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1. Carotid artery stenting during endovascular thrombectomy for acute ischemic stroke with tandem occlusion: the Italian Registry of Endovascular Treatment in Acute Stroke

Author

Sallustio, Fabrizio, Pracucci, Giovanni, Cappellari, Manuel, Saia, Valentina, Mascolo, Alfredo Paolo, Marrama, Federico, Gandini, Roberto, Koch, Giacomo, Diomedi, Marina, D’Agostino, Federica, Rocco, Alessandro, Da Ros, Valerio, Wlderk, Andrea, Nezzo, Marco, Argirò, Renato, Morosetti, Daniele, Renieri, Leonardo, Nencini, Patrizia, Vallone, Stefano, Zini, Andrea, Bigliardi, Guido, Pitrone, Antonio, Grillo, Francesco, Bracco, Sandra, Tassi, Rossana, Bergui, Mauro, Naldi, Andrea, Carità, Giuseppe, Casetta, Ilaria, Gasparotti, Roberto, Magoni, Mauro, Simonetti, Luigi, Haznedari, Nicolò, Paolucci, Matteo, Mavilio, Nicola, Malfatto, Laura, Menozzi, Roberto, Genovese, Antonio, Cosottini, Mirco, Orlandi, Giovanni, Comai, Alessio, Franchini, Enrica, Pedicelli, Alessandro, Frisullo, Giovanni, Puglielli, Edoardo, Casalena, Alfonsina, Cester, Giacomo, Baracchini, Claudio, Castellano, Davide, Di Liberto, Alessandra, Ricciardi, Giuseppe Kenneth, Chiumarulo, Luigi, Petruzzellis, Marco, Lafe, Elvis, Persico, Alessandra, Cavasin, Nicola, Critelli, Adriana, Semeraro, Vittorio, Tinelli, Angelica, Giorgianni, Andrea, Carimati, Federico, Auteri, William, Rizzuto, Stefano, Biraschi, Francesco, Nicolini, Ettore, Ferrari, Antonio, Melis, Maurizio, Calia, Stefano, Tassinari, Tiziana, Nuzzi, Nunzio Paolo, Corato, Manuel, Sacco, Simona, Squassina, Guido, Invernizzi, Paolo, Gallesio, Ivan, Ruiz, Luigi, Dui, Giovanni, Carboni, Nicola, Amistà, Pietro, Russo, Monia, Maiore, Mario, Zanda, Bastianina, Craparo, Giuseppe, Mannino, Marina, Inzitari, Domenico, Toni, Danilo, Mangiafico, Salvatore, Gasparotti, R., Inzitari, D., Mangiafico, S., Toni, D., Vallone, S., Zini, A., Bergui, M., Causin, F., Ciccone, A., Nencini, P., Saletti, A., Sallustio, F., Tassi, R., Thyrion, F. Zappoli, Pracucci, G., Saia, V., Gandini, R., Da Ros, V., Greco, L., Morosetti, D., Diomedi, M., Nappini, S., Limbucci, N., Renieri, L., Fainardi, E., Verganti, L., Sacchetti, F., Zelent, G., Bigliardi, G., Dell’Acqua, M. L., Picchetto, L., Vandelli, L., Pentore, R., Maffei, S., Nichelli, P., Longo, M., Pitrone, A., Vinci, S. L., Velo, M., Caragliano, A., Tessitore, A., Bonomo, O., Musolino, R., La Spina, P., Casella, C., Fazio, M. C., Grillo, F., Cotroneo, M., Dell’Aera, C., Francalanza, I., Bracco, S., Cioni, S., Gennari, P., Vallone, I. M., Cerase, A., Martini, G., Stura, G., Daniele, D., Cerrato, P., Naldi, A., Onofrio, M., De Vito, A., Azzini, C., Casetta, I., Mardighian, D., Frigerio, M., Magoni, M., Costa, A., Simonetti, L., Cirillo, L., Taglialatela, F., Isceri, S., Princiotta, C., Dall’Olio, M., Cellerini, M., Gentile, M., Piccolo, L., Migliaccio, L., Brancaleoni, L., Naldi, F., Romoli, M., Zaniboni, A., Ruggiero, M., Sanna, A., Haznedari, N., Commodaro, C., Longoni, M., Biguzzi, S., Cordici, F., Malatesta, E., Castellan, L., Mavilio, N., Salsano, G., Malfatto, L., Finocchi, C., Menozzi, R., Piazza, P., Epifani, E., Andreone, A., Scoditti, U., Castellini, P., Latte, L., Grisendi, I., Cosottini, M., Puglioli, M., Lazzarotti, G., Lauretti, D., Mancuso, M., Giannini, N., Maccarone, M., Orlandi, G., Comai, A., Bonatti, G., Nano, G., Ferro, F., Bonatti, M., Dall’Ora, E., Dossi, R. Currò, Turri, E., Turri, M., Colosimo, C., Pedicelli, A., D’Argento, F., Alexandre, A., Frisullo, G., Di Egidio, V., Puglielli, E. G., Ruggero, L., Assetta, M., Casalena, A., Cester, G., Baracchini, C., Viaro, F., Pieroni, A., Vaudano, G., Comelli, C., Di Maggio, L., Castellano, D., Cavallo, R., Duc, E., Chianale, G., Ciceri, E. F. M., Plebani, M., Augelli, R., Zampieri, P., Grazioli, A., Cappellari, M., Forlivesi, S., Tomelleri, G., Micheletti, N., Chiumarulo, L., Zimatore, D. S., Federico, F., Petruzzelli, M., Zappoli, F., Lafe, E., Sanfilippo, G., Sgreccia, A., Martignoni, A., Cavallini, A., Denaro, F., Persico, A., Cagliari, E., Cavasin, N., Quatrale, R., Critelli, A., Burdi, N., Semeraro, V., Lucarelli, N., Ganimede, M. P., Internò, S., Tinelli, A., Prontera, M. P., Pesare, A., Cotroneo, E., Pampana, E., Ricciardi, F., Gigli, R., Pezzella, F. R., Corsi, F., Giorgianni, A., Baruzzi, F., Pellegrino, C., Terrana, A., Versino, M., Delodovici, M. L., Carimati, F., Cariddi, L. Princiotta, Auteri, W., Di Benedetto, O., Silvagni, U., Perrotta, P., Crispino, E., Petrone, A., Stancati, F., Rizzuto, S., Pugliese, P., Pisani, E., Siniscalchi, A., Gaudiano, C., Pirritano, D., Del Giudice, F., Piano, M., Agostoni, E., Motto, C., Gatti, A., Guccione, A., Tortorella, R., Stecco, A., Guzzardi, G., Del Sette, B., Coppo, L., Baldan, J., Romano, D., Siani, A., Locatelli, G., Saponiero, R., Napolitano, R., De Gregorio, M., Volpe, G., Tenuta, M., Guidetti, G., Biraschi, F., Wulbek, A., Falcou, A., Anzini, A., Mancini, A., De Michele, M., Fausti, S., Di Mascio, M. T., Durastanti, L., Sbardella, E., Mellina, V., Nicolini, E., Comelli, S., Ganau, C., Corraine, S., Fusaro, F., Ferrari, A., Schirru, F., Ledda, V., Secci, S., Melis, M., Piras, V., Moller, J., Padolecchia, R., Allegretti, L., Caldiera, V., Calia, S., Ganci, G., Tassinari, T., Sugo, A., De Nicola, M., Giannoni, M., Bruni, S., Gambelli, E., Provinciali, L., Nuzzi, N. P., Marcheselli, S., Corato, M., Scomazzoni, F., Simionato, F., Roveri, L., Filauri, P., Sacco, S., Orlandi, B., De Santis, F., Tiseo, C., Notturno, F., Ornello, R., Pavia, M., Squassina, G., Cobelli, M., Morassi, M., Magni, E., Invernizzi, P., Pepe, F., Bigni, B., Costa, P., Crabbio, M., Griffini, S., Palmerini, F., Piras, M. P., Gallesio, I., Barbero, S., Ferrandi, D., Dui, G., Fancello, M. C., Zedda, S., Ticca, A., Saddi, M. V., Deiana, G., Rossi, R., Carboni, N., Mela, A., Amistà, P., Russo, M., Iannucci, G., Pinna, V., Di Clemente, L., Santi, M., De Boni, A., De Luca, C., Natrella, M., Fanelli, G., Cristoferi, M., Bottacchi, E., Corso, G., Tosi, P., Sessa, M., Giossi, A., Baietti, Null, Romano, G., Meineri, P., Armentano, A., Versace, P., Arcudi, L., Galvano, G., Petralia, B., Feraco, P., Luppi, G., Giometto, B., Bignamini, V., Piffer, S., Meloni, G. B., Fabio, C., Maiore, M., Pintus, F., Pischedda, A., Manca, A., Mongili, C., Zanda, B., Baule, A., Florio, F., Ciccarese, G., Leone, M., Di Viesti, P., Pappalardo, M. P., Craparo, G., Gallo, C., Monaco, S., Mannino, M., Muto, M., Guarnieri, Gl., Andreone, V., Passalacqua, G., Allegritti, M., Caproni, S., Filizzolo, M., Salmaggi, A., Giordano, A., Marini, C., Frattale, I., Lucente, G., Nozzoli, C., and Lupo, F. A.

