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1. Day-Ahead Programming of Energy Communities Participating in Pay-as-Bid Service Markets

Author

Conte, F., Massucco, S., Natrella, G., Saviozzi, M., and Silvestro, F.

Subjects
Electrical Engineering and Systems Science - Systems and Control
Abstract

This paper proposes an optimal strategy for a Renewable Energy Community participating in the Italian pay-as-bid ancillary service market. The community is composed by a group of residential customers sharing a common facility equipped with a PV power plant and a battery energy storage system. This battery is employed to maximize the community cash flow obtained by the participation in the service market. A scenario-based optimization problem is defined to size the bids to be submitted to the market and to define the corresponding optimal battery energy exchange profile for the day ahead. The proposed optimization scheme is able to take in to account the probability of acceptance of the service market bids and the uncertainties on the forecasts of PV generation and energy demands. Results prove the effectiveness of the approach and the economic advantages on participating in the service market.

Published
2023

2. Demand Response by Aggregates of Domestic Water Heaters with Adaptive Model Predictive Control

Author

Conte, F., Massucco, S., Silvestro, F., Cirio, D., and Rapizza, M.

Subjects
Electrical Engineering and Systems Science - Systems and Control
Abstract

This paper describes an intelligent management algorithm for an aggregate of domestic electric water heaters called to provide a demand response service. This algorithm is developed using Model Predictive Control. The model of the entire aggregate is dynamically identified using a recursive polynomial model estimation technique. This allows the control to be adaptive, i.e., able to adjust its decisions to the system characteristics, which vary over time due to the daily distribution of users hot water consumption. To answer the demand response requirements, aggregated power variations are realized by modifying the temperature set-points of the water heaters without compromising the users comfort. The developed approach allows tracking a regulation signal and mitigating the so-called rebound, i.e., the recovery of energy needed by the aggregate at the end of the service to return to the baseline thermal state. Analyses in a simulation environment allow the validation of the potentialities of the proposed method.

Published
2023

3. Performance analysis of frequency regulation services provided by aggregates of domestic thermostatically controlled loads

Author

Conte, F., di Vergagni, M. Crosa, Massucco, S., Silvestro, F., Ciapessoni, E., and Cirio, D.

Subjects
Electrical Engineering and Systems Science - Systems and Control
Abstract

This paper proposes a control method for allowing aggregates of thermostatically controlled loads to provide synthetic inertia and primary frequency regulation services to the grid. The proposed control framework is fully distributed and basically consists in the modification of the thermostat logic as a function of the grid frequency. Three strategies are considered: in the first one, the load aggregate provides synthetic inertia by varying its active power demand proportionally to the frequency rate of change; in the second one, the load aggregate provides primary frequency regulation by varying its power demand proportionally to frequency; in the third one, the two services are combined. The performances of the proposed control solutions are analyzed in the forecasted scenario of the electric power system of Sardinia in 2030, characterized by a huge installation of wind and photovoltaic generation and no coil and combustible oil power plants. The considered load aggregate is composed by domestic refrigerators and water heaters. Results prove the effectiveness of the proposed approach and show that, in the particular case of refrigerators and water heaters, the contribution to the frequency regulation is more significant in the case of positive frequency variations. Finally, the correlation between the regulation performances and the level of penetration of the load aggregate with respect to the system total load is evaluated.

Published
2021
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4. Experimental Validation of a Dynamic Equivalent Model for Microgrids

Author

Conte, F., D'Agostino, F., Massucco, S., Silvestro, F., Bossi, C., and Cabiati, M.

