394 results on '"La Cesa A"'
Search Results
52. Repeated courses of radiation treatment in an HER2‐positive breast cancer patient with diffuse brain metastases: A case report
- Author
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Silipigni, Sonia, primary, Ippolito, Edy, additional, Matteucci, Paolo, additional, Santo, Bianca, additional, Gangemi, Emma, additional, La Cesa, Annalisa, additional, Santini, Daniele, additional, Greco, Carlo, additional, and Ramella, Sara, additional
- Published
- 2020
- Full Text
- View/download PDF
53. The new micropatterned interdigitated electrode for selective assessment of the nociceptive system
- Author
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Di Stefano, Giulia, primary, Di Lionardo, Andrea, additional, La Cesa, Silvia, additional, Di Pietro, Giuseppe, additional, Fasolino, Alessandra, additional, Galosi, Eleonora, additional, Leone, Caterina, additional, Cruccu, Giorgio, additional, Marinelli, Lucio, additional, Leandri, Massimo, additional, and Truini, Andrea, additional
- Published
- 2020
- Full Text
- View/download PDF
54. Topographical distribution of warmth, burning and itch sensations in healthy humans: P1426
- Author
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Di Stefano, G., Leone, C., Biasiotta, A., Truini, A., La Cesa, S., and Cruccu, G.
- Published
- 2010
55. Mechanisms of pain in distal symmetric polyneuropathy. A combined clinical and neurophysiological study: P1422
- Author
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Biasiotta, A., La Cesa, S., Di Stefano, G., Inghilleri, M., Truini, A., and Cruccu, G.
- Published
- 2010
56. What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation
- Author
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Castelnuovo, Gianluca, Giusti, Emanuele Maria, Manzoni, Gian Mauro, Saviola, Donatella, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Maria Spatola, Chiara Anna, Rossi, Alessandro, Varallo, Giorgia, Novelli, Margherita, Villa, Valentina, Luzzati, Francesca, Cottini, Andrea, Lai, Carlo, Volpato, Eleonora, Cavalera, Cesare, Pagnini, Francesco, Tesio, Valentina, Castelli, Lorys, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Seitanidis, Ionathan, Ventura, Giuseppe, Capodaglio, Paolo, D'Aniello, Guido Edoardo, Scarpina, Federica, Brioschi, Andrea, Bigoni, Matteo, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Di Lernia, Daniele, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan, Wiederhold, Brenda Kay, Gaudio, Santino, Jackson, Jeffrey B., Tamburin, Stefano, Benedetti, Fabrizio, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiò, Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Dalla Toffola, Elena, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'Isola, Andrea, De Tanti, Antonio, D'Ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammò, Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, BIAGIO ANDREA, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, CARLO ADOLFO, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Castelnuovo, Gianluca, Giusti, Emanuele Maria, Manzoni, Gian Mauro, Saviola, Donatella, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Maria Spatola, Chiara Anna, Rossi, Alessandro, Varallo, Giorgia, Novelli, Margherita, Villa, Valentina, Luzzati, Francesca, Cottini, Andrea, Lai, Carlo, Volpato, Eleonora, Cavalera, Cesare, Pagnini, Francesco, Tesio, Valentina, Castelli, Lory, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Seitanidis, Ionathan, Ventura, Giuseppe, Capodaglio, Paolo, D'Aniello, Guido Edoardo, Scarpina, Federica, Brioschi, Andrea, Bigoni, Matteo, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Di Lernia, Daniele, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan, Wiederhold, Brenda Kay, Gaudio, Santino, Jackson, Jeffrey B., Tamburin, Stefano, Benedetti, Fabrizio, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiò, Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Dalla Toffola, Elena, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'Isola, Andrea, De Tanti, Antonio, D'Ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammò, Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, and Italian Consensus Conference on Pain in Neurorehabilitation
- Subjects
medicine.medical_specialty ,Clinical psychology ,Consensus conference ,Health psychology ,Neurorehabilitation ,Pain ,Placebo ,Placebo effect ,Neurologi ,consensus conference ,Analgesic ,Neurology ,Neurology (clinical) ,Context (language use) ,Review ,Settore M-PSI/08 - PSICOLOGIA CLINICA ,helath psychology ,lcsh:RC346-429 ,03 medical and health sciences ,0302 clinical medicine ,health psychology ,Fibromyalgia ,medicine ,pain ,030212 general & internal medicine ,lcsh:Neurology. Diseases of the nervous system ,neurorehabilitation ,Postherpetic neuralgia ,business.industry ,medicine.disease ,Complex regional pain syndrome ,Neuropathic pain ,placebo ,Physical therapy ,placebo effect ,clinical psychology ,business ,030217 neurology & neurosurgery ,Neuroscience - Abstract
Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy. Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy.
- Published
- 2018
57. Chromosome 4q35 haplotypes and DNA rearrangements segregating in affected subjects of 19 Italian families with facioscapulohumeral musculatur dystrophy (FSHD)
- Author
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Cacurri, S., Deidda, G., Piazzo, N., Novelletto, A., La Cesa, I., Servidei, S., Galluzzi, G., Wijmenga, C., Frants, R. R., and Felicetti, L.
- Published
- 1994
- Full Text
- View/download PDF
58. COX-2 expression in DCIS: correlation with VEGF, HER-2/neu, prognostic molecular markers and clinicopathological features
- Author
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Perrone, G, Santini, D, Vincenzi, B, Zagami, M, La Cesa, A, Bianchi, A, Altomare, V, Primavera, A, Battista, C, Vetrani, A, Tonini, G, and Rabitti, C
- Published
- 2005
59. Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation
- Author
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Castelnuovo, Gianluca, Giusti, Emanuele M., Manzoni, Gian Mauro, Saviola, Donatella, Gatti, Arianna, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Spatola, Chiara A. M., Corti, Stefania, Novelli, Margherita, Villa, Valentina, Cottini, Andrea, Lai, Carlo, Pagnini, Francesco, Castelli, Lorys, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Capodaglio, Paolo, D'aniello, Guido E., Scarpina, Federica, Brioschi, Andrea, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan G., Wiederhold, Brenda, Tamburin, Stefano, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiã², Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'isola, Andrea, De Tanti, Antonio, D'ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammã², Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Castelnuovo, Gianluca, Giusti, Emanuele M., Manzoni, Gian Mauro, Saviola, Donatella, Gatti, Arianna, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Spatola, Chiara A. M., Corti, Stefania, Novelli, Margherita, Villa, Valentina, Cottini, Andrea, Lai, Carlo, Pagnini, Francesco, Castelli, Lory, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Capodaglio, Paolo, D'Aniello, Guido E., Scarpina, Federica, Brioschi, Andrea, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan G., Wiederhold, Brenda, Tamburin, Stefano, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiã², Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'Isola, Andrea, De Tanti, Antonio, D'Ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammã², Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Castelnuovo G., Giusti E.M., Manzoni G.M., Saviola D., Gatti A., Gabrielli S., Lacerenza M., Pietrabissa G., Cattivelli R., Spatola C.A.M., Corti S., Novelli M., Villa V., Cottini A., Lai C., Pagnini F., Castelli L., Tavola M., Torta R., Arreghini M., Zanini L., Brunani A., Capodaglio P., D'Aniello G.E., Scarpina F., Brioschi A., Priano L., Mauro A., Riva G., Repetto C., Regalia C., Molinari E., Notaro P., Paolucci S., Sandrini G., Simpson S.G., Wiederhold B., Tamburin S., Agostini M., Alfonsi E., Aloisi A.M., Alvisi E., Aprile I., Armando M., Avenali M., Azicnuda E., Barale F., Bartolo M., Bergamaschi R., Berlangieri M., Berlincioni V., Berliocchi L., Berra E., Berto G., Bonadiman S., Bonazza S., Bressi F., Brugnera A., Brunelli S., Buzzi M.G., Cacciatori C., Calvo A., Cantarella C., Caraceni A., Carone R., Carraro E., Casale R., Castellazzi P., Castino A., Cerbo R., Chio A., Ciotti C., Cisari C., Coraci D., Toffola E.D., Defazio G., De Icco R., Del Carro U., Dell'Isola A., De Tanti A., D'Ippolito M., Fazzi E., Ferrari A., Ferrari S., Ferraro F., Formaglio F., Formisano R., Franzoni S., Gajofatto F., Gandolfi M., Gardella B., Geppetti P., Giammo A., Gimigliano R., Greco E., Ieraci V., Invernizzi M., Jacopetti M., La Cesa S., Lobba D., Magrinelli F., Mandrini S., Manera U., Marchettini P., Marchioni E., Mariotto S., Martinuzzi A., Masciullo M., Mezzarobba S., Miotti D., Modenese A., Molinari M., Monaco S., Morone G., Nappi R., Negrini S., Pace A., Padua L., Pagliano E., Palmerini V., Pazzaglia C., Pecchioli C., Picelli A., Porro C.A., Porru D., Romano M., Roncari L., Rosa R., Saccavini M., Sacerdote P., Schenone A., Schweiger V., Scivoletto G., Smania N., Solaro C., Spallone V., Springhetti I., Tassorelli C., Tinazzi M., Togni R., Torre M., Traballesi M., Tramontano M., Truini A., Tugnoli V., Turolla A., Vallies G., Verzini E., Vottero M., Zerbinati P., Giusti, Emanuele M, and Simpson, Susan G
- Subjects
medicine.medical_specialty ,lcsh:BF1-990 ,Psychological intervention ,Settore M-PSI/08 - PSICOLOGIA CLINICA ,Review ,03 medical and health sciences ,0302 clinical medicine ,psychological distress ,health psychology ,Chronic pain ,Clinical psychology ,Health psychology ,Neurorehabilitation ,Pain management ,Psychology (all) ,medicine ,Psychology ,psychology (all) ,030212 general & internal medicine ,General Psychology ,neurorehabilitation ,business.industry ,chronic pain ,clinical psychology ,pain management ,medicine.disease ,depression ,pain Treatment ,Settore MED/34 - Medicina Fisica e Riabilitativa ,lcsh:Psychology ,Migraine ,Physical therapy ,Anxiety ,Pain catastrophizing ,medicine.symptom ,business ,Psychosocial ,030217 neurology & neurosurgery ,clinical psychology, health psychology - Abstract
Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions. Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions.