Subjects
Stent, Acute stroke, Settore MED/37 - Neuroradiologia, Acute stroke Internal carotid artery diseases Stent Thrombectomy, Neurology (clinical), General Medicine, Settore MED/26, Internal carotid artery diseases, Thrombectomy
Abstract

The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage.Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively.Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality.

Published
2022

2. IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke

Author

Cappellari, M., Mangiafico, S., Saia, V., Pracucci, G., Nappini, S., Nencini, P., Konda, D., Sallustio, F., Vallone, S., Zini, A., Bracco, S., Tassi, R., Bergui, M., Cerrato, P., Pitrone, A., Grillo, F., Saletti, A., De Vito, A., Gasparotti, Roberto, Magoni, M., Puglielli, E., Casalena, A., Causin, F., Baracchini, C., Castellan, L., Malfatto, L., Menozzi, R., Scoditti, U., Comelli, C., Duc, E., Comai, A., Franchini, E., Cosottini, M., Mancuso, M., Peschillo, S., De Michele, M., Giorgianni, A., Delodovici, M. L., Lafe, E., Denaro, M. F., Burdi, N., Interno, S., Cavasin, N., Critelli, A., Chiumarulo, L., Petruzzellis, M., Doddi, M., Carolei, A., Auteri, W., Petrone, A., Padolecchia, R., Tassinari, T., Pavia, M., Invernizzi, P., Turcato, G., Forlivesi, S., Ciceri, E. F. M., Bonetti, B., Inzitari, D., Toni D., Limbucci N, Consoli, A, Renieri, L, Fainardi, E, Gandini, R, Pampana, E, Diomedi, M, Koch, G, Verganti, L, Sacchetti, F, Zelent, G, Bigliardi, G, Picchetto, L, Vandelli, L, Romano, Dg, Cioni, S, Gennari, P, Cerase, A, Martini, G, Stura, G, Daniele, D, Naldi, A, Papa, R, Vinci, Sl, Bernava, G, Velo, M, Caragliano, A, Tessitore, A, Buonomo, O, Musolino, R, La Spina, P, Casella, C, Carolina Fazio, M, Cotroneo, M, Onofrio, M, Azzini, C, Casetta, I, Mardighian, D, Frigerio, M, Costa, A, Di Egidio, V, Lattanzi, R, Assetta, M, Cester, G, Mavilio, N, Serrati, C, Piazza, P, Epifani, E, Andreone, A, Castellini, P, Latte, L, Grisendi, I, Vaudano, G, Comelli, S, Cavallo, R, Chianale, G, Simonetti, L, Taglialatela, F, Isceri, S, Procaccianti, G, Zaniboni, A, Borghi, A, Bonatti, G, Ferro, F, Bonatti, M, Dall'Ora, E, Currò Dossi, R, Turri, E, Turri, M, Puglioli, M, Lazzarotti, G, Lauretti, D, Giannini, N, Maccarone, M, Orlandi, G, Chiti, A, Guidetti, G, Biraschi, F, Falcou, A, Anzini, A, Mancini, A, Fausti, S, Di Mascio, Mt, Durastanti, L, Sbardella, E, Mellina, V, Baruzzi, F, Pellegrino, C, Terrana, A, Carimati, F, Ruggiero, M, Sanna, A, Passarin, Mg, Colosimo, C, Pedicelli, A, D'Argento, F, Alexandre, A, Frisullo, G, Zappoli, F, Martignoni, A, Cavallini, A, Persico, A, Valvassori, L, Piano, M, Agostoni, E, Motto, C, Gatti, A, Longoni, M, Guccione, A, Tortorella, R, Zampieri, P, Zimatore, D, Grazioli, A, Ricciardi, Gk, Augelli, R, Bovi, P, Tomelleri, G, Micheletti, N, Semeraro, V, Lucarelli, N, Ganimede, M, Tinelli, A, Pia Prontera, M, Pesare, A, Cagliari, E, Quatrale, R, Federico, F, Passalacqua, G, Filauri, P, Orlandi, B, De Santis, F, Gabriele, A, Tiseo, C, Armentano, A, Di Benedetto, O, Silvagni, U, Perrotta, P, Crispino, E, Stancati, F, Rizzuto, S, Pugliese, P, Pisani, E, Siniscalchi, A, Gaudiano, C, Pirritano, D, Del Giudice, F, Calia, S, Ganci, G, Sugo, A, Scomazzoni, F, Simionato, F, Roveri, L, De Nicola, M, Giannoni, M, Bruni, S, Gambelli, E, Provinciali, L, Carriero, A, Coppo, L, Baldan, J, Paolo Nuzzi, N, Marcheselli, S, Corato, M, Cotroneo, E, Ricciardi, F, Gigli, R, Pozzessere, C, Pezzella, Fr, Corsi, F, Squassina, G, Cobelli, M, Morassi, M, Magni, Eugenio, Pepe, F, Bigni, B, Costa, P, Crabbio, M, Griffini, S, Palmerini, F, Piras, Mp, Natrella, M, Fanelli, G, Cristoferi, M, Bottacchi, E, Corso, G, Tosi, P, Amistà, P, Russo, M, Tettoni, S, Gallesio, I, Mascolo, Mc, Meloni, Gb, Fabio, C, Maiore, M, Pintus, F, Pischedda, A, Manca, A, Mongili, C, Zanda, B, Baule, A, Pappalardo, Mp, Craparo, G, Gallo, C, Monaco, S, Mannino, M, Terruso, V, Muto, M, Guarnieri, G, Andreone, V, Dui, G, Ticca, A, Salmaggi, A, Iannucci, G, Pinna, V, Di