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1. Robotic-assisted tracheobronchoplasty: Quality of life and pulmonary function assessment on intermediate follow-up

Author

S. Jacob Scheinerman, Jason Karp, Stuart L. Cohen, Matthew L. Inra, Gregory A. Wasserman, Byron D. Patton, and Richard S. Lazzaro

Subjects
Pulmonary and Respiratory Medicine, Tracheobronchomalacia, COPD, medicine.medical_specialty, business.industry, Robotic assisted, General surgery, medicine.disease, Institutional review board, Pulmonary function testing, Robotic Surgical Procedures, Quality of life, Interquartile range, Forced Expiratory Volume, Tracheobronchoplasty, Quality of Life, Humans, Medicine, Surgery, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, Retrospective Studies
Abstract

The initial description of robotic tracheobronchoplasty for the treatment of tracheobronchomalacia demonstrated feasibility, safety, and short-term symptomatic and functional improvement. The purpose of the current study was to demonstrate intermediate outcomes in postoperative pulmonary function and quality of life after robotic tracheobronchoplasty.We retrospectively reviewed prospectively collected clinical data from 42 patients who underwent robotic tracheobronchoplasty from May 2016 to December 2017. The Institutional Review Board or equivalent ethics committee of the Northwell Health approved the study protocol and publication of data. Patient written consent for the publication of the study data was waived by the Institutional Review Board.A total of 42 patients underwent robotic tracheobronchoplasty during the study period. Median total follow-up is 40 months. There was 1 death since surgery from an unrelated disease. Significant decreases in St George's Respiratory Questionnaire total score (preoperative mean: 64.01, postoperative mean: 38.91, P = .002), St George's Respiratory Questionnaire symptom score (preoperative median: 82.6, postoperative median: 43.99, P .001), and St George's Respiratory Questionnaire impact score (preoperative median: 55.78, postoperative median: 25.95, P .001) were apparent at a median follow-up of 13 months. Comparison of preoperative and postoperative pulmonary function tests revealed a significant increase in percent predicted forced expiratory volume in 1 second (preoperative median: 74% vs postoperative median: 82%, P = .001), forced vital capacity (preoperative median: 68.5% vs postoperative median: 80.63%, P .001), and peak expiratory flow (preoperative median: 61.5% vs postoperative median: 75%, P = .02) measured at a median follow-up of 29 months.Robotic tracheobronchoplasty is associated with low intermediate-term mortality. Robotic tracheobronchoplasty results in significant improvement in quality of life and postoperative pulmonary function. Longer-term follow-up is necessary to continue to elucidate the effect of robotic tracheobronchoplasty on halting pathologic progression of tracheobronchomalacia and to determine the long-term impact of tracheobronchoplasty on symptomatic and functional improvement.

Published
2022
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2. Diagnostic contribution and therapeutic perspectives of transcranial magnetic stimulation in dementia

Author

Yoshikazu Ugawa, Michael Orth, Vincenzo Di Lazzaro, Barbara Borroni, Patrik Šimko, Raffaele Dubbioso, Irena Rektorová, Sara Tremblay, Matthew C. Kiernan, Rita Bella, Jean Pascal Lefaucheur, Hideyuki Matsumoto, Alvaro Pascual-Leone, Giacomo Koch, Kai Hsiang S. Chen, Federico Ranieri, Robert Chen, Andrei V. Chistyakov, Joseph Classen, Alberto Benussi, Fioravante Capone, Matteo Bologna, Giuseppe Lanza, John-Paul Taylor, Jean-Paul Nguyen, Di Lazzaro, V., Bella, R., Benussi, A., Bologna, M., Borroni, B., Capone, F., Chen, K. -H. S., Chen, R., Chistyakov, A. V., Classen, J., Kiernan, M. C., Koch, G., Lanza, G., Lefaucheur, J. -P., Matsumoto, H., Nguyen, J. -P., Orth, M., Pascual-Leone, A., Rektorova, I., Simko, P., Taylor, J. -P., Tremblay, S., Ugawa, Y., Dubbioso, R., and Ranieri, F.

Subjects
Biomarker, Brain stimulation, Connectivity, Cortical excitability, Plasticity, Precision medicine, Brain, Dementia, Electroencephalography, Humans, Neuronal Plasticity, Transcranial Magnetic Stimulation, medicine.medical_treatment, NO, Neuroimaging, Physiology (medical), medicine, Biomarker, Precision medicine, Cortical excitability, Plasticity, Connectivity, Brain stimulation, Cognitive decline, Neurostimulation, business.industry, musculoskeletal, neural, and ocular physiology, Cognition, medicine.disease, Sensory Systems, Cognitive training, Transcranial magnetic stimulation, nervous system, Neurology, 570 Life sciences, biology, Neurology (clinical), business, Neuroscience, Human
Abstract

Transcranial magnetic stimulation (TMS) is a powerful tool to probe in vivo brain circuits, as it allows to assess several cortical properties such as excitability, plasticity and connectivity in humans. In the last 20 years, TMS has been applied to patients with dementia, enabling the identification of potential markers of the pathophysiology and predictors of cognitive decline; moreover, applied repetitively, TMS holds promise as a potential therapeutic intervention. The objective of this paper is to present a comprehensive review of studies that have employed TMS in dementia and to discuss potential clinical applications, from the diagnosis to the treatment. To provide a technical and theoretical framework, we first present an overview of the basic physiological mechanisms of the application of TMS to assess cortical excitability, excitation and inhibition balance, mechanisms of plasticity and cortico-cortical connectivity in the human brain. We then review the insights gained by TMS techniques into the pathophysiology and predictors of progression and response to treatment in dementias, including Alzheimer’s disease (AD)-related dementias and secondary dementias. We show that while a single TMS measure offers low specificity, the use of a panel of measures and/or neurophysiological index can support the clinical diagnosis and predict progression. In the last part of the article, we discuss the therapeutic uses of TMS. So far, only repetitive TMS (rTMS) over the left dorsolateral prefrontal cortex and multisite rTMS associated with cognitive training have been shown to be, respectively, possibly (Level C of evidence) and probably (Level B of evidence) effective to improve cognition, apathy, memory, and language in AD patients, especially at a mild/early stage of the disease. The clinical use of this type of treatment warrants the combination of brain imaging techniques and/or electrophysiological tools to elucidate neurobiological effects of neurostimulation and to optimally tailor rTMS treatment protocols in individual patients or specific patient subgroups with dementia or mild cognitive impairment.

Published
2021
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3. Bortezomib, thalidomide, and dexamethasone followed by double autologous haematopoietic stem-cell transplantation for newly diagnosed multiple myeloma (GIMEMA-MMY-3006): long-term follow-up analysis of a randomised phase 3, open-label study

Author

Paola Tacchetti, Lucia Pantani, Francesca Patriarca, Maria Teresa Petrucci, Elena Zamagni, Luca Dozza, Monica Galli, Francesco Di Raimondo, Claudia Crippa, Mario Boccadoro, Simona Barbato, Patrizia Tosi, Franco Narni, Vittorio Montefusco, Nicoletta Testoni, Antonio Spadano, Carolina Terragna, Norbert Pescosta, Giulia Marzocchi, Claudia Cellini, Piero Galieni, Sonia Ronconi, Marco Gobbi, Lucio Catalano, Antonio Lazzaro, Giovanni De Sabbata, Clotilde Cangialosi, Fabrizio Ciambelli, Pellegrino Musto, Francesca Elice, Michele Cavo, Renato Fanin, Roberto Foa', Alessandro Rambaldi, Giuseppe Rossi, Pietro Leoni, Paolo Corradini, Giuseppe Torelli, Giuseppe Fioritoni, Sergio Cortelazzo, Giorgio Lambertenghi Deliliers, Giorgio La Nasa, Alfonso Zaccaria, Paolo De Fabritiis, Nicola Cascavilla, Alberto Bosi, Gianpietro Semenzato, Luigi Gugliotta, Filippo Gherlinzoni, Emanuele Angelucci, Massimo Fabrizio Martelli, Maria Concetta Petti, Giuseppe Leone, Angelo Michele Carella, Fabio Ciceri, Armando Santoro, Felicetto Ferrara, Francesco Nobile, Alfonso Maria D'Arco, Alessandro Levis, Luciano Guardigni, Andrea Gallamini, Pier Paolo Fattori, Sergio Morandi, Dino Amadori, Bruno Rotoli, Salvatore Mirto, Giorgio Paladini, Ruggero Mozzana, Graziella Pinotti, Francesco Rodeghiero, Nicola Cantore, Vincenzo Pavone, Enrico Maria Pogliani, Anna Marina Liberati, Ignazio Majolino, Sergio Amadori, Francesco Lauria, Massimo Aglietta, Giovanni Quarta, Sergio Storti, Fortunato Morabito, Silvana Franca Capalbo, Alessandro Massimo Gianni, Vincenzo Mettivier, Vittorio Rizzoli, Carlo Bernasconi, Giuseppe Visani, Michele Pizzuti, Giacinto La Verde, Giuseppe Avvisati, Maurizio Longinotti, Eugenio Gallo, Franco Dammacco, Domenico Russo, Andrea Bacigalupo, Caterina Musolino, Tacchetti P., Pantani L., Patriarca F., Petrucci M.T., Zamagni E., Dozza L., Galli M., Di Raimondo F., Crippa C., Boccadoro M., Barbato S., Tosi P., Narni F., Montefusco V., Testoni N., Spadano A., Terragna C., Pescosta N., Marzocchi G., Cellini C., Galieni P., Ronconi S., Gobbi M., Catalano L., Lazzaro A., De Sabbata G., Cangialosi C., Ciambelli F., Musto P., Elice F., Cavo M., Fanin R., Foa' R., Rambaldi A., Rossi G., Leoni P., Corradini P., Torelli G., Fioritoni G., Cortelazzo S., Lambertenghi Deliliers G., La Nasa G., Zaccaria A., De Fabritiis P., Cascavilla N., Bosi A., Semenzato G., Gugliotta L., Gherlinzoni F., Angelucci E., Martelli M.F., Petti M.C., Leone G., Carella A.M., Ciceri F., Santoro A., Ferrara F., Nobile F., D'Arco A.M., Levis A., Guardigni L., Gallamini A., Fattori P.P., Morandi S., Amadori D., Rotoli B., Mirto S., Paladini G., Mozzana R., Pinotti G., Rodeghiero F., Cantore N., Pavone V., Pogliani E.M., Liberati A.M., Majolino I., Amadori S., Lauria F., Aglietta M., Quarta G., Storti S., Morabito F., Capalbo S.F., Gianni A.M., Mettivier V., Rizzoli V., Bernasconi C., Visani G., Pizzuti M., La Verde G., Avvisati G., Longinotti M., Gallo E., Dammacco F., Russo D., Bacigalupo A., and Musolino C.

Subjects
Adult, Male, medicine.medical_specialty, Transplantation Conditioning, Adolescent, Phases of clinical research, Transplantation, Autologous, Dexamethasone, Bortezomib, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, GIMEMA-MMY-3006 trial, bortezomib, thalidomide, dexamethasone, VTD, double autologous haematopoietic stem-cell transplantation, multiple myeloma, Multiple myeloma, Aged, Intention-to-treat analysis, business.industry, Hazard ratio, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, medicine.disease, Thalidomide, Transplantation, Regimen, 030220 oncology & carcinogenesis, Female, Multiple Myeloma, business, Follow-Up Studies, 030215 immunology, medicine.drug
Abstract

Background: The phase 3 GIMEMA-MMY-3006 trial, which compared bortezomib, thalidomide, and dexamethasone (VTD) combination therapy with thalidomide and dexamethasone (TD) as induction therapy before and consolidation therapy after double autologous haematopoietic stem-cell transplantation (HSCT) for newly diagnosed multiple myeloma, showed the superiority of the triplet regimen over the doublet in terms of increased complete response rate and improved progression-free survival. We report the results from the final analysis of the study. Methods: In this randomised, open-label, phase 3 study, patients aged 18–65 years with previously untreated symptomatic multiple myeloma and a Karnofsky Performance Status of 60% or higher were enrolled at 73 centres in Italy. Patients were randomised (1:1) by a web-based system to receive three 21-day cycles of thalidomide (100 mg daily orally for the first 14 days and 200 mg daily thereafter) plus dexamethasone (total 320 mg per cycle; 40 mg on days 1–2, 4–5, 8–9, and 11–12 in the VTD regimen, and 40 mg on days 1–4 and 9–12 in the TD regimen), either alone (TD group) or with bortezomib (1·3 mg/m2 intravenously on days 1, 4, 8, and 11; VTD group). After double autologous HSCT, patients received two 35-day cycles of either the VTD or TD regimen, according to random assignment, as consolidation therapy. The primary outcome was the rate of complete response and near complete response after induction (already reported). In this updated analysis we assessed long-term progression-free survival and overall survival (secondary endpoints of the study) with an extended 10-year median follow-up, and analysed the variables influencing survival. Analysis was by intention to treat. The study is registered with ClinicalTrials.gov, NCT01134484. Findings: Between May 10, 2006, and April 30, 2008, 480 patients were enrolled and randomly assigned to receive VTD (241 patients) or TD (239 patients). Six patients withdrew consent before start of treatment. 236 (99 [42%] women) in the VTD group and 238 (102 [43%] women) in the TD group were included in the intention-to-treat analysis. The data cutoff date for this analysis was May 31, 2018. Median follow-up for surviving patients was 124·1 months (IQR 117·2–131·7). The 10-year progression-free survival estimate for patients in the VTD group was 34% (95% CI 28–41) compared with 17% (13–23) for the TD group (hazard ratio [HR] 0·62 [95% CI 0·50–0·77]; p

Published
2020
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4. Thalamic and cortical hyperexcitability in juvenile myoclonic epilepsy

Author

Raffaele Dubbioso, Lorenzo Ricci, Antonietta Coppola, Jacopo Lanzone, Giovanni Assenza, Mario Tombini, Angelo Insola, Marilisa Boscarino, Leonilda Bilo, Vincenzo Di Lazzaro, Assenza, G., Lanzone, J., Dubbioso, R., Coppola, A., Boscarino, M., Ricci, L., Insola, A., Bilo, L., Tombini, M., and Di Lazzaro, V.

Subjects
Adult, Male, Thalamus, 050105 experimental psychology, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Neuroimaging, Evoked Potentials, Somatosensory, Physiology (medical), Genetic epilepsy, medicine, Humans, 0501 psychology and cognitive sciences, Cerebral Cortex, business.industry, Myoclonic Epilepsy, Juvenile, 05 social sciences, Genetic disorder, Electroencephalography, Juvenile Myoclonic Epilepsy, medicine.disease, Sensory Systems, body regions, medicine.anatomical_structure, Somatosensory evoked potential, Neurology, Scalp, population characteristics, Female, Neurology (clinical), medicine.symptom, Juvenile myoclonic epilepsy, business, Neuroscience, Myoclonus, 030217 neurology & neurosurgery
Abstract

Objectives: Juvenile myoclonic epilepsy (JME) is a genetic generalized epilepsy marked by cortical hyperexcitability. Recent neuroimaging data suggested also a thalamic role in sustaining epileptic propensity in JME. However, thalamic hyperexcitability was not demonstrated so far. Low-frequency (LF-SEPs) and high-frequency somatosensory evoked potentials (HF-SEPs) are very sensitive to thalamic (early HF-SEPs burst, eHFO) and cortical (late HF-SEPs burst, lHFO) excitability. The aim of our experiment was to explore and discern the role of thalamic and cortical excitability in epileptic susceptibility of JME through a LF-SEPs and HF-SEPs study. Methods: Twenty-three subjects with JME (11 females, 30.2 ± 9.8-year-old) and 23 healthy control subjects (12 females, age: 34.7 ± 7.7-year-old) underwent right median LF-SEPs scalp recordings. Cp3′-Fz traces were filtered (400–800 Hz) to reveal HF-SEPs. All JME patients were on drug treatment and seizure free, except for sporadic myoclonus. Results: N20 LF-SEPs amplitude (p < 0.009), areas of totHFO, eHFO and lHFO (all p < 0.005) and totHFO duration (p = 0.013) were increased in JME respect to healthy subjects. totHFO area was negatively correlated with the number of antiepileptic drugs (rho = -0.505, sig.: 0.027), while eHFO area was positively correlated with the myoclonus frequency (rho = 0.555, sig = 0.014). Conclusions: We demonstrated that in JME the thalamic hyperexcitability assists the cortical one in sustaining epileptic susceptibility. Significance: Our results support the concept of JME as a network and genetic disorder.

Published
2020
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5. Machine learning for predicting levetiracetam treatment response in temporal lobe epilepsy

Author

Giovanni Assenza, Mario Tombini, Oriano Mecarelli, Flavia Narducci, Patrizia Pulitano, Lorenzo Ricci, Marilisa Boscarino, Filippo Zappasodi, Vincenzo Di Lazzaro, Jacopo Lanzone, and Pierpaolo Croce

Subjects
Adult, Male, Treatment response, medicine.medical_specialty, Levetiracetam, Future studies, Electroencephalography, Audiology, New diagnosis, Temporal lobe, Machine Learning, Young Adult, Epilepsy, Physiology (medical), Humans, Medicine, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Middle Aged, Prognosis, medicine.disease, Sensory Systems, Treatment Outcome, Epilepsy, Temporal Lobe, Neurology, Cohort, Anticonvulsants, Female, Neurology (clinical), business, medicine.drug
Abstract

Objective To determine the predictive power for seizure-freedom of 19-channels EEG, measured both before and after three months the initiation of the use of Levetiracetam (LEV), in a cohort of people after a new diagnosis of temporal-lobe epilepsy (TLE) using a machine-learning approach. Methods Twenty-three individuals with TLE were examined. We dichotomized clinical outcome into seizure-free (SF) and non-seizure-free (NSF) after two years of LEV. EEG effective power in different frequency bands was compared using baseline EEG (T0) and the EEG after three months of LEV therapy (T1) between SF and NSF patients. Partial Least Square (PLS) analysis was used to test and validate the prediction of the model for clinical outcome. Results A total of 152 features were extracted from the EEG recordings. When considering only the features calculated at T1, a predictive power for seizure-freedom (AUC = 0.750) was obtained. When employing both T0 and T1 features, an AUC = 0.800 was obtained. Conclusions This study provides a proof-of-concept pipeline for predicting the clinical response to anti-seizure medications in people with epilepsy. Significance Future studies may benefit from the pipeline proposed in this study in order to develop a model that can match each patient to the most effective anti-seizure medication.

Published
2021
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6. Pulsed Electromagnetic Fields: A Novel Attractive Therapeutic Opportunity for Neuroprotection After Acute Cerebral Ischemia

Author

Fioravante Capone, Micaela Liberti, Fabrizio Vincenzi, Giorgio Aicardi, Simona Salati, Francesca Apollonio, Vincenzo Di Lazzaro, Katia Varani, Ruggero Cadossi, Capone F., Salati S., Vincenzi F., Liberti M., Aicardi G., Apollonio F., Varani K., Cadossi R., and Di Lazzaro V.

Subjects
acute ischemic stroke, Adenosine, Ischemia, Socio-culturale, Neuroprotection, Brain Ischemia, Brain ischemia, Electromagnetic Fields, medicine, Animals, adenosine receptor, 2A, Stroke, Ischemic Stroke, biophysical stimulation, business.industry, Penumbra, Receptors, Purinergic P1, General Medicine, medicine.disease, Adenosine receptor, adenosine receptors, Anesthesiology and Pain Medicine, Neurology, A2A adenosine receptors, Infarction, Adjunctive treatment, neuroprotection, Neurology (clinical), pulsed electromagnetic fields, business, Neuroscience, medicine.drug
Abstract

Objectives Acute cerebral ischemia is characterized by several pathological processes evolving during time, which contribute to the final tissue damage. Secondary processes, such as prolonged inflammatory response, impaired mitochondrial function and oxidative stress, are responsible for the progression of brain injury to the peri-infarct area, called "penumbra." Adenosine has been shown to play a crucial role in regulating the inflammatory cascade following brain ischemia. Pulsed electromagnetic fields (PEMFs) act as modulators of adenosine receptors, increasing the functionality of the endogenous adenosine. In particular, PEMF exposure induces a significant upregulation of A2A and A3 adenosine receptors in different neuronal cell types. Several lines of evidence suggest that PEMF exposure might play a neuroprotective role after ischemic damage. Materials and methods This review summarizes the current knowledge on the mechanism of action of PEMFs and their biological effects on neuronal damage both in preclinical and clinical studies. Results PEMFs counteract hypoxia-induced apoptosis and ROS production in neuronal-like cells and exert a strong anti-inflammatory effect on microglial cells. Data from stroke animal models showed that PEMFs exposure is able to reduce the size of the infarct area and decrease the levels of pro-inflammatory mediators. In clinical studies, PEMFs stimulation proved to be safe and well tolerated. Preliminary results on acute ischemic stroke patients showed a dose-dependent reduction in the lesion size. Conclusions Altogether, these data demonstrate the efficacy of PEMFs against several mechanisms underlying ischemic damage and suggest that PEMFs might represent a novel noninvasive adjunctive treatment for acute ischemic stroke, providing neuroprotection and reducing functional deficits following ischemia.

Published
2022

7. The effect of Perampanel on EEG spectral power and connectivity in patients with focal epilepsy

Author

Lorenzo Ricci, Giovanni Assenza, Mario Tombini, Vincenzo Di Lazzaro, Oriano Mecarelli, Jacopo Lanzone, Patrizia Pulitano, and Marilisa Boscarino

Subjects
Adult, Male, medicine.medical_specialty, Pyridones, Theta activity, Electroencephalography, Audiology, EEGLAB, Perampanel, chemistry.chemical_compound, Epilepsy, Physiology (medical), Nitriles, medicine, Humans, In patient, Longitudinal Studies, Prospective Studies, Aged, medicine.diagnostic_test, business.industry, Brain, Middle Aged, Neurophysiology, medicine.disease, Sensory Systems, Power (physics), Treatment Outcome, Neurology, chemistry, Anticonvulsants, Drug Therapy, Combination, Female, Epilepsies, Partial, Neurology (clinical), Nerve Net, business
Abstract

Objective Quantitative Encephalography (qEEG) depicts synthetically the features of EEG signal and represents a promising tool in the assessment of neurophysiological changes brought about by Anti-Seizure Medications (ASMs). In this study we characterized qEEG alterations related to add-on therapy with Perampanel (PER). PER is the only ASM presenting a direct glutamatergic antagonism, hence the characterization of PER induced EEG changes could help to better understand its large spectrum of efficacy. Methods We analysed standard-19 channel-EEG from 25 People with Epilepsy (PwE) both before (T0) and after (T1) the introduction of PER as add-on treatment. Normal values were obtained in 30 healthy controls (HC) matched for sex and age. EEGs were analysed using Matlab™ and the EEGlab and Brainstorm toolkits. We extracted spectral power and connectivity (Phase locking Value) of EEG signal and then compared these features between T0 and T1 and across groups (PwE, HC), we also evaluated the correlations with clinical features. Results PwE showed increased theta power (p = 0.036) after the introduction of PER but no significant change of EEG connectivity. We also found that PwE have reduced beta power (p = 0.012) and increased connectivity in delta (p = 0.013) and theta (p = 0.007) range as compared to HC, but no significant change was observed between T0 and T1 in PwE. Finally, we found that PwE classified as drug responders to PER have greater alpha power both at T0 and at T1 (p = 0.024) suggesting that this parameter may predict response to treatment. Conclusions PER causes slight increase of theta activity and does not alter connectivity as assessed by standard EEG. Moreover, greater alpha power could be a good marker of response to PER therapy, and potentially ASM therapy in general. Significance Our results corroborate the hypothesis that pharmaco-EEG is a viable tool to study neurophysiological changes induced by ASM. Additionally, our work highlights the role of alpha power as a marker of ASM therapeutic response.

Published
2021
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8. Effects of head trauma and sport participation in young-onset Parkinson’s disease

Author

Giulia Maria Sancesario, Chiara Salimei, Piergiorgio Grillo, Tommaso Schirinzi, Giulia Di Lazzaro, Kristen Dams-O'Connor, Antonio Pisani, Nicola Biagio Mercuri, and Henri Zenuni

Subjects
0301 basic medicine, Oncology, medicine.medical_specialty, Neurology, Protective factor, Disease, Neurology and Preclinical Neurological Studies - Original Article, Head trauma, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, TBI, medicine, Craniocerebral Trauma, Humans, Age of Onset, Risk factor, Biological Psychiatry, Sport, Amyloid beta-Peptides, Young-onset Parkinson’s disease, business.industry, Neurodegeneration, Parkinson Disease, Middle Aged, medicine.disease, Psychiatry and Mental health, 030104 developmental biology, alpha-Synuclein, Neurology (clinical), Tauopathy, Tau, Age of onset, business, Biomarkers, 030217 neurology & neurosurgery
Abstract

Head trauma (HT) is emerging as an event anticipating onset of neurodegenerative disorders. However, the potential contribution of HT in young-onset cases (YOPD, age at onset

Published
2021
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9. Posterior Reversible Encephalopathy Syndrome and brain haemorrhage as COVID-19 complication: a review of the available literature

Author

Mariagrazia Rossi, Francesco Travaglino, Raffaele Antonelli Incalzi, Fioravante Capone, Alessandro Magliozzi, Massimo Marano, Francesca Ursini, Vincenzo Di Lazzaro, Mario Ferrante, Francesco Motolese, Fabio Pilato, and Martina Sbarra

Subjects
medicine.medical_specialty, Neurology, Review, PRES, Seizures, Internal medicine, Antithrombotic, medicine, Coagulopathy, Humans, Stroke, Posterior Reversible Encephalopathy Syndrome, Respiratory distress, business.industry, Cortical blindness, SARS-CoV-2, COVID-19, Posterior reversible encephalopathy syndrome, medicine.disease, Haemorrhage, Cardiology, Neurology (clinical), Posterior Leukoencephalopathy Syndrome, business, Complication, Intracranial Hemorrhages
Abstract

Background SARS-CoV-2 infection has been associated with various neurological manifestations. Since patients affected by SARS-CoV-2 infection present coagulation and immune system dysregulation, ischemic or haemorragic stroke is not uncommon, irrespective of respiratory distress. However, the occurrence of focal neurological deficits together with other symptoms like headache, cortical blindness, seizure and altered mental status should prompt the diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES). Antithrombotic treatment, the alteration of endothelial function, and coagulopathy due to COVID-19 and PRES leading to the breakdown of blood–brain barrier may then contribute to the occurrence of a brain haemorrhage. Methods We describe the case of a COVID-19 patient who developed bilateral occipital lobe haemorrhages suggestive of haemorrhagic PRES. We then reviewed the available literature about haemorrhagic evolution of PRES in COVID-19. Results We describe the clinical and radiological features of five COVID-19 patients who developed haemorrhagic PRES. Conclusions Coagulopathy and endothelial dysfunction resulting from the massive release of cytokines during the host immune response may be key factors in the pathogenesis of COVID-19-related PRES. Antithrombotic therapy and the leakage of the blood–brain barrier can subsequently increase the risk of haemorrhagic transformation of the lesioned brain tissue. A prompt diagnosis of PRES is mandatory, since the timely interruption/reversal of antithrombotic therapy may be a key determinant for a good prognosis.