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- 2016
- Full Text
- View/download PDF
60. Complications of Therapy in Cancer Patients: CASE 3. Toxic Epidermal Necrolysis Induced by Oral Phenobarbital and Whole-Brain Radiotherapy in a Breast Cancer Patient
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Vincenzi, Bruno, Santini, Daniele, Grilli, Claudia, La Cesa, Annalisa, Dianzani, Caterina, and Tonini, Giuseppe
- Published
- 2004
- Full Text
- View/download PDF
61. Dramatic improvement of psoriasis with gemcitabine monotherapy
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LANDI, D., SANTINI, D., VINCENZI, B., LA CESA, A., DIANZANI, C., and TONINI, G.
- Published
- 2003
62. A NEW DOSE-INTENSE EPOETIN-ALPHA REGIMEN IN ANEMIC CANCER PATIENTS RECEIVING CHEMOTHERAPY: AN OPEN-LABEL, NON-RANDOMIZED, PILOT STUDY
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Tonini, G., La Cesa, A., Vincenzi, B., Schiavon, G., Leoni, V., Landi, D., Virzi, V., and Santini, D.
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- 2003
63. S-ADENOSYLMETHIONINE (ADOMET) SUPPLEMENTATION FOR TREATMENT OF CHEMOTHERAPY-INDUCED LIVER INJURY
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La Cesa, A., Santini, D., Vincenzi, B., Massacesi, C., Picardi, A., Gentilucci, U. Vespasiani, Rocci, L., Marcucci, F., Bonsignori, M., and Tonini, G.
- Published
- 2003
64. PATHOGENESIS OF FEVER RELATED TO ZOLEDRONIC ACID ADMINISTRATION
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Vincenzi, B., Santini, D., Dicuonzo, G., Gavasci, G., Battistoni, F., La Cesa, A., Rocci, L., Grilli, C., and Tonini, G.
- Published
- 2003
65. The antineoplastic role of bisphosphonates: from basic research to clinical evidence
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Santini, D., Gentilucci, U. Vespasiani, Vincenzi, B., Picardi, A., Vasaturo, F., La Cesa, A., Onori, N., Scarpa, S., and Tonini, G.
- Published
- 2003
66. Unusual Problems in Breast Cancer and a Rare Lung Cancer Case: Case 1. Clinical Complete Response of Breast Cancer Metastases After Trastuzumab-Based Immunotherapy
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Tonini, Giuseppe, Vincenzi, Bruno, Santini, Daniele, Avvisati, Giuseppe, La Cesa, Annalisa, and Baldi, Alfonso
- Published
- 2003
67. Raltitrexed plus weekly oxaliplatin as first-line chemotherapy in advanced colorectal cancer patients: A phase II trial
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Santini, Daniele, Massacesi, Cristian, Vincenzi, Bruno, Marcucci, Fabiana, Delprete, Stefano, La Cesa, Annalisa, Pilone, Alberta, Campisi, Costantino, Bonsignori, Maurizio, and Tonini, Giuseppe
- Published
- 2002
68. Central sensitization as the mechanism underlying pain in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type
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G. Di Stefano, R. Baron, Giorgio Cruccu, A. Pepe, M. Di Franco, Caterina Leone, Filippo Camerota, Claudia Celletti, S. La Cesa, Marco Castori, and Andrea Truini
- Subjects
Adult ,Joint Instability ,Male ,Pain Threshold ,Joint hypermobility ,medicine.medical_specialty ,Laser-Evoked Potentials ,Pain ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Fibromyalgia ,Threshold of pain ,Humans ,Medicine ,Prospective Studies ,030203 arthritis & rheumatology ,Central Nervous System Sensitization ,Referred pain ,medicine.diagnostic_test ,business.industry ,Pain Perception ,Middle Aged ,medicine.disease ,Dermatology ,Anesthesiology and Pain Medicine ,Ehlers–Danlos syndrome ,Neuropathic pain ,Nerve conduction study ,Physical therapy ,Ehlers-Danlos Syndrome ,Female ,business ,030217 neurology & neurosurgery - Abstract
Background Patients with joint hypermobility syndrome/Ehlers–Danlos syndrome, hypermobility type (JHS/EDS-HT) commonly suffer from pain. How this hereditary connective tissue disorder causes pain remains unclear although previous studies suggested it shares similar mechanisms with neuropathic pain and fibromyalgia. Methods In this prospective study seeking information on the mechanisms underlying pain in patients with JHS/EDS-HT, we enrolled 27 consecutive patients with this connective tissue disorder. Patients underwent a detailed clinical examination, including the neuropathic pain questionnaire DN4 and the fibromyalgia rapid screening tool. As quantitative sensory testing methods, we included thermal-pain perceptive thresholds and the wind-up ratio and recorded a standard nerve conduction study to assess non-nociceptive fibres and laser-evoked potentials, assessing nociceptive fibres. Results Clinical examination and diagnostic tests disclosed no somatosensory nervous system damage. Conversely, most patients suffered from widespread pain, the fibromyalgia rapid screening tool elicited positive findings, and quantitative sensory testing showed lowered cold and heat pain thresholds and an increased wind-up ratio. Conclusions While the lack of somatosensory nervous system damage is incompatible with neuropathic pain as the mechanism underlying pain in JHS/EDS-HT, the lowered cold and heat pain thresholds and increased wind-up ratio imply that pain in JHS/EDS-HT might arise through central sensitization. Hence, this connective tissue disorder and fibromyalgia share similar pain mechanisms. What does this study add? In patients with JHS/EDS-HT, the persistent nociceptive input due to joint abnormalities probably triggers central sensitization in the dorsal horn neurons and causes widespread pain.
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- 2016
69. Rules governing demonstrative evidence at trial: a practitioner's guide.
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Howarth, Don, Smith, Suzelle M., and La Cesa, Mary
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Evidence, Demonstrative -- Laws, regulations and rules ,Trial practice -- Laws, regulations and rules - Published
- 1992
70. A pain in the skin. Regenerating nerve sprouts are distinctly associated with ongoing burning pain in patients with diabetes
- Author
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Páll Karlsson, Caterina Leone, Giorgio Cruccu, Andrea Truini, G. Di Stefano, S. La Cesa, Eleonora Galosi, Antonella Biasiotta, and Alessandra Fasolino
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,peripheral neuropathy ,neuropathic pain ,diabetes ,Biopsy ,Gastroenterology ,Sensitivity and Specificity ,03 medical and health sciences ,0302 clinical medicine ,GAP-43 Protein ,Nerve Fibers ,Diabetic Neuropathies ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Burning Pain ,Aged ,Skin ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Nerve Regeneration ,030104 developmental biology ,Anesthesiology and Pain Medicine ,Hyperalgesia ,Skin biopsy ,Neuropathic pain ,Neuralgia ,Female ,medicine.symptom ,business ,Ubiquitin Thiolesterase ,030217 neurology & neurosurgery - Abstract
Backgrounds: Patients with diabetic polyneuropathy commonly suffer from ongoing burning pain and dynamic mechanical allodynia. In this clinical and skin biopsy study, we aimed at assessing how intraepidermal regenerating nerve sprouts are associated with these two types of pain. Methods: We consecutively enrolled 85 patients with diabetic polyneuropathy. All patients underwent skin biopsy at the distal leg. Intraepidermal nerve fibres were immunostained with the anti-protein gene product 9.5 (PGP9.5) to quantify all intraepidermal nerve fibres, and the growth-associated protein 43 (GAP43) to quantify regenerating nerve sprouts. Results: We found that the GAP43-stained intraepidermal nerve fibre density and the ratio GAP43/PGP9.5 were significantly higher in patients with ongoing burning pain than in those without. The area of receiver operating characteristic (ROC) curve for the ratio GAP43/PGP9.5 was 0.74 and yielded a sensitivity and specificity for identifying ongoing burning pain of 72% and 71%, respectively. Conversely, although the density of PGP9.5 and GAP43 intraepidermal nerve fibre was higher in patients with dynamic mechanical allodynia than in those without, this difference was statistically weak and the ROC curve analysis of skin biopsy variables for this type of pain failed to reach the statistical significance. Conclusion: Our clinical and skin biopsy study showed that ongoing burning pain was strongly associated with regenerating sprouts, as assessed with GAP43 immunostaining. This finding improves our understanding on the mechanisms underlying neuropathic pain in patients with diabetic polyneuropathy and suggests that the GAP43/PGP 9.5 ratio might be used as an objective marker for ongoing burning pain due to regenerating sprouts. Significance: Our skin biopsy study showing that regenerating sprouts, as assessed with GAP43-staining, were strongly associated with ongoing burning pain, improves our knowledge on the mechanisms underlying neuropathic pain in patients with diabetes.