Clemente, L, Perini, F, De Boni, A, De Luca, C, De Giorgi, F, Corraine, S, Enne, P, Ganau, C, Piras, V., Gasparotti R., Magni E (ORCID:0000-0002-2235-2280), Cappellari, M., Mangiafico, S., Saia, V., Pracucci, G., Nappini, S., Nencini, P., Konda, D., Sallustio, F., Vallone, S., Zini, A., Bracco, S., Tassi, R., Bergui, M., Cerrato, P., Pitrone, A., Grillo, F., Saletti, A., De Vito, A., Gasparotti, Roberto, Magoni, M., Puglielli, E., Casalena, A., Causin, F., Baracchini, C., Castellan, L., Malfatto, L., Menozzi, R., Scoditti, U., Comelli, C., Duc, E., Comai, A., Franchini, E., Cosottini, M., Mancuso, M., Peschillo, S., De Michele, M., Giorgianni, A., Delodovici, M. L., Lafe, E., Denaro, M. F., Burdi, N., Interno, S., Cavasin, N., Critelli, A., Chiumarulo, L., Petruzzellis, M., Doddi, M., Carolei, A., Auteri, W., Petrone, A., Padolecchia, R., Tassinari, T., Pavia, M., Invernizzi, P., Turcato, G., Forlivesi, S., Ciceri, E. F. M., Bonetti, B., Inzitari, D., Toni D., Limbucci N, Consoli, A, Renieri, L, Fainardi, E, Gandini, R, Pampana, E, Diomedi, M, Koch, G, Verganti, L, Sacchetti, F, Zelent, G, Bigliardi, G, Picchetto, L, Vandelli, L, Romano, Dg, Cioni, S, Gennari, P, Cerase, A, Martini, G, Stura, G, Daniele, D, Naldi, A, Papa, R, Vinci, Sl, Bernava, G, Velo, M, Caragliano, A, Tessitore, A, Buonomo, O, Musolino, R, La Spina, P, Casella, C, Carolina Fazio, M, Cotroneo, M, Onofrio, M, Azzini, C, Casetta, I, Mardighian, D, Frigerio, M, Costa, A, Di Egidio, V, Lattanzi, R, Assetta, M, Cester, G, Mavilio, N, Serrati, C, Piazza, P, Epifani, E, Andreone, A, Castellini, P, Latte, L, Grisendi, I, Vaudano, G, Comelli, S, Cavallo, R, Chianale, G, Simonetti, L, Taglialatela, F, Isceri, S, Procaccianti, G, Zaniboni, A, Borghi, A, Bonatti, G, Ferro, F, Bonatti, M, Dall'Ora, E, Currò Dossi, R, Turri, E, Turri, M, Puglioli, M, Lazzarotti, G, Lauretti, D, Giannini, N, Maccarone, M, Orlandi, G, Chiti, A, Guidetti, G, Biraschi, F, Falcou, A, Anzini, A, Mancini, A, Fausti, S, Di Mascio, Mt, Durastanti, L, Sbardella, E, Mellina, V, Baruzzi, F, Pellegrino, C, Terrana, A, Carimati, F, Ruggiero, M, Sanna, A, Passarin, Mg, Colosimo, C, Pedicelli, A, D'Argento, F, Alexandre, A, Frisullo, G, Zappoli, F, Martignoni, A, Cavallini, A, Persico, A, Valvassori, L, Piano, M, Agostoni, E, Motto, C, Gatti, A, Longoni, M, Guccione, A, Tortorella, R, Zampieri, P, Zimatore, D, Grazioli, A, Ricciardi, Gk, Augelli, R, Bovi, P, Tomelleri, G, Micheletti, N, Semeraro, V, Lucarelli, N, Ganimede, M, Tinelli, A, Pia Prontera, M, Pesare, A, Cagliari, E, Quatrale, R, Federico, F, Passalacqua, G, Filauri, P, Orlandi, B, De Santis, F, Gabriele, A, Tiseo, C, Armentano, A, Di Benedetto, O, Silvagni, U, Perrotta, P, Crispino, E, Stancati, F, Rizzuto, S, Pugliese, P, Pisani, E, Siniscalchi, A, Gaudiano, C, Pirritano, D, Del Giudice, F, Calia, S, Ganci, G, Sugo, A, Scomazzoni, F, Simionato, F, Roveri, L, De Nicola, M, Giannoni, M, Bruni, S, Gambelli, E, Provinciali, L, Carriero, A, Coppo, L, Baldan, J, Paolo Nuzzi, N, Marcheselli, S, Corato, M, Cotroneo, E, Ricciardi, F, Gigli, R, Pozzessere, C, Pezzella, Fr, Corsi, F, Squassina, G, Cobelli, M, Morassi, M, Magni, Eugenio, Pepe, F, Bigni, B, Costa, P, Crabbio, M, Griffini, S, Palmerini, F, Piras, Mp, Natrella, M, Fanelli, G, Cristoferi, M, Bottacchi, E, Corso, G, Tosi, P, Amistà, P, Russo, M, Tettoni, S, Gallesio, I, Mascolo, Mc, Meloni, Gb, Fabio, C, Maiore, M, Pintus, F, Pischedda, A, Manca, A, Mongili, C, Zanda, B, Baule, A, Pappalardo, Mp, Craparo, G, Gallo, C, Monaco, S, Mannino, M, Terruso, V, Muto, M, Guarnieri, G, Andreone, V, Dui, G, Ticca, A, Salmaggi, A, Iannucci, G, Pinna, V, Di Clemente, L, Perini, F, De Boni, A, De Luca, C, De Giorgi, F, Corraine, S, Enne, P, Ganau, C, Piras, V., Gasparotti R., and Magni E (ORCID:0000-0002-2235-2280)