Published
2021

10. X‐Linked Parkinsonism: Phenotypic and Genetic Heterogeneity

Author

Enza Maria Valente, Kailash P. Bhatia, Antonio Pisani, Giulia Di Lazzaro, Carlos Estevez-Fraga, and Francesca Magrinelli

Subjects
Male, 0301 basic medicine, Movement disorders, Ataxia, Genetic counseling, Encephalopathy, Bioinformatics, Genetic Heterogeneity, 03 medical and health sciences, 0302 clinical medicine, WDR45, Parkinsonian Disorders, medicine, Humans, Spectrum disorder, Child, MeCP2, XDP, Genetic heterogeneity, business.industry, Parkinsonism, Genetic Diseases, X-Linked, Parkinson Disease, medicine.disease, nervous system diseases, 030104 developmental biology, Neurology, Dystonic Disorders, BPAN, FXTAS, Neurology (clinical), X-linked parkinsonism, medicine.symptom, Carrier Proteins, business, 030217 neurology & neurosurgery
Abstract

X-linked parkinsonism encompasses rare heterogeneous disorders mainly inherited as a recessive trait, therefore being more prevalent in males. Recent developments have revealed a complex underlying panorama, including a spectrum of disorders in which parkinsonism is variably associated with additional neurological and non-neurological signs. In particular, a childhood-onset encephalopathy with epilepsy and/or cognitive disability is the most common feature. Their genetic basis is also heterogeneous, with many causative genes and different mutation types ranging from "classical" coding variants to intronic repeat expansions. In this review, we provide an updated overview of the phenotypic and genetic spectrum of the most relevant X-linked parkinsonian syndromes, namely X-linked dystonia-parkinsonism (XDP, Lubag disease), fragile X-associated tremor/ataxia syndrome (FXTAS), beta-propeller protein-associated neurodegeneration (BPAN, NBIA/PARK-WDR45), Fabry disease, Waisman syndrome, methyl CpG-binding protein 2 (MeCP2) spectrum disorder, phosphoglycerate kinase-1 deficiency syndrome (PGK1) and X-linked parkinsonism and spasticity (XPDS). All clinical and radiological features reported in the literature have been reviewed. Epilepsy occasionally represents the symptom of onset, predating parkinsonism even by a few years; action tremor is another common feature along with akinetic-rigid parkinsonism. A focus on the genetic background and its pathophysiological implications is provided. The pathogenesis of these disorders ranges from well-defined metabolic alterations (PGK1) to non-specific lysosomal dysfunctions (XPDS) and vesicular trafficking alterations (Waisman syndrome). However, in other cases it still remains poorly defined. Recognition of the phenotypic and genetic heterogeneity of X-linked parkinsonism has important implications for diagnosis, management, and genetic counseling. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Published
2021
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11. Remote smartphone gait monitoring and fall prediction in Parkinson’s disease during the COVID-19 lockdown

Author

Massimo Marano, Ziv Yekutieli, Mariagrazia Rossi, Francesco Motolese, Vincenzo Di Lazzaro, and Alessandro Magliozzi

Subjects
medicine.medical_specialty, Neurology, Parkinson's disease, Remote patient monitoring, Dermatology, Timed Up and Go test, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Humans, 030212 general & internal medicine, Gait, Timed-up-and-go test, Postural Balance, Balance (ability), business.industry, Sensors, SARS-CoV-2, COVID-19, Parkinson Disease, General Medicine, medicine.disease, Psychiatry and Mental health, Time and Motion Studies, Cohort, Communicable Disease Control, Parkinson’s disease, Falls, Neurology (clinical), Smartphone, Falling (sensation), business, Gait Analysis, 030217 neurology & neurosurgery
Abstract

Background Falls could be serious events in Parkinson’s disease (PD). Patient remote monitoring strategies are on the raise and may be an additional aid in identifying patients who are at risk of falling. The aim of the study was to evaluate if balance and timed-up-and-go data obtained by a smartphone application during COVID-19 lockdown were able to predict falls in PD patients. Methods A cohort of PD patients were monitored for 4 weeks during the COVID-19 lockdown with an application measuring static balance and timed-up-and-go test. The main outcome was the occurrence of falls (UPDRS-II item 13) during the observation period. Results Thirty-three patients completed the study, and 4 (12%) reported falls in the observation period. The rate of falls was reduced with respect to patient previous falls history (24%). The stand-up time and the mediolateral sway, acquired through the application, differed between “fallers” and “non-fallers” and related to the occurrence of new falls (OR 1.7 and 1.6 respectively, p

Published
2021

12. Effects of the noncompetitive AMPA receptor antagonist perampanel on thalamo-cortical excitability: A study of high-frequency oscillations in somatosensory evoked potentials

Author

Marilisa Boscarino, Lorenzo Ricci, Angelo Insola, Jacopo Lanzone, Vincenzo Di Lazzaro, Giovanni Assenza, and Mario Tombini

Subjects
Adult, Male, medicine.medical_specialty, Pyridones, Thalamus, Population, AMPA receptor, 050105 experimental psychology, 03 medical and health sciences, Perampanel, chemistry.chemical_compound, Epilepsy, 0302 clinical medicine, Evoked Potentials, Somatosensory, Physiology (medical), Internal medicine, Nitriles, medicine, Humans, 0501 psychology and cognitive sciences, Receptors, AMPA, education, Cerebral Cortex, education.field_of_study, business.industry, 05 social sciences, Antagonist, Middle Aged, medicine.disease, Sensory Systems, Thalamo cortical, medicine.anatomical_structure, Neurology, chemistry, Somatosensory evoked potential, Scalp, Cardiology, Anticonvulsants, Female, Neurology (clinical), business, Neuroscience, 030217 neurology & neurosurgery
Abstract

Objective We designed a longitudinal cohort study on People with Epilepsy (PwE) with the aim of assessing the effect of Perampanel (PER) on cortico-subcortical networks, as measured by high-frequency oscillations of somatosensory evoked potentials (SEP-HFOs). SEP-HFOs measure the excitability of both thalamo-cortical projections (early HFOs) and intracortical GABAergic synapses (late HFOs), thus they could be used to study the anti-glutamatergic action of PER, a selective antagonist of the AMPA receptor. Methods 15 PwE eligible for PER add-on therapy, were enrolled prospectively. Subjects underwent SEPs recording from the dominant hand at two times: PwET0 (baseline, before PER titration) and PwET1 (therapeutic dose of 4 mg). HFOs were obtained by filtering N20 scalp response in the 400–800 Hz range. Patients were compared with a normative population of 15 healthy controls (HC) matched for age and sex. Results We found a significant reduction of Total HFOs and mostly early HFOs area between PwET0 and PwET1 (p = 0.05 and p = 0.045 respectively) and between HC and PwET1 (p = 0.01). Furthermore, we found a significant reduction of P24/N24 Amplitude between PwET0 and HC and between PwET0 and PwET1 (p = 0.006 and p = 0.032, respectively). Conclusions Introduction of PER as add-on therapy reduced the area of total HFOs, acting mainly on the early burst, related to thalamo-cortical pathways. Furthermore P24/N24 amplitude, which seems to reflect a form of cortico-subcortical integration, resulted increased in PwE at T0 and normalized at T1. Significance Our findings suggest that PER acts on cortico-subcortical excitability. This could explain the broad spectrum of PER and its success in forms of epilepsy characterized by thalamo-cortical hyperexcitability.

Published
2021
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13. Adaptive, personalized closed-loop therapy for Parkinson's disease: biochemical, neurophysiological, and wearable sensing systems

Author

Maria Letizia Caminiti, Eduardo Martin Moraud, Pasquale Maria Pecoraro, Vincenzo Di Lazzaro, Lazzaro di Biase, and Gerd Tinkhauser

Subjects
Deep brain stimulation, Parkinson's disease, Wearable sensing, Brain activity and meditation, business.industry, General Neuroscience, medicine.medical_treatment, Deep Brain Stimulation, Wearable computer, Parkinson Disease, Disease, Neurophysiology, medicine.disease, Basal Ganglia, Wearable Electronic Devices, medicine, Humans, Pharmacology (medical), Neurology (clinical), business, Closed loop, Neuroscience
Abstract

Introduction Motor complication management is one of the main unmet needs in Parkinson's disease patients. Areas covered Among the most promising emerging approaches for handling motor complications in Parkinson's disease, adaptive deep brain stimulation strategies operating in closed-loop have emerged as pivotal to deliver sustained, near-to-physiological inputs to dysfunctional basal ganglia-cortical circuits over time. Existing sensing systems that can provide feedback signals to close the loop include biochemical-, neurophysiological- or wearable-sensors. Biochemical sensing allows to directly monitor the pharmacokinetic and pharmacodynamic of antiparkinsonian drugs and metabolites. Neurophysiological sensing relies on neurotechnologies to sense cortical or subcortical brain activity and extract real time correlates of symptom intensity or symptom control during DBS. A more direct representation of the symptom state, particularly the phenomenological differentiation and quantification of motor symptoms, can be realized via wearable sensor technology. Expert opinion Biochemical, neurophysiologic, and wearable-based biomarkers are promising technological tools that either individually or in combination could guide adaptive therapy for Parkinson's disease motor symptoms in the future.

Published
2021

14. Complex dyskinesias in Parkinson patients on levodopa/carbidopa intestinal gel

Author

Yu-Yan Poon, Lazzaro di Biase, Vincenzo Di Lazzaro, Pietro Marano, Giovanni Cossu, Roberta Arca, Taline Naranian, Alfonso Fasano, Massimo Marano, and Alessandro Di Santo

Subjects
Male, 0301 basic medicine, Dyskinesia, Drug-Induced, medicine.medical_specialty, Levodopa, Parkinson's disease, Gastroenterology, Antiparkinson Agents, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, otorhinolaryngologic diseases, medicine, Humans, Effective treatment, Longitudinal Studies, Control sample, Oral therapy, Aged, Retrospective Studies, business.industry, Dopaminergic, Carbidopa, Parkinson Disease, Middle Aged, medicine.disease, nervous system diseases, Intestines, Drug Combinations, Cross-Sectional Studies, 030104 developmental biology, Neurology, Dyskinesia, Case-Control Studies, Levodopa carbidopa, Female, Neurology (clinical), Geriatrics and Gerontology, medicine.symptom, business, Gels, 030217 neurology & neurosurgery, medicine.drug
Abstract

Background Levodopa-carbidopa intestinal infusion is an effective treatment for motor fluctuations in Parkinson's disease. However, it has been recently associated with emergent complex/atypical dyskinesias. We sought to characterize patients who developed these dyskinesias after levodopa infusion initiation, and to compare these patients to a control population with conventional motor fluctuations. Methods 208 Parkinson's disease patients, treated with levodopa intestinal infusion due to motor fluctuations, were screened for onset and/or worsening of dyskinesias after initiation of levodopa infusion, resistant to the routine titration, and presenting with atypical or unexpected patterns. Patients with extensive follow-up data were enrolled for a longitudinal analysis. Cases were compared to a control sample with conventional motor fluctuations in order to investigate predisposing factors, difference in dyskinesia phenotype, management strategies and dropouts. Results Thirty patients out of 208 (14.4%) reported atypical (i.e. long-lasting) biphasic, biphasic-like (i.e. continuous) or mixed (peak-dose and continuous biphasic) dyskinesias after levodopa infusion. They were compared at baseline and follow-up to a sample of 49 patients with conventional motor fluctuations on levodopa infusion. Both groups had similar demographic and clinical features, except the former having higher prevalence of biphasic dyskinesias while on oral therapy. Biphasic-like dyskinesias in nearly half the number of cases improved with increasing the dopaminergic load, while mixed dyskinesias had the worst outcome and highest dropout rate (58%). Conclusions Atypical biphasic, biphasic-like and complex dyskinesias could hinder the course of patients treated with levodopa infusion. This study further informs the selection process of advanced therapies, particularly in dyskinetic patients.

Published
2019
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15. Risk of Breast Cancer in Selected Women With Atypical Ductal Hyperplasia Who do not Undergo Surgical Excision

Author

Therese B. Bevers, Marita Lazzaro, Robin Coyne, Isabelle Bedrosian, Min Yi, Constance Albarracin, Deanna L. Lane, and Lyndsey Jo Kilgore

Subjects
Oncology, medicine.medical_specialty, Hyperplasia, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Cancer, Breast Neoplasms, Logistic regression, medicine.disease, Quadrant (abdomen), Carcinoma, Intraductal, Noninfiltrating, Logistic Models, Breast cancer, Internal medicine, Biopsy, Carcinoma, Humans, Medicine, Female, Surgery, Ductal Hyperplasia, Breast, business, Retrospective Studies
Abstract

Objective To review breast cancer incidence in women with atypical ductal hyperplasia (ADH) diagnosed by core needle biopsy (CNB) and managed non-operatively. Background ADH found on CNB is associated with an upgrade to carcinoma in 10-50% of women, thus surgical excision remains the standard of care. Safety of non-operative management is unknown. Methods ADH patients diagnosed between1/2004-10/2018 were identified. Subsequent breast cancer events were compared between those who were excised and those who met predetermined criteria of low risk and were thus observed. Subsequent breast cancer events were classified as index site event if identified in the same quadrant as prior ADH. Multivariable logistic regression models were used to assess potential predictors of subsequent breast cancer events. Results 478 women with 483 ADH lesions were identified; 309 were observed and 174 underwent excision. Median follow-up was 5.2 years. Prior breast cancer history was the only factor associated with subsequent breast cancer risk (OR 2.25, 95%CI 1.04-4.87). After excluding patients with a breast cancer history, there was no association of age, race, chemoprevention or surgical excision of ADH with future cancer risk. 21/387 patients without a breast cancer history developed a subsequent cancer; 10 (7.3%) in the surgical group and 11 (4.4%) in the observed (p = 0.2). Two cancers were identified at the index site in the surgery group (2/137, 1.5%) and three in those observed (3/250, 1.2%). Conclusions Observation, rather than surgical excision, is safe in select women with ADH. National guidelines should consider observation for this select group of patients.

Published
2021
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16. Robotic Pneumonectomy for Lung Cancer: Perioperative Outcomes and Factors Leading to Conversion to Thoracotomy

Author

Byron Patton, Richard S. Lazzaro, Donna Bahroloomi, Paul C. Lee, Iam Claire E. Sarmiento, and Daniel Zarif

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, Pneumonectomy, Robotic Surgical Procedures, medicine, Humans, Thoracotomy, Risk factor, Lung cancer, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, technology, industry, and agriculture, Robotics, General Medicine, Perioperative, medicine.disease, Surgery, body regions, Treatment Outcome, Invasive surgery, Cardiology and Cardiovascular Medicine, business
Abstract

Objective In the tide of robot-assisted minimally invasive surgery, few cases of robot-assisted pneumonectomy exist in the literature. This study evaluates the perioperative outcomes and risk factors for conversion to thoracotomy with an initial robotic approach to pneumonectomy for lung cancer. Methods This study is a single-center retrospective review of all pneumonectomies for lung cancer with an initial robotic approach between 2015 and 2019. Patients were divided into 2 groups: surgeries completed robotically and surgeries converted to thoracotomy. Patient demographics, preoperative clinical data, surgical pathology, and perioperative outcomes were compared for meaningful differences between the groups. Results Thirteen total patients underwent robotic pneumonectomy with 8 of them completed robotically and 5 converted to thoracotomy. There were no significant differences in patient characteristics between the groups. The Robotic group had a shorter operative time ( P < 0.01) and less estimated blood loss ( P = 0.02). There were more lymph nodes harvested in the Robotic group ( P = 0.08) but without statistical significance. There were 2 major complications in the Robotic group and none in the Conversion group. Neither tumor size nor stage were predictive of conversion to thoracotomy. Conversions decreased over time with a majority occurring in the first 2 years. There were no conversions for bleeding and no mortalities. Conclusions Robotic pneumonectomy for lung cancer is a safe procedure and a reasonable alternative to thoracotomy. With meticulous technique, major bleeding can be avoided and most procedures can be completed robotically. Larger studies are needed to elucidate any advantages of a robotic versus open approach.

Published
2021
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17. Individual Differences Modulate the Effects of tDCS on Reading in Children and Adolescents with Dyslexia

Author

Giulia Lazzaro, Deny Menghini, Floriana Costanzo, Maria Elena De Matteis, Cristiana Varuzza, Serena Rossi, and Stefano Vicari

Subjects
tdcs, medicine.medical_specialty, Transcranial direct-current stimulation, medicine.medical_treatment, media_common.quotation_subject, 05 social sciences, Dyslexia, 050301 education, Audiology, medicine.disease, 050105 experimental psychology, Education, Settore MED/39 - NEUROPSICHIATRIA INFANTILE, Reading (process), medicine, 0501 psychology and cognitive sciences, Psychology (miscellaneous), Psychology, 0503 education, media_common
Abstract

Emerging evidence suggests that the combination of transcranial direct current stimulation (tDCS) and reading training may provide promising benefits for dyslexia; however, the clinical effects and...

Published
2020
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18. Quality of life outcomes in tracheobronchomalacia surgery

Author

Byron Patton, Joseph Thomas McGinn, Benoit Herbert, Richard S. Lazzaro, and Andrew Maloney

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Gold standard, Exhalation, respiratory system, 030204 cardiovascular system & hematology, medicine.disease, respiratory tract diseases, Surgery, Review Article on Patient Reported Outcomes in Thoracic Surgery: A new Frontier, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Tracheomalacia, Quality of life, Tracheobronchomalacia, Tracheobronchoplasty, medicine, Bronchomalacia, Airway, business
Abstract

Tracheobronchomalacia (TBM) is an obstructive airway disease characterized by laxity and redundancy of the posterior membrane of the main airways leading to dynamic airway collapse during exhalation. The gold standard for diagnosis is dynamic computed tomography (DCT) scan and dynamic flexible bronchoscopy (DFB). Patients with complete or near-complete collapse (>90% reduction in cross-sectional area) of the airway are possible candidates for surgical management. Central airway stabilization by tracheobronchoplasty (TBP) effectively corrects malacic airways and has demonstrated significant improvement in objective functional measures, which is often but not uniformly accompanied by equal improvement in health-related quality of life (HRQOL) metrics. This article reviews HRQOL instruments used to report outcomes after TBM surgery.

Published
2020
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19. Principal‐agent theory‐based cost and reimbursement structures of isavuconazole treatment in German hospitals

Author

Sebastian M Wingen-Heimann, Florian Kron, Carlo Lazzaro, Julia Jeck, Christian Thielscher, and Oliver A. Cornely

Subjects
0301 basic medicine, Pyridines, Cost-Benefit Analysis, media_common.quotation_subject, 030106 microbiology, Principal–agent problem, Dermatology, German, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Resource (project management), Germany, Nitriles, Health care, Humans, Medicine, Economics, Hospital, Diagnosis-Related Groups, Reimbursement, media_common, business.industry, General Medicine, Length of Stay, Triazoles, Payment, medicine.disease, Hospitals, language.human_language, Infectious Diseases, Incentive, Costs and Cost Analysis, language, Hospital reimbursement, Medical emergency, business
Abstract

Background Isavuconazole (ISA) is a frequently used antifungal agent for the treatment of invasive fungal diseases (IFDs). However, hospital reimbursement data for ISA is limited. Objectives The primary objective of this study was to analyse the different perspectives of relevant stakeholders and the (dis)incentives for the administration of ISA in Germany. To that aim, the health economic effects of using ISA from a hospital management perspective were analysed. Patients/methods Based on principal-agent theory (PAT), the perspectives of (a) the patient (principal) as well as (b) physicians, (c) pharmacists and iv. hospital managers (all agents) were analysed. For the evaluation of the cost-containment and reimbursement strategies of ISA, the German diagnosis-related group (G-DRG) system was used. Results Hospitals individually negotiating additional payments for innovative treatment procedures (zusatzentgelte [ZE]) within the G-DRG system is a key element of hospital management for the reduction of total healthcare expenditure. Our analysis demonstrated the beneficial role of ISA in healthcare resource utilisation, primarily due to a shortened overall length of hospital stay. Depending on underlying disease, coded G-DRG and ISA formulation, large differences in total reimbursement and the amount of ZE was shown. The PAT demonstrated disincentives for hospital managers to use innovative drugs. Conclusions Based on the PAT, beneficial, detrimental and indifferent perspectives of different stakeholders regarding the usage of ISA were shown. A reduction of bureaucratic hurdles is needed in Germany for the extension of effective and innovative antifungal treatment strategies with ISA.

Published
2020
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20. Movement disorders in ADAR1 disease: Insights from a comprehensive cohort

Author

Giulia Di Lazzaro, Federica Graziola, Andrea Sancesario, Gessica Vasco, Alessandro Capuano, Enrico Castelli, Antonella Insalaco, Gian Marco Moneta, Tommaso Schirinzi, Lorena Travaglini, Enrico Bertini, and Fabrizia Stregapede

Subjects
0301 basic medicine, Pediatrics, medicine.medical_specialty, Movement disorders, Adenosine Deaminase, Disease, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Dystonia, Movement Disorders, business.industry, RNA-Binding Proteins, medicine.disease, Status dystonicus, Dyschromatosis symmetrica hereditaria, 030104 developmental biology, Neurology, Cohort, Aicardi–Goutières syndrome, Neurology (clinical), Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery, Progressive disease
Abstract

ADAR1 variants are associated to rare and heterogenous neurological conditions, including Aicardi-Goutieres syndrome type 6, bilateral striatal necrosis, and dyschromatosis symmetrica hereditaria. Movement disorders (MDs) commonly occur in ADAR1-related diseases although a complete overview on the phenomenology has not been provided yet. Here, a cohort of 57 patients with ADAR1-related diseases, including 3 unpublished patients and 54 previously reported cases, was reviewed. Data on demographics, clinical features of MDs, genetics and biomarkers were collected and descriptive statistics, group analysis for genotype and logistic regression were run. Manifestations of MD characterized the onset of ADAR1-related disease in 60% of patients. Specifically, dystonia occurred in 39% of cases, even as severe status dystonicus, while prevalence of other MDs was lower. Patients often presented brain lesions (>90%) and progressive disease course (43%), fatal in some cases. Clinical presentation and outcome differed among patients with distinct genotype. This review shows that phenomenology of MDs in ADAR1-related diseases is wide and heterogeneous, although a severe motor syndrome (often characterized by dystonia) secondary to brain lesions represents the most common manifestation. Waiting for future development of disease-modifying treatments, an appropriate symptomatic intervention is crucial for ADAR1 patients. Accordingly, a deeper knowledge of phenomenology is fundamental.

Published
2020
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21. Normal Pressure Hydrocephalus in Down Syndrome: The Report of Two Cases

Author

Massimo Marano, Angelo Pompucci, Mariagrazia Rossi, Alfonso Fasano, Gianpaolo Petrella, Ernesto Coletta, Francesco Motolese, and Vincenzo Di Lazzaro

Subjects
Senescence, Down syndrome, Pediatrics, medicine.medical_specialty, Adult patients, business.industry, General Neuroscience, 05 social sciences, General Medicine, Disease, medicine.disease, Shunt (medical), 03 medical and health sciences, Psychiatry and Mental health, Clinical Psychology, 0302 clinical medicine, Cerebrospinal fluid, Normal pressure hydrocephalus, 0502 economics and business, Intellectual disability, medicine, 050211 marketing, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract

Down syndrome (DS) is the most common cause of intellectual disability in infants and has a well-known relationship with the Alzheimer’s disease. The association between DS and the other pathologies of senescence, such as normal pressure hydrocephalus (NPH), has been poorly investigated. This series included two DS patients with NPH. In both cases, NPH symptoms were initially misdiagnosed as DS associated senescence. Patients were treated with ventricular-peritoneal shunt, showing a sustained improvement (1 and 4 years of follow-up). To our knowledge, this is the first description of the occurrence of NPH in adult patients with DS and surgical outcomes.