Subjects
Electrical Engineering and Systems Science - Systems and Control
Abstract

The goal of this paper is the experimental validation of a gray-box equivalent modeling approach applied to microgrids. The main objective of the equivalent modeling is to represent the dynamic response of a microgrid with a simplified model. The main contribution of this work is the experimental validation of a two-step process, composed by the definition of a nonlinear equivalent model with operational constraints, adapted to the microgrid environment, and the identification procedure used to define the model parameters. Once the parameters are identified, the simplified model is ready to reproduce the microgrid behavior to voltage and frequency variations, in terms of active and reactive power exchanges at the point of common coupling. To validate the proposed approach, a set of experimental tests have been carried out on a real LV microgrid considering different configurations, including both grid-connected and islanded operating conditions. Results show the effectiveness of the proposed technique and the applicability of the model to perform dynamic simulations., Comment: To be published in IEEE Transactions on Industry Applications

Published
2021
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5. Flexibility Evaluation of Domestic Electric Water Heater Aggregates

Author

Conte, F., Gabriele, B., Massucco, S., Silvestro, F., Cirio, D., and Croci, L.

Subjects
Electrical Engineering and Systems Science - Systems and Control
Abstract

In this paper, a method to evaluate the flexibility of aggregates of domestic electric water heaters is proposed and applied to the Italian case. Flexibility is defined as the capability of the aggregate to vary its power demand for a given time interval. The evaluation method consists of a Monte Carlo analysis, that uses the thermal model of electric water heaters and a proper elaboration of the external inputs, such as ambient and cold water temperatures, and hot water demand. The case of large aggregates defined along the Italian territory has been studied showing the dependence of flexibility on seasons and on time.

Published
2021
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15. Estimating the impact of COVID-19 pandemic on services provided by Italian Neuromuscular Centers: an Italian Association of Myology survey of the acute phase