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- 2018
71. Psychological treatments and psychotherapies in the neurorehabilitation of pain: Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation
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Castelnuovo, Gianluca, Giusti, Emanuele M., Manzoni, Gian Mauro, Saviola, Donatella, Gatti, Arianna, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Spatola, Chiara A. M., Corti, Stefania, Novelli, Margherita, Villa, Valentina, Cottini, Andrea, Lai, Carlo, Pagnini, Francesco, Castelli, Lorys, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Capodaglio, Paolo, D'aniello, Guido E., Scarpina, Federica, Brioschi, Andrea, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan G., Wiederhold, Brenda, Tamburin, Stefano, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiã², Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'isola, Andrea, De Tanti, Antonio, D'ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammã², Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Castelnuovo, Gianluca, Giusti, Emanuele M., Manzoni, Gian Mauro, Saviola, Donatella, Gatti, Arianna, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Spatola, Chiara A. M., Corti, Stefania, Novelli, Margherita, Villa, Valentina, Cottini, Andrea, Lai, Carlo, Pagnini, Francesco, Castelli, Lory, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Capodaglio, Paolo, D'Aniello, Guido E., Scarpina, Federica, Brioschi, Andrea, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan G., Wiederhold, Brenda, Tamburin, Stefano, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiã², Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'Isola, Andrea, De Tanti, Antonio, D'Ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammã², Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Giusti, Emanuele M, Simpson, Susan G, and Italian Consensus Conference on Pain in Neurorehabilitation
- Subjects
medicine.medical_specialty ,neurological rehabilitation ,medicine.medical_treatment ,lcsh:BF1-990 ,Clinical psychology ,Pain ,Chronic pain ,Settore M-PSI/08 - PSICOLOGIA CLINICA ,Review ,Biofeedback ,Neurological rehabilitation ,Acceptance and commitment therapy ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,chronic pain ,clinical psychology ,health psychology ,pain ,psychological treatments ,psychotherapy ,psychology (all) ,Fibromyalgia ,medicine ,Psychology ,030212 general & internal medicine ,Psychological treatment ,General Psychology ,Neurorehabilitation ,business.industry ,Evidence-based medicine ,medicine.disease ,Health psychology ,Psychological treatments ,Psychotherapy ,Psychology (all) ,Settore MED/34 - Medicina Fisica e Riabilitativa ,lcsh:Psychology ,Complex regional pain syndrome ,Physical therapy ,business ,030217 neurology & neurosurgery - Abstract
Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. Conclusions: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper. Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. Conclusions: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper.
- Published
- 2016
72. Differential involvement of myelinated and unmyelinated nerve fibers in painful diabetic polyneuropathy.
- Author
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Galosi, Eleonora, Di Pietro, Giuseppe, La Cesa, Silvia, Di Stefano, Giulia, Leone, Caterina, Fasolino, Alessandra, Di Lionardo, Andrea, Leonetti, Frida, Buzzetti, Raffaella, Mollica, Cristina, Cruccu, Giorgio, and Truini, Andrea
- Abstract
Background: We aimed at evaluating the differential involvement of large myelinated Aβ‐, small myelinated Aδ‐, and unmyelinated C‐fibers in patients with diabetic polyneuropathy and how they contribute to neuropathic pain. Methods: We collected clinical and diagnostic test variables in 133 consecutive patients with diabetic polyneuropathy. All patients underwent Aβ‐fiber mediated nerve conduction study, Aδ‐fiber mediated laser‐evoked potentials and skin biopsy mainly assessing unmyelinated C‐fibers. Results: Pure large‐fiber and small‐fiber polyneuropathy were relatively uncommon; conversely mixed‐fiber polyneuropathy was the most common type of diabetic polyneuropathy (74%). The frequency of neuropathic pain was similar in the three different polyneuropathies. Ongoing burning pain and dynamic mechanical allodynia were similarly associated with specific small‐fiber related variables. Conclusions: Diabetic polyneuropathy mainly manifests as a mixed‐fiber polyneuropathy, simultaneously involving Aβ‐, Aδ‐, and C‐fibers. In most patients, neuropathic pain is distinctly associated with small‐fiber damage. The evidence that the frequency of neuropathic pain does not differ across pure large‐, pure small‐, and mixed‐fiber polyneuropathy, raises the possibility that in patients with pure large‐fiber polyneuropathy nociceptive nerve terminal involvement might be undetected by standard diagnostic techniques. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
73. Skin denervation does not alter cortical potentials to surface concentric electrode stimulation: A comparison with laser evoked potentials and contact heat evoked potentials
- Author
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Eleonora Galosi, A. Pepe, Giorgio Cruccu, Caterina Leone, Massimiliano Valeriani, F. Alu, S. La Cesa, Alessandra Fasolino, G. Di Stefano, and Andrea Truini
- Subjects
0301 basic medicine ,Adult ,Male ,nociceptive stimuli ,Hot Temperature ,Laser-Evoked Potentials ,electrical-stimulation ,Stimulation ,Electroencephalography ,perception ,small-fiber pathology ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,0302 clinical medicine ,Evoked Potentials, Somatosensory ,medicine ,Reaction Time ,Humans ,neuropathic pain ,eeg responses ,capsaicin ,humans ,tool ,Skin ,Denervation ,Cerebral Cortex ,medicine.diagnostic_test ,Chemistry ,Electric Stimulation ,030104 developmental biology ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Nociception ,Cerebral cortex ,Capsaicin ,Anesthesia ,Neuropathic pain ,Sensory System Agents ,Female ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Background In the neurophysiological assessment of patients with neuropathic pain, laser evoked potentials (LEPs), contact heat evoked potentials (CHEPs) and the evoked potentials by the intraepidermal electrical stimulation via concentric needle electrode are widely agreed as nociceptive specific responses; conversely, the nociceptive specificity of evoked potentials by surface concentric electrode (SE-PREPs) is still debated. Methods In this neurophysiological study we aimed at verifying the nociceptive specificity of SE-PREPs. We recorded LEPs, CHEPs and SE-PREPs in eleven healthy participants, before and after epidermal denervation produced by prolonged capsaicin application. We also used skin biopsy to verify the capsaicin-induced nociceptive nerve fibre loss in the epidermis. Results We found that whereas LEPs and CHEPs were suppressed after capsaicin-induced epidermal denervation, the surface concentric electrode stimulation of the same denervated skin area yielded unchanged SE-PREPs. Conclusion The suppression of LEPs and CHEPs after nociceptive nerve fibre loss in the epidermis indicates that these techniques are selectively mediated by nociceptive system. Conversely, the lack of SE-PREP changes suggests that SE-PREPs do not provide selective information on nociceptive system function. Significance Capsaicin-induced epidermal denervation abolishes laser evoked potentials (LEPs) and contact heat evoked potentials (CHEPs), but leaves unaffected pain-related evoked potentials by surface concentric electrode (SE-PREPs). These findings suggest that unlike LEPs and CHEPs, SE-PREPs are not selectively mediated by nociceptive system.
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- 2017
74. Diagnostic accuracy of laser-evoked potentials in diabetic neuropathy
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Marco Fiorelli, Mario Pergolini, Marco Lacerenza, A. Pepe, Antonella Biasiotta, Giorgio Cruccu, Massimiliano Valeriani, Andrea Truini, Caterina Leone, Eleonora Galosi, Silvia La Cesa, and Giulia Di Stefano
- Subjects
Male ,Pathology ,Diabetic neuropathy ,Laser-Evoked Potentials ,Diagnostic accuracy ,0302 clinical medicine ,Diabetic Neuropathies ,030212 general & internal medicine ,Small Fiber Neuropathy ,health care economics and organizations ,Pain Measurement ,Aged, 80 and over ,medicine.diagnostic_test ,Healthy subjects ,small fiber neuropathy ,diabetic neuropathy ,laser-evoked potentials ,skin biopsy ,Middle Aged ,medicine.anatomical_structure ,Neurology ,Female ,Small fiber neuropathy ,Polyneuropathy ,hormones, hormone substitutes, and hormone antagonists ,Adult ,medicine.medical_specialty ,Adolescent ,education ,Diagnostic Techniques, Neurological ,Nerve fiber ,Sensitivity and Specificity ,Young Adult ,03 medical and health sciences ,Evoked Potentials, Somatosensory ,Ophthalmology ,medicine ,Skin biopsy ,Humans ,Aged ,business.industry ,Lasers ,Reproducibility of Results ,Laser-evoked potentials ,medicine.disease ,Anesthesiology and Pain Medicine ,Neurology (clinical) ,business ,Photic Stimulation ,030217 neurology & neurosurgery - Abstract
Although the most widely agreed neurophysiological tool for investigating small fiber damage is laser-evoked potential (LEP) recording, no study has documented its diagnostic accuracy. In this clinical, neurophysiological, and skin biopsy study, we collected age-corrected LEP normative ranges, verified the association of LEPs with pinprick sensory disturbances in the typical diabetic mixed fiber polyneuropathy, and assessed the sensitivity and specificity of LEPs in diabetic small fiber neuropathy. From 288 LEP recordings from the face, hand, and foot in 73 healthy subjects, we collected age-corrected normative ranges for LEPs. We then selected 100 patients with mixed-fiber diabetic neuropathy and 25 patients with possible small-fiber diabetic neuropathy. In the 100 patients with mixed fiber neuropathy, we verified how LEP abnormalities were associated with clinically evident pinprick sensory disturbances. In the 25 patients with possible pure small fiber neuropathy, using the skin biopsy for assessing the intraepidermal nerve fiber density as a reference standard, we calculated LEP sensitivity and specificity. In healthy participants, age strongly influenced normative ranges for all LEP variables. By applying age-corrected normative ranges for LEPs, we found that LEPs were strongly associated with pinprick sensory disturbances. In relation to the skin biopsy findings, LEPs yielded 78% sensitivity and 81% specificity in the diagnosis of diabetic small fiber neuropathy. Our study, providing age-corrected normative ranges for the main LEP data and their diagnostic accuracy, helps to make LEPs more reliable as a clinical diagnostic tool, and proposes this technique as a less invasive alternative to skin biopsy for diagnosing diabetic small fiber neuropathy.