Published
2020
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22. Seizures in Hereditary Aceruloplasminemia

Author

Giovanni Assenza, Vincenzo Di Lazzaro, Mohammad Rohani, Massimo Marano, Lorenzo Ricci, Alfonso Fasano, and Francesco Bove

Subjects
medicine.medical_specialty, biology, business.industry, Brain, Ceruloplasmin, Neuroferritinopathy, Neurodegenerative Diseases, General Medicine, medicine.disease, Iron Metabolism Disorders, Ferritin, Epilepsy, Endocrinology, Neurology, Seizures, Internal medicine, biology.protein, medicine, Humans, Neurology (clinical), Aceruloplasminemia, business
Published
2020
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23. Electroencephalography during SARS-CoV-2 outbreak: practical recommendations from the task force of the Italian Society of Neurophysiology (SINC), the Italian League Against Epilepsy (LICE), and the Italian Association of Neurophysiology Technologists (AITN)

Author

Giovanni Assenza, Rosalia Cilea, Maurizio Vergari, Antonello Grippo, Vincenzo Di Lazzaro, Oriano Mecarelli, Laura Tassi, Maenia Scarpino, Giovanni Lanzo, Carlo Andrea Galimberti, Lidia Broglia, and Roberto Michelucci

Subjects
medicine.medical_specialty, Neurology, Advisory Committees, Pneumonia, Viral, Clinical Neurology, Neurophysiology, Dermatology, Electroencephalography, Recommendations, Clinical neurophysiology, Disease Outbreaks, 03 medical and health sciences, Epilepsy, Betacoronavirus, 0302 clinical medicine, Ambulatory care, Personal hygiene, Pandemic, Medical Laboratory Personnel, medicine, Humans, 030212 general & internal medicine, EEG, Pandemics, Societies, Medical, medicine.diagnostic_test, business.industry, SARS-CoV-2, COVID-19, General Medicine, medicine.disease, Psychiatry and Mental health, Italy, Practice Guidelines as Topic, Neurology (clinical), Neurosurgery, Medical emergency, business, Coronavirus Infections, 030217 neurology & neurosurgery
Abstract

BACKGROUND: During COVID-19 lockdown, non-urgent medical procedures were suspended. Grade of urgency of electroencephalography (EEG) may vary according to the clinical indication, setting, and status of infection of SARS-CoV-2 virus. "Italian Society of Clinical Neurophysiology" (SINC), "Italian League Against Epilepsy" (LICE), and the "Italian Association of Neurophysiology Technologists" (AITN) aimed to provide clinical and technical recommendation for EEG indications and recording standards in this pandemic era. METHODS: Presidents of SINC, LICE, and AITN endorsed three members per each society to formulate recommendations: classification of the degree of urgency of EEG clinical indications, management and behavior of physicians and neurophysiology technologists, hygiene and personal protection standards, and use of technical equipment. RESULTS: Scientific societies endorsed a paper conveying the recommendation for EEG execution in accordance with clinical urgency, setting (inpatients/outpatients), status of SARS-CoV-2 virus infection (positive, negative and uncertain), and phase of governmental restrictions (phase 1 and 2). Briefly, in phase 1, EEG was recommended only for those acute/subacute neurological symptoms where EEG is necessary for diagnosis, prognosis, or therapy. Outpatient examinations should be avoided in phase 1, while they should be recommended in urgent cases in phase 2 when they could prevent an emergency room access. Reduction of staff contacts must be encouraged through rescheduling job shifts. The use of disposable electrodes and dedicated EEG devices for COVID-19-positive patients are recommended. CONCLUSIONS: During the different phases of COVID-19 pandemic, the EEG should be reserved for patients really benefiting from its execution in terms of diagnosis, treatment, prognosis, and avoidance of emergency room access.

Published
2020

24. Nordic Walking and Walking in Parkinson’s disease: a randomized single-blind controlled trial

Author

Anna Rosa Lazzaro, Alberto Scarpa, Andrea Alessandri, Serena Granziera, and Daniela Zara

Subjects
Aging, medicine.medical_specialty, Parkinson's disease, medicine.medical_treatment, Population, law.invention, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Randomized controlled trial, Quality of life, law, medicine, 030212 general & internal medicine, education, Balance (ability), education.field_of_study, Rehabilitation, business.industry, medicine.disease, Clinical trial, Anxiety, Geriatrics and Gerontology, medicine.symptom, business, human activities, 030217 neurology & neurosurgery
Abstract

Non-pharmacological interventions are increasingly being acknowledged as valuable options to overcome or reduce functional problems in patients with Parkinson’s disease. In the last decades, Nordic Walking was employed and investigated by rehabilitation specialists. Clinical trials on the effect of Nordic Walking on motor and non-motor Parkinson’s disease symptoms are few, small, and heterogeneous for inclusion criteria and intervention protocols. As a result, Nordic Walking training cannot be recommended as a standard rehabilitative tool in Parkinson’s disease patients. This randomized controlled single-blind trial recruited Parkinson’s disease patients at a Hoehn and Yahr stage between 2 and 3 assigned to a Nordic Walking vs. Walking group. Subjects were extensively assessed for motor and non-motor symptoms at baseline and after 8 weeks of intervention period. To study the effects of intervention on the overall sample, paired-sample t test and Wilcoxon signed rank test were used, while differences between groups were estimated with general linear models repeated-measure and Mann–Whitney U test. Among 32 patients who ended the study period, improvements were observed in the following assessments: global motor outcome (p 0.001), dynamic and static balance ability (p 0.005; p 0.002), global non-motor symptoms outcome (p 0.003), fatigue (p 0.016), anxiety (p 0.043), and quality of life (p 0.003). The treatment group (Nordic Walking) failed to show any difference compared to the control group (Walking) in all considered outcomes. Nordic Walking was not superior compared to Walking in the studied population. Moderate intensity outdoor group activities like Nordic Walking and Walking seem to improve motor and non-motor symptoms parameters in patients with Parkinson’s disease.

Published
2020
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25. Causes of swine polyserositis in a high-density breeding area in Italy

Author

Paolo Pozzi, Stefano Giovannini, Maria Beatrice Boniotti, Nicoletta Vitale, M. Lazzaro, Paolo Pasquali, Cristian Salogni, and Giovanni Loris Alborali

Subjects
Serositis, Swine Diseases, General Veterinary, biology, Swine, ved/biology, Mycoplasma hyorhinis, Sus scrofa, ved/biology.organism_classification_rank.species, Bacterial Infections, Brief Communication, biology.organism_classification, medicine.disease, Porcine reproductive and respiratory syndrome virus, Microbiology, Porcine circovirus, Italy, Virus Diseases, Haemophilus, Coinfection, medicine, Trueperella pyogenes, Animals, Pasteurella multocida, Actinobacillus pleuropneumoniae
Abstract

We assessed the causes of polyserositis in pigs, categorized by causative agents and ages of animals affected. In a 3-y study, 246 pigs from 80 different farms with recurrent problems of polyserositis, in a high-density breeding area, were submitted for autopsy; 154 pigs with typical fibrinous serosal lesions were sampled for further bacterial and viral investigation. The most common gross lesions were pleuritis and pericarditis (141 of 154; 92%). The animals most affected were weaned pigs (139 of 154; 90%). Haemophilus parasuis and Mycoplasma hyorhinis were the most common bacteria detected and were present at the same rate (85 of 154; 55%). Other bacteria isolated were Streptococcus sp. (44 of 154; 29%), Pasteurella multocida (21 of 154; 14%), Escherichia coli (19 of 154; 12%), Actinobacillus pleuropneumoniae (7 of 154; 5%), and Trueperella pyogenes (4 of 154; 3%). Porcine reproductive and respiratory syndrome virus (PRRSV; 119 of 154; 77%) predominated among the viruses detected, followed, with lesser prevalence, by porcine circovirus 2 (40 of 154; 26%) and swine influenza A virus (19 of 154; 12%). Bacterial coinfection and coinfection of bacteria and viruses were common (128 of 154; 83%). A strong positive correlation was found between coinfection by H. parasuis and M. hyorhinis and also by H. parasuis with PRRSV.

Published
2020
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26. Anemone study: prevalence of risk factors for superficial vein thrombosis in a large Italian population of blood donors

Author

Giovanna Meneghini, Nadia Coffetti, Maurizio Margaglione, Lazzaro Di Mauro, Angelo Ostuni, Elvira Grandone, Roberto Dovigo, Filomena Cappucci, Giobatta Cavallero, Alberto Tosetto, Anna Turrini, Giovanni Luca Tiscia, Antonio De Laurenzo, Patrizia Vergura, Mario Mastroianno, and Fcsa

Subjects
medicine.medical_specialty, education.field_of_study, Hematology, Superficial vein thrombosis, business.industry, medicine.medical_treatment, Population, Disease, 030204 cardiovascular system & hematology, medicine.disease, Bed rest, Thrombosis, 03 medical and health sciences, Venous thrombosis, 0302 clinical medicine, Internal medicine, Varicose veins, Medicine, 030212 general & internal medicine, medicine.symptom, Cardiology and Cardiovascular Medicine, business, education
Abstract

Knowledge of the distribution of risk factors for superficial thrombosis (SVT) in low-risk population is fundamental to improve the prevention of the disease in each individual and high-risk settings of patients. Exact frequency data for the low-risk population are scarce, but could be useful for optimal use of prophylactic strategies against venous thrombosis. Blood donors represent a low-risk population, because are healthier than the general population. The objective of this study was to assess the prevalence of vein thrombosis, particularly SVT, and associated risk factors in a low-risk population such as blood donors. In this multicentre cross-sectional study, donors from six Italian blood banks responded to a self-administered questionnaire. The enrolment lasted from 1st June 2017 to 30th July 2018. History of vein thrombosis was referred by 89 (0.76%) individuals, (49 men) with an age-dependent effect. The prevalence reached 2.9% in women and 0.8% in men aged ≥ 49 years, with a significant difference only for women. After controlling for potential confounders, a significant and independent association was found between a history of vein thrombosis and age (OR: 1.03, 95%CI 1.01–1.05), varicose veins (OR: 15.8, 95%CI 7.7–32.6), plaster cast/bed rest (OR: 2.3, 95% CI 1.0–5.3) and transfusion (OR: 5.1, 95% CI 1.3–19.5). This study shows that low-risk individuals share the same risk factors for SVT as patients in secondary care. It also suggests that transfusion confers an increased risk of SVT in healthy population.

Published
2020
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27. Ischemic injury precipitates neuronal vulnerability in Parkinson's disease: Insights from PINK1 mouse model study and clinical retrospective data

Author

Paola Platania, Paola Bonsi, Ilham El Atiallah, Tommaso Schirinzi, Paola Imbriani, Giulia Di Lazzaro, Vincenza D'Angelo, Antonio Pisani, Vito Luigi Colona, Giuseppina Martella, Chiara Salimei, Simona Scalise, and Nicola Biagio Mercuri

Subjects
Male, 0301 basic medicine, Pathology, Parkinson's disease, Comorbidity, medicine.disease_cause, Basal Ganglia, Brain Ischemia, Mice, 0302 clinical medicine, Ischemia, Risk Factors, Basal ganglia, Aged, 80 and over, Mice, Knockout, Dopaminergic, Parkinson Disease, Middle Aged, Mitochondria, Vascular risk factors, Neurology, Female, medicine.medical_specialty, PINK1, Settore MED/26, Medium spiny neuron, 03 medical and health sciences, Oxidative stress, Interneurons, medicine, Animals, Humans, Vascular Diseases, Aged, Retrospective Studies, business.industry, Dopaminergic Neurons, medicine.disease, Disease Models, Animal, Oxidative Stress, 030104 developmental biology, Neurology (clinical), Geriatrics and Gerontology, business, Protein Kinases, 030217 neurology & neurosurgery
Abstract

Introduction:Increasing evidence demonstrates the relevant association between Parkinson's disease (PD) and vascular diseases/risk factors, as well as a worse clinico-pathological progression in those patients with vascular comorbidity. The mechanisms underlying this relationship have not been clarified yet, although their comprehension is critical in a perspective of disease-modifying treatments development or prevention. Methods:We performed an experimental protocol of ischemic injury (glucose-oxygen deprivation, OGD) on PTEN-induced kinase 1 knockout (PINK1-/-) mice, a well-established PD model, looking at both electrophysiological and morphological changes in basal ganglia. In addition, 253 PD patients were retrospectively analysed, to estimate the prevalence of vascular risk factors. Results:In PINK1-/-mice, the OGD protocol induced electrophysiological (prolonged depolarization) and morphological alterations (picnotic cells, cellular loss and swelling, thickening of nuclear chromatin) in striatal medium spiny neurons and nigral dopaminergic neurons. Vascular comorbidity occurred in 75% of PD patients. Conclusions:The ischemic injury precipitates neuronal vulnerability in basal ganglia of PINK1-/-mice, probably through an impairment of mitochondrial metabolism and higher oxidative stress. These experimental data may provide a potential mechanistic explanation for both the association between vascular diseases and PD and their reciprocal interactions in determining the clinico-pathological burden of PD patients.

Published
2020
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28. Increased risk and early onset of ALS in professional players from Italian Soccer Teams

Author

Nicola Vanacore, Pino Lazzaro, Francesco Saverio Robustelli della Cuna, Massimiliano Castellani, Giuseppe Ricca, Francesco Romeo, Fabio Fumagalli, Elisa Bianchi, Carla Montalto, Elisabetta Pupillo, Damiano Tommasi, Ettore Beghi, and Fabio Poli

Subjects
Population, Disease, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Soccer, Humans, Medicine, Amyotrophic lateral sclerosis, education, Aged, Early onset, education.field_of_study, business.industry, Incidence, Amyotrophic Lateral Sclerosis, Place of birth, medicine.disease, Increased risk, Italy, Neurology, Cohort, Neurology (clinical), Role playing, business, human activities, 030217 neurology & neurosurgery, Demography
Abstract

Objective: Since the observation of several deaths from amyotrophic lateral sclerosis (ALS) among Italian professional soccer players, an association between ALS and soccer has been postulated. The objective of the study is to investigate the association between professional soccer and the risk of ALS in a large cohort of former professional soccer players with prolonged follow-up. Methods: All professional soccer players practicing in the period 1959-2000 were identified through the archives of an Italian soccer cards publisher. For each player, date and place of birth, playing role, and team history were recorded. Each player was followed since 15 years of age. Incident ALS cases were all soccer players first diagnosed during the period 1959-2018. The expected incidence rate was the number of ALS cases/100,000 person-years expected in the cohort. SIR was the ratio between observed and expected incidence rate. Results: 34 ALS cases were detected. The number of expected cases was 17.8. The SIR was 1.91 (95% CI 1.32-2.67) in the entire sample and 4.66 (95% CI 2.66-7.57) in subjects aged less than 45 years. The mean age at diagnosis was 45.0 years. Compared to the mean age of onset of ALS in the general population (65.2 years), the disease in former soccer players occurred 20.2 years earlier. Conclusions: Professional soccer players are at higher risk of developing ALS than the general population. Soccer players with ALS develop the disease at a younger than expected age.

Published
2020
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29. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Author