Abstract

Background and Purpose - As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods - We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results - National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions - The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.

Published
2019

4. Embolic strokes of undetermined source: prevalence and patient features in the esus global registry

Author

Perera, K. S., Vanassche, T., Bosch, J., Giruparajah, M., Swaminathan, B., Mattina, K. R., Berkowitz, S. D., Arauz, A., O'Donnell, M. J., Ameriso, S. F., Hankey, G. J., Yoon, B. -W., Lavallee, P., Cunha, L., Shamalov, N., Brouns, R., Gagliardi, R. J., Kasner, S. E., Pieroni, A., Vermehren, P., Kitagawa, K., Wang, Y., Muir, K., Coutinho, J., Vastagh, I., Connolly, S. J., Hart, R. G., Czeto, K., Kahn, M., Gomez Schneider, M., Pujol Lereis, V., Hawkes, M., Pertierra, L., Perera, N., De Smedt, A., Van Dyck, R., Van Hooff, R. J., Yperzeele, L., Baptista Gagliardi, V. D., Cerqueir, L. G., Yang, X., Chen, W., Amarenco, P., Guidoux, C., Ringleb, P. A., Bereczki, D., Canavan, M., Toni, D., Anzini, A., Colosimo, C., De Michele, M., Di Mascio, M. T., Durastanti, L., Falcou, A., Fausti, S., Mancini, A., Mizumo, S., Uchiyama, S., Kim, C. K., Jung, S., Kim, Y., Kim, J. A., J. Y., Jo, Barboza, M., Quiroz-Compean, A., Colin, J., Nederkoorn, P. J., Roxas, A., Perez Marianito, V., Santo, G., Silva, F., Sargento-Freitas, J., Coelho, J., Kustova, M., Meshkova, K., Williams, G., Siegler, J., Zhang, C., Gallatti, N., Kruszewski, M., Clinical sciences, Neuroprotection & Neuromodulation, ANS - Neurovascular Disorders, Neurology, ACS - Amsterdam Cardiovascular Sciences, and ESUS Global Registry Investigators

Subjects
Male, medicine.medical_specialty, Internationality, Cross-sectional study, 030204 cardiovascular system & hematology, stroke-etiology, cerebral embolism, embolism, Atrial fibrillation, Cerebral embolism, Diagnostic evaluation, Embolism, Stroke, Stroke-etiology, Brain Ischemia, 03 medical and health sciences, ischemic-stroke, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Prevalence, Humans, atrial fibrillation, Registries, cardiovascular diseases, Aged, Retrospective Studies, Medicine(all), business.industry, International survey, Retrospective cohort study, Mean age, Middle Aged, diagnostic evaluation, medicine.disease, stroke, atrial-fibrillation, Cross-Sectional Studies, Neurology, stroke—etiology, Ischemic stroke, Cardiology, cryptogenic stroke, Female, Human medicine, business, 030217 neurology & neurosurgery
Abstract