Author

Mauri, E, Abati, E, Musumeci, O, Rodolico, C, D'Angelo, Mg, Mirabella, M, Lucchini, M, Bello, L, Pegoraro, E, Maggi, L, Manneschi, L, Gemelli, C, Grandis, M, Zuppa, A, Massucco, S, Benedetti, L, Caponnetto, C, Schenone, A, Prelle, A, Previtali, Sc, Scarlato, M, D'Amico, A, Bertini, E, Pennisi, Em, De Giglio, L, Pane, M, Mercuri, E, Mongini, T, Ricci, F, Berardinelli, A, Astrea, G, Lenzi, S, Battini, R, Ricci, G, Torri, F, Siciliano, G, Santorelli, Fm, Ariatti, A, Filosto, M, Passamano, L, Politano, L, Scutifero, M, Tonin, P, Fossati, B, Panicucci, C, Bruno, C, Ravaglia, S, Monforte, M, Tasca, G, Ricci, E, Petrucci, A, Santoro, L, Ruggiero, L, Barp, A, Albamonte, E, Sansone, V, Gagliardi, D, Costamagna, G, Govoni, A, Magri, F, Brusa, R, Velardo, D, Meneri, M, Sciacco, M, Corti, S, Bresolin, N, Moroni, I, Messina, S, Di Muzio, A, Nigro, V, Liguori, R, Antonini, G, Toscano, A, Minetti, C, Comi, Gp, Italian Association of, Myology., Mauri, Eleonora, Abati, Elena, Musumeci, Olimpia, Rodolico, Carmelo, D'Angelo, Maria Grazia, Mirabella, Massimiliano, Lucchini, Matteo, Bello, Luca, Pegoraro, Elena, Maggi, Lorenzo, Manneschi, Letizia, Gemelli, Chiara, Grandis, Marina, Zuppa, Angela, Massucco, Sara, Benedetti, Luana, Caponnetto, Claudia, Schenone, Angelo, Prelle, Alessandro, Previtali, Stefano C, Scarlato, Marina, D'Amico, Adele, Bertini, Enrico, Pennisi, Elena M, De Giglio, Laura, Pane, Marika, Mercuri, Eugenio, Mongini, Tiziana, Ricci, Federica, Berardinelli, Angela, Astrea, Guja, Lenzi, Sara, Battini, Roberta, Ricci, Giulia, Torri, Francesca, Siciliano, Gabriele, Santorelli, Filippo M, Ariatti, Alessandra, Filosto, Massimiliano, Passamano, Luigia, Politano, Luisa, Scutifero, Marianna, Tonin, Paola, Fossati, Barbara, Panicucci, Chiara, Bruno, Claudio, Ravaglia, Sabrina, Monforte, Mauro, Tasca, Giorgio, Ricci, Enzo, Petrucci, Antonio, Santoro, Lucio, Ruggiero, Lucia, Barp, Andrea, Albamonte, Emilio, Sansone, Valeria, Gagliardi, Delia, Costamagna, Gianluca, Govoni, Alessandra, Magri, Francesca, Brusa, Roberta, Velardo, Daniele, Meneri, Megi, Sciacco, Monica, Corti, Stefania, Bresolin, Nereo, Moroni, Isabella, Messina, Sonia, Di Muzio, Antonio, Nigro, Vincenzo, Liguori, Rocco, Antonini, Giovanni, Toscano, Antonio, Minetti, Carlo, Comi, Giacomo Pietro, Mauri E., Abati E., Musumeci O., Rodolico C., D'Angelo M.G., Mirabella M., Lucchini M., Bello L., Pegoraro E., Maggi L., Manneschi L., Gemelli C., Grandis M., Zuppa A., Massucco S., Benedetti L., Caponnetto C., Schenone A., Prelle A., Previtali S.C., Scarlato M., D'Amico A., Bertini E., Pennisi E.M., de Giglio L., Pane M., Mercuri E., Mongini T., Ricci F., Berardinelli A., Astrea G., Lenzi S., Battini R., Ricci G., Torri F., Siciliano G., Santorelli F.M., Ariatti A., Filosto M., Passamano L., Politano L., Scutifero M., Tonin P., Fossati B., Panicucci C., Bruno C., Ravaglia S., Monforte M., Tasca G., Ricci E., Petrucci A., Santoro L., Ruggiero L., Barp A., Albamonte E., Sansone V., Gagliardi D., Costamagna G., Govoni A., Magri F., Brusa R., Velardo D., Meneri M., Sciacco M., Corti S., Bresolin N., Moroni I., Messina S., Muzio A.D., Nigro V., Liguori R., Antonini G., Toscano A., Minetti C., Comi G.P., Mauri, E., Abati, E., Musumeci, O., Rodolico, C., D'Angelo, M. G., Mirabella, M., Lucchini, M., Bello, L., Pegoraro, E., Maggi, L., Manneschi, L., Gemelli, C., Grandis, M., Zuppa, A., Massucco, S., Benedetti, L., Caponnetto, C., Schenone, A., Prelle, A., Previtali, S. C., Scarlato, M., D'Amico, A., Bertini, E., Pennisi, E. M., de Giglio, L., Pane, M., Mercuri, E., Mongini, T., Ricci, F., Berardinelli, A., Astrea, G., Lenzi, S., Battini, R., Ricci, G., Torri, F., Siciliano, G., Santorelli, F. M., Ariatti, A., Filosto, M., Passamano, L., Politano, L., Scutifero, M., Tonin, P., Fossati, B., Panicucci, C., Bruno, C., Ravaglia, S., Monforte, M., Tasca, G., Ricci, E., Petrucci, A., Santoro, L., Ruggiero, L., Barp, A., Albamonte, E., Sansone, V., Gagliardi, D., Costamagna, G., Govoni, A., Magri, F., Brusa, R., Velardo, D., Meneri, M., Sciacco, M., Corti, S., Bresolin, N., Moroni, I., Messina, S., Muzio, A. D., Nigro, V., Liguori, R., Antonini, G., Toscano, A., Minetti, C., and Comi, G. P.

Subjects
COVID-19, Myastenia gravis, Myopathies, Neuromuscular diseases, Neuromuscular services, Neuropathies, SARS-CoV-2, neuropathies, Ambulatory Care, Coronavirus Infections, Cross-Sectional Studies, Health Services Accessibility, Hospitalization, Humans, Italy, Neuromuscular Diseases, Pandemics, Pneumonia, Viral, Referral and Consultation, Surveys and Questionnaires, Telemedicine, Betacoronavirus, neuromuscular diseases, myastenia gravis, neuromuscular services, neuromuscular service, Surveys and Questionnaire, Viral, myopathie, Cross-Sectional Studie, Pandemic, Coronavirus Infection, Pneumonia, neuromuscular disease, myastenia gravi, Settore MED/26 - NEUROLOGIA, neuropathie, myopathies, Original Article, Human
Abstract