Alison Halliday, Richard Bulbulia, Leo H Bonati, Johanna Chester, Andrea Cradduck-Bamford, Richard Peto, Hongchao Pan, John Potter, Hans Henning Eckstein, Barbara Farrell, Marcus Flather, Averil Mansfield, Boby Mihaylova, Kazim Rahimi, David Simpson, Dafydd Thomas, Peter Sandercock, Richard Gray, Andrew Molyneux, Cliff P Shearman, Peter Rothwell, Anna Belli, Will Herrington, Parminder Judge, Peter Leopold, Marion Mafham, Michael Gough, Piergiorgio Cao, Sumaira MacDonald, Vasha Bari, Clive Berry, S Bradshaw, Wojciech Brudlo, Alison Clarke, Robin Cox, Susan Fathers, Kamran Gaba, Mo Gray, Elizabeth Hayter, Constance Holliday, Rijo Kurien, Michael Lay, Steffi le Conte, Jessica McManus, Zahra Madgwick, Dylan Morris, Andrew Munday, Sandra Pickworth, Wiktor Ostasz, Michiel Poorthuis, Sue Richards, Louisa Teixeira, Sergey Tochlin, Lynda Tully, Carol Wallis, Monique Willet, Alan Young, Renato Casana, Chiara Malloggi, Andrea Odero Jr, Vincenzo Silani, Gianfranco Parati, Giuseppe Malchiodi, Giovanni Malferrari, Francesco Strozzi, Nicola Tusini, Enrico Vecchiati, Gioacchino Coppi, Antonio Lauricella, Roberto Moratto, Roberto Silingardi, Jessica Veronesi, Andrea Zini, Emanuele Ferrero, Michelangelo Ferri, Andrea Gaggiano, Carmelo Labate, Franco Nessi, Daniele Psacharopulo, Andrea Viazzo, Giovanni Malacrida, Daniela Mazzaccaro, Giovanni Meola, Alfredo Modafferi, Giovanni Nano, Maria Teresa Occhiuto, Paolo Righini, Silvia Stegher, Stefano Chiarandini, Filippo Griselli, Sandro Lepidi, Fabio Pozzi Mucelli, Marcello Naccarato, Mario D'Oria, Barbara Ziani, Andrea Stella, Mortalla Dieng, Gianluca Faggioli, Mauro Gargiulo, Sergio Palermo, Rodolfo Pini, Giovanni Maria Puddu, Andrea Vacirca, Domenico Angiletta, Claudio Desantis, Davide Marinazzo, Giovanni Mastrangelo, Guido Regina, Raffaele Pulli, Paolo Bianchi, Lea Cireni, Elisabetta Coppi, Rocco Pizzirusso, Filippo Scalise, Giovanni Sorropago, Valerio Tolva, Valeria Caso, Enrico Cieri, Paola DeRango, Luca Farchioni, Giacomo Isernia, Massimo Lenti, Gian Battista Parlani, Guglielmo Pupo, Grazia Pula, Gioele Simonte, Fabio Verzini, Federico Carimati, Maria Luisa Delodovici, Federico Fontana, Gabriele Piffaretti, Matteo Tozzi, Efrem Civilini, Giorgio Poletto, Bernhard Reimers, Barbara Praquin, Sonia Ronchey, Laura Capoccia, Wassim Mansour, Enrico Sbarigia, Francesco Speziale, Pasqualino Sirignano, Danilo Toni, Roberto Galeotti, Vincenzo Gasbarro, Francesco Mascoli, Tiberio Rocca, Elpiniki Tsolaki, Giulia Bernardini, Ester DeMarco, Alessia Giaquinta, Francesco Patti, Massimiliano Veroux, Pierfrancesco Veroux, Carla Virgilio, Nicola Mangialardi, Matteo Orrico, Vincenzo Di Lazzaro, Nunzio Montelione, Francesco Spinelli, Francesco Stilo, Carlo Cernetti, Sandro Irsara, Giuseppe Maccarrone, Diego Tonello, Adriana Visonà, Beniamino Zalunardo, Emiliano Chisci, Stefano Michelagnoli, Nicola Troisi, Maela Masato, Massimo Dei Negri, Andrea Pacchioni, Salvatore Saccà, Giovanni Amatucci, Alfredo Cannizzaro, Federico Accrocca, Cesare Ambrogi, Renzo Barbazza, Giustino Marcucci, Andrea Siani, Guido Bajardi, Giovanni Savettieri, Angelo Argentieri, Riccardo Corbetta, Attilio Odero, Pietro Quaretti, Federico Z Thyrion, Alessandro Cappelli, Domenico Benevento, Gianmarco De Donato, Maria Agnese Mele, Giancarlo Palasciano, Daniela Pieragalli, Alessandro Rossi, Carlo Setacci, Francesco Setacci, Domenico Palombo, Maria Cecilia Perfumo, Edoardo Martelli, Aldo Paolucci, Santi Trimarchi, Viviana Grassi, Luigi Grimaldi, Giuliana La Rosa, Domenico Mirabella, Matteo Scialabba, Leonildo Sichel, Costantino L D'Angelo, Gian Franco Fadda, Holta Kasemi, Mario Marino, Francesco Burzotta, Francesco Alberto Codispoti, Angela Ferrante, Giovanni Tinelli, Yamume Tshomba, Claudio Vincenzoni, Deborah Amis, Dawn Anderson, Martin Catterson, Mike Clarke, Michelle Davis, Anand Dixit, Alexander Dyker, Gary Ford, Ralph Jackson, Sreevalsan Kappadath, David Lambert, Tim Lees, Stephen Louw, James McCaslin, Noala Parr, Rebecca Robson, Gerard Stansby, Lucy Wales, Vera Wealleans, Lesley Wilson, Michael Wyatt, Hardeep Baht, Ibrahim Balogun, Ilse Burger, Tracy Cosier, Linda Cowie, Gunaratnam Gunathilagan, David Hargroves, Robert Insall, Sally Jones, Hannah Rudenko, Natasha Schumacher, Jawaharlal Senaratne, George Thomas, Audrey Thomson, Tom Webb, Ellen Brown, Bernard Esisi, Ali Mehrzad, Shane MacSweeney, Norman McConachie, Alison Southam, Wayne Sunman, Ahmed Abdul-Hamiq, Jenny Bryce, Ian Chetter, Duncan Ettles, Raghuram Lakshminarayan, Kim Mitchelson, Christopher Rhymes, Graham Robinson, Paul Scott, Alison Vickers, Ray Ashleigh, Stephen Butterfield, Ed Gamble, Jonathan Ghosh, Charles N McCollum, Mark Welch, Sarah Welsh, Leszek Wolowczyk, Mary Donnelly, Stephen D'Souza, Anselm A Egun, Bindu Gregary, Thomas Joseph, Christine Kelly, Shuja Punekar, M Asad Rahi, Sonia Raj, Dare Seriki, George Thomson, James Brown, Ragunath Durairajan, Iris Grunwald, Paul Guyler, Paula Harman, Matthew Jakeways, Christopher Khuoge, Ashish Kundu, Thayalini Loganathan, Nisha Menon, Raji O Prabakaran, Devesh Sinha, Vicky Thompson, Sharon Tysoe, Dennis Briley, Chris Darby, Linda Hands, Dominic Howard, Wilhelm Kuker, Ursula Schulz, Rachel Teal, David Barer, Andrew Brown, Susan Crawford, Paul Dunlop, Ramesh Krishnamurthy, Nikhil Majmudar, Duncan Mitchell, Min P Myint, Richard O'Brien, Janice O'Connell, Naweed Sattar, Shanmugam Vetrivel, Jonathan Beard, Trevor Cleveland, Peter Gaines, John Humphreys, Alison Jenkins, Craig King, Daniel Kusuma, Ralph Lindert, Robbie Lonsdale, Raj Nair, Shah Nawaz, Faith Okhuoya, Douglas Turner, Graham Venables, Paul Dorman, Andrea Hughes, Deborah Jones, David Mendelow, Helen Rodgers, Aidas Raudoniitis, Peter Enevoldson, Hans Nahser, Imelda O'Brien, Francesco Torella, Dave Watling, Richard White, Pauline Brown, Dipankar Dutta, Lorraine Emerson, Paula Hilltout, Sachin Kulkarni, Jackie Morrison, Keith Poskitt, Fiona Slim, Sarah Smith, Amanda Tyler, Joanne Waldron, Mark Whyman, Milda Bajoriene, Lucy Baker, Amanda Colston, Bekky Eliot-Jones, Gita Gramizadeh, Catherine Lewis-Clarke, Laura McCafferty, Deborah Oliver, Debbie Palmer, Abhijeet Patil, Suzannah Pegler, Gopi Ramadurai, Aisling Roberts, Tracey Sargent, Shivaprasad Siddegowda, Ravi Singh-Ranger, Akintunde Williams, Lucy Williams, Steve Windebank, Tadas Zuromskis, Lanka Alwis, Jane Angus, Asaipillai Asokanathan, Caroline Fornolles, Diana Hardy, Sophy Hunte, Frances Justin, Duke Phiri, Marie Mitabouana-Kibou, Lakshmanan Sekaran, Sakthivel Sethuraman, Margaret L Tate, Joyce Akyea-Mensah, Stephen Ball, Angela Chrisopoulou, Elizabeth Keene, Alison Phair, Steven Rogers, John V Smyth, Colin Bicknell, Jeremy Chataway, Nicholas Cheshire, Andrew Clifton, Caroline Eley, Richard Gibbs, Mohammad Hamady, Beth Hazel, Alex James, Michael Jenkins, Nyma Khanom, Austin Lacey, Maz Mireskandari, Joanna O'Reilly, Antony Pereira, Tina Sachs, John Wolfe, Philip Davey, Gill Rogers, Gemma Smith, Gareth Tervit, Ian Nichol, Andrew Parry, Gavin Young, Simon Ashley, James Barwell, Francis Dix, Azlisham M Nor, Chris Parry, Angela Birt, Paul Davies, Jim George, Anne Graham, Leon Jonker, Nicci Kelsall, Caroline Potts, Toni Wilson, Jamie Crinnion, Larissa Cuenoud, Nikola Aleksic, Srdan Babic, Nenad Ilijevski, Đorde Radak, Dragan Sagic, Slobodan Tanaskovic, Momcilo Colic, Vladimir Cvetic, Lazar Davidovic, Dejana R Jovanovic, Igor Koncar, Perica Mutavdžic, Miloš Sladojevic, Ivan Tomic, Eike S Debus, Ulrich Grzyska, Dagmar Otto, Götz Thomalla, Jessica Barlinn, Johannes Gerber, Kathrin Haase, Christian Hartmann, Stefan Ludwig, Volker Pütz, Christian Reeps, Christine Schmidt, Norbert Weiss, Sebastian Werth, Simon Winzer, Janine Gemper, Albrecht Günther, Bianka Heiling, Elisabeth Jochmann, Panagiota Karvouniari, Carsten Klingner, Thomas Mayer, Julia Schubert, Friederike Schulze-Hartung, Jürgen Zanow, Yvonne Bausback, Franka Borger, Spiridon Botsios, Daniela Branzan, Sven Bräunlich, Henryk Hölzer, Janin Lenzer, Christopher Piorkowski, Nadine Richter, Johannes Schuster, Dierk Scheinert, Andrej Schmidt, Holger Staab, Matthias Ulrich, Martin Werner, Hermann Berger, Gábor Biró, Hans-Henning Eckstein, Michael Kallmayer, Kornelia Kreiser, Alexander Zimmermann, Bärbel Berekoven, Klaus Frerker, Vera Gordon, Giovanni Torsello, Sebastian Arnold, Cora Dienel, Martin Storck, Bernhard Biermaier, Hans Martin Gissler, Christof Klötzsch, Tomas Pfeiffer, Ralph Schneider, Leander Söhl, Michael Wennrich, Angelika Alonso, Michael Keese, Christoph Groden, Andreas Cöster, Andreas Engelhardt, Christoph-Maria Ratusinski, Bengt Berg, Martin Delle, Johan Formgren, Peter Gillgren, Lotta Jarl, Torbjörn B Kall, Peter Konrad, Niklas Nyman, Claes Skiöldebrand, Johnny Steuer, Rabbe Takolander, Jonas Malmstedt, Stefan Acosta, Katarina Björses, Kerstin Brandt, Nuno Dias, Anders Gottsäter, Jan Holst, Thorarinn Kristmundsson, Tobias Kühme, Tilo Kölbel, Bengt Lindblad, Mats Lindh, Martin Malina, Tomas Ohrlander, Tim Resch, Viola Rönnle, Björn Sonesson, Margareta Warvsten, Zbigniew Zdanowski, Erik Campbell, Per Kjellin, Hans Lindgren, Johan Nyberg, Björn Petersen, Gunnar Plate, Håkan Pärsson, Peter Qvarfordt, Pavel Ignatenko, Andrey Karpenko, Vladimir Starodubtsev, Mikhail A Chernyavsky, Maria S Golovkova, Boris B Komakha, Nikolay N Zherdev, Andrey Belyasnik, Pavel Chechulov, Dmitry Kandyba, Igor Stepanishchev, Csaba Csobay-Novák, Edit Dósa, László Entz, Balázs Nemes, Zoltán Szeberin, Pál Barzó, Mihaly Bodosi, Eniko Fákó, Béla Fülöp, Tamás Németh, Szilárd Pazdernyik, Krisztina Skoba, Erika Vörös, Eleni Chatzinikou, Athanasios Giannoukas, Christos Karathanos, Stylianos Koutsias, Georgios Kouvelos, Miltiadis Matsagkas, Styliani Ralli, Christos Rountas, Nikolaos Rousas, Konstantinos Spanos, Elias Brountzos, John D Kakisis, Andreas Lazaris, Konstantinos G Moulakakis, Leonidas Stefanis, Georgios Tsivgoulis, Spyros Vasdekis, Constantine N Antonopoulos, Ion Bellenis, Dimitrios Maras, Antonios Polydorou, Victoria Polydorou, Antonios Tavernarakis, Nikolaos Ioannou, Maria Terzoudi, Miltos Lazarides, Michalis Mantatzis, Kostas Vadikolias, Lukasz Dzieciuchowicz, Marcin Gabriel, Zbigniew Krasinski, Grzegorz Oszkinis, Fryderyk Pukacki, Maciej Slowinski, Michal-Goran Stanišic, Ryszard Staniszewski, Jolanta Tomczak, Maciej Zielinski, Piotr Myrcha, Dorota Rózanski, Stanislaw Drelichowski, Wojciech Iwanowski, Katarzyna Koncewicz, Pawel Bialek, Zbigniew Biejat, Wojciech Czepel, Anna Czlonkowska, Anatol Dowzenko, Julia Jedrzejewska, Adam Kobayashi, Jerzy Leszczynski, Andrzej Malek, Jerzy Polanski, Robert Proczka, Maciej Skorski, Mieczyslaw Szostek, Piotr Andziak, Maciej Dratwicki, Robert Gil, Miroslaw Nowicki, Jaroslaw Pniewski, Jaroslaw Rzezak, Piotr Seweryniak, Pawel Dabek, Michal Juszynski, Grzegorz Madycki, Bartosz Pacewski, Witold Raciborski, Piotr Slowinski, Walerian Staszkiewicz, Martin Bombic, Vladimír Chlouba, Jirí Fiedler, Karel Hes, Petr Koštál, Jindrich Sova, Zdenek Kríž, Mojmír Prívara, Michal Reif, Robert Staffa, Robert Vlachovský, Bohuslav Vojtíšek, Tomáš Hrbác, Martin Kuliha, Václav Procházka, Martin Roubec, David Školoudík, David Netuka, Anna Šteklácová, Vladimír Beneš III, Pavel Buchvald, Ladislav Endrych, Miroslav Šercl, Walter Campos Jr, Ivan B Casella, Nelson de Luccia, André E V Estenssoro, Calógero Presti, Pedro Puech-Leão, Celso R B Neves, Erasmo S da Silva, Cid J Sitrângulo Jr, José A T Monteiro, Gisela Tinone, Marcelo Bellini Dalio, Edwaldo E Joviliano, Octávio M Pontes Neto, Mauricio Serra Ribeiro, Patrick Cras, Jeroen M H Hendriks, Mieke Hoppenbrouwers, Patrick Lauwers, Caroline Loos, Laetitia Yperzeele, Mia Geenens, Dimitri Hemelsoet, Isabelle van Herzeele, Frank Vermassen, Parla Astarci, Frank Hammer, Valérie Lacroix, André Peeters, Robert Verhelst, Silvana Cirelli, Pol Dormal, Annelies Grimonprez, Bart Lambrecht, Philipe Lerut, Eddy Thues, Guy De Koster, Quentin Desiron, Alain Maertens de Noordhout, Danielle Malmendier, Mireille Massoz, Georges Saad, Marc Bosiers, Joren Callaert, Koen Deloose, Estrella Blanco Cañibano, Beatriz García Fresnillo, Mercedes Guerra Requena, Pilar C Morata Barrado, Miguel Muela Méndez, Antonio Yusta Izquierdo, Fernando Aparici Robles, Paula Blanes Orti, Luis García Dominguez, Rafael Martínez López, Manuel Miralles Hernández, José I Tembl Ferrairo, Ángel Chamorro, Juan Macho, Víctor Obach, Vincent Riambau, Luis San Román, Frank J Ahlhelm, Kristine Blackham, Stefan Engelter, Thomas Eugster, Henrik Gensicke, Lorenz Gürke, Philippe Lyrer, Luigi Mariani, Marina Maurer, Edin Mujagic, Mandy Müller, Marios Psychogios, Peter Stierli, Christoph Stippich, Christopher Traenka, Thomas Wolff, Benjamin Wagner, Martina M Wiegert, Sandra Clarke, Michael Diepers, Ernst Gröchenig, Philipp Gruber, Andrej Isaak, Timo Kahles, Regula Marti, Krassen Nedeltchev, Luca Remonda, Nadir Tissira, Martina Valença Falcão, Gert J de Borst, Rob H Lo, Frans L Moll, Raechel Toorop, Bart H van der Worp, Evert J Vonken, Jaap L Kappelle, Ommid Jahrome, Floris Vos, Wouter Schuiling, Hendrik van Overhagen, Rudolf W M Keunen, Bob Knippenberg, Jan J Wever, Jan W Lardenoije, Michel Reijnen, Luuk Smeets, Steven van Sterkenburg, Gustav Fraedrich, Elke Gizewski, Ingrid Gruber, Michael Knoflach, Stefan Kiechl, Barbara Rantner, Timur Abdulamit, Patrice Bergeron, Raymond Padovani, Jean-Christophe Trastour, Jean-Marie Cardon, Anne Le Gallou-Wittenberg, Eric Allaire, Jean-Pierre Becquemin, Frédéric Cochennec-Paliwoda, Pascal Desgranges, Hassan Hosseini, Hicham Kobeiter, Jean Marzelle, Mohammed A Almekhlafi, Simerpreet Bal, Phillip A Barber, Shelagh B Coutts, Andrew M Demchuk, Muneer Eesa, Michelle Gillies, Mayank Goyal, Michael D Hill, Mark E Hudon, Anitha Jambula, Carol Kenney, Gary Klein, Marie McClelland, Alim Mitha, Bijoy K Menon, William F Morrish, Steven Peters, Karla J Ryckborst, Greg Samis, Supriya Save, Eric E Smith, Peter Stys, Suresh Subramaniam, Garnette R Sutherland, Tim Watson, John H Wong, L Zimmel, Vojko Flis, Jože Matela, Kazimir Miksic, Franko Milotic, Božidar Mrdja, Barbara Stirn, Erih Tetickovic, Mladen Gasparini, Anton Grad, Ingrid Kompara, Zoren Miloševic, Veronika Palmiste, Toomas Toomsoo, Balzhan Aidashova, Nursultan Kospanov, Roman Lyssenko, Daulet Mussagaliev, Rafi Beyar, Aaron Hoffman, Tony Karram, Arthur Kerner, Eugenia Nikolsky, Samy Nitecki, Silva Andonova, Chavdar Bachvarov, Vesko Petrov, Ivan Cvjetko, Vinko Vidjak, Damir Halužan, Mladen Petrunic, Bao Liu, Chang-Wei Liu, Daniel Bartko, Peter Beno, František Rusnák, Kamil Zelenák, Masayuki Ezura, Takashi Inoue, Naoto Kimura, Ryushi Kondo, Yasushi Matsumoto, Hiroaki Shimizu, Hidenori Endo, Eisuke Furui, Søren Bakke, Kristen Krohg-Sørensen, Terje Nome, Mona Skjelland, Bjørn Tennøe, João Albuquerque e Castro, Gonçalo Alves, Frederico Bastos Gonçalves, José de Aragão Morais, Ana C Garcia, Hugo Valentim, Leonor Vasconcelos, Fernando Belcastro, Fernando Cura, Patricio Zaefferer, Foad Abd-Allah, Mohamed H Eldessoki, Hussein Heshmat Kassem, Haytham Soliman Gharieb, Mary P Colgan, Syed N Haider, Joe Harbison, Prakash Madhavan, Dermot Moore, Gregor Shanik, Viviane Kazan, Munier Nazzal, Vicki Ramsey-Williams, ACST-2 Collaborative Group, Group, ACST-2 Collaborative, Halliday A., Bulbulia R., Bonati L.H., Chester J., Cradduck-Bamford A., Peto R., Pan H., Potter J., Henning Eckstein H., Farrell B., Flather M., Mansfield A., Mihaylova B., Rahimi K., Simpson D., Thomas D., Sandercock P., Gray R., Molyneux A., Shearman C.P., Rothwell P., Belli A., Herrington W., Judge P., Leopold P., Mafham M., Gough M., Cao P., MacDonald S., Bari V., Berry C., Bradshaw S., Brudlo W., Clarke A., Cox R., Fathers S., Gaba K., Gray M., Hayter E., Holliday C., Kurien R., Lay M., le Conte S., McManus J., Madgwick Z., Morris D., Munday A., Pickworth S., Ostasz W., Poorthuis M., Richards S., Teixeira L., Tochlin S., Tully L., Wallis C., Willet M., Young A., Casana R., Malloggi C., Odero A., Silani V., Parati G., Malchiodi G., Malferrari G., Strozzi F., Tusini N., Vecchiati E., Coppi G., Lauricella A., Moratto R., Silingardi R., Veronesi J., Zini A., Ferrero E., Ferri M., Gaggiano A., Labate C., Nessi F., Psacharopulo D., Viazzo A., Malacrida G., Mazzaccaro D., Meola G., Modafferi A., Nano G., Occhiuto M.T., Righini P., Stegher S., Chiarandini S., Griselli F., Lepidi S., Pozzi Mucelli F., Naccarato M., D'Oria M., Ziani B., Stella A., Dieng M., Faggioli G., Gargiulo M., Palermo S., Pini R., Puddu G.M., Vacirca A., Angiletta D., Desantis C., Marinazzo D., Mastrangelo G., Regina G., Pulli R., Bianchi P., Cireni L., Coppi E., Pizzirusso R., Scalise F., Sorropago G., Tolva V., Caso V., Cieri E., DeRango P., Farchioni L., Isernia G., Lenti M., Parlani G.B., Pupo G., Pula G., Simonte G., Verzini F., Carimati F., Delodovici M.L., Fontana F., Piffaretti G., Tozzi M., Civilini E., Poletto G., Reimers B., Praquin B., Ronchey S., Capoccia L., Mansour W., Sbarigia E., Speziale F., Sirignano P., Toni D., Galeotti R., Gasbarro V., Mascoli F., Rocca T., Tsolaki E., Bernardini G., DeMarco E., Giaquinta A., Patti F., Veroux M., Veroux P., Virgilio C., Mangialardi N., Orrico M., Di Lazzaro V., Montelione N., Spinelli F., Stilo F., Cernetti C., Irsara S., Maccarrone G., Tonello D., Visona A., Zalunardo B., Chisci E., Michelagnoli S., Troisi N., Masato M., Dei Negri M., Pacchioni A., Sacca S., Amatucci G., Cannizzaro A., Accrocca F., Ambrogi C., Barbazza R., Marcucci G., Siani A., Bajardi G., Savettieri G., Argentieri A., Corbetta R., Quaretti P., Thyrion F.Z., Cappelli A., Benevento D., De Donato G., Mele M.A., Palasciano G., Pieragalli D., Rossi A., Setacci C., Setacci F., Palombo D., Perfumo M.C., Martelli E., Paolucci A., Trimarchi S., Grassi V., Grimaldi L., La Rosa G., Mirabella D., Scialabba M., Sichel L., D'Angelo C.L., Fadda G.F., Kasemi H., Marino M., Burzotta F., Codispoti F.A., Ferrante A., Tinelli G., Tshomba Y., Vincenzoni C., Amis D., Anderson D., Catterson M., Clarke M., Davis M., Dixit A., Dyker A., Ford G., Jackson R., Kappadath S., Lambert D., Lees T., Louw S., McCaslin J., Parr N., Robson R., Stansby G., Wales L., Wealleans V., Wilson L., Wyatt M., Baht H., Balogun I., Burger I., Cosier T., Cowie L., Gunathilagan G., Hargroves D., Insall R., Jones S., Rudenko H., Schumacher N., Senaratne J., Thomas G., Thomson A., Webb T., Brown E., Esisi B., Mehrzad A., MacSweeney S., McConachie N., Southam A., Sunman W., Abdul-Hamiq A., Bryce J., Chetter I., Ettles D., Lakshminarayan R., Mitchelson K., Rhymes C., Robinson G., Scott P., Vickers A., Ashleigh R., Butterfield S., Gamble E., Ghosh J., McCollum C.N., Welch M., Welsh S., Wolowczyk L., Donnelly M., D'Souza S., Egun A.A., Gregary B., Joseph T., Kelly C., Punekar S., Rahi M.A., Raj S., Seriki D., Thomson G., Brown J., Durairajan R., Grunwald I., Guyler P., Harman P., Jakeways M., Khuoge C., Kundu A., Loganathan T., Menon N., Prabakaran R.O., Sinha D., Thompson V., Tysoe S., Briley D., Darby C., Hands L., Howard D., Kuker W., Schulz U., Teal R., Barer D., Brown A., Crawford S., Dunlop P., Krishnamurthy R., Majmudar N., Mitchell D., Myint M.P., O'Brien R., O'Connell J., Sattar N., Vetrivel S., Beard J., Cleveland T., Gaines P., Humphreys J., Jenkins A., King C., Kusuma D., Lindert R., Lonsdale R., Nair R., Nawaz S., Okhuoya F., Turner D., Venables G., Dorman P., Hughes A., Jones D., Mendelow D., Rodgers H., Raudoniitis A., Enevoldson P., Nahser H., O'Brien I., Torella F., Watling D., White R., Brown P., Dutta D., Emerson L., Hilltout P., Kulkarni S., Morrison J., Poskitt K., Slim F., Smith S., Tyler A., Waldron J., Whyman M., Bajoriene M., Baker L., Colston A., Eliot-Jones B., Gramizadeh G., Lewis-Clarke C., McCafferty L., Oliver D., Palmer D., Patil A., Pegler S., Ramadurai G., Roberts A., Sargent T., Siddegowda S., Singh-Ranger R., Williams A., Williams L., Windebank S., Zuromskis T., Alwis L., Angus J., Asokanathan A., Fornolles C., Hardy D., Hunte S., Justin F., Phiri D., Mitabouana-Kibou M., Sekaran L., Sethuraman S., Tate M.L., Akyea-Mensah J., Ball S., Chrisopoulou A., Keene E., Phair A., Rogers S., Smyth J.V., Bicknell C., Chataway J., Cheshire N., Clifton A., Eley C., Gibbs R., Hamady M., Hazel B., James A., Jenkins M., Khanom N., Lacey A., Mireskandari M., O'Reilly J., Pereira A., Sachs T., Wolfe J., Davey P., Rogers G., Smith G., Tervit G., Nichol I., Parry A., Young G., Ashley S., Barwell J., Dix F., Nor A.M., Parry C., Birt A., Davies P., George J., Graham A., Jonker L., Kelsall N., Potts C., Wilson T., Crinnion J., Cuenoud L., Aleksic N., Babic S., Ilijevski N., Radak, Sagic D., Tanaskovic S., Colic M., Cvetic V., Davidovic L., Jovanovic D.R., Koncar I., Mutavdzic P., Sladojevic M., Tomic I., Debus E.S., Grzyska U., Otto D., Thomalla G., Barlinn J., Gerber J., Haase K., Hartmann C., Ludwig S., Putz V., Reeps C., Schmidt C., Weiss N., Werth S., Winzer S., Gemper J., Gunther A., Heiling B., Jochmann E., Karvouniari P., Klingner C., Mayer T., Schubert J., Schulze-Hartung F., Zanow J., Bausback Y., Borger F., Botsios S., Branzan D., Braunlich S., Holzer H., Lenzer J., Piorkowski C., Richter N., Schuster J., Scheinert D., Schmidt A., Staab H., Ulrich M., Werner M., Berger H., Biro G., Eckstein H.-H., Kallmayer M., Kreiser K., Zimmermann A., Berekoven B., Frerker K., Gordon V., Torsello G., Arnold S., Dienel C., Storck M., Biermaier B., Gissler H.M., Klotzsch C., Pfeiffer T., Schneider R., Sohl L., Wennrich M., Alonso A., Keese M., Groden C., Coster A., Engelhardt A., Ratusinski C.-M., Berg B., Delle M., Formgren J., Gillgren P., Jarl L., Kall T.B., Konrad P., Nyman N., Skioldebrand C., Steuer J., Takolander R., Malmstedt J., Acosta S., Bjorses K., Brandt K., Dias N., Gottsater A., Holst J., Kristmundsson T., Kuhme T., Kolbel T., Lindblad B., Lindh M., Malina M., Ohrlander T., Resch T., Ronnle V., Sonesson B., Warvsten M., Zdanowski Z., Campbell E., Kjellin P., Lindgren H., Nyberg J., Petersen B., Plate G., Parsson H., Qvarfordt P., Ignatenko P., Karpenko A., Starodubtsev V., Chernyavsky M.A., Golovkova M.S., Komakha B.B., Zherdev N.N., Belyasnik A., Chechulov P., Kandyba D., Stepanishchev I., Csobay-Novak C., Dosa E., Entz L., Nemes B., Szeberin Z., Barzo P., Bodosi M., Fako E., Fulop B., Nemeth T., Pazdernyik S., Skoba K., Voros E., Chatzinikou E., Giannoukas A., Karathanos C., Koutsias S., Kouvelos G., Matsagkas M., Ralli S., Rountas C., Rousas N., Spanos K., Brountzos E., Kakisis J.D., Lazaris A., Moulakakis K.G., Stefanis L., Tsivgoulis G., Vasdekis S., Antonopoulos C.N., Bellenis I., Maras D., Polydorou A., Polydorou V., Tavernarakis A., Ioannou N., Terzoudi M., Lazarides M., Mantatzis M., Vadikolias K., Dzieciuchowicz L., Gabriel M., Krasinski Z., Oszkinis G., Pukacki F., Slowinski M., Stanisic M.-G., Staniszewski R., Tomczak J., Zielinski M., Myrcha P., Rozanski D., Drelichowski S., Iwanowski W., Koncewicz K., Bialek P., Biejat Z., Czepel W., Czlonkowska A., Dowzenko A., Jedrzejewska J., Kobayashi A., Leszczynski J., Malek A., Polanski J., Proczka R., Skorski M., Szostek M., Andziak P., Dratwicki M., Gil R., Nowicki M., Pniewski J., Rzezak J., Seweryniak P., Dabek P., Juszynski M., Madycki G., Pacewski B., Raciborski W., Slowinski P., Staszkiewicz W., Bombic M., Chlouba V., Fiedler J., Hes K., Kostal P., Sova J., Kriz Z., Privara M., Reif M., Staffa R., Vlachovsky R., Vojtisek B., Hrbac T., Kuliha M., Prochazka V., Roubec M., Skoloudik D., Netuka D., Steklacova A., Benes III V., Buchvald P., Endrych L., Sercl M., Campos W., Casella I.B., de Luccia N., Estenssoro A.E.V., Presti C., Puech-Leao P., Neves C.R.B., da Silva E.S., Sitrangulo C.J., Monteiro J.A.T., Tinone G., Bellini Dalio M., Joviliano E.E., Pontes Neto O.M., Serra Ribeiro M., Cras P., Hendriks J.M.H., Hoppenbrouwers M., Lauwers P., Loos C., Yperzeele L., Geenens M., Hemelsoet D., van Herzeele I., Vermassen F., Astarci P., Hammer F., Lacroix V., Peeters A., Verhelst R., Cirelli S., Dormal P., Grimonprez A., Lambrecht B., Lerut P., Thues E., De Koster G., Desiron Q., Maertens de Noordhout A., Malmendier D., Massoz M., Saad G., Bosiers M., Callaert J., Deloose K., Blanco Canibano E., Garcia Fresnillo B., Guerra Requena M., Morata Barrado P.C., Muela Mendez M., Yusta Izquierdo A., Aparici Robles F., Blanes Orti P., Garcia Dominguez L., Martinez Lopez R., Miralles Hernandez M., Tembl Ferrairo J.I., Chamorro A., Macho J., Obach V., Riambau V., San Roman L., Ahlhelm F.J., Blackham K., Engelter S., Eugster T., Gensicke H., Gurke L., Lyrer P., Mariani L., Maurer M., Mujagic E., Muller M., Psychogios M., Stierli P., Stippich C., Traenka C., Wolff T., Wagner B., Wiegert M.M., Clarke S., Diepers M., Grochenig E., Gruber P., Isaak A., Kahles T., Marti R., Nedeltchev K., Remonda L., Tissira N., Valenca Falcao M., de Borst G.J., Lo R.H., Moll F.L., Toorop R., van der Worp B.H., Vonken E.J., Kappelle J.L., Jahrome O., Vos F., Schuiling W., van Overhagen H., Keunen R.W.M., Knippenberg B., Wever J.J., Lardenoije J.W., Reijnen M., Smeets L., van Sterkenburg S., Fraedrich G., Gizewski E., Gruber I., Knoflach M., Kiechl S., Rantner B., Abdulamit T., Bergeron P., Padovani R., Trastour J.-C., Cardon J.-M., Le Gallou-Wittenberg A., Allaire E., Becquemin J.-P., Cochennec-Paliwoda F., Desgranges P., Hosseini H., Kobeiter H., Marzelle J., Almekhlafi M.A., Bal S., Barber P.A., Coutts S.B., Demchuk A.M., Eesa M., Gillies M., Goyal M., Hill M.D., Hudon M.E., Jambula A., Kenney C., Klein G., McClelland M., Mitha A., Menon B.K., Morrish W.F., Peters S., Ryckborst K.J., Samis G., Save S., Smith E.E., Stys P., Subramaniam S., Sutherland G.R., Watson T., Wong J.H., Zimmel L., Flis V., Matela J., Miksic K., Milotic F., Mrdja B., Stirn B., Tetickovic E., Gasparini M., Grad A., Kompara I., Milosevic Z., Palmiste V., Toomsoo T., Aidashova B., Kospanov N., Lyssenko R., Mussagaliev D., Beyar R., Hoffman A., Karram T., Kerner A., Nikolsky E., Nitecki S., Andonova S., Bachvarov C., Petrov V., Cvjetko I., Vidjak V., Haluzan D., Petrunic M., Liu B., Liu C.-W., Bartko D., Beno P., Rusnak F., Zelenak K., Ezura M., Inoue T., Kimura N., Kondo R., Matsumoto Y., Shimizu H., Endo H., Furui E., Bakke S., Krohg-Sorensen K., Nome T., Skjelland M., Tennoe B., Albuquerque e Castro J., Alves G., Bastos Goncalves F., de Aragao Morais J., Garcia A.C., Valentim H., Vasconcelos L., Belcastro F., Cura F., Zaefferer P., Abd-Allah F., Eldessoki M.H., Heshmat Kassem H., Soliman Gharieb H., Colgan M.P., Haider S.N., Harbison J., Madhavan P., Moore D., Shanik G., Kazan V., Nazzal M., Ramsey-Williams V., and Gargiulo M

Subjects
Male, medicine.medical_specialty, Time Factors, Time Factor, medicine.medical_treatment, Carotid Stenosi, MEDLINE, Carotid endarterectomy, Rate ratio, Risk Assessment, Asymptomatic, law.invention, Randomized controlled trial, law, Risk Factors, carotid artery stenting (CAS), carotid endarterectomy (CEA), Stent, medicine, Humans, Carotid Stenosis, Stroke, Endarterectomy, Aged, Endarterectomy, Carotid, business.industry, carotid artery, Risk Factor, Articles, General Medicine, trial, medicine.disease, Settore MED/22 - CHIRURGIA VASCOLARE, Surgery, Stenosis, Treatment Outcome, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Female, Stents, Human medicine, medicine.symptom, business, Human
Abstract

Summary Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding UK Medical Research Council and Health Technology Assessment Programme.

Published
2021

30. Biofluids profile of α-Klotho in patients with Parkinson's disease

Author

Piergiorgio Grillo, Benedetta Biticchi, Massimo Pieri, Antonio Pisani, Nicola Biagio Mercuri, Emilia Giannella, Sergio Bernardini, Mohammad Alwardat, Giulia Di Lazzaro, Giulia Maria Sancesario, and Tommaso Schirinzi

Subjects
Male, Oncology, medicine.medical_specialty, Parkinson's disease, Disease, urologic and male genital diseases, Internal medicine, medicine, Humans, In patient, Stage (cooking), Klotho Proteins, business.industry, Parkinson Disease, Middle Aged, α klotho, medicine.disease, female genital diseases and pregnancy complications, Neurology, Case-Control Studies, Potential biomarkers, alpha-Synuclein, Female, Neurology (clinical), Geriatrics and Gerontology, business, Biomarkers
Abstract

We measured α-Klotho in CSF and serum of PD patients at early stage of the disease, finding two distinct pools, the first increased, the second reduced. CSF α-Klotho was inversely associated with CSF α-synuclein levels. Our preliminary results suggest α-Klotho as potential biomarker or therapeutic target in PD.