Background Recent evidence supports that most non-lacunar cryptogenic strokes are embolic. Accordingly, these strokes have been designated as embolic strokes of undetermined source (ESUS). Aims We undertook an international survey to characterize the frequency and clinical features of ESUS patients across global regions. Methods Consecutive patients hospitalized for ischemic stroke were retrospectively surveyed from 19 stroke research centers in 19 different countries to collect patients meeting criteria for ESUS. Results Of 2144 patients with recent ischemic stroke, 351 (16%, 95% CI 15% to 18%) met ESUS criteria, similar across global regions (range 16% to 21%), and an additional 308 (14%) patients had incomplete evaluation required for ESUS diagnosis. The mean age of ESUS patients (62 years; SD = 15) was significantly lower than the 1793 non-ESUS ischemic stroke patients (68 years, p ≤ 0.001). Excluding patients with atrial fibrillation ( n = 590, mean age = 75 years), the mean age of the remaining 1203 non-ESUS ischemic stroke patients was 64 years ( p = 0.02 vs. ESUS patients). Among ESUS patients, hypertension, diabetes, and prior stroke were present in 64%, 25%, and 17%, respectively. Median NIHSS score was 4 (interquartile range 2–8). At discharge, 90% of ESUS patients received antiplatelet therapy and 7% received anticoagulation. Conclusions This cross-sectional global sample of patients with recent ischemic stroke shows that one-sixth met criteria for ESUS, with additional ESUS patients likely among those with incomplete diagnostic investigation. ESUS patients were relatively young with mild strokes. Antiplatelet therapy was the standard antithrombotic therapy for secondary stroke prevention in all global regions.

Published
2016

5. Global survey of the frequency of atrial fibrillation–associated stroke

Author

Perera, Kanjana S., Vanassche, Thomas, Bosch, Jackie, Swaminathan, Balakumar, Mundl, Hardi, Giruparajah, Mohana, Barboza, Miguel A., O’Donnell, Martin J., Gomez-Schneider, Maia, Hankey, Graeme J., Yoon, Byung-Woo, Roxas, Artemio, Lavallee, Philippa, Sargento-Freitas, Joao, Shamalov, Nikolay, Brouns, Raf, Gagliardi, Rubens J., Kasner, Scott E., Pieroni, Alessio, Vermehren, Philipp, Kitagawa, Kazuo, Wang, Yongjun, Muir, Keith, Coutinho, Jonathan M., Connolly, Stuart J., Hart, Robert G., Czeto, K., Kahn, M., Mattina, K.R., Ameriso, S.F., Pujol-Lereis, V., Hawkes, M., Pertierra, L., Perera, N., De Smedt, A., Van Dyck, R., Van Hooff, R.J., Yperzeele, Laetitia, Gagliardi, V.D.B., Cerqueir, L.G., Yang, X., Chen, W., Amarenco, P., Guidoux, C., Ringleb, P.A., Bereczki, D., Vastagh, I., Canavan, M., Toni, D., Anzini, A., Colosimo, C., De Michele, M., Di Mascio, M.T., Durastanti, L., Falcou, A., Fausti, S., Mancini, A., Mizumo, S., Uchiyama, S., Kim, C.K., Jung, S., Kim, Y., Kim, J.A., Jo, J.Y., Arauz, A., Quiroz-Compean, A., Colin, J., Nederkoorn, P.J., Marianito, V.P., Cunha, L., Santo, G., Silva, F., Coelho, J., Kustova, M., Meshkova, K., Williams, G., Siegler, J., Zhang, C., Gallatti, N., and Kruszewski, M.

Subjects
Human medicine
Abstract

Background and Purpose— Atrial fibrillation (AF) is increasingly recognized as the single most important cause of disabling ischemic stroke in the elderly. We undertook an international survey to characterize the frequency of AF-associated stroke, methods of AF detection, and patient features. Methods— Consecutive patients hospitalized for ischemic stroke in 2013 to 2014 were surveyed from 19 stroke research centers in 19 different countries. Data were analyzed by global regions and World Bank income levels. Results— Of 2144 patients with ischemic stroke, 590 (28%; 95% confidence interval, 25.6–29.5) had AF-associated stroke, with highest frequencies in North America (35%) and Europe (33%) and lowest in Latin America (17%). Most had a history of AF before stroke (15%) or newly detected AF on electrocardiography (10%); only 2% of patients with ischemic stroke had unsuspected AF detected by poststroke cardiac rhythm monitoring. The mean age and 30-day mortality rate of patients with AF-associated stroke (75 years; SD, 11.5 years; 10%; 95% confidence interval, 7.6–12.6, respectively) were substantially higher than those of patients without AF (64 years; SD, 15.58 years; 4%; 95% confidence interval, 3.3–5.4; P75 years old) and more often women.

Published
2016

6. [Untitled]

Author

La Penna G, Paoletti J, Lancelot G, Fausti S, D. Genest, and Angelo Perico

Subjects
chemistry.chemical_classification, RNA, Sequence (biology), Computational biology, Stem-loop, Biochemistry, Genome, Crystallography, chemistry, Nucleotide, Relaxation (approximation), Two-dimensional nuclear magnetic resonance spectroscopy, Spectroscopy, Macromolecule
Abstract

The cross-peaks of 1H-NOESY spectra at different time delays are compared to a mode-coupling diffusion (MCD) calculation, including the evaluation of the full 1H relaxation matrix, in the case of a 23 nucleotide fragment of the stem-loop SL1 domain of HIV-1Lai genomic RNA mutated in a single position. The MCD theory gives significant agreement with 1H relaxation experiments enabling a thorough understanding of the differential local dynamics along the sequence and particularly of the dynamics of nucleotides in the stem and in the loop. The differential dynamics of this hairpin structure is important in directing the dimerization of the retroviral genome, a fundamental step in the infectious process. The demonstration of a reliable use of time dependent NOE cross-peaks, largely available from NMR solution structure determination, coupled to MCD analysis, to probe the local dynamics of biological macromolecules, is a result of general interest of this paper.