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- 2017
75. A pain in the skin. Regenerating nerve sprouts are distinctly associated with ongoing burning pain in patients with diabetes
- Author
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Galosi, E., primary, La Cesa, S., additional, Di Stefano, G., additional, Karlsson, P., additional, Fasolino, A., additional, Leone, C., additional, Biasiotta, A., additional, Cruccu, G., additional, and Truini, A., additional
- Published
- 2018
- Full Text
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76. P.10.20 EVALUATION OF APPETITE AND FOOD INTAKE IN GASTROINTESTINAL CANCER PATIENTS AT FIRST ONCOLOGY VISIT
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Emerenziani, S., primary, Molfino, A., additional, Santini, D., additional, Nuglio, C., additional, La Cesa, A., additional, Falco, S., additional, Asensio, L.M. Trillo, additional, Ferravante, F., additional, Muscaritoli, M., additional, and Cicala, M., additional
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- 2018
- Full Text
- View/download PDF
77. Cardioembolic stroke: Protective effect of a severe internal carotid artery stenosis in a patient with cardiac embolism
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Massimiliano Toscano, Gian Luigi Lenzi, S. La Cesa, Edoardo Vicenzini, Barbara Petolicchio, Francesca Puledda, and V. Di Piero
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medicine.medical_specialty ,Cardioembolic stroke ,business.industry ,Intracranial Embolism ,Intracranial Artery ,Posterior cerebral artery ,medicine.disease ,Stenosis ,Embolus ,Internal medicine ,medicine.artery ,Occlusion ,cardiovascular system ,Cardiology ,Medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Radiology ,business ,Stroke - Abstract
Cardioembolic stroke is generally caused by intracranial artery occlusion. Clots may be identified in the intracranial vessels by means of conventional neuroimaging in the acute phase. High-resolution ultrasonography may show some features suggestive of cardiac emboli when occluding extracranial carotid arteries. We describe a patient with cardioembolic ischemic stroke in the right hemisphere in whom a left internal carotid artery stenosis paradoxically protected the ipsilateral hemisphere from distal intracranial embolism. The patient also presented multiple acute ischemic embolic lesions in the right middle cerebral artery territory and in the right occipital lobe, which was fed by the posterior cerebral artery, anomally originating from the right carotid siphon. Interestingly, the left internal carotid artery--which showed a severe preexisting stenosis--was occluded by the cardiac clot, whereas the right internal carotid artery only presented a moderate stenosis that had probably allowed the clots to pass. Therefore, the severe left internal carotid artery stenosis may have blocked the cardiac embolus, preventing it from reaching the ipsilateral hemisphere.
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- 2013
78. Pain-motor integration in the primary motor cortex in Parkinson's disease
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Caterina Leone, A. Di Santo, Alfredo Berardelli, S. La Cesa, Andrea Truini, Luca Marsili, Giorgio Cruccu, F. Di Stasio, Antonio Suppa, and Antonella Biasiotta
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0301 basic medicine ,Adult ,Male ,Parkinson's disease ,Laser-Evoked Potentials ,medicine.medical_treatment ,Primary motor cortex ,Long-Term Potentiation ,Biophysics ,lcsh:RC321-571 ,03 medical and health sciences ,Random Allocation ,0302 clinical medicine ,medicine ,Humans ,Paired associative stimulation ,laser-evoked potentials ,pain-motor integration ,paired associative stimulation ,primary motor cortex ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Anterior cingulate cortex ,Aged ,Neuronal Plasticity ,General Neuroscience ,Chronic pain ,Motor Cortex ,Parkinson Disease ,Middle Aged ,medicine.disease ,Evoked Potentials, Motor ,Transcranial Magnetic Stimulation ,Pain-motor integration ,Transcranial magnetic stimulation ,030104 developmental biology ,Nociception ,medicine.anatomical_structure ,Anesthesia ,Body region ,Female ,Neurology (clinical) ,Chronic Pain ,Psychology ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Background In Parkinson's disease (PD), the influence of chronic pain on motor features has never been investigated. We have recently designed a technique that combines nociceptive system activation by laser stimuli and primary motor cortex (M1) activation through transcranial magnetic stimulation (TMS), in a laser-paired associative stimulation design (Laser-PAS). In controls, Laser-PAS induces long-term changes in motor evoked potentials reflecting M1 long-term potentiation-like plasticity, arising from pain-motor integration. Objective We here examined the possible influence of chronic pain on motor responses to Laser-PAS in patients with PD, with and without chronic pain. Methods We compared motor responses to Laser-PAS in healthy subjects and in patients with PD, with and without chronic pain. Results Unlike controls, we found reduced responses to Laser-PAS in patients with PD, with and without pain. Patients off and on dopaminergic therapy had similar responses to Laser-PAS. When comparing responses to Laser-PAS in patients with and without pain, the two patients' subgroups had similar abnormalities. When we compared patients with pain in the body region investigated with Laser-PAS, with those with pain in other body regions, we found prominent changes in patients with homotopic pain. Finally, when comparing Laser-PAS with the original PAS protocol, which combines electric peripheral nerve stimuli and TMS, in patients without pain and those with homotopic pain, we found similar responses to both techniques in patients without pain, whereas Laser-PAS induced greater abnormalities than PAS in patients with pain. Conclusions In PD, chronic pain degrades response to Laser-PAS through abnormal pain-motor integration.
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- 2016
79. Abnormal resting state functional connectivity of the periaqueductal grey in patients with fibromyalgia
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Truini, A., Tinelli, E., Gerardi, M. C., Calistri, V., Iannuccelli, C., La Cesa, S., Tarsitani, L., Mainero, C., Sarzi-Puttini, P., Cruccu, G., Francesca CARAMIA, and Di Franco, M.
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Adult ,Male ,Settore MED/16 - Reumatologia ,Brain Mapping ,fMRI, fibromyalgia, pain ,Fibromyalgia ,Humans ,Periaqueductal Gray ,Female ,Chronic Pain ,Middle Aged ,Magnetic Resonance Imaging - Abstract
Emerging evidence associates chronic pain syndrome, such as fibromyalgia, with endogenous pain modulatory system dysfunction, leading to an impaired descending pain inhibition. In this study, using resting-state functional magnetic resonance imaging (fMRI), we aimed at seeking possible functional connectivity changes of the periaqueductal gray (PAG), a brainstem area that belongs to the endogenous pain modulatory system, in patients with fibromyalgia.In 20 patients with fibromyalgia and 15 healthy subjects, we investigated PAG functional connectivity using resting-state fMRI. We also analysed the correlation between clinical variables, such as pain severity, disease duration, and depressive personality traits with PAG functional connectivity.Compared with control subjects, we identified that patients with fibromyalgia had an increased PAG connectivity with insula, anterior cingulate cortex, and anterior prefrontal cortex. The functional connectivity between PAG and the rostral ventral medulla, however, was not concordantly increased. PAG functional connectivity correlated with pain severity, disease duration, and the depressive personality trait rating.Our fMRI study showing abnormal resting state functional connectivity of the PAG suggests that patients with fibromyalgia have an endogenous pain modulatory system dysfunction, possibly causing an impaired descending pain inhibition. This abnormal PAG functioning might underlay the chronic pain these patients suffer from.
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- 2016
80. Diagnosing and assessing pain in neurorehabilitation: from translational research to the clinical setting. Evidence and recommendations from the Italian Consensus conference on pain in neurorehabilitation
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Porro, Carlo A., Sandrini, Giorgio, Truini, Andrea, Tugnoli, Valeria, Alfonsi, Enrico, Berliocchi, Laura, Cacciatori, Carlo, La Cesa, Silvia, Magrinelli, Francesca, Sacerdote, Paola, Valeriani, Massimiliano, and Tamburin, Stefano
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diagnosis ,Consensus Development Conferences as Topic ,assessment ,functional neuroimaging ,Translational Research, Biomedical ,translational medicine ,psychophysics ,Outcome Assessment, Health Care ,magnetic resonance imaging ,Animals ,Humans ,neurorehabilitation, pain, diagnosis, assessment ,pain ,Randomized Controlled Trials as Topic ,neurorehabilitation ,Evidence-Based Medicine ,theoretical models ,Neurological Rehabilitation ,Neurophysiology - Functional neuroimaging - Magnetic resonance imaging - Theoretical models - Psychophysics - Translational medicine ,neurophysiology ,Disease Models, Animal ,Italy ,Practice Guidelines as Topic ,Neuralgia - Abstract
Pain is very common in neurorehabilitation, where it may be a target for treatment and have a negative effect on rehabilitation procedures and outcomes. Promising preliminary preclinical data support certain therapeutic approaches to pain, but there is a strong need of adequate preclinical models, experimental settings, outcome measures, and biomarkers that are more relevant for pain within the neurorehabilitation field. Data on the diagnosis and assessment of nociceptive and neuropathic pain (NP) are very scanty in neurorehabilitation, but those from other contexts can be adapted and translated to this specific setting. The Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) has searched and evaluated existing evidence on animal models for the treatment of pain, definition and diagnostic criteria for nociceptive and NP, screening tools and questionnaires, along with diagnostic, clinical and instrumental techniques to distinguish nociceptive from NP and, more generally, to assess pain in the field of neurorehabilitation. The present ICCPN recommendations provide information on the relevance of current preclinical models, and may be helpful in ameliorating pain diagnosis and assessment, which are prerequisites for better application and tailoring of current pharmacological and non-pharmacological treatments. They may also be useful for future studies aimed at filling the gaps in the current knowledge of these topics.