Published
2021
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31. The imitation game: Pulmonary artery sarcoma masquerading as an acute pulmonary embolism

Author

Stevan S. Pupovac, I. Claire Sarmiento, S. Jacob Scheinerman, Jonathan M. Hemli, Richard S. Lazzaro, and Derek R. Brinster

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, medicine.disease, Adult: Pulmonary Artery Sarcoma: AATS 2021 Resident Case Report Competition, Pulmonary embolism, Internal medicine, medicine.artery, Pulmonary artery, medicine, Cardiology, Surgery, Imitation (music), Sarcoma, business
Published
2021

32. Focused Ultrasound (FUS) for Chronic Pain Management: Approved and Potential Applications

Author

Flavia Narducci, Lazzaro di Biase, Maria Letizia Caminiti, Emma Falato, Vincenzo Di Lazzaro, and Pasquale Maria Pecoraro

Subjects
medicine.medical_specialty, medicine.medical_treatment, Population, Phantom limb, Osteoarthritis, Review Article, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Medicine, education, RC346-429, Sacroiliac joint, education.field_of_study, business.industry, Thalamotomy, Chronic pain, medicine.disease, Neuromodulation (medicine), medicine.anatomical_structure, Neurology, Neuropathic pain, Neurology (clinical), Radiology, Neurology. Diseases of the nervous system, business, 030217 neurology & neurosurgery
Abstract

Chronic pain is one of the leading causes of disability and disease burden worldwide, accounting for a prevalence between 6.9% and 10% in the general population. Pharmacotherapy alone results ineffective in about 70-60% of patients in terms of a satisfactory degree of pain relief. Focused ultrasound is a promising tool for chronic pain management, being approved for thalamotomy in chronic neuropathic pain and for bone metastases-related pain treatment. FUS is a noninvasive technique for neuromodulation and for tissue ablation that can be applied to several tissues. Transcranial FUS (tFUS) can lead to opposite biological effects, depending on stimulation parameters: from reversible neural activity facilitation or suppression (low-intensity, low-frequency ultrasound, LILFUS) to irreversible tissue ablation (high-intensity focused ultrasounds, HIFU). HIFU is approved for thalamotomy in neuropathic pain at the central nervous system level and for the treatment of facet joint osteoarthritis at the peripheral level. Potential applications include HIFU at the spinal cord level for selected cases of refractory chronic neuropathic pain, knee osteoarthritis, sacroiliac joint disease, intervertebral disc nucleolysis, phantom limb, and ablation of peripheral nerves. FUS at nonablative dosage, LILFUS, has potential reversible and tissue-selective effects. FUS applications at nonablative doses currently are at a research stage. The main potential applications include targeted drug and gene delivery through the Blood-Brain Barrier, assessment of pain thresholds and study of pain, and reversible peripheral nerve conduction block. The aim of the present review is to describe the approved and potential applications of the focused ultrasound technology in the field of chronic pain management.

Published
2021

33. Diabetic ketoacidosis at the onset of disease during a national awareness campaign: A 2-year observational study in children aged 0-18 years

Author

Rabbone I., Maltoni G., Tinti D., Zucchini S., Cherubini V., Bonfanti R., Scaramuzza A., Lera R., Bobbio A., Piccinno E., Reinstadler P., Felappi B., Prandi E., Gallo F., Frongia AP., Ripoli C., Lo Presti D., Tomaselli L., Cardinale G., Stamati FA., Citriniti F., Suprani T., Graziani V., De Berardinis F., Zampolli M., De Marco R., Cavalli C., Lazzaro N., De Donno V., Toni S., Piccini B., Lenzi L., Mainetti B., Coccioli MS., d'Annunzio G., Minuto N., Aloe S., Lucchesi D., Cirillo S., Sordelli M., Del Vecchio F., Salzano LG., Meschi F., Iughetti L., Predieri B., Franzese A., Mozzillo Enza., Iafusco D., Cadario F., Savastio S., Piredda G., Cardella F., Iovane B., Calcaterra V., Berioli MG., Biagioni M., Randazzo E., Patera I., Schiaffini R., Rutigliano I., Lasagni A., Innaurato S., Gaiero A., Fichera G., Trada M., Guerraggio L., Cauvin V., Franceschi R., Tornese G., Salvatoni A., Marigliano M., Sabbion A., Maffeis C., Arnaldi C., Rabbone, I., Maltoni, G., Tinti, D., Zucchini, S., Cherubini, V., Bonfanti, R., Scaramuzza, A., Lera, R., Bobbio, A., Piccinno, E., Reinstadler, P., Felappi, B., Prandi, E., Gallo, F., Frongia, Ap., Ripoli, C., Lo Presti, D., Tomaselli, L., Cardinale, G., Stamati, Fa., Citriniti, F., Suprani, T., Graziani, V., De Berardinis, F., Zampolli, M., De Marco, R., Cavalli, C., Lazzaro, N., De Donno, V., Toni, S., Piccini, B., Lenzi, L., Mainetti, B., Coccioli, Ms., D'Annunzio, G., Minuto, N., Aloe, S., Lucchesi, D., Cirillo, S., Sordelli, M., Del Vecchio, F., Salzano, Lg., Meschi, F., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, Enza., Iafusco, D., Cadario, F., Savastio, S., Piredda, G., Cardella, F., Iovane, B., Calcaterra, V., Berioli, Mg., Biagioni, M., Randazzo, E., Patera, I., Schiaffini, R., Rutigliano, I., Lasagni, A., Innaurato, S., Gaiero, A., Fichera, G., Trada, M., Guerraggio, L., Cauvin, V., Franceschi, R., Tornese, G., Salvatoni, A., Marigliano, M., Sabbion, A., Maffeis, C., Arnaldi, C., Rabbone, Ivana, Maltoni, Giulio, Tinti, Davide, Zucchini, Stefano, Cherubini, Valentino, Bonfanti, Riccardo, Scaramuzza, Andrea, Lera, Riccardo, Bobbio, Adriana, Piccinno, Elvira, Reinstadler, Petra, Felappi, Barbara, Prandi, Elena, Gallo, Francesco, Frongia, Anna Paola, Ripoli, Carlo, Lo Presti, Donatella, Tomaselli, Letizia, Cardinale, Giuliana, Stamati, Filomena Andreina, Citriniti, Felice, Suprani, Tosca, Graziani, Vanna, De Berardinis, Fiorella, Zampolli, Maria, De Marco, Rosaria, Cavalli, Claudio, Lazzaro, Nicola, De Donno, Valeria, Toni, Sonia, Piccini, Barbara, Lenzi, Lorenzo, Mainetti, Benedetta, Coccioli, Maria Susanna, D’Annunzio, Giuseppe, Minuto, Nicola, Aloe, Monica, Lucchesi, Sonia, Cirillo, Dante, Sordelli, Silvia, Delvecchio, Maurizio, Lombardo, Fortunato, Salzano, Giusy, Meschi, Franco, Iughetti, Lorenzo, Predieri, Barbara, Franzese, Adriana, Mozzillo, Enza, Iafusco, Dario, Cadario, Francesco, Savastio, Silvia, Cardella, Francesca, Iovane, Brunella, Calcaterra, Valeria, Berioli, Maria Giulia, Biagioni, Martina, Randazzo, Emioli, Patera, Ippolita Patrizia, Schiaffini, Riccardo, Rutigliano, Irene, Lasagni, Anna, Innaurato, Silvia, Gaiero, Alberto, Fichera, Grazziella, Trada, Michela, Guerraggio, Lucia, Cauvin, Vittoria, Franceschi, Roberto, Tornese, Gianluca, Salvatoni, Alessandro, Marigliano, Marco, Sabbion, Alberto, Maffeis, Claudio, and Arnaldi, Claudia

Subjects
Blood Glucose, Male, medicine.medical_specialty, Pediatrics, endocrine system diseases, Diabetic ketoacidosis, Adolescent, 030209 endocrinology & metabolism, Disease, 03 medical and health sciences, 0302 clinical medicine, diabetic ketoacidosis, Patient Education as Topic, Diabetes mellitus, Epidemiology, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Child, Type 1 diabetes, diabetes, business.industry, Incidence (epidemiology), Incidence, epidemiology, Infant, Newborn, diabetic ketoacidosi, nutritional and metabolic diseases, Infant, medicine.disease, Diabetes Mellitus, Type 1, Italy, diabete, Child, Preschool, Pediatrics, Perinatology and Child Health, Observational study, Female, business, Prevention campaign
Abstract

ObjectiveAfter a previous survey on the incidence of diabetic ketoacidosis (DKA) at onset of type 1 diabetes in children in 2013–2014 in Italy, we aimed to verify a possible decline in the incidence of DKA at onset during a national prevention campaign.DesignProspective observational study.SettingMulticentre study throughout Italy.InterventionNational awareness campaign started in November 2015 and held until December 2017.PatientsDuring 2016 and 2017 we collected data on all patients aged 0–18 years with new-onset diabetes.Main outcome measuresDKA (pH ResultsRecords (n=2361) of children with newly diagnosed type 1 diabetes were collected from 58 out of 68 (85.3%) centres of the original survey participants and 100% of the previously surveyed tertiary centres. Overall, DKA was observed in 1124 patients, with an increased rate when compared with the previous survey (47.6% vs 38.5%, p=0.002), and severe DKA in 15.3%. In children below 6 years, DKA was observed in 323 out of 617 (52.5%) and severe DKA in 16.7%; in this age group, occurrence of DKA reduced by 21.3% (p=0.009). DKA treatment according to the ISPED guidelines was adopted in 95% of the centres, with a 27% improvement (p=0.025).ConclusionsDuring a 2-year awareness campaign, DKA at onset of diabetes in children and adolescents 0–18 years is still common and increased when compared with the 2013–2014 survey.

Published
2020

34. Perampanel Improves Cortical Myoclonus and Disability in Progressive Myoclonic Epilepsies: A Case Series and a Systematic Review of the Literature

Author

Alfonso Marrelli, Lorenzo Ricci, Antonietta Coppola, Giancarlo Di Gennaro, Leonilda Bilo, Alberto Verrotti, Giovanni Assenza, Alfredo D'Aniello, Mario Tombini, C. Nocerino, Jacopo Lanzone, Vincenzo Di Lazzaro, Assenza, G., Nocerino, C., Tombini, M., Di Gennaro, G., D'Aniello, A., Verrotti, A., Marrelli, A., Ricci, L., Lanzone, J., Di Lazzaro, V., Bilo, L., and Coppola, A.

Subjects
Pediatrics, medicine.medical_specialty, Progressive myoclonus epilepsy, Disease, 050105 experimental psychology, Lafora disease, lcsh:RC346-429, 03 medical and health sciences, Perampanel, chemistry.chemical_compound, Epilepsy, progressive myoclonic epilepsy, 0302 clinical medicine, perampanel, Medicine, 0501 psychology and cognitive sciences, lcsh:Neurology. Diseases of the nervous system, myoclonu, business.industry, 05 social sciences, Cortical myoclonus, medicine.disease, myoclonus, Systematic review, chemistry, Neurology, disability, systematic (literature) review, Neurology (clinical), Systematic Review, medicine.symptom, business, Myoclonus, 030217 neurology & neurosurgery
Abstract

Introduction: Progressive myoclonic epilepsies (PMEs) are a heterogenous group of genetic diseases presenting with epilepsy, cognitive impairment, and severe action myoclonus, which can severely affect daily life activities and independent walking ability. Perampanel is a recent commercially available antiseizure medication with high efficacy against generalized seizures. Some reports supported the role of perampanel in ameliorating action myoclonus in PMEs. Here, we aimed to describe a case series and provide a systematic literature review on perampanel effects on PMEs.Methods: We report the perampanel effectiveness on myoclonus, daily life activities, and seizures on an original Italian multicenter case series of 11 individuals with PMEs. Then, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we performed a systematic review on perampanel effect on myoclonus and disability in PMEs. We searched PubMed, Scopus, and Google Scholar articles on perampanel and PMEs up to June 2020. No prospective trials were found. We reviewed 11 case series manuscripts reporting 104 cases of different PMEs.Results: Here, we are reporting the effectiveness of perampanel in five individuals affected by Unverricht–Lundborg disease, three by Lafora disease, two by sialidosis, and one by an undetermined PME. Nine out of 11 individuals improved their disability related to the action myoclonus (two with Lafora disease did not). Among the 104 persons with PMEs collected by the systematic review, we found that more than half of the patients receiving perampanel exhibited an amelioration of action myoclonus and, consequently, of their independence in daily life activities. The Unverricht–Lundborg disease seemed to show the best clinical response to perampanel, in comparison with the other more severe PMEs. A significant seizure reduction was achieved by almost all persons with active epilepsy. Only 11% of PME patients dropped out due to inefficacy.Conclusions: Perampanel demonstrated a beneficial effect with regard to action myoclonus, disability, and seizures and was well-tolerated in people with PMEs, independently from their genetic diagnosis. Given the limited scientific evidence, broader prospective trials should be encouraged.

Published
2021
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35. Appendicitis risk prediction models in children presenting with right iliac fossa pain (RIFT study): a prospective, multicentre validation study

