Search

Your search keyword '"Micieli, G."' showing total 608 results
Start Over Author "Micieli, G."
608 results on '"Micieli, G."'

1. COVID-19-associated Guillain-Barré syndrome in the early pandemic experience in Lombardia (Italy)

Author

Martinelli-Boneschi, F, Colombo, A, Bresolin, N, Sessa, M, Bassi, P, Grampa, G, Magni, E, Versino, M, Ferrarese, C, Zarcone, D, Albanese, A, Micieli, G, Zanferrari, C, Cagnana, A, Ferrante, C, Zilioli, A, Locatelli, D, Calloni, M, Delodovici, M, Pozzato, M, Patisso, V, Bortolan, F, Foresti, C, Frigeni, B, Canella, S, Xhani, R, Crabbio, M, Clemenzi, A, Mauri, M, Beretta, S, La Spina, I, Bernasconi, S, De Santis, T, Cavallini, A, Ranieri, M, D'Adda, E, Fruguglietti, M, Peverelli, L, Agosti, E, Leoni, O, Rigamonti, A, Salmaggi, A, Martinelli-Boneschi F., Colombo A., Bresolin N., Sessa M., Bassi P., Grampa G., Magni E., Versino M., Ferrarese C., Zarcone D., Albanese A., Micieli G., Zanferrari C., Cagnana A., Ferrante C., Zilioli A., Locatelli D., Calloni M. V., Delodovici M. L., Pozzato M., Patisso V., Bortolan F., Foresti C., Frigeni B., Canella S., Xhani R., Crabbio M., Clemenzi A., Mauri M., Beretta S., La Spina I., Bernasconi S., De Santis T., Cavallini A., Ranieri M., D'Adda E., Fruguglietti M. E., Peverelli L., Agosti E., Leoni O., Rigamonti A., Salmaggi A., Martinelli-Boneschi, F, Colombo, A, Bresolin, N, Sessa, M, Bassi, P, Grampa, G, Magni, E, Versino, M, Ferrarese, C, Zarcone, D, Albanese, A, Micieli, G, Zanferrari, C, Cagnana, A, Ferrante, C, Zilioli, A, Locatelli, D, Calloni, M, Delodovici, M, Pozzato, M, Patisso, V, Bortolan, F, Foresti, C, Frigeni, B, Canella, S, Xhani, R, Crabbio, M, Clemenzi, A, Mauri, M, Beretta, S, La Spina, I, Bernasconi, S, De Santis, T, Cavallini, A, Ranieri, M, D'Adda, E, Fruguglietti, M, Peverelli, L, Agosti, E, Leoni, O, Rigamonti, A, Salmaggi, A, Martinelli-Boneschi F., Colombo A., Bresolin N., Sessa M., Bassi P., Grampa G., Magni E., Versino M., Ferrarese C., Zarcone D., Albanese A., Micieli G., Zanferrari C., Cagnana A., Ferrante C., Zilioli A., Locatelli D., Calloni M. V., Delodovici M. L., Pozzato M., Patisso V., Bortolan F., Foresti C., Frigeni B., Canella S., Xhani R., Crabbio M., Clemenzi A., Mauri M., Beretta S., La Spina I., Bernasconi S., De Santis T., Cavallini A., Ranieri M., D'Adda E., Fruguglietti M. E., Peverelli L., Agosti E., Leoni O., Rigamonti A., and Salmaggi A.

Abstract

Objective: To estimate the incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients (COVID19-GBS) in one of the most hit regions during the first pandemic wave, Lombardia. Methods: Adult patients admitted to 20 Neurological Units between 1/3–30/4/2020 with COVID19-GBS were included as part of a multi-center study organized by the Italian society of Hospital Neuroscience (SNO). Results: Thirty-eight COVID19-GBS patients had a mean age of 60.7 years and male frequency of 86.8%. CSF albuminocytological dissociation was detected in 71.4%, and PCR for SARS-CoV-2 was negative in 19 tested patients. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP, 12.1% of AMSAN, and 6.1% of AMAN. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.2% worsened, of which 3 died. The estimated occurrence rate in Lombardia ranges from 0.5 to 0.05 GBS cases per 1000 COVID-19 infections depending on whether you consider positive cases or estimated seropositive cases. When we compared GBS cases with the pre-pandemic period, we found a reduction of cases from 165 to 135 cases in the 2-month study period in Lombardia. Conclusions: We detected an increased incidence of GBS in COVID-19 patients which can reflect a higher risk of GBS in COVID-19 patients and a reduction of GBS events during the pandemic period possibly due to a lower spread of more common respiratory infectious diseases determined by an increased use of preventive measures.