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- 2016
81. Peripheral nociceptor sensitization mediates allodynia in patients with distal symmetric polyneuropathy
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Frida Leonetti, Maria Teresa Petrucci, Andrea Truini, Claudio Cartoni, Milvia Casato, Giorgio Cruccu, G. Di Stefano, Mario Pergolini, S. La Cesa, Antonella Biasiotta, and Caterina Leone
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medicine.medical_specialty ,Neurology ,Laser-Evoked Potentials ,Pain ,Nerve Fibers, Myelinated ,Polyneuropathies ,painful neuropathy ,Evoked Potentials, Somatosensory ,Physical Stimulation ,medicine ,Humans ,Prospective Studies ,Sensitization ,allodynia ,medicine.diagnostic_test ,business.industry ,Nociceptors ,laser evoked potentials ,medicine.anatomical_structure ,Allodynia ,Nociception ,Hyperalgesia ,Anesthesia ,Neuropathic pain ,Nociceptor ,Nerve conduction study ,Neurology (clinical) ,medicine.symptom ,business - Abstract
Patients with painful neuropathy frequently complain of pain in response to normally non-painful brushing, namely dynamic mechanical allodynia. Despite many animal studies suggesting that allodynia arises when the spontaneous firing in damaged nociceptive afferents sensitise second-order nociceptive neurons to Aβ-fibre input, no studies have sought to confirm this mechanism by investigating Aβ-fibre sparing in human patients with allodynia. In this study we compared data from Aβ-fibre-mediated nerve conduction studies and nociceptive-fibre-mediated laser-evoked potentials (LEPs) in 200 patients with distal symmetric polyneuropathy (114 with neuropathic pain, 86 without). Of the 114 patients with painful neuropathy studied, 44 suffered from allodynia. Whereas no statistical difference was found in nerve conduction study data between patients with and without allodynia, LEP amplitudes were larger in patients with allodynia than in those without (P
- Published
- 2012
82. Heat-Evoked Experimental Pain Induces Long-Term Potentiation-Like Plasticity in Human Primary Motor Cortex
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Daniele Belvisi, Andrea Truini, Antonio Suppa, S. La Cesa, Giorgio Cruccu, Luca Marsili, Antonella Biasiotta, and Alfredo Berardelli
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Adult ,Male ,Hot Temperature ,Laser-Evoked Potentials ,Cognitive Neuroscience ,medicine.medical_treatment ,Long-Term Potentiation ,Receptors, N-Methyl-D-Aspartate ,pain-motor integration ,Young Adult ,Cellular and Molecular Neuroscience ,tms ,Physical Stimulation ,Neuroplasticity ,laser-evoked potentials ,medicine ,Humans ,primary motor cortex ,Motor Cortex ,Memantine ,spike timing-dependent plasticity ,Pain Perception ,Long-term potentiation ,Evoked Potentials, Motor ,Transcranial Magnetic Stimulation ,Transcranial magnetic stimulation ,medicine.anatomical_structure ,NMDA receptor ,Female ,Primary motor cortex ,Psychology ,Neuroscience ,medicine.drug ,Motor cortex - Abstract
We designed a new paired associative stimulation (PAS) protocol that combines experimental pain evoked by laser stimuli and transcranial magnetic stimulation (TMS) (Laser-PAS) to primary motor cortex (M1). We tested in healthy subjects whether Laser-PAS elicits cortical plasticity as reflected by long-term changes in motor-evoked potentials (MEPs) (after-effects). In separate experiments, we examined numerous variables including changes induced by varying the interstimulus intervals (ISIs) and Laser-PAS-induced changes in target and non-target muscle MEPs. We measured MEPs after repetitive laser or TMS (rTMS) pulses, and compared magnetic- and electric (TES)-induced MEPs. We tested MEPs after applying Laser-PAS with laser pulses ipsilaterally to M1. Finally, we studied subjects receiving an N-methyl-D-aspartate (NMDA) receptor antagonist (memantine) or placebo (α-lipoic acid). During Laser-PAS at the 50 ms ISI MEPs decreased, thereafter they increased for 60 min; other ISIs induced no after-effects. The after-effects remained restricted to the target muscle. Repetitive laser pulses and rTMS induced no after-effects. After Laser-PAS, TMS-induced MEPs increased, whereas TES-induced MEPs did not. Laser-PAS with laser pulses ipsilaterally to M1 left MEPs unchanged. Memantine, but not α-lipoic acid, abolished the after-effects. In conclusion, Laser-PAS elicits NMDA-dependent cortical plasticity and provides new insights into human pain-motor integration.
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- 2012
83. An observational study assessing peripheral neuropathy related to multiple myeloma
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Vincenzo Federico, Maria Teresa Petrucci, Andrea Truini, R. Labriola, Caterina Leone, Paola Finsinger, G. Di Stefano, Eleonora Russo, Giorgio Cruccu, and S. La Cesa
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Male ,medicine.medical_specialty ,Neurology ,Neurological examination ,Dermatology ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,multiple myeloma ,polyneuropathy ,skin biopsy ,Internal medicine ,medicine ,Humans ,Multiple myeloma ,Aged ,medicine.diagnostic_test ,business.industry ,Peripheral Nervous System Diseases ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Psychiatry and Mental health ,Peripheral neuropathy ,030220 oncology & carcinogenesis ,Skin biopsy ,Nerve conduction study ,Female ,Neurology (clinical) ,Neurosurgery ,business ,Multiple Myeloma ,Polyneuropathy ,030217 neurology & neurosurgery - Abstract
We aimed at assessing the prevalence of peripheral neuropathy in newly diagnosed, treatment-naive patients with multiple myeloma. We enrolled 153 patients with multiple myeloma at initial diagnosis. All patients underwent neurological examination and nerve conduction study. Patients with suspected pure small fiber neuropathy underwent skin biopsy. Of the 153 patients included in this study, 7.2 % had a multiple myeloma-related neuropathy. All patients suffered from a distal symmetric sensory peripheral neuropathy, associated with age (P = 0.04). Our study on prevalence rate of multiple myeloma-related peripheral neuropathy might provide a basis for improving the clinical management of this condition.
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- 2015
84. Pathophysiological mechanisms of neuropathic pain
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Antonella Biasiotta, Giorgio Cruccu, Giulia Di Stefano, Caterina Leone, Silvia La Cesa, and Andrea Truini
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neuropathic pain ,medicine.medical_specialty ,peripheral neuropathy ,Central sensitization ,medicine.diagnostic_test ,business.industry ,peripheral sensitization ,central sensitization ,medicine.disease ,Dermatology ,Pathophysiology ,Peripheral neuropathy ,Neurology ,laser-evoked potential ,painful neuropathy ,skin biopsy ,Neurology (clinical) ,Skin biopsy ,Neuropathic pain ,medicine ,business - Abstract
Neuropathic pain is a common problem in clinical practice and one that adversely affects patients’ quality of life. Converging evidence from animal and human studies demonstrates that neuropathic pain arises from a lesion in the somatosensory system. Injured peripheral nerve fibers give rise to an intense and prolonged ectopic input to the CNS and, in some cases, also to secondary changes in dorsal horn neuronal excitability. Convincing evidence now suggests that classifying neuropathic pain according to a mechanism-based rather than an etiology-based approach might help in targeting therapy to the individual patient and would be useful in testing new drugs. This article summarizes our current understanding of the peripheral and central pathophysiological mechanisms underlying neuropathic pain and focuses on how symptoms translate into mechanisms.
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- 2011
85. Topographical distribution of warmth, burning and itch sensations in healthy humans
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Andrea Truini, P Teofoli, Giorgio Cruccu, Luca Padua, Antonella Biasiotta, Caterina Leone, S. La Cesa, and G. Di Stefano
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Adult ,Capsaicine ,Shoulder ,medicine.medical_specialty ,Sensation ,Laser ,Pain ,Audiology ,Itch ,immune system diseases ,C fibres ,otorhinolaryngologic diseases ,medicine ,c fibres ,capsaicine ,histamine ,itch ,laser ,pain ,Humans ,skin and connective tissue diseases ,Skin ,Nerve Fibers, Unmyelinated ,Foot ,Pruritus ,General Neuroscience ,Healthy subjects ,Hand ,body regions ,Settore MED/26 - NEUROLOGIA ,Thigh ,Thermography ,Face ,Anesthesia ,Topographical distribution ,Psychology ,Foot (unit) ,Histamine - Abstract
To gain information on the topographical distribution of warmth, burning and itch sensations in healthy humans, we delivered laser stimuli to elicit sensations of warmth, applied capsaicin cream for burning, and pricked histamine for itch on the skin of the face, shoulder, hand, thigh and foot in 12 healthy subjects. We found that whereas warm and burning sensations progressively increased from foot to face, itch sensation increased from face to foot (P0.0001). Hence our findings indicate that unlike thermal and pain receptors, itch receptors are denser at distal than at proximal body sites. Our psychophysical study provides new information supporting the idea that specific unmyelinated neuronal pathways mediate sensations of warmth, burning and itch.
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- 2011
86. P.10.20 EVALUATION OF APPETITE AND FOOD INTAKE IN GASTROINTESTINAL CANCER PATIENTS AT FIRST ONCOLOGY VISIT
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Alessio Molfino, L.M. Trillo Asensio, Sara Emerenziani, C. Nuglio, Michele Cicala, Daniele Santini, S. Falco, Maurizio Muscaritoli, A. La Cesa, and F. Ferravante
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Food intake ,medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,media_common.quotation_subject ,Gastroenterology ,medicine ,Appetite ,Gastrointestinal cancer ,medicine.disease ,business ,media_common - Published
- 2018
87. Weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) as first-line chemotherapy for elderly patients with advanced gastric cancer: results of a phase II trial
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Antonio Russo, Bruno Vincenzi, Francesco Graziano, M. Di Seri, A. La Cesa, Michele Caraglia, Bruno Spalletta, Stefano Cascinu, Anna Maria Baldelli, E. Testa, Paolo Giordani, Daniele Santini, Vincenzo Catalano, Vladimir Virzì, Giuseppe Tonini, SANTINI D, GRAZIANO F, CATALANO V, DI SERI M, TESTA E, BALDELLI AM, GIORDANI P, LA CESA A, SPALLETTA B, VINCENZI B, RUSSO A, CARAGLIA M, VIRZI V, CASCINU S, TONINI G, D, Santini, F, Graziano, V, Catalano, M, DI SERI, E, Testa, Am, Baldelli, P, Giordani, A, LA CESA, B, Spalletta, B, Vincenzi, A, Russo, M, Caraglia, V, Virzi, Cascinu, S., G, Tonini, Santini, D, Graziano, F, Catalano, V, DI SERI, M, Testa, E, Baldelli, Am, Giordani, P, LA CESA, A, Spalletta, B, Vincenzi, B, Russo, A, Caraglia, Michele, Virzi, V, Cascinu, S, and Tonini, G.