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Dmitri Nepogodiev, Richard JW Wilkin, Catherine J Bradshaw, Clare Skerritt, Alasdair Ball, Waaka Moni-Nwinia, Ruth Blanco-Colino, Priyesh Chauhan, Thomas M Drake, Matteo Frasson, Oliver Gee, James C Glasbey, Jacob H Matthews, Gabriella L Morley, David N Naumann, Francesco Pata, Antonio S Soares, Aneel Bhangu, SH Abbas, AM Abdelgadir, A Abdelrahman, M Abdelrahman, A Abdelwahed, Y Abou El Ella, M Abulafi, A Acharya, ME Adam, RE Adams, SO Adegbola, A Adimonye, M Adnan, S Afshar, A Ahad, J Ahel, DP Ahern, A Ahmad Asmadi, B Ahmed, G Ahmed, OS Ahmed, S Ahmed, K Akbari, O Akinsola, W Al-Khyatt, B Al-Sarireh, M Al-Sheikh, M Alani, R Alexander, T Alhammali, M Ali, A Aljorfi, M Allen, J Allington, A Alshafei, R Amarasinghe, A Amayo, V Amin, Thuva Amuthalingam, L Anandan, O Anderson, SM Andreani, B Andrews, A Ang, B Aravind, JE Archer, MA Aremu, S Arunachalam, N Aruparayil, DL Ashmore, O Ashour, N Ashraf, N Assaf, H Avalapati, OO Awokoya, J Ayube-Brown, T Badenoch, R Bagga, A Baginski, S Bailey, STR Bailey, C Baird, B Baker, EJ Balai, A Balasubramaniam, SK Bandyopadhyay, A Banks, H Bansal, W Barnieh, A Barrie, CA Barter, J Bastianpillai, WD Beasley, CR Bell, J Bell, D Beral, BJM Berry, KE Bevan, V Bevan, Shiv Bhanderi, A Bhargava, D Bilku, A Birindelli, OD Blackford, JEM Blackwell, L Blake, Natalie S Blencowe, TD Boam, C Boereboom, M Bogdan, P Bohra, JC Bolger, W Bolton, S Bond, CM Borg, K Borghol, PR Boshier, N Bouhadiba, J Bowen, H Bowerman, CR Bowman, H Boyd-Carson, CJ Bradshaw, G Branagan, P Brennan, M Brett, HK Brewer, H Brewer, C Bronder, A Brown, AG Brown, CE Brown, M Brown, R Brown, S Buckley-Jones, A Budzanowski, W Bukhari, C Bull, JK Bullivant, KM Burns, D Burnside, A Busuttil, BE Byrne, CK Byrnes, M Caldwell, R Callan, FC Cameron, U Campbell, UM Campbell, W Campbell, CA Carden, CFW Carder, K Carney, H Cartwright, P Cay, A Chalk, B Chambers, A Champsi, D Chan, TCW Chan, SB Chandler, J Chapman, A Charalabopoulos, B Chasty, M Chatzikonstantinou, WL Cheah, CS Chean, S Cheng, SA Cheng, M Cheruvu, MY Chin, IA Chishti, S Choi, SM Chok, B Chong, JH Choong, M Chowdhary, F Chowdhury, CH Choy, L Christian, P Christopoulos, K Chui, M Cipparrone, GL Clark, SA Clarke, SJ Cleeve, KD Clement, B Clements, C Clements, JD Clements, JM Clements, JS Clements, JA Clements, R Clingan, L Cloney, ECS Clough, PO Coe, O Collier-Wakefield, DW Colliver, DA Colvin, TM Connelly, MJ Connor, V Cook, F Cooke, F Cooper, AE Cotton, DG Couch, L Cousins, D Coyle, W Creasy, RL Cresner, A Crone, K Cross, J Crozier, P Cunha, NJ Curtis, N D'Souza, H Dagash, S Dalmia, I Daniels, D Danquah-Boateng, FA Dar, K Dart, A Das, R Daureeawoo, S Davidson, JR Davidson, PL Davies, S Davis, V Daya Shetty, A De-Manzoni-Garberini, JA De-Marchi, EA Dean, S Dean, C Delimpalta, S Denley, G Dennison, AA Devine, S Dharamavaram, AA Dhari, F Di Franco, S Di Saverio, C Dobson, JA Docherty, C Doherty, G Donaldson, NO Donohoe, O Donohoe, E Douka, T Doulias, M Downey, C Doyle, N Drye, DT Du, JG Dudek, PG Dunning, ARS Dyal, NJ Eardley, L Earnshaw, S Easdon, SE Edwards, RJ Egan, S El-Masry, O El-Tayar, CR Elbourne, S Elgaddal, M Elseedawy, M Elshaer, OH Elsharnoby, WMA Elzeneini, KM Emslie, NFT Engall, B Ertansel, HD Esmail, C Ettles, J Evans, JD Evans, A Everden, M Fadel, SE Fahmy, CJ Fairfield, BF Fanibi, Valeria Farina, SM Farrell, EZ Farrow, JA Fasuyi, G Faulkner, D Fawkner-Corbett, F Fawzi, M Fehervari, N Ferguson, JG Finch, H Finlayson, T Flack, W Foers, NM Foley, K Ford, A Forgie, A Foster, JD Foster, AMW Fox, N Francis, D Franklin, H Froud, HL Fuller, E Gaines, J Galea, E Gammeri, J Garnham, J Garvin, Z Gates, R Gentry, I Ghaffari, S Ghatorae, AL Gidwani, TG Gilbert, TM Gilbert, S Gill, M Gillespie, J Gillick, A Giorga, K Gopalakrishnan, S Gopalswamy, S Gopinath, R Gormely, G Govind, C Grant, J Graveston, J Gray, RT Gray, D Griffith, JP Griffith, Ewen A Griffiths, SN Griffiths, EJ Griggs, S Grosvenor, T Grove, M Gulamhussein, J Guliani, A Gummaraju, S Gunning, SV Gurjar, S Guru-Naidu, S Gurung, H Habib, L Hackney, James B Haddow, S Hajibandeh, C Halkias, NJ Hall, RN Hamelmann, M Haneef, MS Haneef, Z Hanif, C Hanley, AJ Hann, T Hanna, E Hardy, A Harlinska, F Harper, RL Harries, A Harris, Grant Harris, MP Harris, R Hasan, A Hassane, JR Hatt, Z Haveliwala, W Hawkins, Z Hayat, C Hayes, KRM Hebbar, L Henderson, LT Henderson, PJJ Herrod, P Hever, LM Hickey, G Hicks, JM Hodgson, M Hoff, A Hollingsworth, A Hook, ST Hornby, E Horsfield, EE Howie, L Huang, NJ Hudson-Peacock, DL Hughes, KA Hureibi, A Hussain, N Hussain, SA Hussaini, A Hussein, B Hutchinson, YMS Ibrahim, S Ikram, T Ilozue, E Iosif, MR Iqbal, S Irukulla, R Irwin, N Islam, P Ivey, CR Jackson, A Jackson, SMH Jah, A Jain, S Jain, Sarus Jain, GM Jama, NB Jamieson, S Janardanan, B Jasinski, D Jenner, E Jerome, B Johnson, A Johnstone, S Jokhan, A Jones, CE Jones, CS Jones, E Jones, L Jones, U Kabir, S Kabwama, M Kamal, IW Kamande, V Kanakala, M Kannegieser-Bailey, S Kaptanis, MJ Karim, RS Karwal, G Kaur, R Keegan, A Kelay, ND Kennedy, DA Kent, A Khair, K Khan, S Khan, A Khasria, H Kho, J Kilkenny, R King, J Kinross, EN Kirkham, B Knight, R Kochupapy, C Koh, O Kouli, A Krishnamoorthy, S Krivan, K Kumar, S Kumar, VWS Kung, R Kuo, G Lafaurie, CW Lai, N Lal, S Lawday, S Layman, GR Layton, A Lazzaro, L Lecky-Thompson, KA Lee, KJ Lee, M Lee, SL Lee, PA Leighton, RP Leitch, HC Lennox-Warburton, EL Leung, CH Li, JM Lim, C Limb, G Ljungqvist, G Lloyd, S Lodhia, PC Logan, M Long, P Long, RH Long, A Longshaw, C Louw, JN Lund, C Ly, MJ Lynch Wong, JKY Ma, A Macdonald, EGE Macinnes, T Magro, R Mahapatra, B Mahendran, F Mahmood, A Mahmoud, D Mahon, D Mai, A Maina, CP Major, R Makhija, Y Malam, A Malik, K Malik, SN Malik, VM Manda, KM Manektella, C Mann, P Manoharan, R Manson, S Mansoor, MM Mansour, S Mansour, F Maqboul, D Maragouthakis, G Marangoni, S Mardhiah, H Maripi, P Marriott, L Marsh, G Marshall, A Martin, LM Martin, E Martinou, R Mashar, John Mason, M Masood, G Mathew, K Maude, E Mazumdar, A Mc-Dermott, D Mcarthur, RS Mccain, S McCain, C Mccann, P Mccaughey, SJ Mccluney, J Mccullough, D Mcdonnell, NA Mcdowall, JE McEntee, K McGlynn, D Mcgrath, O Mcgucken, S Mcilwaine, AC Mcilwrath, SC Mckay, MA McKelvie, M Mckenna, J Mckeon, KL Mckevitt, NC Mckinley, D McLaughlin, SV McMahon, D Mcmorran, L McNally, M Mcquaid, DM Mcwhirter, K Mealy, A Mears, D Menzies, H Merai, RJ Mersh, M Miguras, D Milgrom, K Miller, J Milward, S Mirza, AT Misky, D Mistry, MJ Mitchard, RM Mitru, IM Mohamed, Imran Mohamed, TM Mohamed, WO Mohamed, N Mohd, C Moore, J Moradzadeh, TEM Morrison, V Morrison-Jones, Dion G Morton, BS Mothe, Fh Motiwala, D Motter, NG Mowbray, Z Mughal, J Mulsow, N Mundkur, A Muntean, C Murphy, R Murphy, MP Murray, M Muzaffar, A Myatt, A Nadeem, D Nagarajan, S Nagendram, A Nair, MK Nair, MS Nair, KN Naismith, K Nambiar, GR Nana, Z Nash, P Nastro, S Nazarian, G Neagle, A Neale, PM Neary, RC Newton, M Ng, S Ng, O Niaz, S Nickson, D Nicol, E Nimako, MS Noor Mohamed, M Nyeko-Lacek, BR O'Connor, E O'Neill, N O'Neill, D O'Sullivan, J O'Brien, M Oakey, N Obeid, A Odeh, S Ogboru, C Ogbuokiri, B Okekunle, E Okorocha, O Olagbaiye, JB Olivier, R Ooi, P Orawiec, M Orizu, N Orme, R Ormiston, C Paget, A Pal, LK Palani-Velu, Y Pan, N Panda, V Pandey, R Pandya, D Pandya, KR Paramasevon, C Pardy, MJ Parkola, Sandro Pasquali, AS Patel, BY Patel, C Patel, H Patel, N Patel, RT Patel, S Patel, Y Patel, MM Patel, SD Patil, CJ Payne, RE Payne, JCH Pearce, L Pearce, A Pedder, CB Peirce, GB Peiris, A Peleki, Gianluca Pellino, V Pento, D Peprah, HS Perera, MI Perera, L Phelan, D Photiou, R Pierre, JP Pilkington, Thomas D Pinkney, B Pisavadia, A Poacher, M Podda, H Pollard, D Popova, M Poudevigne, A Prideaux, UP Pullabatla Venkata, A Quddus, S Quill, M Rabie, MR Rabie, RW Radwan, JF Rae, A Rahim, LS Rahmani, S Rajagopal, R Rajaram, N Rajaretnam, Y Rajjoub, H Rallage, S Ramcharan, S Ranathunga, M Rao, VSR Rao, A Raofi, M Rashid, A Rate, R Ravindran, M Raymond, SS Raza, A Reddy, EP Redman, AE Redmond, S Rekhraj, S Renshaw, D Rex, M Rezacova, S Rezvani, B Ribeiro, JE Rich, TD Richardson, S Rigby, B Rigney, S Rinkoff, HD Robb, C Robertson, D Robinson, A Robinson, V Rodger, R Rolph, S Roomi, NPG Roth, K Rothnie, C Roy, S Rupani, DG Rutherford, R Sacks, N Saghir, A Saha, SJ Sahay, K Sahnan, Y Salama, S Salim, M Samuel, S Sana, L Sandu, P Sarmah, J Sarveswaran, SMF Saunders, A Savill, F Savioli, JR Schuster Bruce, JF Sebastian, TC Seddon, N Seneviratne, M Seth, T Setshwaelo, E Sezen, P Sgardelis, A Sgrò, C Shah, J Shah, K Shah, SM Shah, Z Shakoor, MS Shalaby, V Shanmuganathan, K Shanmugarajah, A Sharma, P Sharma, OL Sharp, JA Shepherd, MA Sherif, S Shet, G Shingler, MH Shiwani, D Shreshta, T Sian, MN Siddiqui, ZA Siddiqui, KL Siggens, N Sihra, I Silva, A Simioni, LFC Simmonds, DJ Simpson, A Singh, S Singh, T Singhal, P Sivaloganathan, K Sloan, N Smallcombe, CJ Smart, Neil J Smart, R Smith, H Smoker, L Solinas, JEH Souter, EL Springate, GF Stephens, R Stevenson, DJ Stewart, I Stoica, E Strachan, BM Stubbs, W Stupalkowska, A Suliman, A Sultana, H Sunter, S Suriyakumar, NRA Symons, K Szentpali, A Szucs, V Tabain, LE Tague, K Tailor, CY Tan, S Tan, AM Tang, M Tarazi, YH Tay, S Tayeh, M Taylor, NS Taylor, D Taze, E Teasdale, N Thakral, B Thava, N Thavanesan, AJ Thaventhiran, K Theodoropoulou, AT Thomas, L Thomas, DB Thompson, R Thompson, SN Thoukididou, SG Tiboni, LA Tiedt, N Ting, BJ Tinsley, JM Tognarelli, J Torkington, A Torrance, DC Townsend, PJ Tozer, M Trail, F Trew, V Tudyka, L Tullie, A Turnbull, EJ Turner, CS Twum-Barima, Robert Tyler, S Vakis, A La Valle, GI Van Boxel, J Vance-Daniel, M Varcada, N Varma, EM Vaughan, VR Velchuru, R Velho, AK Venkatasubramaniam, ML Venn, V Vijay, Z Vinnicombe, P Vitish-Sharma, S Wagener, K Waite, KJ Walters, U Walters, BG Wardle, SD Wardle, J Warusavitarne, J Watfah, N Watson, J Wauchope, LW Weatherburn, CR Weegenaar, S Welsh, S Wheatstone, HE Whewell, P Whitehouse, E Whiteman, L Whittaker, K Wijesundera, D Wilkinson, GL Williams, M Williams, R Williams, S Williams, EJ Wilson, MSJ Wilson, DC Winter, G Winter, J Wolff, A Wong, CLL Wong, SY Wong, CS Wood, C Woodrow, A Woodward, B Woodward, E Wright, HL Wright, F Wu, S Yalamarthi, P Yang, E Yardimci, T Yasin, SK Yen, S Yoganathan, S Yoong, H Youssef, LPS Yow, A Zaborowski, AZ Zadi, ZA Zarka, MA Zarog, AY Zhang, Nepogodiev, D., Wilkin, R. J., Bradshaw, C. J., Skerritt, C., Ball, A., Moni-Nwinia, W., Blanco-Colino, R., Chauhan, P., Drake, T. M., Frasson, M., Gee, O., Glasbey, J. C., Matthews, J. H., Morley, G. L., Naumann, D. N., Pata, F., Soares, A. S., Bhangu, A., Abbas, S. H., Abdelgadir, A. M., Abdelrahman, A., Abdelrahman, M., Abdelwahed, A., Abou El Ella, Y., Abulafi, M., Acharya, A., Adam, M. E., Adams, R. E., Adegbola, S. O., Adimonye, A., Adnan, M., Afshar, S., Ahad, A., Ahel, J., Ahern, D. P., Ahmad Asmadi, A., Ahmed, B., Ahmed, G., Ahmed, O. S., Ahmed, S., Akbari, K., Akinsola, O., Al-Khyatt, W., Al-Sarireh, B., Al-Sheikh, M., Alani, M., Alexander, R., Alhammali, T., Ali, M., Aljorfi, A., Allen, M., Allington, J., Alshafei, A., Amarasinghe, R., Amayo, A., Amin, V., Amuthalingam, T., Anandan, L., Anderson, O., Andreani, S. M., Andrews, B., Ang, A., Aravind, B., Archer, J. E., Aremu, M. A., Arunachalam, S., Aruparayil, N., Ashmore, D. L., Ashour, O., Ashraf, N., Assaf, N., Avalapati, H., Awokoya, O. O., Ayube-Brown, J., Badenoch, T., Bagga, R., Baginski, A., Bailey, S., Bailey, S. T. R., Baird, C., Baker, B., Balai, E. J., Balasubramaniam, A., Bandyopadhyay, S. K., Banks, A., Bansal, H., Barnieh, W., Barrie, A., Barter, C. A., Bastianpillai, J., Beasley, W. D., Bell, C. R., Bell, J., Beral, D., Berry, B. J. M., Bevan, K. E., Bevan, V., Bhanderi, S., Bhargava, A., Bilku, D., Birindelli, A., Blackford, O. D., Blackwell, J. E. M., Blake, L., Blencowe, N. S., Boam, T. D., Boereboom, C., Bogdan, M., Bohra, P., Bolger, J. C., Bolton, W., Bond, S., Borg, C. M., Borghol, K., Boshier, P. R., Bouhadiba, N., Bowen, J., Bowerman, H., Bowman, C. R., Boyd-Carson, H., Branagan, G., Brennan, P., Brett, M., Brewer, H. K., Brewer, H., Bronder, C., Brown, A., Brown, A. G., Brown, C. E., Brown, M., Brown, R., Buckley-Jones, S., Budzanowski, A., Bukhari, W., Bull, C., Bullivant, J. K., Burns, K. M., Burnside, D., Busuttil, A., Byrne, B. E., Byrnes, C. K., Caldwell, M., Callan, R., Cameron, F. C., Campbell, U., Campbell, U. M., Campbell, W., Carden, C. A., Carder, C. F. W., Carney, K., Cartwright, H., Cay, P., Chalk, A., Chambers, B., Champsi, A., Chan, D., Chan, T. C. W., Chandler, S. B., Chapman, J., Charalabopoulos, A., Chasty, B., Chatzikonstantinou, M., Cheah, W. L., Chean, C. S., Cheng, S., Cheng, S. A., Cheruvu, M., Chin, M. Y., Chishti, I. A., Choi, S., Chok, S. M., Chong, B., Choong, J. H., Chowdhary, M., Chowdhury, F., Choy, C. H., Christian, L., Christopoulos, P., Chui, K., Cipparrone, M., Clark, G. L., Clarke, S. A., Cleeve, S. J., Clement, K. D., Clements, B., Clements, C., Clements, J. D., Clements, J. M., Clements, J. S., Clements, J. A., Clingan, R., Cloney, L., Clough, E. C. S., Coe, P. O., Collier-Wakefield, O., Colliver, D. W., Colvin, D. A., Connelly, T. M., Connor, M. J., Cook, V., Cooke, F., Cooper, F., Cotton, A. E., Couch, D. G., Cousins, L., Coyle, D., Creasy, W., Cresner, R. L., Crone, A., Cross, K., Crozier, J., Cunha, P., Curtis, N. J., D'Souza, N., Dagash, H., Dalmia, S., Daniels, I., Danquah-Boateng, D., Dar, F. A., Dart, K., Das, A., Daureeawoo, R., Davidson, S., Davidson, J. R., Davies, P. L., Davis, S., Daya Shetty, V., De-Manzoni-Garberini, A., De-Marchi, J. A., Dean, E. A., Dean, S., Delimpalta, C., Denley, S., Dennison, G., Devine, A. A., Dharamavaram, S., Dhari, A. A., Di Franco, F., Di Saverio, S., Dobson, C., Docherty, J. A., Doherty, C., Donaldson, G., Donohoe, N. O., Donohoe, O., Douka, E., Doulias, T., Downey, M., Doyle, C., Drye, N., Du, D. T., Dudek, J. G., Dunning, P. G., Dyal, A. R. S., Eardley, N. J., Earnshaw, L., Easdon, S., Edwards, S. E., Egan, R. J., El-Masry, S., El-Tayar, O., Elbourne, C. R., Elgaddal, S., Elseedawy, M., Elshaer, M., Elsharnoby, O. H., Elzeneini, W. M. A., Emslie, K. M., Engall, N. F. T., Ertansel, B., Esmail, H. D., Ettles, C., Evans, J., Evans, J. D., Everden, A., Fadel, M., Fahmy, S. E., Fairfield, C. J., Fanibi, B. F., Farina, V., Farrell, S. M., Farrow, E. Z., Fasuyi, J. A., Faulkner, G., Fawkner-Corbett, D., Fawzi, F., Fehervari, M., Ferguson, N., Finch, J. G., Finlayson, H., Flack, T., Foers, W., Foley, N. M., Ford, K., Forgie, A., Foster, A., Foster, J. D., Fox, A. M. W., Francis, N., Franklin, D., Froud, H., Fuller, H. L., Gaines, E., Galea, J., Gammeri, E., Garnham, J., Garvin, J., Gates, Z., Gentry, R., Ghaffari, I., Ghatorae, S., Gidwani, A. L., Gilbert, T. G., Gilbert, T. M., Gill, S., Gillespie, M., Gillick, J., Giorga, A., Gopalakrishnan, K., Gopalswamy, S., Gopinath, S., Gormely, R., Govind, G., Grant, C., Graveston, J., Gray, J., Gray, R. T., Griffith, D., Griffith, J. P., Griffiths, E. A., Griffiths, S. N., Griggs, E. J., Grosvenor, S., Grove, T., Gulamhussein, M., Guliani, J., Gummaraju, A., Gunning, S., Gurjar, S. V., Guru-Naidu, S., Gurung, S., Habib, H., Hackney, L., Haddow, J. B., Hajibandeh, S., Halkias, C., Hall, N. J., Hamelmann, R. N., Haneef, M., Haneef, M. S., Hanif, Z., Hanley, C., Hann, A. J., Hanna, T., Hardy, E., Harlinska, A., Harper, F., Harries, R. L., Harris, A., Harris, G., Harris, M. P., Hasan, R., Hassane, A., Hatt, J. R., Haveliwala, Z., Hawkins, W., Hayat, Z., Hayes, C., Hebbar, K. R. M., Henderson, L., Henderson, L. T., Herrod, P. J. J., Hever, P., Hickey, L. M., Hicks, G., Hodgson, J. M., Hoff, M., Hollingsworth, A., Hook, A., Hornby, S. T., Horsfield, E., Howie, E. E., Huang, L., Hudson-Peacock, N. J., Hughes, D. L., Hureibi, K. A., Hussain, A., Hussain, N., Hussaini, S. A., Hussein, A., Hutchinson, B., Ibrahim, Y. M. S., Ikram, S., Ilozue, T., Iosif, E., Iqbal, M. R., Irukulla, S., Irwin, R., Islam, N., Ivey, P., Jackson, C. R., Jackson, A., Jah, S. M. H., Jain, A., Jain, S., Jama, G. M., Jamieson, N. B., Janardanan, S., Jasinski, B., Jenner, D., Jerome, E., Johnson, B., Johnstone, A., Jokhan, S., Jones, A., Jones, C. E., Jones, C. S., Jones, E., Jones, L., Kabir, U., Kabwama, S., Kamal, M., Kamande, I. W., Kanakala, V., Kannegieser-Bailey, M., Kaptanis, S., Karim, M. J., Karwal, R. S., Kaur, G., Keegan, R., Kelay, A., Kennedy, N. D., Kent, D. A., Khair, A., Khan, K., Khan, S., Khasria, A., Kho, H., Kilkenny, J., King, R., Kinross, J., Kirkham, E. N., Knight, B., Kochupapy, R., Koh, C., Kouli, O., Krishnamoorthy, A., Krivan, S., Kumar, K., Kumar, S., Kung, V. W. S., Kuo, R., Lafaurie, G., Lai, C. W., Lal, N., Lawday, S., Layman, S., Layton, G. R., Lazzaro, A., Lecky-Thompson, L., Lee, K. A., Lee, K. J., Lee, M., Lee, S. L., Leighton, P. A., Leitch, R. P., Lennox-Warburton, H. C., Leung, E. L., Li, C. H., Lim, J. M., Limb, C., Ljungqvist, G., Lloyd, G., Lodhia, S., Logan, P. C., Long, M., Long, P., Long, R. H., Longshaw, A., Louw, C., Lund, J. N., Ly, C., Lynch Wong, M. J., Ma, J. K. Y., Macdonald, A., Macinnes, E. G. E., Magro, T., Mahapatra, R., Mahendran, B., Mahmood, F., Mahmoud, A., Mahon, D., Mai, D., Maina, A., Major, C. P., Makhija, R., Malam, Y., Malik, A., Malik, K., Malik, S. N., Manda, V. M., Manektella, K. M., Mann, C., Manoharan, P., Manson, R., Mansoor, S., Mansour, M. M., Mansour, S., Maqboul, F., Maragouthakis, D., Marangoni, G., Mardhiah, S., Maripi, H., Marriott, P., Marsh, L., Marshall, G., Martin, A., Martin, L. M., Martinou, E., Mashar, R., Mason, J., Masood, M., Mathew, G., Maude, K., Mazumdar, E., Mc-Dermott, A., Mcarthur, D., Mccain, R. S., Mccain, S., Mccann, C., Mccaughey, P., Mccluney, S. J., Mccullough, J., Mcdonnell, D., Mcdowall, N. A., Mcentee, J. E., Mcglynn, K., Mcgrath, D., Mcgucken, O., Mcilwaine, S., Mcilwrath, A. C., Mckay, S. C., Mckelvie, M. A., Mckenna, M., Mckeon, J., Mckevitt, K. L., Mckinley, N. C., Mclaughlin, D., Mcmahon, S. V., Mcmorran, D., Mcnally, L., Mcquaid, M., Mcwhirter, D. M., Mealy, K., Mears, A., Menzies, D., Merai, H., Mersh, R. J., Miguras, M., Milgrom, D., Miller, K., Milward, J., Mirza, S., Misky, A. T., Mistry, D., Mitchard, M. J., Mitru, R. M., Mohamed, I. M., Mohamed, I., Mohamed, T. M., Mohamed, W. O., Mohd, N., Moore, C., Moradzadeh, J., Morrison, T. E. M., Morrison-Jones, V., Morton, D. G., Mothe, B. S., Motiwala, F., Motter, D., Mowbray, N. G., Mughal, Z., Mulsow, J., Mundkur, N., Muntean, A., Murphy, C., Murphy, R., Murray, M. P., Muzaffar, M., Myatt, A., Nadeem, A., Nagarajan, D., Nagendram, S., Nair, A., Nair, M. K., Nair, M. S., Naismith, K. N., Nambiar, K., Nana, G. R., Nash, Z., Nastro, P., Nazarian, S., Neagle, G., Neale, A., Neary, P. M., Newton, R. C., Ng, M., Ng, S., Niaz, O., Nickson, S., Nicol, D., Nimako, E., Noor Mohamed, M. S., Nyeko-Lacek, M., O'Connor, B. R., O'Neill, E., O'Neill, N., O'Sullivan, D., O'Brien, J., Oakey, M., Obeid, N., Odeh, A., Ogboru, S., Ogbuokiri, C., Okekunle, B., Okorocha, E., Olagbaiye, O., Olivier, J. B., Ooi, R., Orawiec, P., Orizu, M., Orme, N., Ormiston, R., Paget, C., Pal, A., Palani-Velu, L. K., Pan, Y., Panda, N., Pandey, V., Pandya, R., Pandya, D., Paramasevon, K. R., Pardy, C., Parkola, M. J., Pasquali, S., Patel, A. S., Patel, B. Y., Patel, C., Patel, H., Patel, N., Patel, R. T., Patel, S., Patel, Y., Patel, M. M., Patil, S. D., Payne, C. J., Payne, R. E., Pearce, J. C. H., Pearce, L., Pedder, A., Peirce, C. B., Peiris, G. B., Peleki, A., Pellino, G., Pento, V., Peprah, D., Perera, H. S., Perera, M. I., Phelan, L., Photiou, D., Pierre, R., Pilkington, J. P., Pinkney, T. D., Pisavadia, B., Poacher, A., Podda, M., Pollard, H., Popova, D., Poudevigne, M., Prideaux, A., Pullabatla Venkata, U. P., Quddus, A., Quill, S., Rabie, M., Rabie, M. R., Radwan, R. W., Rae, J. F., Rahim, A., Rahmani, L. S., Rajagopal, S., Rajaram, R., Rajaretnam, N., Rajjoub, Y., Rallage, H., Ramcharan, S., Ranathunga, S., Rao, M., Rao, V. S. R., Raofi, A., Rashid, M., Rate, A., Ravindran, R., Raymond, M., Raza, S. S., Reddy, A., Redman, E. P., Redmond, A. E., Rekhraj, S., Renshaw, S., Rex, D., Rezacova, M., Rezvani, S., Ribeiro, B., Rich, J. E., Richardson, T. D., Rigby, S., Rigney, B., Rinkoff, S., Robb, H. D., Robertson, C., Robinson, D., Robinson, A., Rodger, V., Rolph, R., Roomi, S., Roth, N. P. G., Rothnie, K., Roy, C., Rupani, S., Rutherford, D. G., Sacks, R., Saghir, N., Saha, A., Sahay, S. J., Sahnan, K., Salama, Y., Salim, S., Samuel, M., Sana, S., Sandu, L., Sarmah, P., Sarveswaran, J., Saunders, S. M. F., Savill, A., Savioli, F., Schuster Bruce, J. R., Sebastian, J. F., Seddon, T. C., Seneviratne, N., Seth, M., Setshwaelo, T., Sezen, E., Sgardelis, P., Sgro, A., Shah, C., Shah, J., Shah, K., Shah, S. M., Shakoor, Z., Shalaby, M. S., Shanmuganathan, V., Shanmugarajah, K., Sharma, A., Sharma, P., Sharp, O. L., Shepherd, J. A., Sherif, M. A., Shet, S., Shingler, G., Shiwani, M. H., Shreshta, D., Sian, T., Siddiqui, M. N., Siddiqui, Z. A., Siggens, K. L., Sihra, N., Silva, I., Simioni, A., Simmonds, L. F. C., Simpson, D. J., Singh, A., Singh, S., Singhal, T., Sivaloganathan, P., Sloan, K., Smallcombe, N., Smart, C. J., Smart, N. J., Smith, R., Smoker, H., Solinas, L., Souter, J. E. H., Springate, E. L., Stephens, G. F., Stevenson, R., Stewart, D. J., Stoica, I., Strachan, E., Stubbs, B. M., Stupalkowska, W., Suliman, A., Sultana, A., Sunter, H., Suriyakumar, S., Symons, N. R. A., Szentpali, K., Szucs, A., Tabain, V., Tague, L. E., Tailor, K., Tan, C. Y., Tan, S., Tang, A. M., Tarazi, M., Tay, Y. H., Tayeh, S., Taylor, M., Taylor, N. S., Taze, D., Teasdale, E., Thakral, N., Thava, B., Thavanesan, N., Thaventhiran, A. J., Theodoropoulou, K., Thomas, A. T., Thomas, L., Thompson, D. B., Thompson, R., Thoukididou, S. N., Tiboni, S. G., Tiedt, L. A., Ting, N., Tinsley, B. J., Tognarelli, J. M., Torkington, J., Torrance, A., Townsend, D. C., Tozer, P. J., Trail, M., Trew, F., Tudyka, V., Tullie, L., Turnbull, A., Turner, E. J., Twum-Barima, C. S., Tyler, R., Vakis, S., Valle, A. L., Van Boxel, G. I., Vance-Daniel, J., Varcada, M., Varma, N., Vaughan, E. M., Velchuru, V. R., Velho, R., Venkatasubramaniam, A. K., Venn, M. L., Vijay, V., Vinnicombe, Z., Vitish-Sharma, P., Wagener, S., Waite, K., Walters, K. J., Walters, U., Wardle, B. G., Wardle, S. D., Warusavitarne, J., Watfah, J., Watson, N., Wauchope, J., Weatherburn, L. W., Weegenaar, C. R., Welsh, S., Wheatstone, S., Whewell, H. E., Whitehouse, P., Whiteman, E., Whittaker, L., Wijesundera, K., Wilkinson, D., Williams, G. L., Williams, M., Williams, R., Williams, S., Wilson, E. J., Wilson, M. S. J., Winter, D. C., Winter, G., Wolff, J., Wong, A., Wong, C. L. L., Wong, S. Y., Wood, C. S., Woodrow, C., Woodward, A., Woodward, B., Wright, E., Wright, H. L., Wu, F., Yalamarthi, S., Yang, P., Yardimci, E., Yasin, T., Yen, S. K., Yoganathan, S., Yoong, S., Youssef, H., Yow, L. P. S., Zaborowski, A., Zadi, A. Z., Zarka, Z. A., Zarog, M. A., and Zhang, A. Y.

Subjects
Male, Pediatrics, medicine.medical_specialty, Validation study, Adolescent, Ultrasound scan, Pain, Risk prediction models, Risk Assessment, Sensitivity and Specificity, Cohort Studies, Ilium, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, 030225 pediatrics, Developmental and Educational Psychology, medicine, Appendectomy, Humans, Prospective Studies, 030212 general & internal medicine, Surgical emergency, Child, Ultrasonography, business.industry, Area under the curve, Appendicitis, medicine.disease, United Kingdom, Child, Preschool, Acute Disease, Pediatrics, Perinatology and Child Health, Female, Right iliac fossa pain, business, Ireland, Cohort study
Abstract

BACKGROUND: Acute appendicitis is the most common surgical emergency in children. Differentiation of acute appendicitis from conditions that do not require operative management can be challenging in children. This study aimed to identify the optimum risk prediction model to stratify acute appendicitis risk in children. METHODS: We did a rapid review to identify acute appendicitis risk prediction models. A prospective, multicentre cohort study was then done to evaluate performance of these models. Children (aged 5-15 years) presenting with acute right iliac fossa pain in the UK and Ireland were included. For each model, score cutoff thresholds were systematically varied to identify the best achievable specificity while maintaining a failure rate (ie, proportion of patients identified as low risk who had acute appendicitis) less than 5%. The normal appendicectomy rate was the proportion of resected appendixes found to be normal on histopathological examination. FINDINGS:15 risk prediction models were identified that could be assessed. The cohort study enrolled 1827 children from 139 centres, of whom 630 (34·5%) underwent appendicectomy. The normal appendicectomy rate was 15·9% (100 of 630 patients). The Shera score was the best performing model, with an area under the curve of 0·84 (95% CI 0·82-0·86). Applying score cutoffs of 3 points or lower for children aged 5-10 years and girls aged 11-15 years, and 2 points or lower for boys aged 11-15 years, the failure rate was 3·3% (95% CI 2·0-5·2; 18 of 539 patients), specificity was 44·3% (95% CI 41·4-47·2; 521 of 1176), and positive predictive value was 41·4% (38·5-44·4; 463 of 1118). Positive predictive value for the Shera score with a cutoff of 6 points or lower (72·6%, 67·4-77·4) was similar to that of ultrasound scan (75·0%, 65·3-83·1). INTERPRETATION: The Shera score has the potential to identify a large group of children at low risk of acute appendicitis who could be considered for early discharge. Risk scoring does not identify children who should proceed directly to surgery. Medium-risk and high-risk children should undergo routine preoperative ultrasound imaging by operators trained to assess for acute appendicitis, and MRI or low-dose CT if uncertainty remains. FUNDING: None.

Published
2021
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36. Classification accuracy of TMS for the diagnosis of Mild Cognitive Impairment

Author

Giacomo Koch, Barbara Borroni, Enrico Premi, Maria Cotelli, Vincenzo Di Lazzaro, Gabriella Musumeci, Federico Ranieri, Raffaele Nardone, Paolo Manganotti, Francesco Di Lorenzo, Valentina Cantoni, Maria Concetta Pellicciari, Mario Grassi, Alberto Benussi, Fernando Palluzzi, Camillo Marra, Benussi, A., Grassi, M., Palluzzi, F., Cantoni, V., Cotelli, M. S., Premi, E., Di Lorenzo, F., Pellicciari, M. C., Ranieri, F., Musumeci, G., Marra, C., Manganotti, P., Nardone, R., Di Lazzaro, V., Koch, G., and Borroni, B.

Subjects
Dementia with Lewy bodie, medicine.medical_treatment, Dementia with Lewy bodies, Short interval intracortical inhibition, Intracortical facilitation, Audiology, Diagnostic accuracy, 0302 clinical medicine, Decision tree, Cognitive impairment, General Neuroscience, 05 social sciences, Alzheimer's disease, Random forest, Settore MED/26 - NEUROLOGIA, Cohort, diagnostic accuracy, Alzheimer’s disease, Frontotemporal dementia, medicine.medical_specialty, Biophysics, behavioral disciplines and activities, 050105 experimental psychology, lcsh:RC321-571, NO, 03 medical and health sciences, mild cognitive impairment, Mild cognitive impairment, Short latency afferent inhibition, Transcranial magnetic stimulation, Alzheimer Disease, Alzheimer''s disease, mental disorders, medicine, Humans, Dementia, Cognitive Dysfunction, 0501 psychology and cognitive sciences, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Recall, business.industry, Decision tree, Transcranial magnetic stimulation, Short latency afferent inhibition, Alzheimer's disease, Mild cognitive impairment, Short interval intracortical inhibition, Intracortical facilitation, Frontotemporal dementia, Diagnostic accuracy, Dementia with Lewy bodies, medicine.disease, nervous system diseases, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Objective To evaluate the performance of a Random Forest (RF) classifier on Transcranial Magnetic Stimulation (TMS) measures in patients with Mild Cognitive Impairment (MCI). Methods We applied a RF classifier on TMS measures obtained from a multicenter cohort of patients with MCI, including MCI-Alzheimer’s Disease (MCI-AD), MCI-frontotemporal dementia (MCI-FTD), MCI-dementia with Lewy bodies (MCI-DLB), and healthy controls (HC). All patients underwent TMS assessment at recruitment (index test), with application of reference clinical criteria, to predict different neurodegenerative disorders. The primary outcome measures were the classification accuracy, precision, recall and F1-score of TMS in differentiating each disorder. Results 160 participants were included, namely 64 patients diagnosed as MCI-AD, 28 as MCI-FTD, 14 as MCI-DLB, and 47 as healthy controls (HC). A series of 3 binary classifiers was employed, and the prediction model exhibited high classification accuracy (ranging from 0.72 to 0.86), high precision (0.72–0.90), high recall (0.75–0.98), and high F1-scores (0.78–0.92), in differentiating each neurodegenerative disorder. By computing a new classifier, trained and validated on the current cohort of MCI patients, classification indices showed even higher accuracy (ranging from 0.83 to 0.93), precision (0.87–0.89), recall (0.83–1.00), and F1-scores (0.85–0.94). Conclusions TMS may be considered a useful additional screening tool to be used in clinical practice in the prodromal stages of neurodegenerative dementias.

