomotic branch anomalies were evaluated in this study. Non-recurrent inferior laryngeal nerves stem from vascular anomalies involving the right subclavian artery and aortic arches during embryological development. These anomalies usually have no functional consequences (except for occasional dysphagia), but are potentially dangerous during thyroid surgery, occurring in about 1% of cases. Sympathetic-inferior laryngeal anastomotic branches are described in about 1.5% of cases, and may be confused with non-recurrent inferior laryngeal nerves. 1473 patients submitted to total thyroidectomy for benign disease over the period 2001-2006 were evaluated. Four non-recurrent inferior laryngeal nerves (incidence: 0.27%) and 11 sympathetic-inferior laryingeal anastomotic branches (incidence: 0.74%) were observed. Out of a total of 25 definitive inferior laryngeal nerve lesions, 1 occurred in a case of non-recurrent inferior laryngeal nerve. Awareness of the anatomical anomalies described and accurate surgical technique, including a constant search for the inferior laryngeal nerve, are the requirements for identification of non-recurrent inferior laryngeal nerves and sympathetic-inferior laryngeal anastomotic branches. During the pre-operative workup, ultrasonographic study of the right subclavian artery may be advisable in order to rule out alterations of its origin and course.

Published
2008

38. Treatment acceleration program and the experience of the DREAM program in prevention of mother-to-child transmission of HIV

Author

Palombi, L, Marazzi, Mc, Voetberg, A, Magid, Na, Bartolo, M, Bestagini, P, Bortolot, G, Germano, P, San Lio, Mm, Tintisona, G, Buonomo, E, DORO ALTAN, Am, Liotta, G, Mancinelli, S, Scarcella, P, Guidotti, G, and Nielsen Saines, K

Subjects
DREAM Program, Pediatrics, Infectious Disease Transmission, Settore MED/42 - Igiene Generale e Applicata, Breastfeeding, HIV Infections, Regional Medical Programs, Pregnancy, Antiretroviral Therapy, Highly Active, Vertical, Immunology and Allergy, Cumulative incidence, Pregnancy Complications, Infectious, Infant Nutritional Physiological Phenomena, education.field_of_study, Incidence (epidemiology), Mortality rate, Treatment acceleration program (TAP), Infectious, Milk, Infectious Diseases, Breast Feeding, HIV, Mother-to-child transmission, Cohort, Female, Human, medicine.medical_specialty, Anti-HIV Agents, Immunology, Population, Antiretroviral Therapy, Acquired immunodeficiency syndrome (AIDS), medicine, Humans, Highly Active, education, Africa South of the Sahara, Milk, Human, business.industry, Infant, Newborn, Infant, Newborn, medicine.disease, Infectious Disease Transmission, Vertical, Bottle Feeding, Pregnancy Complications, HIV-1, Program Evaluation, Epidemiologic Methods, business, Breast feeding
Abstract

Background: The Drug Resource Enhancement against AIDS and Malnutrition (DREAM) program is a large antiretroviral therapy treatment program financed by the Treatment Acceleration Program (TAP) of the World Bank. in addition to provision of antiretroviral treatment to individuals infected with human immunodeficiency virus (HIV) in sub-Saharan Africa, one major aspect of the DREAM program is nutritional supplementation and prevention of mother-to-child transmission (PMTCT) of HIV. Methods: HIV-positive pregnant women enrolled in the DREAM program receive highly active antiretroviral therapy (HAART) free of charge from the 25th week of gestation, irrespective of clinical stage, CD4 count, and viral load. Their infants receive post-exposure prophylaxis. From 2004 to 2006, women enrolled in the DREAM program in Mozambique, Tanzania, and Malawi received water filters and formula for the first 6 months of lactation. In a second cohort starting in 2005 until 2006 in Mozambique, women received HAART for up to 6 months after delivery and were given the option to breastfeed. We conducted a comparative analysis of the two cohorts of HIV-positive pregnant women followed prospectively and evaluated HIV-1 mother-tochild transmission rates, infant morbidity, and mortality in both cohorts. Results: In the first cohort, 879 live-born children were delivered, with 809 evaluable infants at 1 and 6 months. In the second cohort, 341 infants were delivered and evaluable at I month, and 251 infants were evaluable at 6months. At age 1 month, HIV-1 transmission rates were 4/341 (1.2%) among breastfed infants and 7/809 (0.8%) among formula-fed infants. At age 6 months, HIV-1 mother-to-child transmission rates were 2/251 (0.8%) among breastfed infants of women receiving HAART and 15/809 (1.8%) among formula-fed infants (X-2 = 0.77, P=0.38 [NS]). The cumulative incidence rate at 6 months of age was 2.7% for formula-fed infants and 2.2% for breastfed infants (X-2 =0.27, P=0.60 [NS]). There was a trend for HIV-1 infection rates to be slightly greater among formula-fed infants, but overall mother-to-child transmission rates in both cohorts were extremely low. Most infants did relatively well on both feeding regimens. Observed Z scores were greater than among the general infant population in the community. Z scores