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Male ,Oncology ,medicine.medical_specialty ,Cancer Research ,Organoplatinum Compounds ,medicine.medical_treatment ,lcsh:RC254-282 ,Drug Administration Schedule ,LEUCOVORIN ,Folinic acid ,EPI-DOXORUBICIN ,TRACT CANCER ,CISPLATIN ,ADVANCED ESOPHAGOGASTRIC CANCER ,Stomach Neoplasms ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Clinical endpoint ,Genetics ,Humans ,Aged ,6S-LEUCOVORIN ,Aged, 80 and over ,Cisplatin ,Chemotherapy ,business.industry ,Combination chemotherapy ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,INFUSIONAL FLUOROURACIL ,RANDOMIZED-TRIAL ,Oxaliplatin ,Survival Rate ,Regimen ,Fluorouracil ,INTENSIVE WEEKLY CHEMOTHERAPY ,ETOPOSIDE ,Female ,business ,Research Article ,medicine.drug - Abstract
Background Elderly patients have been often excluded from or underrepresented in the study populations of combination chemotherapy trials. The primary end point of this study was to determine the response rate and the toxicity of the weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) regimen in elderly patients with advanced gastric cancer. The secondary objective was to measure the time to disease progression and the survival time. Methods Chemotherapy-naive patients with advanced gastric cancer aged 70 or older were considered eligible for study entry. Patients received weekly oxaliplatin 40 mg/m2, fluorouracil 500 mg/m2 and folinic acid 250 mg/m2. All drugs were given intravenously on a day-1 schedule. Results A total of 42 elderly patients were enrolled. Median age was 73 years and all patients had metastatic disease. The response rate according to RECIST criteria was 45.2% (95% CIs: 30%–56%) with two complete responses, 17 partial responses, 13 stable diseases and 10 progressions, for an overall tumor rate control of 76.2% (32 patients). Toxicity was generally mild and only three patients discontinued treatment because of treatment related adverse events. The most common treatment-related grade 3/4 adverse events were fatigue (7.1%), diarrhoea (4.8%), mucositis (2.4%), neurotoxicity (2.4%) and neutropenia (4.8%). The median response duration was 5.3 months (95% CIs: 2.13 – 7.34), the median time to disease progression was 5.0 months (95% CIs: 3.75 – 6.25) and the median survival time was 9.0 months (95% CIs: 6.18 – 11.82). Conclusion OXALF represents an active and well-tolerated treatment modality for elderly patients with locally advanced and metastatic gastric cancer.
- Published
- 2006
88. Diagnostic accuracy of laser-evoked potentials in diabetic neuropathy.
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Di Stefano, Giulia, La Cesa, Silvia, Leone, Caterina, Pepe, Alessia, Galosi, Eleonora, Fiorelli, Marco, Valeriani, Massimiliano, Lacerenza, Marco, Pergolini, Mario, Biasiotta, Antonella, Cruccu, Giorgio, Truini, Andrea, Di Stefano, G, La Cesa, S, Leone, C, Pepe, A, Galosi, E, Fiorelli, M, Valeriani, M, and Lacerenza, M
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DIAGNOSIS of diabetic neuropathies , *EVOKED potentials (Electrophysiology) , *NEUROPHYSIOLOGY , *MEDICAL lasers , *SKIN biopsy - Abstract
Although the most widely agreed neurophysiological tool for investigating small fiber damage is laser-evoked potential (LEP) recording, no study has documented its diagnostic accuracy. In this clinical, neurophysiological, and skin biopsy study, we collected age-corrected LEP normative ranges, verified the association of LEPs with pinprick sensory disturbances in the typical diabetic mixed fiber polyneuropathy, and assessed the sensitivity and specificity of LEPs in diabetic small fiber neuropathy. From 288 LEP recordings from the face, hand, and foot in 73 healthy subjects, we collected age-corrected normative ranges for LEPs. We then selected 100 patients with mixed-fiber diabetic neuropathy and 25 patients with possible small-fiber diabetic neuropathy. In the 100 patients with mixed fiber neuropathy, we verified how LEP abnormalities were associated with clinically evident pinprick sensory disturbances. In the 25 patients with possible pure small fiber neuropathy, using the skin biopsy for assessing the intraepidermal nerve fiber density as a reference standard, we calculated LEP sensitivity and specificity. In healthy participants, age strongly influenced normative ranges for all LEP variables. By applying age-corrected normative ranges for LEPs, we found that LEPs were strongly associated with pinprick sensory disturbances. In relation to the skin biopsy findings, LEPs yielded 78% sensitivity and 81% specificity in the diagnosis of diabetic small fiber neuropathy. Our study, providing age-corrected normative ranges for the main LEP data and their diagnostic accuracy, helps to make LEPs more reliable as a clinical diagnostic tool, and proposes this technique as a less invasive alternative to skin biopsy for diagnosing diabetic small fiber neuropathy. [ABSTRACT FROM AUTHOR]
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- 2017
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89. Skin denervation does not alter cortical potentials to surface concentric electrode stimulation: A comparison with laser evoked potentials and contact heat evoked potentials
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La Cesa, S., primary, Di Stefano, G., additional, Leone, C., additional, Pepe, A., additional, Galosi, E., additional, Alu, F., additional, Fasolino, A., additional, Cruccu, G., additional, Valeriani, M., additional, and Truini, A., additional
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- 2017
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90. 39. Central sensitization as the mechanism underlying pain in joint hypermobility syndrome/Ehlers–Danlos syndrome, hypermobility type
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Pepe, A., primary, Leone, C., additional, Di Stefano, G., additional, Celletti, C., additional, Baron, R., additional, Castori, M., additional, Di Franco, M., additional, La Cesa, S., additional, Cruccu, G., additional, Truini, A., additional, and Camerota, F., additional
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- 2016
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91. 13. Which is the best evoked potential technique for assessing the nociceptive system? Preliminary results of a neurophysiological study in healthy humans
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Leone, C., primary, La Cesa, S., additional, Di Stefano, G., additional, Pepe, A., additional, Truini, A., additional, and Cruccu, G., additional
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- 2016
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92. How to diagnose neuropathic pain? The contribution from clinical examination, pain questionnaires and diagnostic tests
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Giorgio Cruccu, P. Marchettini, Andrea Truini, S. La Cesa, Giorgio Sandrini, Stefano Paolucci, Stefano Tamburin, Valeria Tugnoli, and Marco Lacerenza
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medicine.medical_specialty ,Neurology ,Laser-Evoked Potentials ,Physical examination ,Dermatology ,Diagnosis, Differential ,Surveys and Questionnaires ,Humans ,Medicine ,Physical Examination ,skin biopsy ,Pain Measurement ,Neuroradiology ,neuropathic pain ,medicine.diagnostic_test ,Diagnostic Tests, Routine ,business.industry ,laser evoked potentials ,screening tools ,General Medicine ,medicine.disease ,Psychiatry and Mental health ,Neuropathic pain ,Neuralgia ,Physical therapy ,Neurology (clinical) ,Neurosurgery ,Differential diagnosis ,business - Abstract
Patients with peripheral and central nervous system diseases may suffer from different types of pain, namely nociceptive, neuropathic and mixed pain. Although in some cases, the distinction between these types of pain is clinically evident, yet in some patients an accurate differential diagnosis requires dedicated clinical examination, screening questionnaires and diagnostic techniques some of which are available only in specialized pain centres. This review briefly addresses the currently agreed definitions of the different types of pain and shows how clinical examination, pain questionnaires and diagnostic tests can help the clinicians in identifying neuropathic pain.
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- 2015
93. Capecitabine and Mitomycin C Is an Effective Combination for Anthracycline- and Taxane-Resistant Metastatic Breast Cancer
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Annalisa La Cesa, F. Marcucci, Marco B. L. Rocchi, Daniele Santini, Laura Zepponi, Luciano Burattini, Cristian Massacesi, Giuseppe Tonini, and A. Pilone
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Oncology ,Cancer Research ,medicine.medical_specialty ,Anthracycline ,Mitomycin ,Breast Neoplasms ,Deoxycytidine ,Disease-Free Survival ,Metastasis ,Capecitabine ,Breast cancer ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Anthracyclines ,Neoplasm Metastasis ,Thymidine phosphorylase ,Taxane ,business.industry ,Mitomycin C ,General Medicine ,Middle Aged ,medicine.disease ,Survival Analysis ,Metastatic breast cancer ,Treatment Outcome ,Drug Resistance, Neoplasm ,Cancer research ,Female ,Taxoids ,Fluorouracil ,business ,medicine.drug - Abstract
Capecitabine is converted to 5-fluorouracil by thymidine phosphorylase, and mitomycin C is capable of upregulating the expression of thymidine phosphorylase suggesting a synergistic effect. Fifty-three patients (median age 62 years) with anthracycline- and taxane-resistant, metastatic breast cancer received mitomycin C 6 mg/m2 on day 1, and capecitabine (Xeloda) 2,000 mg/m2/day from day 1 to day 14 with cycles repeated every 4 weeks. Overall, 77.4% had visceral metastases and 33 were pretreated with ≧3 chemotherapy lines. A median of 6 cycles were given (range 1–19) with a complete response observed in 2 patients (3.9%), partial response in 17 (33.3%) and stable disease in 19 (37.2%). Overall response rate was 37.2% (95% CI, 24.0–50.5%), with a median duration of 10.4 months. Median time to progression was 8.1 months and median survival was 17.4 months (1- and 2-year survival rates of 60 and 28%, respectively). Toxicity was mild. The most frequent grade 3/4 events were neutropenia (5.7% of patients), diarrhea (3.8%), and deep venous thrombosis (3.8%). Capecitabine plus mitomycin C may represent an effective and manageable treatment option for advanced breast cancer patients resistant to anthracyclines and taxanes. This approach provides an alternative for pretreated patients with advanced breast cancer.
- Published
- 2006
94. Trigeminal isolated sensory neuropathy (TISN) and FOSMN syndrome: despite a dissimilar disease course do they share common pathophysiological mechanisms?