Published
2021

37. The vitamin D, IL-6 and the eGFR markers a possible way to elucidate the lung–heart–kidney cross-talk in COVID-19 disease: A foregone conclusion

Author

Maria Contaldo, Maria Elena Maggiore, Kieu C. D. Nguyen, Alessio Danilo Inchingolo, Ciro Gargiulo Isacco, Giovanni Migliore, Sergey K. Aityan, Diego Tomassone, Tran Cong Toai, Angelo Cefalo, Antonio Mancini, Angelo M Inchingolo, Silvio Tafuri, Donatello Iacobone, Luigi Santacroce, Felice Lorusso, Pietro Distratis, Luigi Vimercati, Mario Giosuè Balzanelli, Rosario Serpico, Antonio Scarano, Van Hung Pham, Orazio Catucci, Rita Lazzaro, Francesco Inchingolo, Gianna Dipalma, Loreto Gesualdo, Balzanelli, M. G., Distratis, P., Lazzaro, R., Cefalo, A., Catucci, O., Aityan, S. K., Dipalma, G., Vimercati, L., Inchingolo, A. D., Maggiore, M. E., Mancini, A., Santacroce, L., Gesualdo, L., Pham, V. H., Iacobone, D., Contaldo, M., Serpico, R., Scarano, A., Lorusso, F., Toai, T. C., Tafuri, S., Migliore, G., Inchingolo, A. M., Nguyen, K. C. D., Inchingolo, F., Tomassone, D., and Isacco, C. G.

Subjects
Microbiology (medical), medicine.medical_specialty, Heart disease, QH301-705.5, EGFR, Renal function, Context (language use), Disease, Microbiology, Article, Lung Disorder, Virology, Internal medicine, Vitamin D and neurology, Medicine, Biology (General), Vitamin D, vitamin D, eGFR, IL-6, SARS-CoV-2, Coronavirus 19 (COVID-19), lung–heart–kidney cross-talk, Kidney, business.industry, Lung–heart–kidney cross-talk, medicine.disease, medicine.anatomical_structure, Heart failure, business
Abstract

Background: Based on recent findings, we speculated the existence of the lung, heart, and kidney axis as the main pathway for the COVID-19 disease progression. Methods: This paper reports on an observational study conducted by a team of researchers and doctors of the 118-Pre-Hospital and Emergency Department of SG Moscati of Taranto City in Italy. The study was conducted on a totality of 185 participants that were divided into three groups. The study group included COVID-19 affected patients (PP n = 80), the first control group included patients with different pathologies (non-COVID-19 NNp n = 62) of the SG Moscati Hospital, and the second control group included healthy individuals (NNh n = 43). The core of the current trial was focused on assessing the level of the vitamin D (serum 25(OH) D concentration), IL-6, and the renal glomerular filtrate (eGFR) in COVID-19 disease and non-COVID-19 patients in both groups. Results: It was observed that the majority of COVID-19-infected patients showed a progressive multi-organ involvement, especially in regard to the lung, kidney, and heart. The majority of the COVID-19 patients exhibited preexisting comorbidities which include cardiovascular, respiratory, and renal disorders accompanied by a severely low level of vitamin D, extremely high level of IL-6, and low glomerular filtration rate (eGFR). The significant overall damages exerted by the immune-mediated responses under the hyper-expression of proinflammatory cytokines and interleukins, such as IL-6, may be facilitated by either a decreased level of vitamin D or the ageing process. The reduced presence of vitamin D was often found together with a reduced functionality of renal activity, as revealed by the low eGFR, and both were seen to be concomitant with an increased mortality risk in patients with lung disorders and heart failure (HF), whether it is showed at baseline or it develops during manifestation of COVID-19. Therefore, the documentation of the modifiable risk factors related to SARS-CoV-2 and lung impairment in older patients with kidney and heart disease may help the clinician to better manage the situation. Conclusions: This paper addresses how a low level of vitamin D and older age may be indicative of systemic worsening in patients with COVID-19, with a goal of providing a broader context in which to view a better therapeutic approach.

Published
2021

38. Elective Surgery for Diverticulitis in Swiss Hospitals

Author

Seraina Faes, Martin Hübner, Nicolas Demartines, Dieter Hahnloser, David Martin, The Swiss Snapshot Diverticulitis Group, Paolo Abitabile, Dritan Abrazhda, Michele Arigoni, Vahid Bakhshi-Tahami, Jean-Pierre Barras, Thomas Beck, Vincent Bettschart, Paul Biegger, Karin Bläuer, Stefan Breitenstein, Franziska Brinkmann, Lukas Brügger, Hans Brunner, Walter Brunner, Claude Bussard, Jean-Marie Calmes, Jean-Pierre Chevalley, Michael Chilcott, Denis Christinaz, Dimitri Christoforidis, Carlo Coduri, Nadine Crivelli, Aris D'Ambrogio, Branimir Damjanovic, Wiebke Decking, Diego De Lorenzi, Charles de Montmollin, Sona Deretti, Alexandre Descloux, Urs Diener, Marco Di Lazzaro, Luca Di Mare, Rok Dolanc, Andrea Donadini, Georg Donner, Bernhard Egger, Michel Erne, Fabrizio Fasolini, Charlotte-Ulrike Finkenzeller, Ivo Ralf Fischer, Daniel Frey, Raffaele Galli, Walter Gantert, Alain Garcia, Jörg Genstorfer, Pascal Gervaz, Bijan Ghavami, Nicola Ghisletta, Duri Gianom-Campell, Mauro Giuliani, Christine Glaser, Emanuel Gmür, Federico Goti, Jürg Gresser, Felix Grieder, Gerald Gubler, Adriano Guerra, Silvio Gujer, Jürg Gurzeler, Susanne Habelt, Peter Häfliger, Andres Heigl, Dominik Heim, Juliette Henri, Mark Henschel, Rudolf Herzig, Franc Hetzer, Henry Hoffmann, Markus Huber, Regula Humm, Adrienne Imhof, Daniel Inderbitzin, Manuel Jakob, Renata Jori, Philomena Kastner, Andreas Keerl, Ulf Kessler, Philipp Kirchhoff, Jennifer Klasen, Katrin Kleinschmidt, Jürg Knaus, Markus Koch, Michael Kodsi, Erwin Kohlberger, Stefan Kull, Beat Künzli, Sebastian Lamm, Stéphanie Laperrousaz, André Leuenberger, Patrick Mäder, Styliani Mantziari, Florian Martens, Lukas Marti, Olivier Martinet, Jean Mégevand, Gian Melcher, Antoine Meyer, Pierre Meyer, Philippe Morel, Murielle Mormont, Beat Muggli, Markus Müller, Stephan Müller, Andrew Munday, Surennaidoo Naiken, Antonio Nocito, Peter Nussbaumer, Daniel Oertli, Alexandre Paroz, Angelo Pelloni, Jörg Peltzer, Matthias Peter, Sebastian Pohle, Philippe Posso, Hervé Probst, Alexander Radke, Martin Reber, Luca Regusci, Verena Reichl, Andreas Remiger, Jean-Claude Renggli, Monika Richter, Paavo Rillmann, Frédéric Ris, Nadja Ristagno, Luca Rondi, Robert Rosenberg, Raffaele Rosso, Alend Saadi, Bernd Schenkluhn, Martin Schilling, Rolf Schlumpf, Bruno Schmied, Michael Schmitz, Rémi Schneider, Othmar Schöb, Claudio Soravia, René Spalinger, Rudolf Steffen, Daniel Steinemann, Reto Stocker, Ulrich Stricker, Alexander Stupnicki, Michel Suter, Daniel Tassile, Adrien Tempia, Derya Topal, Rebekka Troller, Daniel Trötschler, Cédric Vallet, Denise Vettorel, Carsten Viehl, Peter Villiger, Peter Vogelbach, Marco von Strauss und Torney, Stephan Vorburger, Matthias Walting, Markus Weber, Heinz Wehrli, Bernhard Widmann, Stefan Wildi, Alessandro Wildisen, Bernd Wilhelm, Mariano Winckler, Marc Worreth, Jörg Wydler, Sidika Yakarisik, Urs Zingg, Christof Zöllner, Markus Zuber, Michael Zünd, Swiss Snapshot Diverticulitis Group, Abitabile, P., Abrazhda, D., Arigoni, M., Bakhshi-Tahami, V., Barras, J.P., Beck, T., Bettschart, V., Biegger, P., Bläuer, K., Breitenstein, S., Brinkmann, F., Brügger, L., Brunner, H., Brunner, W., Bussard, C., Calmes, J.M., Chevalley, J.P., Chilcott, M., Christinaz, D., Christoforidis, D., Coduri, C., Crivelli, N., D'Ambrogio, A., Damjanovic, B., Decking, W., De Lorenzi, D., de Montmollin, C., Deretti, S., Descloux, A., Diener, U., Di Lazzaro, M., Di Mare, L., Dolanc, R., Donadini, A., Donner, G., Egger, B., Erne, M., Fasolini, F., Finkenzeller, C.U., Fischer, I.R., Frey, D., Galli, R., Gantert, W., Garcia, A., Genstorfer, J., Gervaz, P., Ghavami, B., Ghisletta, N., Gianom-Campell, D., Giuliani, M., Glaser, C., Gmür, E., Goti, F., Gresser, J., Grieder, F., Gubler, G., Guerra, A., Gujer, S., Gurzeler, J., Habelt, S., Häfliger, P., Heigl, A., Heim, D., Henri, J., Henschel, M., Herzig, R., Hetzer, F., Hoffmann, H., Huber, M., Humm, R., Imhof, A., Inderbitzin, D., Jakob, M., Jori, R., Kastner, P., Keerl, A., Kessler, U., Kirchhoff, P., Klasen, J., Kleinschmidt, K., Knaus, J., Koch, M., Kodsi, M., Kohlberger, E., Kull, S., Künzli, B., Lamm, S., Laperrousaz, S., Leuenberger, A., Mäder, P., Mantziari, S., Martens, F., Marti, L., Martinet, O., Mégevand, J., Melcher, G., Meyer, A., Meyer, P., Morel, P., Mormont, M., Muggli, B., Müller, M., Müller, S., Munday, A., Naiken, S., Nocito, A., Nussbaumer, P., Oertli, D., Paroz, A., Pelloni, A., Peltzer, J., Peter, M., Pohle, S., Posso, P., Probst, H., Radke, A., Reber, M., Regusci, L., Reichl, V., Remiger, A., Renggli, J.C., Richter, M., Rillmann, P., Ris, F., Ristagno, N., Rondi, L., Rosenberg, R., Rosso, R., Saadi, A., Schenkluhn, B., Schilling, M., Schlumpf, R., Schmied, B., Schmitz, M., Schneider, R., Schöb, O., Soravia, C., Spalinger, R., Steffen, R., Steinemann, D., Stocker, R., Stricker, U., Stupnicki, A., Suter, M., Tassile, D., Tempia, A., Topal, D., Troller, R., Trötschler, D., Vallet, C., Vettorel, D., Viehl, C., Villiger, P., Vogelbach, P., Torney, MVSU, Vorburger, S., Walting, M., Weber, M., Wehrli, H., Widmann, B., Wildi, S., Wildisen, A., Wilhelm, B., Winckler, M., Worreth, M., Wydler, J., Yakarisik, S., Zingg, U., Zöllner, C., Zuber, M., Zünd, M., and Ris, Frédéric

Subjects
medicine.medical_specialty, Recurrent diverticulitis, RD1-811, genetic structures, laparoscopy, medicine, Elective surgery, Laparoscopy, Diverticulitis, ddc:617, medicine.diagnostic_test, business.industry, General surgery, Postoperative complication, Elective resection, Brief Research Report, medicine.disease, Management, Stenosis, diverticulitis, elective surgery, Observational study, Surgery, Switzerland, management, business
Abstract

Objective: To assess current management of diverticulitis in Switzerland.Methods: Prospective observational study of diverticulitis management and outcomes in surgical departments over a 3-month time period. Hospital category was graded according to the Swiss Medical Association (FMH) as: U: University; A: Cantonal; B: Regional; P: Private.Results: 75 participating hospitals treated 1,015 patients, among whom 214 patients (21%) had elective sigmoid resections in 49 hospitals. Indication for elective resection were recurrent diverticulitis, previous complicated diverticulitis, fistulas, and stenosis. Surgeries were performed completely laparoscopically in 185 cases (86%) and required conversion to open in 19 cases (9%). Overall postoperative complication rate was 18% (n = 39) and no mortality was observed. Operation time, surgeons experience and hospital stay differed considerably between hospital categories.Conclusions: Elective sigmoid resection for diverticulitis in Switzerland was mainly performed laparoscopically with low postoperative morbidity. Different practices and outcomes between institutions were observed.

Published
2021

39. Choreo‐Athetosis and Ataxia as Leading Features in a Case of Erdheim‐Chester Disease

Author

Francesco Motolese, Anna Crescenzi, Carlo Cosimo Quattrocchi, Vincenzo Di Lazzaro, Massimo Marano, Giovanni Cirillo, Antonio Todisco, Marano, M., Todisco, A., Motolese, F., Quattrocchi, C. C., Crescenzi, A., Cirillo, G., and Di Lazzaro, V.

Subjects
Athetosis, medicine.medical_specialty, Ataxia, business.industry, Case Reports, medicine.disease, Dermatology, BRAF, histiocytosi, Histiocytosis, spinocerebellar ataxia, Neurology, Erdheim–Chester disease, Huntington's disease (HD), medicine, Spinocerebellar ataxia, vemurafenib, neurodegeneration with brain iron accumulation (NBIA), Neurology (clinical), medicine.symptom, Vemurafenib, business, medicine.drug
Published
2020
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40. A rare cause of axial worsening in Parkinson’s disease: A case of myasthenic pseudo-parkinsonism

Author

Lazzaro di Biase, Alessio Pepe, Vincenzo Di Lazzaro, Massimo Marano, Jacopo Lanzone, and Alessandro Di Santo

Subjects
Male, Pediatrics, medicine.medical_specialty, Parkinson's disease, Electromyography, business.industry, Parkinsonism, Parkinson Disease, General Medicine, medicine.disease, Myasthenia gravis, Progressive supranuclear palsy, Ophthalmoparesis, Myasthenia Gravis, Disease Progression, medicine, Humans, Surgery, Neurology (clinical), medicine.symptom, Head drop, business, Fatigue, Aged
Published
2019
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41. Dupilumab-Associated Blepharoconjunctivits with Giant Papillae

Author

Douglas R. Lazzaro and Filippos Vingopoulos

Subjects
Difluprednate, medicine.medical_specialty, business.industry, medicine.drug_class, Dry eyes, General Medicine, Atopic dermatitis, 030204 cardiovascular system & hematology, medicine.disease, Dermatology, Dupilumab, eye diseases, Eyelid swelling, 03 medical and health sciences, 0302 clinical medicine, 030221 ophthalmology & optometry, medicine, Severe atopic dermatitis, Corticosteroid, sense organs, business, Dexamethasone, medicine.drug
Abstract

Purpose To describe a case of severe dupilumab-associated blepharoconjunctivitis with giant papillae treated with high potency corticosteroid eyedrops, without discontinuing or reducing dupilumab therapy. Case report A 22-year-old Latin American female with a long history of severe atopic dermatitis (AD) with no ocular involvement presented 20 weeks after starting treatment with dupilumab injections with blurry vision, multiple chalazia, eyelid swelling and severe conjunctival injection in both eyes. She also reports having a hordeolum 2 months prior and severely dry eyes starting 2 weeks prior. Slit-lamp examination revealed severe conjunctivitis with macroscopically visible giant papillae in the right lower tarsal conjunctiva. The diagnosis of severe dupilumab-associated blepharoconjunctivitis was made and difluprednate 0.05% eyedrops two times a day for 7 days was initiated. Given the severity of her AD and her marked skin improvement with dupilumab, it was decided to continue dupilumab without reducing the dose. At 2-day follow-up, conjunctival injection had markedly improved, and at 2-month follow-up, her examination was unremarkable. Currently, our patient only uses dexamethasone 0.1% drops few times a week as per needed for occasional eye irritation. Conclusion As dupilumab injections begin to claim a rightful place in medicine, the ophthalmic community may start encountering dupilumab-associated ocular surface disease all more often and potentially play an important role in identifying, characterizing and treating the adverse ocular effects from this novel medication.

Published
2020
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42. Tuning Frequencies Across Leads with Interleaving Deep Brain Stimulation to Treat Asymmetric Tremor in Parkinson’s Disease

Author

Riccardo Antonio Ricciuti, Manuela Pilleri, Massimo Marano, Vincenzo Di Lazzaro, Francesco Motolese, and Daniele Marruzzo

Subjects
Internal capsule, Parkinson's disease, Deep brain stimulation, Interleaving, business.industry, medicine.medical_treatment, General Medicine, medicine.disease, Neuromodulation (medicine), Subthalamic nucleus, Neurology, Medicine, Neurology (clinical), business, Neuroscience
Published
2020
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43. Assessment of Motor Impairments in Early Untreated Parkinson's Disease Patients: The Wearable Electronics Impact

Author

Franco Giannini, Antonio Pisani, Mariachiara Ricci, Giovanni Saggio, Giulia Di Lazzaro, and Nicola Biagio Mercuri

Subjects
Adult, Male, medicine.medical_specialty, Parkinson's disease, Movement, 0206 medical engineering, Wearable computer, Health Informatics, 02 engineering and technology, Newly diagnosed, Settore ING-INF/01 - Elettronica, Wearable Electronic Devices, 03 medical and health sciences, wearable technology, 0302 clinical medicine, Physical medicine and rehabilitation, Atmospheric measurements, Health Information Management, Accelerometry, Humans, Medicine, Electrical and Electronic Engineering, signal processing, Wearable technology, Aged, Monitoring, Physiologic, Aged, 80 and over, business.industry, motion analysis, Healthy subjects, Novelty, Parkinson Disease, Signal Processing, Computer-Assisted, Motor impairment, Equipment Design, Middle Aged, IMU, machine learning, medicine.disease, 020601 biomedical engineering, Computer Science Applications, Female, business, 030217 neurology & neurosurgery
Abstract

Objective: The complex nature of Parkinson's disease (PD) makes difficult to rate its severity, mainly based on the visual inspection of motor impairments. Wearable sensors have been demonstrated to help overcoming such a difficulty, by providing objective measures of motor abnormalities. However, up to now, those sensors have been used on advanced PD patients with evident motor impairment. As a novelty, here we report the impact of wearable sensors in the evaluation of motor abnormalities in newly diagnosed, untreated, namely de novo , patients. Methods: A network of wearable sensors was used to measure motor capabilities, in 30 de novo PD patients and 30 healthy subjects, while performing five motor tasks. Measurement data were used to determine motor features useful to highlight impairments and were compared with the corresponding clinical scores. Three classifiers were used to differentiate PD from healthy subjects. Results: Motor features gathered from wearable sensors showed a high degree of significance in discriminating the early untreated de novo PD patients from the healthy subjects, with 95% accuracy. The rates of severity obtained from the measured features are partially in agreement with the clinical scores, with some highlighted, though justified, exceptions. Conclusion: Our findings support the feasibility of adopting wearable sensors in the detection of motor anomalies in early, untreated, PD patients. Significance: This work demonstrates that subtle motor impairments, occurring in de novo patients, can be evidenced by means of wearable sensors, providing clinicians with instrumental tools as suitable supports for early diagnosis, and subsequent management.

Published
2020
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44. Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction

Author

Thomas M. Drake, Matthew J. Lee, Adele E. Sayers, John Abercrombie, Austin Acheson, Derek Alderson, Iain Anderson, Mike Bradburn, Michael Davies, Zaed Hamady, Daniel Hind, Marianne Hollyman, Sarah Hare, Ellen Lee, John Northover, Christopher Lewis, Paul J. Marriott, Nick Maynard, Malcolm McFall, Aravinth Muragananthan, David Murray, Pritam Singh, Gillian Tierney, Azmina Verjee, Ciaran Walsh, Jonathan RL. Wild, Timothy Wilson, S. Abbott, Y. Abdulaal, S. Afshar, M. Akhtar, D. Anderson, S. Appleton, D. Bandyopadhyay, G. Bashir, N. Behar, S. Bhandari, G. Branagan, R. Boulton, C. Borg, G. Bouras, J. Boyle, H. Brewer, L. Brown, C. Briggs, M. Cartmell, S. Chan, N. Chandratreya, P. Conaghan, J. Cornish, D. Cotton, P. Coyne, J. Crozier, T. Cook, P. Cunha, N. Curtis, A. Day, S. Dayal, R. Dennis, P. Dent, H. Dowson, R. Fallaize, S. Farag, M. El Farran, G. Faulkner, P. Giordano, T. Grey, V. Halahakoon, J. Hannay, A. Harikrishnan, S. Holtham, P. Hawkin, C. Hall, L. Hancock, J. Hartley, F. Howse, R. Kallam, G. Kakaniaris, S. Kelly, S. Lockwood, D. Leinhardt, B. Levy, R. Lal, T. Lazim, J. Lund, R. Lunevicius, P. Mathur, K. Maude, D. McArthur, B. McIlroy, A. Miles, S. Moug, M. Mondragon-Pritchard, D. Messenger, M. Mullan, A. Myers, K. Muhammad, C. Mason, J. Sarveswaran, V. Shatkar, B. Singh, B. Skelly, S. Subramonia, M. Swinscoe, B. Thava, C. Thorn, S. Panagiotopoulos, P. Patel, J. Phillips, I. Peristerakis, A. Qureshi, M. Saunders, P. Shah, A. Sheel, S. Siddiqui, P. Skaife, N. Smart, I. Smith, L. Stevenson, N. Stylianides, J. Steinke, B. Stubbs, R. Thompson, M. Varcada, D. Vimalachandran, I. Virlos, J. Watfah, N. Watson, M. Walker, N. Ventham, H. West, J. Wilson, S. Wijeyekoon, J. Ah-Chuen, T. Ahmed, F. Akram, E. Aldred, A. Ali, M. Aly, A. Amajuoyi, V. Amin, A. Andreou, A. Ansari, R. Ardley, F. Arshad, O. Ashour, A. Asour, F. Ayoub, H. Azeem, B. Azhar, C. Baillie, J. Barker, B. Barkham, R. Baron, J. Barrie, E. Barry-Yarrow, N. Battersby, G. Bazoua, C. Berger, S. Bhasin, S. Biggs, C. Bisset, N. Blencowe, A. Boddy, C. Boereboom, M. Bogdan, R. Bogle, P. Bohra, H. Bolkan, M. Boyer, J. Broadhurst, E. Brown, J. Brown, K. Burns, K. Butcher, C. Capper, T. Cash, J. Chapman, S. Chapman, A. Charalabopoulos, C. Cheek, S. Chok, W. Choong, J. Chowdhury, P. Coe, G. Conn, N. Cook, S. Cooper, C. Cox, R. Crook, G. Cuffolo, L. da Silva, B. Das, M. Davenport, J. Davies, T. Davies, S. Dean, G. Demetriou, F. Dengu, H. Dent, G. Di Benedetto, S. Dindyal, E. Donnelly, E. Douka, C. Downham, H. Edent, K. Edgerton, M. El-Sharif, O. Elamin, N. Elsaid, J. Evans, M. Evans, R. Ewe, A. Ewing, H. Ferguson, O. Fisher, J. Fletcher, A. Forouzanfar, A. Foster, R. Fox, N. Francis, V. Fretwell, D. Fung, E. Gammeri, J. Garnham, A. Geraghty, A. Gilbert, M. Gill, M. Gillespie, J. Glasbey, A. Golder, N. Green, E. Groundwater, T. Grove, H. Habib, J. Haddow, C. Halkias, A. Hampson, T. Hanna, R. Harries, K. Harvey, J. Hawkins, R. Healy, R. Heartshorne, S. Heller, L. Hendra, P. Herrod, N. Heywood, G. Hicks, P. Ng, C. Hope, P. Hopley, T. Hossain, S. Hossaini, T. Hubbard, A. Humphreys, H. Ikram, M. Ioannis, M. Iqbal, J. Jatania, P. Jenkinson, S. Jokhan, A. Jones, C. Jones, L. Jones, H. Joshi, K. Joshi, M. Joy, P. Jull, E. Kane, R. Kanitkar, S. Kauser, F. Kazmi, M. Kedrzycki, J. Kendall, T. Khan, G. King, A. Kisiel, C. Kitsis, I. Kolawole, S. Kosasih, A. Kosti, A. Kotb, A. Lau, G. Lafaurie, A. Lazzaro, R. Lefroy, H. Lennon, K. Leong, E. Lim, J. Lim, S. Lindley, D. Liu, P. Lloyd, D. Locker, C. Lowe, A. Lunt, S. Lutfi, A. Luther, S. Luwemba, P. Mahankali-Rao, D. Mai, S. Majid, A. Malik, N. Manu, R. Mapara, C. Martin, J. Martin, L. Massey, J. Mathias, S. McCain, S. McCluney, A. McNair, P. Mekhail, J. Merchant, L. Merker, S. Mir, P. Mistry, V. Miu, M. Moat, E. Mohamed, I. Mohamed, N. Moore, L. Moretti, H. Morris, T. Morrison, J. Moss, D. Mountford, R. Moynihan, D. Muldoon-Smith, J. Mulholland, E. Murgitroyd, K. Murugaiyan, I. Mykoniatis, G. Nana, T. Nash, A. Nassar, R. Newton, K. Nguyen, F. Nicholas, M. Noor, J. Nowers, C. Nugent, A. Nunn, J. O'Callaghan, R. O'Hara, A. O'Neill, J. Olivier, D. Osei-Bordom, L. Osgood, B. Panchasara, R. Parks, H. Patel, K. Pawelec, C. Payne, K. Pearson, G. Perin, B. Petronio, L. Phelan, C. Pisaneschi, J. Pitt, L. Ponchietti, A. Powell, A. Powell-Chandler, N. Pranesh, V. Proctor, N. Qureshi, M. Rahman, Z. Rai, S. Ramcharan, K. Rangarajan, M. Rashid, H. Reader, A. Rehman, S. Rehan, C. Rengifo, N. Richardson, A. Robinson, D. Robinson, B. Rossi, F. Rutherford, I. Sadien, T. Saghir, K. Sahnan, G. Salahia, B. Scott, K. Scott, A. Seager, S. Seal, E. Sezen, F. Shaban, M. Shahmohammadi, A. Shamsiddinova, S. Shankar, A. Sharpe, T. Shields, M. Shinkwin, J. Shurmer, A. Siddika, R. Simson, S. Singh, J. Sivaraj, A. Skinner, C. Smart, F. Smith, R. Smith, A. Sreedhar, E. Stewart-Parker, M. Stott, N. Symons, T. Taj, J. Tam, K. Tan, S. Tani, D. Tao, K. Thippeswamy, C. Thomas, E. Thompson, C. Thompson-Reil, F. Tongo, G. Toth, A. Turnbull, J. Turnbull, T. Wade, A. Wafi, K. Waite, N. Walker, T. Walker, U. Walsh, S. Wardle, R. Warner, J. Watt, J. Watts, J. Wayman, C. Weegenaar, M. West, M. Whyler, L. Whitehurst, M. Wiggans, G. Williams, R. Williams, A. Williamson, J. Williamson, A. Winter, L. Wolpert, J. Wong, G. van Boxel, E. Yeap, S. Zaman, B. Zappa, D. Zosimas, O. Anderson, A. Athem, M. Athersmith, T. Badenoch, S. Barker, S. Bellam, T. Boam, M. Boland, L. Blake, O. Brown, M. Butler, B. Byrne, L. Campbell, M. Chow, K. Da Costa, J. Cutting, M. Deputy, L. Devoto, P. Doody, N. Ekpete, M. Eljaafari, K. Exarchou, M. Faoury, E. Farinella, C. Gill, M. Goh, T. Gregoir, S. Growcott, S. Gunasekaran, G. Harris, R. Heard, B. Hobson, N. Iqbal, R. Jain, P. Kang, M. Khan, S. Korambayil, S. Kouris, K. Kshatriya, S. Kumar, K. Lee, S. Mahroof, K. Malik, K. Mann, S. Mansour, R. Martin, S. McKay, N. McKinley, D. McWhirter, K. Mellor, A. Mishra, K. Mockford, V. Morrison-Jones, C. Ng, R. Nunn, S. O'Neill, O. Oke, N. Obeid, R. Patel, S. Patel, K. Plunkett-Reed, M. Pouzi, S. Pywell, E. Richards, P. Sinclair, N. Slim, G. Spence, M. Swinkin, W. Tahir, K. Takacs, N. Tanner, M. Taylor, C. Valero, M. Venn, M. Venza, T. Yeong, and Nicola S. Fearnhead