Published
2007

42. Spinal myoclonus with giant somatosensory evoked potentials and enhanced long-loop reflex: a case report

Author

Serrao, Mariano, Cardinali, P, Rossi, P, Perrotta, A, Bartolo, M, Parisi, Leoluca, and Pierelli, Francesco

Subjects
Myoclonus, Levetiracetam, Electromyography, Spinal Cord Ischemia, Electroencephalography, Piracetam, Treatment Outcome, Evoked Potentials, Somatosensory, Reflex, Cervical Vertebrae, Humans, Anticonvulsants, Female, Aged
Abstract

We describe a patient with an ischaemic lesion of the cervical spinal cord who presented with clinical evidence of stimulus-sensitive, multisegmental myoclonic jerks restricted to the truncal and proximal limb muscles and accompanied by electrophysiological features (giant somatosensory evoked potentials and enhanced long-loop reflex) of cortical myoclonus. We hypothesize that these features might result from a loss of inhibitory influences on the sensory input to cortical structures: a concomitant contribution of spinal and cortical hyperexcitability seems to have played a crucial role in inducing myoclonus in our patient.

Published
2004

44. Modulation of the human nociceptive flexion reflex by pleasant and unpleasant odors

Author

Bartolo, M, Serrao, M, Gamgebeli, Z, Alpaidze, M, Perrotta, A, Padua, Luca, Pierelli, F, Nappi, G, Sandrini, G., Padua, Luca (ORCID:0000-0003-2570-9326), Bartolo, M, Serrao, M, Gamgebeli, Z, Alpaidze, M, Perrotta, A, Padua, Luca, Pierelli, F, Nappi, G, Sandrini, G., and Padua, Luca (ORCID:0000-0003-2570-9326)

Abstract

The nociceptive withdrawal reflex (NWR), a defensive response that allows withdrawal from a noxious stimulus, is a reliable index of spinal nociception in humans. It has been shown that various kinds of stimuli (emotional, visual, auditory) can modulate the transmission and perception of pain. The aim of the present study was to evaluate, by means of the NWR, the modulatory effect on the spinal circuitry of olfactory stimuli with different emotional valence. The magnitude of the NWR elicited by electrical stimulation of the sural nerve was measured while 18 subjects (9 women, 9 men) smelled pleasant, unpleasant, or neutral odors. The NWR was conditioned by odor probe with interstimulus intervals (ISIs) of 500 ms and 1,500 ms. The magnitude of NWR was significantly greater after the unpleasant odor probe (P <.001) and reduced following the pleasant odor probe (P<.001) at both ISIs. A significant effect of olfactory stimuli on subjective pain ratings were found at both ISIs for pleasant vs unpleasant odors (P<.000), and for both pleasant and unpleasant odors vs neutral and basal conditions (P<.000). No statistical differences in subjective pain ratings at different ISIs were found. Consistent with the notion that NWR magnitude and pain perception can be modulated by stimuli with different emotional valence, these results show that olfactory stimuli, too, can modulate spinal nociception in humans.