Published
2001

15. Fase dell'assistenza in emergenza-urgenza

Author

Danilo Toni, Anzini, A., Falcou, A., Fausti, S., Gori, C., Gragnani, F., Mancini, A., Cavalletti, Cristina, Colosimo, Carlo, Fiorelli, Marco, Maria Luisa Sacchetti, and Argentino, Corrado

Published
2003

16. Electromyographic mixed nerve and cutaneous silent period in evaluating the A-delta fibres in a patient with hereditary sensory-autonomic neuropathy

Author

Corsi, F. M., Fausti, S., Serrao, Mariano, Casali, Carlo, Parisi, Leoluca, and Piazza, G.

Subjects
a-delta fibres, Adult, Male, cutaneous silent period, mixed nerve silent period, Electromyography, Nociceptors, Pain, Nerve Fibers, Myelinated, Electric Stimulation, Median Nerve, Gangrene, Skin Ulcer, electromyography, hereditary sensory-autonomic neuropathy, Humans, Thermosensing, Hereditary Sensory and Autonomic Neuropathies, Muscle, Skeletal, Skin
Abstract

The aim of this study was to evaluate A-delta fibre function in a patient with hereditary sensory-autonomic neuropathy (HSAN). We used the mixed and cutaneous silent period techniques in addition to a conventional electromyographic investigation in a patient with type 2 HSAN, a rare disease characterised by wide-spread sensory and variable autonomic dysfunction caused by incomplete development of sensory and autonomic neurons. Whereas the stimulation of one digital nerve did not show any evidence of silent period in either the left or the right hand, the simultaneous stimulation of two digital nerves, as well as the stimulation of a mixed nerve, revealed a measurable delayed and shortened silent period. These data suggest that a spatial summation mediated by A-delta fibres was required for generation of the silent period in this patient and that combining the CSP and MNSP may be of practical use in evaluating impairment of the small myelinated fibres.

Published
2002

20. Backbone dynamics for the wild type and a double H52R/T56W mutant of the vnd/NK-2 homeodomain from Drosophila Melanogaster

Author

Fausti S. 1, Nirenberg M. 2, Weiler S. 2, Cuniberti C. 3, Perico A. 1, Gruschus J.M. 2, and Ferretti J.A. 2

Subjects
STRUCTURE, HOMEODOMAIN, DNA complex, NMR
Abstract

The N-15 relaxation behavior and heteronuclear Overhauser effect data for the wild type and an H52R/T56W double mutant protein that encompasses the vnd/NK-2 homeodomain from Drosophila melanogaster were used to characterize and describe the protein backbone dynamics. This investigation. which includes a description of a model structure for the H52R/T56W double mutant vnd/NK-2 homeodomain. was carried out for the two proteins in both the free and DNA-bound states. The double residue replacement at positions 52 and 56 within the DNA recognition helix of vnd/NK-2 has been shown to lead to a significant secondary structural modification resulting in an increase in the length of the recognition helix for the unbound protein. These structural changes are accompanied by corresponding changes in the T, and Tip relaxation times as well as in the heteronuclear Overhauser effect (XNOE) values that show that the structural stability of the protein is enhanced by the two residue replacements. The values of the rotational anisotropy, D-parallel to/D-perpendicular to, derived from analysis of the N-15 T-1 and T-1 rho relaxation values are small (1.189 for the unbound homeodomain and 1.110 for the bound homeodomain; both analyzed as prolate ellipsoids of revolution). A comparison of the T, values of the wild type and double mutant homeodomain reveals the presence of a low-frequency exchange contribution for the wild type analogue. These relaxation studies show that the motional behavior of the protein primarily reflects the tertiary structure and stability of the homeodomain backbone as well as the respective changes induced upon site-directed residue replacement or DNA binding.

Published
2001

33. Age categorization of high-frequency auditory threshold data.

Author

Schechter, M. A., Fausti, S. A., Rappaport, B. Z., and Frey, R. H.

Abstract

This article presents high-frequency (8- to 20-kHz) auditory threshold measurements for 157 subjects with normal conventional hearing, ranging in age from 6-30 years. Normative descriptive data are provided in five semidecade age categories. Intra-age category mean and variance values for threshold sensitivity and interaural threshold differences are included. Generally, the data are consistent with the expectation of a gradual diminution of high-frequency sensitivity through the adolescent and early adult years. Several unresolved issues related to high-frequency normative data and clinical applicability of high-frequency threshold measurements are discussed. [ABSTRACT FROM AUTHOR]

Published
1986
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34. An investigation of the validity of high-frequency audition.

Author

Fausti, S. A., Rappaport, B. Z., Schechter, M. A., and Frey, R. H.

Abstract

In this investigation, a masking experiment was utilized to explore the validity of high-frequency audition. Threshold shifts produced by a narrow-band noise with sharp filter slopes and variable center frequency were determined for pure-tone stimuli from 8000 to 14 000 Hz. Subjects were young adults with normal hearing from 250 through 8000 Hz, and with high-frequency thresholds comparable to those obtained in a previously conducted normative survey. After pure-tone thresholds were obtained for each test frequency, a narrow-band masker was presented ipsilateral to the pure-tone stimulus with center frequency equal to the pure tone. The masker was adjusted to an intensity level necessary to shift the pure-tone threshold approximately 17 dB. The center frequency of the masker was then decreased in discrete steps with the pure-tone threshold re-established at each step. The experimental results, as demonstrated by release-from-masking functions, are consistent with the expectation of increased masker effectiveness as the center frequency of the masker approximates the test frequency. The findings of this investigation suggest that responses to high-frequency auditory stimulation are the result of high-frequency perception, and not the perception of some lower frequency distortion process. [ABSTRACT FROM AUTHOR]

Published
1982
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37. Smoluchowski dynamics of the vnd/NK-2 homeodomain from <TOGGLE>Drosophila melanogaster:</TOGGLE> Second-order maximum correlation approximation

Author

Penna, Giovanni La, Fausti, S., Perico, Angelo, and Ferretti, J. A.