Published
2023

2. Correction to: COVID‐19‐associated Guillain‐Barré syndrome in the early pandemic experience in Lombardia (Italy) (Neurological Sciences, (2023), 44, 2, (437-446), 10.1007/s10072-022-06429-6)

Author

Martinelli-Boneschi F., Martinelli-Boneschi, F, Colombo, A, Bresolin, N, Sessa, M, Bassi, P, Grampa, G, Magni, E, Versino, M, Ferrarese, C, Zarcone, D, Albanese, A, Micieli, G, Zanferrari, C, Cagnana, A, Ferrante, C, Zilioli, A, Locatelli, D, Calloni, M, Delodovici, M, Pozzato, M, Patisso, V, Bortolan, F, Foresti, C, Frigeni, B, Canella, S, Xhani, R, Crabbio, M, Clemenzi, A, Mauri, M, Beretta, S, La Spina, I, Bernasconi, S, De Santis, T, Cavallini, A, Ranieri, M, D'Adda, E, Fruguglietti, M, Peverelli, L, Agosti, E, Leoni, O, Rigamonti, A, Salmaggi, A, Martinelli-Boneschi F., Colombo A., Bresolin N., Sessa M., Bassi P., Grampa G., Magni E., Versino M., Ferrarese C., Zarcone D., Albanese A., Micieli G., Zanferrari C., Cagnana A., Ferrante C., Zilioli A., Locatelli D., Calloni M. V., Delodovici M. L., Pozzato M., Patisso V., Bortolan F., Foresti C., Frigeni B., Canella S., Xhani R., Crabbio M., Clemenzi A., Mauri M., Beretta S., La Spina I., Bernasconi S., De Santis T., Cavallini A., Ranieri M., D'Adda E., Fruguglietti M. E., Peverelli L., Agosti E., Leoni O., Rigamonti A., Salmaggi A., Martinelli-Boneschi F., Martinelli-Boneschi, F, Colombo, A, Bresolin, N, Sessa, M, Bassi, P, Grampa, G, Magni, E, Versino, M, Ferrarese, C, Zarcone, D, Albanese, A, Micieli, G, Zanferrari, C, Cagnana, A, Ferrante, C, Zilioli, A, Locatelli, D, Calloni, M, Delodovici, M, Pozzato, M, Patisso, V, Bortolan, F, Foresti, C, Frigeni, B, Canella, S, Xhani, R, Crabbio, M, Clemenzi, A, Mauri, M, Beretta, S, La Spina, I, Bernasconi, S, De Santis, T, Cavallini, A, Ranieri, M, D'Adda, E, Fruguglietti, M, Peverelli, L, Agosti, E, Leoni, O, Rigamonti, A, Salmaggi, A, Martinelli-Boneschi F., Colombo A., Bresolin N., Sessa M., Bassi P., Grampa G., Magni E., Versino M., Ferrarese C., Zarcone D., Albanese A., Micieli G., Zanferrari C., Cagnana A., Ferrante C., Zilioli A., Locatelli D., Calloni M. V., Delodovici M. L., Pozzato M., Patisso V., Bortolan F., Foresti C., Frigeni B., Canella S., Xhani R., Crabbio M., Clemenzi A., Mauri M., Beretta S., La Spina I., Bernasconi S., De Santis T., Cavallini A., Ranieri M., D'Adda E., Fruguglietti M. E., Peverelli L., Agosti E., Leoni O., Rigamonti A., and Salmaggi A.

Abstract

The above article was published with error. The affiliation address of the authors Alberto Albanese and Tiziana De Santis has been modified to: “U.O. Neurologia, IRCCS Istituto Clinico Humanitas, Milan, Italy”.The Original article has been corrected.