Published
2013

45. Modelling the spine as a deformable body: Feasibility of reconstruction using an optoelectronic system

Author

Ranavolo, A, Don, R, Draicchio, F, Bartolo, M, Serrao, M, Padua, Luca, Cipolla, G, Pierelli, F, Iavicoli, S, Sandrini, G., Padua, Luca (ORCID:0000-0003-2570-9326), Ranavolo, A, Don, R, Draicchio, F, Bartolo, M, Serrao, M, Padua, Luca, Cipolla, G, Pierelli, F, Iavicoli, S, Sandrini, G., and Padua, Luca (ORCID:0000-0003-2570-9326)

Abstract

The aims of this study were to develop a kinematic model of the spine, seen as a continuous deformable body and to identify the smallest set of surface markers allowing adequate measurements of spine motion. The spine is widely considered as a rigid body or as a kinematic chain made up of a smaller number of segments, thereby introducing an approximation. It would be useful to have at our disposal a technique ensuring accurate and repeatable measurement of the shape of the whole spine. Ten healthy subjects underwent a whole-spine radiographic assessment and, simultaneously, an optoelectronic recording. Polynomial interpolations of the vertebral centroids, of the whole set of markers were performed. The similarity of the resulting curves was assessed. Our findings indicate that spine shape can be reproduced by 5th order polynomial interpolation. The best approximating curves are obtained from either 10- or 9-marker sets. Sagittal angles are systematically underestimated.

Published
2012

46. Reorganization of multi-muscle and joint withdrawal reflex during arm movements in post-stroke hemiparetic patients

Author

Serrao, M, Ranavolo, A, Andersen, Ok, Don, R, Draicchio, F, Conte, C, Di Fabio, R, Perrotta, A, Bartolo, M, Padua, Luca, Santilli, V, Sandrini, G, Pierelli, F., Padua, Luca (ORCID:0000-0003-2570-9326), Serrao, M, Ranavolo, A, Andersen, Ok, Don, R, Draicchio, F, Conte, C, Di Fabio, R, Perrotta, A, Bartolo, M, Padua, Luca, Santilli, V, Sandrini, G, Pierelli, F., and Padua, Luca (ORCID:0000-0003-2570-9326)

Abstract

Objectives To investigate the behavior of the nociceptive withdrawal reflex (NWR) in the upper limb during reaching and grasping movements in post-stroke hemiparetic patients. Methods Eight patients with chronic stroke and moderate motor deficits were included. An optoelectronic motion analysis system integrated with a surface EMG machine was used to record the kinematic and EMG data. The NWR was evoked through a painful electrical stimulation of the index finger during a movement which consisted of reaching out, picking up a cylinder, and returning it to the starting position. Results We found that: (i) the NWR is extensively rearranged in hemiparetic patients, who were found to present different kinematic and EMG reflex patterns with respect to controls; (ii) patients partially lose the ability to modulate the reflex in the different movement phases; (iii) the impairment of the reflex modulation occurs at single-muscle, single-joint and multi-joint level. Conclusions Patients with chronic and mild-moderate post-stroke motor deficits lose the ability to modulate the NWR dynamically according to the movement variables at individual as well as at multi-muscle and joint levels. Significance The central nervous system is unable to use the NWR substrate dynamically and flexibly in order to select the muscle synergies needed to govern the spatio–temporal interaction among joints.

Published
2012

47. The contribution of trigemino-cervical reflexes in distinguishing progressive supranuclear palsy from multiple system atrophy

Author

Serrao, M, Di Fabio, R, Bartolo, M, Perrotta, A, Tassorelli, C, Coppola, G, Davassi, C, Padua, Luca, Sandrini, G, Pierelli, F., Padua, Luca (ORCID:0000-0003-2570-9326), Serrao, M, Di Fabio, R, Bartolo, M, Perrotta, A, Tassorelli, C, Coppola, G, Davassi, C, Padua, Luca, Sandrini, G, Pierelli, F., and Padua, Luca (ORCID:0000-0003-2570-9326)

Abstract

OBJECTIVE: Trigemino-cervical reflexes (TCRs) are electromyographic responses induced by electrical stimulation of the trigeminal nerve and recorded in the neck muscles. Trigemino-cervical reflexes are detectable in Parkinson's disease, whereas they are absent in progressive supranuclear palsy (PSP), an atypical parkinsonism associated with brainstem degeneration. To date, no study has investigated TCRs in multiple system atrophy (MSA), another atypical parkinsonism associated with brainstem involvement, which resembles PSP. METHODS: To understand whether TCRs are helpful in differentiating PSP from MSA, we compared the TCRs recorded in 10 PSP patients with those obtained from 10 patients diagnosed as having probable MSA, parkinsonian type (MSA-P). RESULTS: Trigemino-cervical reflexes were not recorded in any of the PSP patients, while they were clearly detectable in all the MSA-P patients. CONCLUSIONS: Trigemino-cervical reflex recording is a rapid neurophysiological method, which could assist in the differential diagnosis between PSP and MSA-P. SIGNIFICANCE: This study further improves our understanding of the different neuronal functioning of extrapyramidal disorders. TCRs monitoring may be useful to support the diagnosis of atypical parkinsonisms especially when clinical evidence is uncertain.