Abstract

The mode coupling diffusion theory is applied to the derivation of local dynamics in proteins in solution. The rotational dynamics of the bonds along the protein sequence are calculated and compared to the experimentally measured nmr 15N spin-lattice relaxation time T1, at 36.5, 60.8, and 81.1 MHz of the vnd/NK-2 homeodomain from Drosophila melanogaster. The starting point for the calculations is the experimental three-dimensional solution structure of the homeodomain determined by multidimensional nmr spectroscopy. The higher order mode-coupling computations are compared also with the recently published first-order approximation calculations. The more accurate calculations improve substantially the first-order ORZLD calculations and show that the role of the strength of the hydrodynamic interactions becomes crucial to fix the order of magnitude of the rotational dynanics for these very compact molecules characterized by partial screening of the internal atoms to water. However, the relative mobility of the bonds along the sequence and the differential fluctuations depend only weakly on the hydrodynamic strength but strongly on the geometry of the three-dimensional structure and on the statistics incorporated into the theory. Both rigid and fluctuating dynamic models are examined, with fluctuations evaluated using molecular dynamics simulations. The comparison with nmr data shows that mode coupling diffusion accounts for the T1 relaxation pattern at low frequency where the rotational tumbling dominates. An important contribution of internal motions in the nanosecond time scale is seen at high frequencies and is discussed in terms of diffusive concepts.© 2000 John Wiley & Sons, Inc. Biopoly 54: 89–103, 2000

Published
2000
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38. A Prospective Study of High-Frequency Auditory Function in Patients Receiving Oral Neomycin

Author

Rappaport, B. Z., Fausti, S. A., Schechter, M. A., and Frey, R. H.

Abstract

Orally administered, neomycin is reported to cause ototoxicity rarely. Most reports on hearing loss due to oral neomycin have been case studies. One prospective study of a pediatric sample demonstrated a significant loss of hearing in the frequency range of 2 to 8 kHz in 9 of 17 children. To our knowledge there are no published prospective studies on this type with adult samples and therefore little is known of the true incidence or nature of ototoxicity from oral neomycin. This prospective study presents the results of long-term use of oral neomycin in 30 adult subjects. Hearing sensitivity was serially monitored in the frequency range 250-20000 Hz. Two of the 30 subjects subsequently revealed ototoxicity. Thus the results of this investigation suggest that clinical use of oral neomycin implies relatively little risk of ototoxicity.

Published
1986
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39. The Effects of Impulsive Noise Upon Human Hearing Sensitivity (8 to 20 kHz)

Author

Fausti, S. A., Erickson, D. A., Frey, R. H., and Rappaport, B. Z.

Abstract

The effects of impulsive noise exposure upon hearing sensitivity from 8 000 to 20 000 Hz were determined for a sample of 23 young military veterans. The subjects' histories consisted primarily of major incidents of weapons fire. Based on audiometric configuration, the subject sample was divided in two groups characterized by predominantly unilateral or bilateral shifts in threshold sensitivity. This division was consistent with history information. The main finding was extensive threshold shifts from 8 000 to 20 000 Hz which was highly individual-specific and unpredictable. High frequency audiometry frequently revealed extensive changes not evident in the 250 through 8 000 Hz range.

Published
1981
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43. Safe Implementation of Thrombolysis In Stroke (SITS)

Author

Danilo Toni, Durastanti, L., Romano, A., Falcou, A., Diangelantonio, E., Lorenzano, Svetlana, Maria Luisa Sacchetti, Cavalletti, Cristina, Fiorelli, Marco, Colosimo, Carlo, Fausti, S., Cao, M., Argentino, Corrado, and Fieschi, C.

46. Auditory brainstem response differences in diabetic and non-diabetic veterans.

Author

Vaughan N, James K, McDermott D, Griest S, and Fausti S

Abstract

A number of studies have found statistically significant delays in auditory brainstem latencies of patients with diabetes compared with non-diabetic controls. However, the mechanisms ascribed as responsible for the latency differences between diabetic and non-diabetic patients vary among studies, and the latency differences, while significant, are small. In this 5-year prospective study, auditory brainstem response testing was conducted with 416 non-diabetic and 375 diabetic veterans from the Portland Veterans Affairs Medical Center as part of a larger study. Patients with diabetes had significantly delayed latencies of Wave III and V in the right ear and significantly prolonged interpeak I-III and I-V latencies in both ears. Stimulus polarity difference yielded slightly different results. None of the diabetes-related clinical characteristics were associated with the latency differences between the subject groups after accounting for hearing loss and age. Effect size was calculated and clinical significance of these differences is discussed. [ABSTRACT FROM AUTHOR]

Published
2007
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47. Normative data for the Attitudes towards Loss of Hearing Questionnaire.

Author

Saunders GH, Cienkowski KM, Forsline A, and Fausti S

Abstract

Investigations have shown that patient attitudes toward hearing loss and hearing aids impact self-reported handicap and disability, hearing aid benefit, and hearing aid use. The Attitudes towards Loss of Hearing Questionnaire (ALHQ) was developed by Saunders and Cienkowski (1996) to examine some of the psychosocial factors underlying the use and acquisition of hearing aids. Here we report data from a new version of questionnaire (ALHQ v2.1), which examines attitudes towards hearing loss and hearing aids on five scales: Denial of Hearing Loss, Negative Associations, Negative Coping Strategies, Manual Dexterity and Vision, and Hearing-Related Esteem. Reliability values, internal consistency values, and cut points for typical and atypical scores are provided, along with comparison of the scores of women, men, current hearing aid users, non-hearing aid users, and paying versus nonpaying individuals. The ALHQ takes about ten minutes to complete and identifies for the clinician some of the issues that might jeopardize successful hearing aid outcome. [ABSTRACT FROM AUTHOR]

Published
2005
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48. Extensive usage of insecticide and changing crop rotation patterns: A South Dakota case study.