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Silvia La Cesa, Giorgio Cruccu, Salvatore Raffa, Antonella Biasiotta, Andrea Truini, Claudia Sommer, Elena Maria Pennisi, Giovanni Antonini, Giulia Di Stefano, and Caterina Leone
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Neurology ,Facial pain ,Clinical Neurology ,Trigeminal nerve ,Neuronopathy ,FOSMN ,Cohort Studies ,Hypesthesia ,Young Adult ,Reflex ,Biopsy ,Humans ,Medicine ,Neurochemistry ,ddc:610 ,Motor Neuron Disease ,Aged ,Proprioception ,medicine.diagnostic_test ,business.industry ,Trigeminal neuropathy ,Disease Progression ,Facial Pain ,Female ,Middle Aged ,Neuralgia ,Syndrome ,Trigeminal Nerve ,Trigeminal Nerve Diseases ,General Medicine ,Hypoesthesia ,Supraorbital nerve ,Neurology (clinical) ,medicine.symptom ,business ,Neuroscience ,Research Article - Abstract
Background: Patients presenting with bilateral trigeminal hypoesthesia may go on to have trigeminal isolated sensory neuropathy, a benign, purely trigeminal neuropathy, or facial-onset sensory motor neuronopathy (FOSMN), a malignant life-threatening condition. No diagnostic criteria can yet differentiate the two conditions at their onset. Nor is it clear whether the two diseases are distinct entities or share common pathophysiological mechanisms. Methods: Seeking pathophysiological and diagnostic information to distinguish these two conditions at their onset, in this neurophysiological and morphometric study we neurophysiologically assessed function in myelinated and unmyelinated fibres and histologically examined supraorbital nerve biopsy specimens with optic and electron microscopy in 13 consecutive patients with recent onset trigeminal hypoesthesia and pain. Results: The disease course distinctly differed in the 13 patients. During a mean 10 year follow-up whereas in eight patients the disease remained relatively stable, in the other five it progressed to possibly life-threatening motor disturbances and extra-trigeminal spread. From two to six years elapsed between the first sensory symptoms and the onset of motor disorders. In patients with trigeminal isolated sensory neuropathy (TISN) and in those with FOSMN neurophysiological and histological examination documented a neuronopathy manifesting with trigeminal nerve damage selectively affecting myelinated fibres, but sparing the Ia-fibre-mediated proprioceptive reflex. Conclusions: Although no clinical diagnostic criteria can distinguish the two conditions at onset, neurophysiological and nerve-biopsy findings specify that in both disorders trigeminal nerve damage manifests as a dissociated neuronopathy affecting myelinated and sparing unmyelinated fibres, thus suggesting similar pathophysiological mechanisms.
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- 2014
95. Zoledronic Acid-Related Angiogenesis Modifications and Survival in Advanced Breast Cancer Patients
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Giordano Dicuonzo, Annalisa La Cesa, Bruno Vincenzi, Daniele Santini, Michele Gavasci, Vladimir Virzì, Giuseppe Tonini, Claudia Grilli, Fabrizio Battistoni, Simona Gasparro, and Laura Rocci
- Subjects
Vascular Endothelial Growth Factor A ,Oncology ,medicine.medical_specialty ,Angiogenesis ,medicine.medical_treatment ,Immunology ,Antineoplastic Agents ,Bone Neoplasms ,Breast Neoplasms ,Zoledronic Acid ,Cohort Studies ,Interferon-gamma ,chemistry.chemical_compound ,Breast cancer ,Virology ,Internal medicine ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,Survival rate ,Aged ,Aged, 80 and over ,Diphosphonates ,Neovascularization, Pathologic ,business.industry ,Imidazoles ,Cancer ,Cell Biology ,Bisphosphonate ,medicine.disease ,Survival Rate ,Vascular endothelial growth factor ,Zoledronic acid ,chemistry ,Female ,business ,medicine.drug - Abstract
The proven antiangiogenic activity of zoledronic acid, a third-generation bisphosphonate widely used in bone metastatic cancer patients, led us to investigate if the vascular endothelial growth factor (VEGF)-related zoledronic acid modifications are correlated with survival advantages in advanced breast cancer patients. Forty-two consecutive breast cancer patients with scintigraphic and radiographic evidence of bone metastases were treated with a single infusion of 4 mg zoledronic acid before anticancer chemotherapy. The patients were prospectively evaluated for circulating levels of VEGF and interferon-gamma (IFN-gamma) just before and at 1, 2, 7, and 21 days after zoledronic acid infusion. Afterward, clinical outcome was prospectively monitored. The basal serum VEGF median levels were significantly decreased at each time point, but the major reduction was recorded 21 days after the infusion. In particular, 25 patients of 42 (59.5%) experienced a reduction of at least 25% in the VEGF circulating levels. In contrast, no statistically significant modifications of the IFN-gamma serum levels were recorded. We stratified patients on the basis of this VEGF reduction 21 days after the infusion. No differences in patient features were recorded between those with or without the VEGF reduction. The analysis of survival showed that patients with a reduction in the VEGF circulating levels had a longer time to first skeletal-related event (p = 0.0002), time to bone progression disease (p = 0.0024), and time to performance status worsening (p = 0.0352) than those without the VEGF reduction. No statistically significant differences were recorded in terms of overall survival and time to visceral progression. This study confirms that zoledronic acid could have an in vivo antiangiogenic property and that the VEGF modifications may represent a surrogate marker able to predict time to first skeletal-related event, time to bone progression disease, and time to worsening of performance status.
- Published
- 2005
96. Continuous Infusion of Oxaliplatin plus Chronomodulated Capecitabine in 5-Fluorouracil- and Irinotecan-Resistant Advanced Colorectal Cancer Patients
- Author
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Giuseppe Tonini, Daniele Santini, Annalisa La Cesa, Bruno Vincenzi, Bruno Spalletta, Roberto Coppola, Gaia Schiavon, Laura Rocci, Marisa Di Seri, and Marco Caricato
- Subjects
Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Colorectal Neoplasms ,Disease Progression ,Antineoplastic Combined Chemotherapy Protocols ,Organoplatinum Compounds ,Colorectal cancer ,medicine.drug_class ,Irinotecan ,Deoxycytidine ,Thymidylate synthase ,Antimetabolite ,Drug Administration Schedule ,Metastasis ,Capecitabine ,Internal medicine ,medicine ,Humans ,Infusions, Intravenous ,Aged ,Neoplasm Staging ,Chronotherapy ,biology ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Survival Analysis ,Oxaliplatin ,Treatment Outcome ,Drug Resistance, Neoplasm ,Fluorouracil ,biology.protein ,Camptothecin ,Female ,business ,medicine.drug - Abstract
Objectives: The aim of the study was to define the feasibility and efficacy of Xelox (capecitabine and oxaliplatin) administered through a new and original schedule in advanced pretreated colorectal cancer (CRC) patients. Methods: 36 metastatic CRC patients resistant at least to a previous 5-fluorouracil- and irinotecan-based chemotherapy line were included in the study. Treatment: Oxaliplatin 70 mg/m2 as continuous infusion for 12 h (8.00 a.m. to 8.00 p.m.) on days 1, 8 plus chronomodulated capecitabine 1,750 mg/m2/day per os (8.00 a.m. 25% of total dose; 6.00 p.m. 25% of total dose; 11.00 p.m. 50% of total dose), on days 1–14 every 21 days. 16 (44.4%) patients had previously received only 1 chemotherapy line for metastatic disease and 20 patients (55.6%) 2 chemotherapy lines. Moreover, 12 patients (33.3%) progressed after a first or second line of oxaliplatin-based regimen as well. Results: Most frequent related G3–4 adverse reactions were diarrhea (11.6%), nausea/vomiting (8.3%), neuropathy (8.3%), mucositis (8.3%), asthenia (16.7%) and hand-foot syndrome (5.5%). G3–4 anemia, leucopenia and liver toxicities were not observed. The overall response rate was 30.6% (11/36 patients). Disease stabilization was observed in 13 patients (36.1%) and progression in 12 patients (34.3%). Between the 12 oxaliplatin-resistant patients, the overall response rate was 25% (3 patients); 6 patients (54.5%) obtained a stable disease, and only 3 patients (25%) progressed. The median overall survival was 11.3 months (95% confidence interval 7.0–15.7 months), the median response duration 2.8 months (95% confidence interval 1.2–5.6 months) and the median time to progression 6.7 months (95% confidence interval 5.7–6.3 months). The 1-year survival rate was 53.8%. Conclusions: The high overall tumor growth control, the remarkable median time to progression and overall survival and the good safety profile are of particular interest for patients with heavy pretreated metastatic CRC.