Published
2011

48. Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson's disease

Author

Bartolo, M, Serrao, M, Tassorelli, C, Don, R, Ranavolo, A, Draicchio, F, Pacchetti, C, Buscone, S, Perrotta, A, Furnari, A, Bramanti, P, Padua, Luca, Pierelli, F, Sandrini, G., Padua, Luca (ORCID:0000-0003-2570-9326), Bartolo, M, Serrao, M, Tassorelli, C, Don, R, Ranavolo, A, Draicchio, F, Pacchetti, C, Buscone, S, Perrotta, A, Furnari, A, Bramanti, P, Padua, Luca, Pierelli, F, Sandrini, G., and Padua, Luca (ORCID:0000-0003-2570-9326)

Abstract

People with Parkinson's disease (PD) often have a posture characterized by lateral trunk flexion poorly responsive to antiparkinsonian drugs. To examine the effects of a rehabilitation programme (daily individual 90-minute-sessions, 5-days-a-week for 4-consecutive weeks) on lateral trunk flexion and mobility, 22 PD patients with mild to severe lateral trunk flexion, and 22 PD patients without trunk flexion were studied. Patients were evaluated using the Unified Parkinson's Disease Rating Scale motor subscale (UPDRS-III) score, and the kinematic behavior of the trunk was recorded by means of an optoelectronic system to determine: a) trunk flexion, inclination and rotation values in the erect standing posture; b) ranges of trunk flexion and inclination during trunk movements. After the treatment, significant decreases in trunk flexion [24 degrees (4) vs. 14 degrees (3), P < 0.001] and inclination in the static condition [23 degrees (5) vs. 12 degrees (4), P < 0.001)] were observed, both of which were maintained at the 6-month follow up. During the trunk flexion task, a significantly increased range of trunk flexion [64 degrees (15) vs. 83 degrees (15), P < 0.001] was observed; similarly, during the lateral bending task, the range of trunk inclination was found to be significantly increased, both toward the side of the trunk deviation [29 degrees (8) vs. 42 degrees (13), P < 0.01] and toward the contralateral side [14 degrees (6) vs 29 degrees (11), P < 0.01]. No further significant changes were observed at the 6-month follow-up. Trunk flexion and inclination values in the upright standing posture correlated slightly with the UPDRS-III score. Our findings show that significant improvements in axial posture and trunk mobility can be obtained through the 4-week rehabilitation programme described, with a parallel improvement in clinical status.

Published
2010

49. Angiomegaly

Author

D'Andrea, Vito, Malinovsky, L., Cavallotti, Carlo, BENEDETTI VALENTINI, F., Malinovska, V., Bartolo, M., Todini, A. R., Biancari, F., DI MATTEO, Filippo Maria, and DE ANTONI, Enrico

Published
1997

50. [Arteriomegaly in the aorto-iliac-femoral area with or without associated aneurysm]

Author

D'Andrea, Vito, Malinovsky, L, Bartolo, M, Todini, A, Biancari, F, Catania, Antonio, DI MATTEO, Filippo Maria, Manfredi, Rm, Bartolucci, R, and DE ANTONI, Enrico

Subjects
Femoral Artery, Humans, Aneurysm, Iliac Artery, Dilatation, Pathologic
Abstract

The authors present a group of 199 patients with arteriomegaly, an affection characterized by elongated and distended blood vessels of the arterial system, with or without accompanying aneurysms. Our study on this group of patients, drawn from a large arteriographic series of peripheral abdominal and lower limb arterial disorders, focuses on a comparison between atherosclerotic arteriopathy and arteriomegaly. Small tissue blocks were taken from the arterial wall of patients operated on for megadolichoarteries. Electron microscopic examination of such specimens revealed a specific alteration of the elastic component of the vessel wall. The authors believe that surgical treatment of this condition is indicated in order to prevent thromboembolic complications or aneurysmal rupture.

Published
1996

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