Introduction. Since February 2020, the outbreak of COVID-19 in Italy has forced the health care system to undergo profound rearrangements in its services and facilities, especially in the worst-hit areas in Northern Italy. In this setting, inpatient and outpatient services had to rethink and reorganize their activities to meet the needs of patients during the “lockdown”. The Italian Association of Myology developed a survey to estimate the impact of these changes on patients affected by neuromuscular disorders and on specialized neuromuscular centers during the acute phase of COVID-19 pandemic. Methods. We developed an electronic survey that was sent to neuromuscular centers affiliated with the Italian Association of Myology, assessing changes in pharmacological therapies provision, outpatient clinical and instrumental services, support services (physiotherapy, nursing care, psychological support) and clinical trials. Results. 40% of surveyed neuromuscular centers reported a reduction in outpatient visit and examinations (44.5% of centers in Northern regions; 25% of centers in Central regions; 50% of centers in Southern regions). Twenty-two% of centers postponed in-hospital administration of therapies for neuromuscular diseases (23.4% in Northern regions; 13.0% in Central regions; 20% in Southern regions). Diagnostic and support services (physiotherapy, nursing care, psychological support) were suspended in 57% of centers (66/43/44% in Northern, Central and Southern centers respectively) Overall, the most affected services were rehabilitative services and on-site outpatient visits, which were suspended in 93% of centers. Strategies adopted by neuromuscular centers to overcome these changes included maintaining urgent on-site visits, addressing patients to available services and promoting remote contact and telemedicine. Conclusions. Overall, COVID-19 pandemic resulted in a significant disruption of clinical and support services for patients with neuromuscular diseases. Despite the efforts to provide telemedicine consults to patients, this option could be promoted and improved further. A close collaboration between the different neuromuscular centers and service providers as well as further implementation of telehealth platforms are necessary to ensure quality care to NMD patients in the near future and in case of recurrent pandemic waves.

Published
2020

17. Referral from vascular surgery to cardiovascular rehabilitation and related outcomes in patients with peripheral arterial disease: The THINKPAD-RELOADED survey

Author

Ambrosetti, M, Faggiano, P, Greco, C, Mureddu, G, Temporelli, P, Pedretti, R, Cremona, V, Passera, M, Tozzi, M, Angrisano, G, Piffaretti, G, Riccobono, S, Giannattasio, C, Ferrari, A, Lista, A, Romani, F, Dal Corso, L, Favretto, G, Nicolai, L, Galeazzi, E, Passaretti, B, Orlando, M, Barzaghi, M, Setti, M, Palvarini, M, Frisinghelli, A, Mazzucco, G, Massucco, S, Bardile, A, Aloi, T, Salerno, M, Bonardelli, S, Farina, A, Febo, O, Ambrosetti M., Faggiano P., Greco C., Mureddu G. F., Temporelli P. L., Pedretti R. F. E., Cremona V., Passera M., Tozzi M., Angrisano G., Piffaretti G., Riccobono S. P., Giannattasio C., Ferrari A., Lista A., Romani F., Dal Corso L., Favretto G., Nicolai L., Galeazzi E., Passaretti B., Orlando M., Barzaghi M. E., Setti M., Palvarini M., Frisinghelli A., Mazzucco G., Massucco S., Bardile A. F., Aloi T., Salerno M., Bonardelli S., Farina A., Febo O., Ambrosetti, M, Faggiano, P, Greco, C, Mureddu, G, Temporelli, P, Pedretti, R, Cremona, V, Passera, M, Tozzi, M, Angrisano, G, Piffaretti, G, Riccobono, S, Giannattasio, C, Ferrari, A, Lista, A, Romani, F, Dal Corso, L, Favretto, G, Nicolai, L, Galeazzi, E, Passaretti, B, Orlando, M, Barzaghi, M, Setti, M, Palvarini, M, Frisinghelli, A, Mazzucco, G, Massucco, S, Bardile, A, Aloi, T, Salerno, M, Bonardelli, S, Farina, A, Febo, O, Ambrosetti M., Faggiano P., Greco C., Mureddu G. F., Temporelli P. L., Pedretti R. F. E., Cremona V., Passera M., Tozzi M., Angrisano G., Piffaretti G., Riccobono S. P., Giannattasio C., Ferrari A., Lista A., Romani F., Dal Corso L., Favretto G., Nicolai L., Galeazzi E., Passaretti B., Orlando M., Barzaghi M. E., Setti M., Palvarini M., Frisinghelli A., Mazzucco G., Massucco S., Bardile A. F., Aloi T., Salerno M., Bonardelli S., Farina A., and Febo O.