- Published
- 2005
97. Time for a Consensus Conference on pain in neurorehabilitation
- Author
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Sandrini, Giorgio, Tamburin, Stefano, Paolucci, Stefano, Boldrini, Paolo, Saraceni, Vincenzo M, Smania, Nicola, Agostini, M, Alfonsi, E, Aloisi, Am, Alvisi, E, Aprile, I, Armando, M, Avenali, M, Azicnuda, E, Barale, F, Bartolo, M, Bergamaschi, R, Berlangieri, M, Berlincioni, V, Berliocchi, L, Berra, E, Berto, G, Bonadiman, S, Bonazza, S, Bressi, F, Brugnera, A, Brunelli, S, Buzzi, Mg, Cacciatori, C, Calvo, A, Cantarella, C, Caraceni, At, Carone, R, Carraro, E, Casale, R, Castellazzi, P, Castelnuovo, G, Castino, A, Cella, M, Cerbo, R, Chiò, A, Ciotti, C, Cisari, C, Coraci, D, Dalla Toffola, E, Defazio, G, De Icco, R, Del Carro, U, Dell’Isola, A, De Tanti, A, D’Ippolito, M, Fazzi, E, Federico, A, Ferrari, A, Ferrari, S, Ferraro, F, Formaglio, F, Formisano, R, Franzoni, S, Gajofatto, F, Gandolfi, M, Gardella, B, Geppetti, P, Giammò, A, Gimigliano, R, Giusti, Em, Greco, E, Ieraci, V, Invernizzi, M, Jacopetti, M, Jedrychowska, I, Lacerenza, M, La Cesa, S, Lobba, D, Magrinelli, F, Mandrini, S, Manera, U, Manzoni, Gm, Marchettini, P, Marchioni, E, Mariotto, S, Martinuzzi, A, Masciullo, M, Mezzarobba, S, Miotti, D, Modenese, A, Molinari, M, Monaco, S, Morone, G, Nappi, R, Negrini, S, Pace, A, Padua, L, Pagliano, E, Palmerini, V, Paolucci, S, Pazzaglia, C, Pecchioli, C, Pietrabissa, G, Picelli, A, Polli, A, Porro, Ca, Porru, D, Romano, M, Roncari, L, Rosa, R, Saccavini, M, Sacerdote, P, Sandrini, G, Saviola, D, Schenone, A, Schweiger, V, Scivoletto, G, Smania, N, Solaro, C, Spallone, V, Springhetti, I, Tamburin, S, Tassorelli, C, Tinazzi, M, Togni, R, Torre, M, Torta, R, Traballesi, M, Trabucco, E, Tramontano, M, Truini, A, Tugnoli, V, Turolla, A, Valeriani, M, Vallies, G, Verzini, E, Vottero, M, Mario, P., Castelnuovo G (ORCID:0000-0003-2633-9822), Giusti EM (ORCID:0000-0001-5767-8785), Padua L (ORCID:0000-0003-2570-9326), Pietrabissa G (ORCID:0000-0002-5911-5748), Sandrini, Giorgio, Tamburin, Stefano, Paolucci, Stefano, Boldrini, Paolo, Saraceni, Vincenzo M, Smania, Nicola, Agostini, M, Alfonsi, E, Aloisi, Am, Alvisi, E, Aprile, I, Armando, M, Avenali, M, Azicnuda, E, Barale, F, Bartolo, M, Bergamaschi, R, Berlangieri, M, Berlincioni, V, Berliocchi, L, Berra, E, Berto, G, Bonadiman, S, Bonazza, S, Bressi, F, Brugnera, A, Brunelli, S, Buzzi, Mg, Cacciatori, C, Calvo, A, Cantarella, C, Caraceni, At, Carone, R, Carraro, E, Casale, R, Castellazzi, P, Castelnuovo, G, Castino, A, Cella, M, Cerbo, R, Chiò, A, Ciotti, C, Cisari, C, Coraci, D, Dalla Toffola, E, Defazio, G, De Icco, R, Del Carro, U, Dell’Isola, A, De Tanti, A, D’Ippolito, M, Fazzi, E, Federico, A, Ferrari, A, Ferrari, S, Ferraro, F, Formaglio, F, Formisano, R, Franzoni, S, Gajofatto, F, Gandolfi, M, Gardella, B, Geppetti, P, Giammò, A, Gimigliano, R, Giusti, Em, Greco, E, Ieraci, V, Invernizzi, M, Jacopetti, M, Jedrychowska, I, Lacerenza, M, La Cesa, S, Lobba, D, Magrinelli, F, Mandrini, S, Manera, U, Manzoni, Gm, Marchettini, P, Marchioni, E, Mariotto, S, Martinuzzi, A, Masciullo, M, Mezzarobba, S, Miotti, D, Modenese, A, Molinari, M, Monaco, S, Morone, G, Nappi, R, Negrini, S, Pace, A, Padua, L, Pagliano, E, Palmerini, V, Paolucci, S, Pazzaglia, C, Pecchioli, C, Pietrabissa, G, Picelli, A, Polli, A, Porro, Ca, Porru, D, Romano, M, Roncari, L, Rosa, R, Saccavini, M, Sacerdote, P, Sandrini, G, Saviola, D, Schenone, A, Schweiger, V, Scivoletto, G, Smania, N, Solaro, C, Spallone, V, Springhetti, I, Tamburin, S, Tassorelli, C, Tinazzi, M, Togni, R, Torre, M, Torta, R, Traballesi, M, Trabucco, E, Tramontano, M, Truini, A, Tugnoli, V, Turolla, A, Valeriani, M, Vallies, G, Verzini, E, Vottero, M, Mario, P., Castelnuovo G (ORCID:0000-0003-2633-9822), Giusti EM (ORCID:0000-0001-5767-8785), Padua L (ORCID:0000-0003-2570-9326), and Pietrabissa G (ORCID:0000-0002-5911-5748)
- Abstract
Time for a Consensus Conference on pain in neurorehabilitation.
- Published
- 2016
98. Predictive factors for response to chemotherapy in colorectal cancer patients
- Author
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Annalisa La Cesa, Bruno Vincenzi, Francesco Graziano, Claudia Grilli, Daniele Santini, Giuseppe Tonini, and Gaia Schiavon
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Oncology ,Response rate (survey) ,Chemotherapy ,medicine.medical_specialty ,Colorectal cancer ,business.industry ,medicine.medical_treatment ,Antineoplastic Agents ,Hematology ,Disease ,Prognosis ,Anticancer chemotherapy ,medicine.disease ,Gastroenterology ,Predictive Value of Tests ,Anticancer treatment ,Internal medicine ,medicine ,Humans ,Colorectal Neoplasms ,Medline database ,business ,Adjuvant ,Biomarkers - Abstract
Colorectal cancer represents a major health problem in the western world. A lot of drugs have been employed in treatment of this disease, but only few data are available about predictive factors for response to anticancer treatments in colorectal cancer. Aim of this paper is to review the main data about this investigation field. Using a Medline database search (1966–2003) we reviewed all the relevant papers that investigate clinical and molecular predictors for response to the main drugs used in the treatment of colorectal cancer patients, both in adjuvant and in advanced setting. Moreover we comprehensively reviewed all the data published in abstract form during the most significant international meetings. Our review put in evidence the most important predictive factors for response in colorectal cancer patients treated with anticancer chemotherapy both in adjuvant and in advanced setting. The predictive factors are clustered on the basis of the different anticancer drugs. The results of this review provide the rationale basis for personalizing anticancer treatment in colorectal cancer patients by molecular and clinical features, aiming to improve response rate and reduce toxicities.
- Published
- 2004
99. The antineoplastic role of bisphosphonates: from basic research to clinical evidence
- Author
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N. Onori, U. Vespasiani Gentilucci, Daniele Santini, Sigfrido Scarpa, A. La Cesa, F. Vasaturo, Giuseppe Tonini, Antonio Picardi, and Bruno Vincenzi
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Osteolysis ,Bone disease ,antineoplastic ,Population ,Apoptosis ,clinical and preclinical evidence ,angiogenesis ,Prostate cancer ,Breast cancer ,Neoplasms ,Cell Adhesion ,medicine ,Humans ,Neoplasm Invasiveness ,Growth Substances ,education ,bisphosphonates ,Multiple myeloma ,education.field_of_study ,Diphosphonates ,Neovascularization, Pathologic ,business.industry ,Bone metastasis ,Cancer ,Hematology ,medicine.disease ,Oncology ,Immunology ,Cancer research ,apoptosis ,business - Abstract
Bisphosphonates are now well established as successful agents for the prevention and treatment of postmenopausal osteoporosis, corticosteroid-induced bone loss and Paget's disease. Bisphosphonates have also recently become important in the management of cancer-induced bone disease, and they now have a widely recognized role for patients with multiple myeloma and bone metastases secondary to breast cancer and prostate cancer. Recent studies suggest that, besides the strong antiosteoclastic activity, the efficacy of such compounds in the oncological setting could also be due also to direct antitumor effect, exerted at different levels. Here, after a brief analysis of the chemical structure, we will review the antineoplastic and biological properties of bisphosphonates. We will start from well estabilished mechanisms of action and go on to discuss the latest evidence and hypotheses. In particular, we will review the antiresorptive properties in malignant osteolysis and the recent evidence of a direct antitumor effect. Furthermore, this review will analyze the influence of bisphosphonates on cancer growth factor release, their effect on cancer cell adhesion, invasion and viability, the proapoptotic potential on cancer cells, the antiangiogenic effect, and, finally, the immunomodulating properties of bisphosphonates on the gammadelta T cell population.
- Published
- 2003
100. Natural history and outcome of 200 outpatients with classical trigeminal neuralgia treated with carbamazepine or oxcarbazepine in a tertiary centre for neuropathic pain
- Author
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Silvia La Cesa, Giulia Di Stefano, Andrea Truini, and Giorgio Cruccu
- Subjects
Male ,medicine.medical_specialty ,Neurology ,Clinical Neurology ,Short Report ,Natural history ,Oxcarbazepine ,Tertiary Care Centers ,Trigeminal neuralgia ,Internal medicine ,medicine ,Ambulatory Care ,Humans ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,General Medicine ,Carbamazepine ,Analgesics, Non-Narcotic ,Middle Aged ,Trigeminal Neuralgia ,medicine.disease ,Tolerability ,Classic trigeminal neuralgia ,Surgery ,Anesthesiology and Pain Medicine ,Treatment Outcome ,Neuropathic pain ,Neuralgia ,Female ,Neurology (clinical) ,business ,medicine.drug ,Follow-Up Studies - Abstract
Background The guidelines on trigeminal neuralgia management that have been agreed and jointly published by the American Academy of Neurology and the European Federation of Neurological Societies recommend carbamazepine (CBZ) and oxcarbazepine (OXC) as the first-choice medical treatments in patients with trigeminal neuralgia (TN). The aim of this retrospective study was to analyze the natural history of classical trigeminal neuralgia in a large cohort of patients, focusing on drug responsiveness, side effects related to CBZ and OXC, and changes in pain characteristics during the course of disease. Findings We selected the last 100 consecutive patients with typical TN who began treatment with CBZ and the last 100 with OXC. All had MRI scans and a complete neurophysiological study of trigeminal reflexes. Among them, 22 were excluded on the basis of neuroradiological or neurophysiological investigations, to avoid the inclusion of patients with possible secondary TN. The initial number of responders was 98% with CBZ with a median dose of 600 mg (range 200–1200), and of 94% with OXC, with a median dose of 1200 mg (range 600–1800). In a mean period of 8.6 months, 27% of responders to CBZ incurred in undesired effects to a level that caused interruption of treatment or a dosage reduction to an unsatisfactory level. In a mean period of 13 months, the same occurred to 18% of responders to OXC. Among patients who had a good initial response, only 3 patients with CBZ and 2 with OXC developed late resistance. During the course of disease, paroxysms worsened in intensity in 3% of patients, and paroxysms duration increased in 2%. We did not observe the onset of a clinically manifest sensory deficit at any time in any patient. Conclusions Unlike common notion, in our large patient sample the worsening of pain with time and the development of late resistance only occurred in a very small minority of patients. CBZ and OXC were confirmed to be efficacious in a large majority of patients, but the side effects caused withdrawal from treatment in an important percentage of patients. These results suggest the opportunity to develop a better tolerated drug.
- Published
- 2014
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