Author

Fausti S, Kolady DE, Van der Sluis E, Lundgren J, and Qasmi BA

Subjects
Algorithms, Insecticides toxicity, Natural Resources, South Dakota, Crop Production methods, Crops, Agricultural growth & development, Insecticides supply & distribution, Glycine max growth & development, Zea mays growth & development
Abstract

Driven by factors such as an increased reliance on genetically modified crops, government policies, and market forces, the crop mix in South Dakota and elsewhere in the United States has become less diverse and moved toward the production of corn and soybeans as the most predominant cash crops over the past two decades. Coinciding with a reduced complexity of crop rotation practices, the prevalence of mono-cropping has increased and crop chemical usage has changed as well. Overall, the reduced reliance on traditional crop rotation practices for mitigating pests corresponds with an increase in crop acres treated with insecticides, expressed as a proportion of total cropland acres, and referred to in the literature as the extensive usage of insecticides. In this paper, we identify how changing cropping patterns in South Dakota have affected the extensive usage of insecticides, an aspect often overlooked by producers and policy makers. Results indicate that increased corn production has contributed to an increase in the share of cropland acres treated with insecticides at the county level in eastern South Dakota., Competing Interests: The authors have declared that no competing interests exist.

Published
2018
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49. Efficacy and safety of N-acetylcysteine in prevention of noise induced hearing loss: a randomized clinical trial.

Author

Kopke R, Slade MD, Jackson R, Hammill T, Fausti S, Lonsbury-Martin B, Sanderson A, Dreisbach L, Rabinowitz P, Torre P 3rd, and Balough B

Subjects
Acetylcysteine adverse effects, Adolescent, Adult, Audiometry, Pure-Tone, Auditory Threshold, Cytoprotection, Double-Blind Method, Hearing, Hearing Loss, Noise-Induced diagnosis, Hearing Loss, Noise-Induced etiology, Hearing Loss, Noise-Induced physiopathology, Hearing Loss, Noise-Induced psychology, Humans, Male, Military Personnel, Occupational Diseases diagnosis, Occupational Diseases etiology, Occupational Diseases physiopathology, Occupational Diseases psychology, Prospective Studies, Protective Agents adverse effects, Time Factors, Treatment Outcome, Young Adult, Acetylcysteine therapeutic use, Hearing Loss, Noise-Induced prevention & control, Noise adverse effects, Occupational Diseases prevention & control, Occupational Exposure adverse effects, Protective Agents therapeutic use, Weapons
Abstract

Despite a robust hearing conservation program, military personnel continue to be at high risk for noise induced hearing loss (NIHL). For more than a decade, a number of laboratories have investigated the use of antioxidants as a safe and effective adjunct to hearing conservation programs. Of the antioxidants that have been investigated, N-acetylcysteine (NAC) has consistently reduced permanent NIHL in the laboratory, but its clinical efficacy is still controversial. This study provides a prospective, randomized, double-blinded, placebo-controlled clinical trial investigating the safety profile and the efficacy of NAC to prevent hearing loss in a military population after weapons training. Of the 566 total study subjects, 277 received NAC while 289 were given placebo. The null hypothesis for the rate of STS was not rejected based on the measured results. While no significant differences were found for the primary outcome, rate of threshold shifts, the right ear threshold shift rate difference did approach significance (p = 0.0562). No significant difference was found in the second primary outcome, percentage of subjects experiencing an adverse event between placebo and NAC groups (26.7% and 27.4%, respectively, p = 0.4465). Results for the secondary outcome, STS rate in the trigger hand ear, did show a significant difference (34.98% for placebo-treated, 27.14% for NAC-treated, p-value = 0.0288). Additionally, post-hoc analysis showed significant differences in threshold shift rates when handedness was taken into account. While the secondary outcomes and post-hoc analysis suggest that NAC treatment is superior to the placebo, the present study design failed to confirm this. The lack of significant differences in overall hearing loss between the treatment and placebo groups may be due to a number of factors, including suboptimal dosing, premature post-exposure audiograms, or differences in risk between ears or subjects. Based on secondary outcomes and post hoc analyses however, further studies seem warranted and are needed to clarify dose response and the factors that may have played a role in the observed results., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Published
2015
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50. Does interferon beta-1a impact pure-tone hearing sensitivity among individuals with multiple sclerosis?

Author

Lewis MS, McMillan GP, Hutter M, Folmer RL, Wilmington D, Casiana L, Fitzpatrick M, Lilly DJ, Bourdette D, Overs S, Cameron M, and Fausti S

Subjects
Adult, Female, Humans, Interferon beta-1a, Interferon-beta administration & dosage, Male, Middle Aged, Reference Values, Audiometry, Pure-Tone nursing, Auditory Threshold drug effects, Interferon-beta adverse effects, Multiple Sclerosis drug therapy, Multiple Sclerosis nursing
Abstract

Background: Previous studies reported that particular types of interferon medications might contribute to hearing loss in some patients. The package insert included in the original Food and Drug Administration application for intramuscular interferon beta-1a (Avonex) stated that some patients in the treatment group reported decreased hearing sensitivity., Objective: The purpose of the present investigation was to assess if individuals with multiple sclerosis (MS) taking intramuscular interferon beta-1a have significantly poorer hearing thresholds than those not currently using any disease-modifying therapies., Methods: This was a secondary analysis of data collected as part of two larger studies evaluating auditory function in patients with MS. The goal of this analysis was to determine if users of interferon beta-1a do not have significantly worse hearing thresholds than nonusers of disease-modifying therapies, after adjusting for potential confounders. A linear mixed model was fit to the audiometric thresholds of our subjects. This model included interferon beta-1a use, MS disease subtype, gender, test frequency, age, disease duration (number of years), and the Expanded Disability Status Scale score., Results and Conclusions: With all subjects included, there is insufficient evidence to say that intramuscular interferon-beta 1a is not ototoxic (in relation to nonuse of a disease-modifying therapy) at all frequencies tested except 3000 and 6000 Hz. After removing two influential subjects, the results indicated that there is statistical support for no ototoxic effect of intramuscular interferon beta-1a at test frequencies from 250 to 6000 Hz. There is insufficient evidence, however, to rule out an ototoxic effect at 8000 Hz. Future studies should further evaluate the effect of interferon on auditory function in patients with MS. Neuroscience nurses should monitor their patients' hearing throughout the course of treatment.

Published
2014
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