Abstract

The utilization of cardiovascular rehabilitation (CR) programmes in patients with Lower Extremity Peripheral Artery Disease (LEPAD) is generally poor, with limited evidence of current policies for referral. The aim of the study was to evaluate, within a cohesive network of CR and vascular surgery facilities with facilitated referral process, the clinical characteristic of LEPAD patients referred to CR and related outcomes, as compared to patients not referred. The present is an observational prospective study of consecutive patients recruited at vascular surgery facilities. Out of 329 patients observed, the average referral rate to CR was 34% (28% and 39% in patients with and without recent peripheral revascularization, p<0.05). LEPAD patients entering the CR programme were similar to those who did not according to sex, age, the vascular surgery setting of evaluation, and localization of arterial lesions. Patients with moderate intermittent claudication and patients with acute limb ischemia as index event were more represented among those who attended CR (41% vs 21% and 9% vs 2% respectively, p<0.05). Patients referred to CR had five times more episodes of acute coronary syndrome and heart failure as complication of the index event. The cardiovascular risk profile (obesity 29.5% vs 11%, p<0.05; hypercholesterolemia 80% vs 61%, p<0.05) was much worse in LEPAD patients referred to CR, but conversely, they better achieved secondary prevention targets, particularly for blood pressure control (97% vs 57%, p<0.05). All-cause 2-year mortality in the whole patients' population was 6%. Patients entering the CR programme displayed less events (13.5% vs 37.7%, p<0.05), mainly death (3.1% vs 11.3%, p<0.05) and limb-related events (4.2% vs 15.2%, p<0.05). The results of our study suggest that when a cohesive network of vascular surgery and CR facilities becomes available, the referral rate to rehabilitation may increase up to one third of eligible patient

Published
2019

18. Referral from vascular surgery to cardiovascular rehabilitation and related outcomes in patients with peripheral arterial disease: the THINKPAD-RELOADED survey

Author

Ambrosetti M., Faggiano P., Greco C., Mureddu G. F., Temporelli P. L., Pedretti R. F. E., Cremona V., Passera M., Tozzi M., Angrisano G., Piffaretti G., Riccobono S. P., Giannattasio C., Ferrari A., Lista A., Romani F., Dal Corso L., Favretto G., Nicolai L., Galeazzi E., Passaretti B., Orlando M., Barzaghi M. E., Setti M., Palvarini M., Frisinghelli A., Mazzucco G., Massucco S., Bardile A. F., Aloi T., Salerno M., Bonardelli S., Farina A., Febo O., Ambrosetti, M, Faggiano, P, Greco, C, Mureddu, G, Temporelli, P, Pedretti, R, Cremona, V, Passera, M, Tozzi, M, Angrisano, G, Piffaretti, G, Riccobono, S, Giannattasio, C, Ferrari, A, Lista, A, Romani, F, Dal Corso, L, Favretto, G, Nicolai, L, Galeazzi, E, Passaretti, B, Orlando, M, Barzaghi, M, Setti, M, Palvarini, M, Frisinghelli, A, Mazzucco, G, Massucco, S, Bardile, A, Aloi, T, Salerno, M, Bonardelli, S, Farina, A, and Febo, O