Subjects
Male, medicine.medical_specialty, Colorectal cancer, 030230 surgery, Malignancy, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Internal medicine, Intestinal Neoplasms, Intestine, Small, Humans, Medicine, Prospective Studies, Aged, business.industry, Mortality rate, Hazard ratio, Cancer, General Medicine, medicine.disease, United Kingdom, Bowel obstruction, Oncology, Abdominal Neoplasms, 030220 oncology & carcinogenesis, Cohort, Female, Surgery, business, Intestinal Obstruction, Cohort study
Abstract

Introduction\ud \ud Patients with cancer who develop small bowel obstruction are at high risk of malnutrition and morbidity following compromise of gastrointestinal tract continuity. This study aimed to characterise current management and outcomes following malignant small bowel obstruction.\ud \ud \ud \ud Methods\ud \ud A prospective, multicentre cohort study of patients with small bowel obstruction who presented to UK hospitals between 16th January and 13th March 2017. Patients who presented with small bowel obstruction due to primary tumours of the intestine (excluding left-sided colonic tumours) or disseminated intra-abdominal malignancy were included. Outcomes included 30-day mortality and in-hospital complications. Cox-proportional hazards models were used to generate adjusted effects estimates, which are presented as hazard ratios (HR) alongside the corresponding 95% confidence interval (95% CI). The threshold for statistical significance was set at the level of P ≤ 0.05 a-priori.\ud \ud \ud \ud Results\ud \ud 205 patients with malignant small bowel obstruction presented to emergency surgery services during the study period. Of these patients, 50 had obstruction due to right sided colon cancer, 143 due to disseminated intraabdominal malignancy, 10 had primary tumours of the small bowel and 2 patients had gastrointestinal stromal tumours. In total 100 out of 205 patients underwent a surgical intervention for obstruction. 30-day in-hospital mortality rate was 11.3% for those with primary tumours and 19.6% for those with disseminated malignancy. Severe risk of malnutrition was an independent predictor for poor mortality in this cohort (adjusted HR 16.18, 95% CI 1.86 to 140.84, p = 0.012). Patients with right-sided colon cancer had high rates of morbidity.\ud \ud \ud \ud Conclusions\ud \ud Mortality rates were high in patients with disseminated malignancy and in those with right sided colon cancer. Further research should identify optimal management strategy to reduce morbidity for these patient groups.

Published
2019
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45. Epilepsy-associated stigma from the perspective of people with epilepsy and the community in Italy

Author

Roberta De Mojà, Livia Quintiliani, Vincenzo Di Lazzaro, Lorenzo Ricci, Jacopo Lanzone, Martina Ulivi, Giovanni Assenza, and Mario Tombini

Subjects
Adult, Male, media_common.quotation_subject, Social Stigma, Stigma (botany), Affect (psychology), Young Adult, 03 medical and health sciences, Behavioral Neuroscience, Epilepsy, 0302 clinical medicine, Quality of life, Seizures, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, Aged, media_common, Stereotyping, Depression, Perspective (graphical), Beck Depression Inventory, Middle Aged, medicine.disease, Mood, Italy, Neurology, Feeling, Quality of Life, Anticonvulsants, Female, Independent Living, Neurology (clinical), Psychology, Social Adjustment, 030217 neurology & neurosurgery, Clinical psychology
Abstract

The objective of this study was to assess the stigma related to epilepsy from the perspective of people with epilepsy (PWE) and from the Italian community (Rome and central Italy); moreover, the impact of the perceived stigma on the mood and quality of life of patients was also evaluated.We consecutively enrolled 100 PWE and 202 nonepileptic subjects (NES). Both PWE and NES completed an Italian version of the Stigma Scale of Epilepsy (SSE), a 24-items questionnaire that has been demonstrated to allow the quantification of the stigma perception by patients and people from the community. Moreover, the PWE fulfilled a 3-item Jacoby's Stigma Scale, the Quality of Life in Epilepsy-31 (QOLIE-31 [Q3])), and Beck Depression Inventory II (BDI-II) questionnaires for the evaluation of the quality of life and depressive symptoms. The results of the SSE were correlated with clinical and demographic details of PWE and NES, as well as the Q31 and BDI-II scores in PWE.The SSE scores were significantly higher in NES with respect to PWE (respectively 47.1 vs 39.5, p .001). Forty-two percent of PWE reported feeling stigmatized, with 5% reporting feeling highly stigmatized. In PWE, the perceived stigma was not correlated with seizure frequency but was significantly associated with worse quality of life, more severe depressive symptoms, and higher number of AEDs. The multiple regression analysis showed that the quality-of-life overall score and Q31 subscale exploring "social function" are the most significant predictors of stigma.By using an Italian translation of the SSE questionnaire, even if we cannot consider our sample representative of the whole Italian community our study evidenced higher rates of stigma related to epilepsy in NES than in PWE. The PWE still experience feelings of stigmatization strongly correlated with higher depressive symptoms and worse quality of life that has proven to be the most significant predictor of stigma. Finally, seizure frequency does not affect the perceived stigma, which is instead significantly influenced by antiepileptic therapy.

Published
2019
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46. First detection of TBE virus in ticks and sero-reactivity in goats in a non-endemic region in the southern part of Switzerland (Canton of Ticino)

Author

Christian Beuret, Nicola Bomio-Pacciorini, Mario Lazzaro, Rahel Ackermann, Ottavio Beretta, Simona Casati Pagani, Giorgio Merlani, Donata Hoffmann, Christine Klaus, and Simona Frigerio Malossa

Subjects
Nymph, 0301 basic medicine, Veterinary medicine, Ixodes ricinus, 030231 tropical medicine, Antibodies, Viral, Real-Time Polymerase Chain Reaction, Microbiology, Encephalitis Viruses, Tick-Borne, 03 medical and health sciences, 0302 clinical medicine, Seroepidemiologic Studies, parasitic diseases, Prevalence, medicine, Animals, Humans, Seroprevalence, Ixodes, biology, Goats, Ricinus, Antibody titer, Sequence Analysis, DNA, medicine.disease, biology.organism_classification, Tick Infestations, 030104 developmental biology, Infectious Diseases, Insect Science, RNA, Viral, Parasitology, Metagenomics, Seasons, Flock, Encephalitis, Tick-Borne, Switzerland, Encephalitis
Abstract

In Switzerland, tick-borne encephalitis (TBE) is a notifiable human disease with an average of 210 cases per year in the last 10 years (2008-2017). A national surveillance conducted in 2009 reported a prevalence of 0.46% for tick-borne encephalitis virus (TBEV) detected in ticks, which is in accordance with the prevalences found in Europe from 0.1%-5%. The Canton of Ticino in the southern part of Switzerland, geographically separated from the rest of the national territory by the Alps, is considered a non-endemic region, as no autochthonous clinical cases and no TBEV presence in ticks have ever been reported. In order to understand the epidemiological situation in Ticino, we conducted a large study investigating the TBEV presence in field-collected Ixodes ricinus ticks and in goat and human sera. Goats and sheep were considered as sentinel hosts showing persistence of antibodies also after 28 months in the absence of symptoms; this longevity supports the data validity to characterize an area with the TBEV status. The goat sera collection was composed of a total of 662 samples from 37 flocks. The total seroprevalence was 14.6%. 39 (40%) of the 97 SNT-positive samples showed an antibody titer ≥ 1:120 which indicates recent infection and consequently the probable presence of active foci among the pastures frequented by the goats belonging to 10 flocks. In total, 51 owners participated in the study and all were TBEV antibody-free. A total of 12'052 I. ricinus ticks (nymphs and adults) were collected and 1'371 pools were tested using quantitative real-time RT-PCR. Only one positive pool was reported with a prevalence of 0.35%. Metagenomic analysis revealed that the TBEV strain isolated from the ticks collected in Ticino is closely related to 2 strains coming from the Canton of Valais (99.1% and 98.7% identity, respectively), a neighbouring region of the Canton of Ticino. These two Cantons are close together but separated by high mountains (Alps) and we hypothesize that infected ticks were transported by wild animals from Valais into the Valle Maggia in Ticino where we found positive ticks. In conclusion, our data show for the first time the presence of TBEV in ticks and the related sero-reactivity in goats, confirming the presence of TBEV in the environment of the Canton of Ticino. Further surveillance studies will have to be conducted to follow the persistence of TBEV in this region.

Published
2019
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47. Knowledge of congenital cytomegalovirus (CMV) in pregnant women in Australia is low, and improved with education

Author

Mai Linh Vo, Antonia W. Shand, Amanda Lazzaro, Anne Lainchbury, Natasha Nassar, William D. Rawlinson, Justin Zeltzer, and Kate Daly

Subjects
Adult, Health Knowledge, Attitudes, Practice, Hand washing, medicine.medical_specialty, Hearing loss, Congenital cytomegalovirus infection, Cytomegalovirus, 03 medical and health sciences, 0302 clinical medicine, Patient Education as Topic, Pregnancy, medicine, Humans, 030212 general & internal medicine, Pregnancy Complications, Infectious, 030219 obstetrics & reproductive medicine, Risk behaviour, business.industry, Obstetrics, Transmission (medicine), Australia, Infant, Newborn, Obstetrics and Gynecology, General Medicine, medicine.disease, Infectious Disease Transmission, Vertical, Increasing risk, Cross-Sectional Studies, Cytomegalovirus Infections, Female, Health education, medicine.symptom, business
Abstract

Background Cytomegalovirus (CMV) is the most common congenital infection and can cause hearing loss and neurodevelopmental disability in infected infants. International research shows women have limited knowledge about CMV. Aims To assess pregnant women's knowledge and attitudes about CMV before and after provision of information. Materials and methods Cross-sectional survey of pregnant women between November 2017 and February 2018 at two Australian hospitals. Participating women completed an initial survey on maternal characteristics, knowledge of infections, and CMV risk behaviours. Participants were then given an information leaflet and completed a follow-up survey. Results Four hundred and fifty-seven women completed the initial survey, of whom 73/457 (16%) had heard of CMV. Behaviours increasing risk of CMV transmission were common: 58% reported regularly kissing their child on the lips; 57% did not always wash their hands after changing a wet nappy. Knowledge about CMV significantly improved after reading the leaflet in the 145 women completing the follow-up survey. More women correctly identified that CMV could cause deafness in a baby (35% before, 85% after), was spread by saliva (38% vs 94%) or urine (27% vs 86%) and prevented by hand-washing (55% vs 99%; all P Conclusion Knowledge about CMV was low in pregnant women. An educational leaflet was effective in improving knowledge.

Published
2019
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48. CSF α-synuclein inversely correlates with non-motor symptoms in a cohort of PD patients

Author

Giulia Di Lazzaro, Antonio Pisani, Vito Luigi Colona, Benedetta Biticchi, Tommaso Schirinzi, Sergio Bernardini, Giulia Maria Sancesario, and Nicola Biagio Mercuri

Subjects
Male, 0301 basic medicine, Oncology, medicine.medical_specialty, Parkinson's disease, Non-motor symptoms, 03 medical and health sciences, α-synuclein, 0302 clinical medicine, Internal medicine, medicine, CSF biomarkers, Humans, Aged, business.industry, Parkinson Disease, Middle Aged, medicine.disease, Cross-Sectional Studies, 030104 developmental biology, Neurology, Tau phosphorylation, Potential biomarkers, Cohort, Csf biomarkers, alpha-Synuclein, Non motor, Settore MED/26 - Neurologia, Female, α synuclein, Neurology (clinical), Geriatrics and Gerontology, business, Biomarkers, 030217 neurology & neurosurgery
Abstract

Although non-motor symptoms are early and disabling features of PD, reliable predictors and effective therapies are not yet available. Measurement of CSF proteins mirroring brain pathology is currently utilized for diagnostic and prognostic clustering of patients with neurodegenerative diseases but the association with non-motor symptoms in PD has not been evaluated. Here we performed a cross-sectional correlation study, aimed at identifying potential fluid biomarkers for non-motor symptoms in PD.CSF levels of 42-amyloid-β, total and phosphorylated tau, α-synuclein and reciprocal ratios were measured in a group of 46 PD patients compared to 37 gender/age-matched controls and correlated with standard clinical scores for motor and non-motor features.We observed that α-synuclein levels were reduced in PD (p 0.05, AUC = 0.8; p 0.05) and inversely correlated with non-motor symptoms scale total score and items 3 and 9, even independently from age, disease duration, motor impairment severity and dopaminergic treatment (T = -2,9, p 0.014; T = -3.6, p 0.05; item 9: T = -2.1, p 0.05, respectively).Our findings suggest that the reduction of CSF α-synuclein may parallel degeneration of non-dopaminergic systems. Although confirmatory studies are necessary, CSF α-synuclein reduction might represent a potential biomarker to monitor non-motor symptoms burden.

Published
2019
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49. A European Observational Study to Evaluate the Safety and the Effectiveness of Safinamide in Routine Clinical Practice: The SYNAPSES Trial

Author

Abbruzzese, G., Kulisevsky, J., Bergmans, B., Gomez-Esteban, J. C., Kagi, G., Raw, J., Stefani, A., Warnecke, T., Jost, W. H., Bourgeois, P., Cras, P., de Klippel, N., Dethy, S., Franco, G., Garraux, G., Geens, K., Jacquerye, P., Jeanjean, A., Santens, P., Supiot, F., van der Linden, C., Blersch, W. K., Delf, M., Hellwig, B., Herbst, H. P., Kupsch, A., Lang, M., Muhlack, S., Nastos, I., Oehlwein, C., Schlegel, E., Schwarz, J., Woitalla, D., Aguggia, M., Avarello, T., Barone, P., Baruffaldi, R., Belgrado, E., Bentivoglio, A. R., Bosco, D., Calabresi, P., Callegarini, C., Cannas, A., Centonze, D., Ceravolo, R., Colosimo, C., Comi, C., Contardi, S., Cortelli, P., Cossu, G., D'Amelio, M., de Pandis, M. F., Denaro, A., Di Lazzaro, V., Fabbrini, G., Gasparoli, E., Guidi, M., Iliceto, G., Lopiano, L., Manganotti, P., Marconi, R., Marini, C., Marsala, S. Z., Mauri, M., Moleri, M., Monge, A., Morgante, F., Negrotti, A., Nordera, G., Onofrj, M., Pacchetti, C., Padovani, A., Pontieri, F. E., Priori, A., Quatrale, R., Sensi, M., Tamma, F., Tessitore, A., Tinazzi, M., Vitale, C., Volonte, M. A., Zappia, M., Zecchinelli, A. L., Arbelo Gonzalez, J. M., Bayes, A., Blazquez, M., Calopa Garriga, M., Callen, A., Campos Arillo, V., Cubo, E., de Fabregues, O., Escalante Arroyo, S., Espinosa Rosso, R., Esquivel Lopez, A., Freire, E., Garcia Cobos, E., Garcia Moreno, J. M., Gonzalez-Ardura, J., Grandas Perez, F., Kurtis, M., Juni, J., Legarda, I., Leiva, C., Lopez Aristegui, N., Lopez Manzanares, L., Lozano, J. J., Luquin, M. R., Martinez Castrillo, J. C., Marti Domenech, M. J., Martinez, I., Mata, M., Mir Rivera, P., Pascual Sedano, B., Rodriguez Oroz, M. C., Rodriguez Uranga, J. J., Sanchez, S., Santos Garcia, D., Solano, B., Vaamonde Gamo, J., Accolla, E., Bohlhalter, S., Kalin, A., Michelis, J., Carrol, C., Henderson, E., Raha, S., Silva, N., Silverdale, M., Universidad de Sevilla. Departamento de Medicina, Abbruzzese G., Kulisevsky J., Bergmans B., Gomez-Esteban J.C., Kagi G., Raw J., Stefani A., Warnecke T., Jost W.H., Bourgeois P., Cras P., de Klippel N., Dethy S., Franco G., Garraux G., Geens K., Jacquerye P., Jeanjean A., Santens P., Supiot F., van der Linden C., Blersch W.K., Delf M., Hellwig B., Herbst H.P., Kupsch A., Lang M., Muhlack S., Nastos I., Oehlwein C., Schlegel E., Schwarz J., Woitalla D., Aguggia M., Avarello T., Barone P., Baruffaldi R., Belgrado E., Bentivoglio A.R., Bosco D., Calabresi P., Callegarini C., Cannas A., Centonze D., Ceravolo R., Colosimo C., Comi C., Contardi S., Cortelli P., Cossu G., D'Amelio M., de Pandis M.F., Denaro A., Di Lazzaro V., Fabbrini G., Gasparoli E., Guidi M., Iliceto G., Lopiano L., Manganotti P., Marconi R., Marini C., Marsala S.Z., Mauri M., Moleri M., Monge A., Morgante F., Negrotti A., Nordera G., Onofrj M., Pacchetti C., Padovani A., Pontieri F.E., Priori A., Quatrale R., Sensi M., Tamma F., Tessitore A., Tinazzi M., Vitale C., Volonte M.A., Zappia M., Zecchinelli A.L., Arbelo Gonzalez J.M., Bayes A., Blazquez M., Calopa Garriga M., Callen A., Campos Arillo V., Cubo E., de Fabregues O., Escalante Arroyo S., Espinosa Rosso R., Esquivel Lopez A., Freire E., Garcia Cobos E., Garcia Moreno J.M., Gonzalez-Ardura J., Grandas Perez F., Kurtis M., Juni J., Legarda I., Leiva C., Lopez Aristegui N., Lopez Manzanares L., Lozano J.J., Luquin M.R., Martinez Castrillo J.C., Marti Domenech M.J., Martinez I., Mata M., Mir Rivera P., Pascual Sedano B., Rodriguez Oroz M.C., Rodriguez Uranga J.J., Sanchez S., Santos Garcia D., Solano B., Vaamonde Gamo J., Accolla E., Bohlhalter S., Kalin A., Michelis J., Carrol C., Henderson E., Raha S., Silva N., and Silverdale M.

Subjects
Research Report, Male, 0301 basic medicine, Benzylamines, Parkinson's disease, Outcome Assessment, Comorbidity, Disease, Real-life evaluation, chemistry.chemical_compound, 0302 clinical medicine, Outcome Assessment, Health Care, 80 and over, MAO-B inhibitor, Aged, 80 and over, Safinamide, education.field_of_study, Alanine, Mental Disorders, Parkinson Disease, Middle Aged, Aged, Drug-Related Side Effects and Adverse Reactions, Europe, Female, Follow-Up Studies, Humans, Monoamine Oxidase Inhibitors, Retrospective Studies, Settore MED/26 - NEUROLOGIA, Erratum, Cohort study, medicine.medical_specialty, Population, MEDLINE, 03 medical and health sciences, Cellular and Molecular Neuroscience, Internal medicine, medicine, Adverse effect, education, business.industry, medicine.disease, Health Care, 030104 developmental biology, chemistry, Parkinson’s disease, Observational study, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background: Safinamide modulates both dopaminergic and glutamatergic systems with positive effects on motor and non-motor symptoms of Parkinson's disease (PD). The drug utilization study SYNAPSES was designed to investigate the use of safinamide in routine clinical practice, as recommended by the European Medicines Agency. Objective: To describe the occurrence of adverse events in PD patients treated with safinamide in real-life conditions. Methods: The SYNAPSES trial is an observational, European, multicenter, retrospective-prospective cohort study. Patients were followed up to 12 months with analyses performed in the overall population and in patients aged >75 years, with relevant comorbidities and with psychiatric conditions. Results: Of the 1610 patients included, 82.4% were evaluable after 12 months with 25.1% of patients >75 years, 70.8% with relevant comorbidities and 42.4% with psychiatric conditions. During observation 45.8% patients experienced adverse events, 27.7% patients had adverse drug reactions and 9.2% patients had serious adverse events. The adverse events were those already described in the patients' information leaflet. The majority were mild or moderate and completely resolved and no differences were detected between the subgroup of patients. Clinically significant improvements were seen in the UPDRS motor score and in the UPDRS total score in >= 40% of patients, according to the criteria developed by Shulman et al. Conclusion: The SYNAPSES study confirms the good safety profile of safinamide even in special groups of patients. Motor complications and motor scores improved with clinically significant results in the UPDRS scale maintained in the long-term.

Published
2022
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50. Immunity Profiling of COVID-19 Infection, Dynamic Variations of Lymphocyte Subsets, a Comparative Analysis on Four Different Groups

Author

Donatello Iacobone, Rita Laforgia, Angelo Cefalo, Luigi Vimercati, Francesco Inchingolo, Giancarla Pricolo, Pietro Distratis, Davide Palazzo, Felice Lorusso, Antonella Prudenzano, Van Hung Pham, Ciro Gargiulo Isacco, Kieu C. D. Nguyen, Sergey K. Aityan, Gianna Dipalma, Giuseppe Mancusi Materi, Angela Pezzolla, Orazio Catucci, Antonio Scarano, Diego Tomassone, Felice Amatulli, Alessio Danilo Inchingolo, Patrizia D’Errico, Rita Lazzaro, and Mario Giosuè Balzanelli

Subjects
Microbiology (medical), medicine.medical_specialty, Cellular immunity, Coronavirus disease 2019 (COVID-19), QH301-705.5, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), broncho-alveolar lavage fluid (BALF), coronavirus, cellular immunity, CD38, Microbiology, Gastroenterology, Article, Immunity, Virology, Internal medicine, medicine, Biology (General), Respiratory system, business.industry, SARS-CoV-2, humoral response, medicine.disease, Pneumonia, business, Lymphocyte subsets
Abstract

Background: A novel coronavirus (SARS-CoV-2)-induced pneumonia (COVID-19) emerged in December 2019 in China, spreading worldwide. The aim of the present investigation was to evaluate the immunological response and the clinical subset of peripheral lymphocyte subset alteration in COVID-19 infection. Methods: the study was conducted on four different clinical groups (n = 4; total n = 138). Each individual was assigned to different groups based on specific criteria evaluated at the admission such as fever, dyspnea, arterial blood gas analysis (ABG), oral-nasopharyngeal swab/RT-PCR, and thoracic CT-scan. Treatment was performed only after blood samples were collected from each patient (PP and PP) at day 1. The blood samples were analyzed and tested the same day (CBC and Flowcytometry). The positive–positive group (PP n = 45; F = 18/ M = 27; median age = 62.33), comprised individuals affected by COVID-19 who showed fever, dyspnea (ABG = pO2 < 60), confirmed positive by oral-nasopharyngeal swab/RT-PCR and with CT-scan showing ground-glass opacities. The negative–positive (NP; n = 37; F = 11/M = 26; median age = 75.94) or “COVID-like” group comprised individuals with fever and dyspnea (ABG = pO2 < 60), who tested negative to nasopharyngeal swab/RT-PCR, with CT-scans showing ground-glass opacities in the lungs. The negative–affected group (NA; n = 40; F = 14/M = 26; median age = 58.5) included individuals negative to COVID-19 (RT-PCR) but affected by different chronic respiratory diseases (the CT-scans didn’t show ground-glass opacities). Finally, the negative–negative group (NN; n = 16; F = 14/M = 2) included healthy patients (NN; n = 16; median age = 42.62). Data and findings were collected and compared. Results: Lymphocytes (%) cells showed a decline in COVID-19 patients. The subsets showed a significant association with the inflammatory status in COVID-19, especially with regard to increased neutrophils, T-killer, T-active, T-suppressor, and T-CD8+CD38+ in individuals belong to the either COVID-19 and Covid-like NP group. Conclusions: Peripheral lymphocyte subset alteration was associated with the clinical characteristics and progression of COVID-19. The level of sub-set cells T-lymphocytes (either high or low) and B-lymphocytes could be used as an independent predictor for COVID-19 severity and treatment efficacy.

Published
2021
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