Published
2023

3. Did the role of the neurologist in the emergency department change during the COVID-19 pandemic? Evidence from an Italian nationwide survey

Author

Micieli, G, Cavallini, A, Cortelli, P, Rea, F, Micieli G., Cavallini A., Cortelli P., Rea F., Micieli, G, Cavallini, A, Cortelli, P, Rea, F, Micieli G., Cavallini A., Cortelli P., and Rea F.

Abstract

Objective: This study aims to assess whether the role of neurologists in the emergency department changed during the coronavirus (COVID)-19 pandemic. Methods: Data from an Italian national survey investigating the role of neurologists in the emergency room conducted in December 2020 were compared with those of the same survey of the previous year. These surveys involved a questionnaire being completed filled in for patients who received a neurological consultation following a visit to the emergency room. Information gathered included demographic characteristics, triage level according to both the emergency physician and neurologist, reason for the consultation, neurological evaluation, and discharge mode. Results: In both years, approximately half of the patients were women, and the median age was 61 years. More patients in 2020 arrived by ambulance and had a greater need for assistance based on triage level than in 2019. During 2020, the proportion of consultancy requests judged by the neurologist was higher than that in 2019 (77% vs. 73%). Moreover, in 2020, fewer patients required consultation for headache, muscle pain, fever, and neurological signs, whereas coma was more prevalent. The diagnosis of ischemic stroke was the most prevalent in both years, followed by transient ischemic attack. In 2020, the status epilepticus increased and discopathy decreased. Conclusion: This study showed the significant role played by neurologists in emergency activities, especially during the COVID-19 pandemic, and highlighted the differences in patients admitted between the year of the epidemic and the year previous.

Published
2022

4. Assessing mood and cognitive functioning in acute stroke: clinical usability of a Visual Analogue Mood Scale (VAMS)

Author

Pasotti, F, Serrano, S, Aiello, E, Gramegna, C, Querzola, M, Gallucci, M, Micieli, G, Bollani, A, Agostoni, E, Bottini, G, Pasotti F., Serrano S., Aiello E. N., Gramegna C., Querzola M., Gallucci M., Micieli G., Bollani A., Agostoni E. C., Bottini G., Pasotti, F, Serrano, S, Aiello, E, Gramegna, C, Querzola, M, Gallucci, M, Micieli, G, Bollani, A, Agostoni, E, Bottini, G, Pasotti F., Serrano S., Aiello E. N., Gramegna C., Querzola M., Gallucci M., Micieli G., Bollani A., Agostoni E. C., and Bottini G.

Abstract

Background: Patients suffering from stroke in the acute/post-acute phases often present with depressive mood — which negatively impacts on patients’ prognosis. However, psychometric evaluation of mood in acute stroke patients may be challenging due to cognitive deficits. Tools investigating emotional states via a vertical analogue line may overcome language/visuo-spatial disorders. This study thus aimed at (a) investigating the clinical usability of a Visual Analogue Mood Scale (VAMS) in acute stroke patients and (b) investigating the interplay between mood and cognition in this population. Methods: Forty-one acute stroke patients were compared to 41 age-, education- and sex-matched healthy participants (HPs) on the VAMS and on cognitive measures (mental performance in acute stroke, MEPS). A control line bisection (LB) task was administered to control for potential visuo-spatial deficits in patients. Results: Patients reported higher depression levels than HPs (lower VAMS scores); this between-group difference stayed significant when covarying for LB scores. MEPS scores discriminated patients from HPs; among cognitive measures, only the Clock drawing test (CDT) was positively associated with VAMS scores. Lesion side did not affect patients’ mood state; however, disease duration was inversely related to VAMS scores. Discussion: The VAMS proved to be a suitable tool for assessing mood in acute stroke patients, as being independent from post-stroke cognitive sequelae. The CDT might represent an adequate measure of depression-induced, post-stroke cognitive efficiency decrease. Mood disorders might occur and thus should be adequately addressed also in post-acute phases — likely due to longer hospitalization times and regression of anosognosic features.