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Acute coronary syndrome, Referral, medicine.medical_treatment, Population, lcsh:Medicine, Revascularization, rehabilitation, Exercise, Peripheral arterial disease, Referral, Rehabilitation, Aged, Cardiovascular Diseases, Exercise Therapy, Facilities and Services Utilization, Female, Health Care Surveys, Humans, Intermittent Claudication, Ischemia, Lower Extremity, Male, Middle Aged, Peripheral Arterial Disease, Postoperative Complications, Prospective Studies, Risk Factors, Secondary Prevention, Vascular Surgical Procedures, Cardiac Rehabilitation, Referral and Consultation, Peripheral Arterial Disease, Postoperative Complications, Ischemia, Risk Factors, Internal medicine, Secondary Prevention, medicine, Humans, Prospective Studies, Prospective cohort study, education, Referral and Consultation, Aged, education.field_of_study, Cardiac Rehabilitation, exercise, business.industry, lcsh:R, Intermittent Claudication, Middle Aged, Vascular surgery, medicine.disease, Comorbidity, Intermittent claudication, Exercise Therapy, Lower Extremity, Cardiovascular Diseases, Health Care Surveys, referral, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures, Facilities and Services Utilization
Abstract

The utilization of cardiovascular rehabilitation (CR) programmes in patients with Lower Extremity Peripheral Artery Disease (LEPAD) is generally poor, with limited evidence of current policies for referral. The aim of the study was to evaluate, within a cohesive network of CR and vascular surgery facilities with facilitated referral process, the clinical characteristic of LEPAD patients referred to CR and related outcomes, as compared to patients not referred. The present is an observational prospective study of consecutive patients recruited at vascular surgery facilities. Out of 329 patients observed, the average referral rate to CR was 34% (28% and 39% in patients with and without recent peripheral revascularization, p

Published
2019
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19. Small-Signal Stability Analysis of a DC Shipboard Microgrid With Droop-Controlled Batteries and Constant Power Resources

Author

Conte, F., D'Agostino, F., Massucco, S., Silvestro, F., and Grillo, S.

Subjects
droop control, dc microgrids, FOS: Electrical engineering, electronic engineering, information engineering, Systems and Control (eess.SY), stability analysis, shipboard power system, Electrical Engineering and Systems Science - Systems and Control
Abstract

The presence of constant power loads (CPLs) in dc shipboard microgrids may lead to unstable conditions. The present work investigates the stability properties of dc microgrids where CPLs are fed by fuel cells (FCs), and energy storage systems (ESSs) equipped with voltage droop control. With respect to the previous literature, the dynamics of the duty cycles of the dc-dc converters implementing the droop regulation are considered. A mathematical model has been derived, and tuned to best mimic the behavior of the electrical representation implemented in DIgSILENT. Then the model is used to find the sufficient conditions for stability with respect to the droop coefficient, the dc-bus capacitor, and the inductances of the dc-dc converters.

Published
2021

23. Management and dynamic performances of combined cycle power plants during parallel and islanding operation

Author

Bagnasco, A., Delfino, B., Denegri, G.B., and Massucco, S.

Subjects
Combined-cycle power plants -- Analysis, Business, Electronics, Electronics and electrical industries
Abstract

The subject of a cogeneration plant modeling has already been discussed in the past, but mostly from the thermal and energy point of view. There are several aspects to be considered for assuring that the plant will operate satisfactoraly. Furthermore the increasing number of energy producers poses more and more attention to these types of plants and to their regulation mode. Among these aspects, particular care is devoted in this paper to the modeling and setting-up of gas turbine regulators, also because it is not generally such a trivial work to adapt existing software for large power systems' dynamic analysis to the requirements of combined-cycle power plants. On the basis of the specialized literature, a detailed model for the regulator of a gas turbine unit is adopted, which includes speed, acceleration and temperature controls as well as inlet guide vanes' control. The proposed regulator is tested on a realistic industrial power plant with particular attention to parallel and isolated operation. Keywords: power system analysis, dynamic models, combined-cycle plants, regulators.

Published
1998

24. hATTR pathology: Nerve biopsy results from Italian referral centers

Author

Luigetti, Marco, Romozzi, Marina, Bisogni, G., Cardellini, D., Cavallaro, T., Di Paolantonio, Andrea, Fabrizi, G. M., Fenu, S., Gentile, L., Grandis, M., Marucci, G., Massucco, S., Mazzeo, A., Pareyson, D., Romano, Angela, Russo, M., Schenone, A., Tagliapietra, M., Tozza, S., Vita, G., Sabatelli, Mario, Luigetti M. (ORCID:0000-0001-7539-505X), Romozzi M., Di Paolantonio A., Romano A., Sabatelli M. (ORCID:0000-0001-6635-4985), Luigetti, Marco, Romozzi, Marina, Bisogni, G., Cardellini, D., Cavallaro, T., Di Paolantonio, Andrea, Fabrizi, G. M., Fenu, S., Gentile, L., Grandis, M., Marucci, G., Massucco, S., Mazzeo, A., Pareyson, D., Romano, Angela, Russo, M., Schenone, A., Tagliapietra, M., Tozza, S., Vita, G., Sabatelli, Mario, Luigetti M. (ORCID:0000-0001-7539-505X), Romozzi M., Di Paolantonio A., Romano A., and Sabatelli M. (ORCID:0000-0001-6635-4985)

Abstract

ObjectivePathological evidence of amyloid on nerve biopsy has been the gold standard for diagnosis in hereditary transthyretin amyloidosis polyneuropathy (hATTR-PN) for a long time. In this article, we reviewed the pathological findings of a large series of sural nerve biopsies from a cohort of hATTR-PN patients, collected by different Italian referral centers. Patients and Methods: We reviewed clinical and pathological data from hATTR-PN patients, diagnosed and followed in five Italian referral centers for peripheral neuropathies. Diagnosis was formulated after a positive genetic test for transthyretin (TTR) mutations. Sural nerve biopsy was performed according to standard protocols. Results: Sixty-nine sural nerve biopsies from hATTR-PN patients were examined. Congo red positive deposits were found in 73% of cases. Only the Phe64Leu mutation failed to show amyloid deposits in a high percentage of biopsies (54%), as already described. Unusual pathological findings, such as myelin abnormalities or inflammatory infiltrates, were detected in occasional cases. Conclusions: Even if no longer indicated to confirm hATTR-PN clinical suspicion, nerve biopsy remains, in expert hands, a rapid and inexpensive tool to detect amyloid deposition. In Italy, clinicians should be aware that a negative biopsy does not exclude hATTR-PN, particularly for Phe64Leu, one of the most frequent mutations in this country.

Published
2020

25. Estimating the impact of COVID-19 pandemic on services provided by Italian Neuromuscular Centers: an Italian Association of Myology survey of the acute phase

Author

Mauri, E., Abati, E., Musumeci, O., Rodolico, C., D'Angelo, M. G., Mirabella, Massimiliano, Lucchini, Matteo, Bello, L., Pegoraro, E., Maggi, L., Manneschi, L., Gemelli, C., Grandis, M., Zuppa, A., Massucco, S., Benedetti, L., Caponnetto, C., Schenone, A., Prelle, A., Previtali, S. C., Scarlato, M., D'Amico, A., Bertini, E., Pennisi, E. M., de Giglio, L., Pane, Marika, Mercuri, Eugenio Maria, Mongini, T., Ricci, F., Berardinelli, A., Astrea, G., Lenzi, S., Battini, R., Ricci, G., Torri, F., Siciliano, G., Santorelli, F. M., Ariatti, A., Filosto, M., Passamano, L., Politano, L., Scutifero, M., Tonin, P., Fossati, B., Panicucci, C., Bruno, C., Ravaglia, S., Monforte, Mauro, Tasca, Giorgio, Ricci, Enzo, Petrucci, A., Santoro, L., Ruggiero, L., Barp, A., Albamonte, E., Sansone, V., Gagliardi, D., Costamagna, G., Govoni, A., Magri, F., Brusa, R., Velardo, D., Meneri, M., Sciacco, M., Corti, S., Bresolin, N., Moroni, I., Messina, S., Muzio, A. D., Nigro, V., Liguori, R., Antonini, G., Toscano, A., Minetti, C., Comi, G. P., Mirabella M. (ORCID:0000-0002-7783-114X), Lucchini M. (ORCID:0000-0002-0447-2297), Pane M. (ORCID:0000-0002-4851-6124), Mercuri E. (ORCID:0000-0002-9851-5365), Monforte M., Tasca G., Ricci E. (ORCID:0000-0003-3092-3597), Mauri, E., Abati, E., Musumeci, O., Rodolico, C., D'Angelo, M. G., Mirabella, Massimiliano, Lucchini, Matteo, Bello, L., Pegoraro, E., Maggi, L., Manneschi, L., Gemelli, C., Grandis, M., Zuppa, A., Massucco, S., Benedetti, L., Caponnetto, C., Schenone, A., Prelle, A., Previtali, S. C., Scarlato, M., D'Amico, A., Bertini, E., Pennisi, E. M., de Giglio, L., Pane, Marika, Mercuri, Eugenio Maria, Mongini, T., Ricci, F., Berardinelli, A., Astrea, G., Lenzi, S., Battini, R., Ricci, G., Torri, F., Siciliano, G., Santorelli, F. M., Ariatti, A., Filosto, M., Passamano, L., Politano, L., Scutifero, M., Tonin, P., Fossati, B., Panicucci, C., Bruno, C., Ravaglia, S., Monforte, Mauro, Tasca, Giorgio, Ricci, Enzo, Petrucci, A., Santoro, L., Ruggiero, L., Barp, A., Albamonte, E., Sansone, V., Gagliardi, D., Costamagna, G., Govoni, A., Magri, F., Brusa, R., Velardo, D., Meneri, M., Sciacco, M., Corti, S., Bresolin, N., Moroni, I., Messina, S., Muzio, A. D., Nigro, V., Liguori, R., Antonini, G., Toscano, A., Minetti, C., Comi, G. P., Mirabella M. (ORCID:0000-0002-7783-114X), Lucchini M. (ORCID:0000-0002-0447-2297), Pane M. (ORCID:0000-0002-4851-6124), Mercuri E. (ORCID:0000-0002-9851-5365), Monforte M., Tasca G., and Ricci E. (ORCID:0000-0003-3092-3597)

Abstract

Introduction. Since February 2020, the outbreak of COVID-19 in Italy has forced the health care system to undergo profound rearrangements in its services and facilities, especially in the worst-hit areas in Northern Italy. In this setting, inpatient and outpatient services had to rethink and reorganize their activities to meet the needs of patients during the “lockdown”. The Italian Association of Myology developed a survey to estimate the impact of these changes on patients affected by neuromuscular disorders and on specialized neuromuscular centers during the acute phase of COVID-19 pandemic. Methods. We developed an electronic survey that was sent to neuromuscular centers affiliated with the Italian Association of Myology, assessing changes in pharmacological therapies provision, outpatient clinical and instrumental services, support services (physiotherapy, nursing care, psychological support) and clinical trials. Results. 40% of surveyed neuromuscular centers reported a reduction in outpatient visit and examinations (44.5% of centers in Northern regions; 25% of centers in Central regions; 50% of centers in Southern regions). Twenty-two% of centers postponed in-hospital administration of therapies for neuromuscular diseases (23.4% in Northern regions; 13.0% in Central regions; 20% in Southern regions). Diagnostic and support services (physiotherapy, nursing care, psychological support) were suspended in 57% of centers (66/43/44% in Northern, Central and Southern centers respectively) Overall, the most affected services were rehabilitative services and on-site outpatient visits, which were suspended in 93% of centers. Strategies adopted by neuromuscular centers to overcome these changes included maintaining urgent on-site visits, addressing patients to available services and promoting remote contact and telemedicine. Conclusions. Overall, COVID-19 pandemic resulted in a significant disruption of clinical and support services for patients with neuromuscular diseas

Published
2020

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