Published
2022

6. The Italian hub-and-spoke network for the emergency neurology management

Author

Micieli, G, Cortelli, P, Del Sette, M, Cavallini, A, Zanferrari, C, De Falco, A, Quatrale, R, Maria, G, Cossu, G, Haggiag, S, Pezzella, F, Zedde, M, Rea, F, Molise, A, Basilicata, P, Sardegna, N, Calabria, N, Campania, N, Emilia-Romagna, N, Bolzano, P, Lazio, N, Liguria, N, Lombardia, N, Marche, N, D’Aosta, P, Sicilia, N, Toscana, N, Umbria, N, Veneto, N, Null, N, Micieli, Giuseppe, Cortelli, Pietro, Del Sette, Massimo, Cavallini, Anna, Zanferrari, Carla, De Falco, Arturo, Quatrale, Rocco, Maria, Guarino, Cossu, Giovanni, Haggiag, Shalom, Pezzella, Francesca Romana, Zedde, Maria Luisa, Rea, Federico, Molise, Abruzzo e, Basilicata, Puglia e, Sardegna, null, Calabria, null, Campania, null, Emilia-Romagna, null, Bolzano, Province Trento e, Lazio, null, Liguria, null, Lombardia, null, Marche, null, d’Aosta, Piemonte eVal, Sicilia, null, Toscana, null, Umbria, null, Veneto, null, null, null, Micieli, G, Cortelli, P, Del Sette, M, Cavallini, A, Zanferrari, C, De Falco, A, Quatrale, R, Maria, G, Cossu, G, Haggiag, S, Pezzella, F, Zedde, M, Rea, F, Molise, A, Basilicata, P, Sardegna, N, Calabria, N, Campania, N, Emilia-Romagna, N, Bolzano, P, Lazio, N, Liguria, N, Lombardia, N, Marche, N, D’Aosta, P, Sicilia, N, Toscana, N, Umbria, N, Veneto, N, Null, N, Micieli, Giuseppe, Cortelli, Pietro, Del Sette, Massimo, Cavallini, Anna, Zanferrari, Carla, De Falco, Arturo, Quatrale, Rocco, Maria, Guarino, Cossu, Giovanni, Haggiag, Shalom, Pezzella, Francesca Romana, Zedde, Maria Luisa, Rea, Federico, Molise, Abruzzo e, Basilicata, Puglia e, Sardegna, null, Calabria, null, Campania, null, Emilia-Romagna, null, Bolzano, Province Trento e, Lazio, null, Liguria, null, Lombardia, null, Marche, null, d’Aosta, Piemonte eVal, Sicilia, null, Toscana, null, Umbria, null, Veneto, null, and null, null

Abstract

Objective: The aim of the presentstudy was to assess emergency neurology management in Italy by comparing patients admitted to the hub and spoke hospitals. Methods: Data obtained from the annual Italian national survey (NEUDay) investigating the activity and facilities of neurology in the emergency room conducted in November 2021 were considered. Information for each patient who received a neurologic consultation after accessing the emergency room was acquired. Data on facilities were also gathered, including hospital classification (hub vs spoke), number of consultations, presence of neurology and stroke unit, number of beds, availability of neurologist, radiologist, neuroradiologist, and instrumental diagnostic accessibility. Results: Overall, 1,111 patients were admitted to the emergency room and had neurological consultation across 153 facilities (out of the 260 Italian ones). Hub hospitals had significantly more beds, availability of neurological staff, and instrumental diagnostic accessibility. Patients admitted to hub hospital had a greater need for assistance (higher number of yellow/red codes at neurologist triage). A higher propensity to be admitted to hub centers for cerebrovascular problems and to receive a diagnosis of stroke was observed. Conclusions: The identification of hub and spoke hospitals is strongly characterized by the presence of beds and instrumentation mainly dedicated to acute cerebrovascular pathologies. Moreover, the similarity in the number and type of accesses between hub and spoke hospitals suggests the need to look for adequate identification of all the neurological pathologies requiring urgent treatment.

Published
2023

8. Smooth Integration of Decision Support into an Existing Electronic Patient Record

Author

Quaglini, S., Panzarasa, S., Cavallini, A., Micieli, G., Pernice, C., Stefanelli, M., Hutchison, David, editor, Kanade, Takeo, editor, Kittler, Josef, editor, Kleinberg, Jon M., editor, Mattern, Friedemann, editor, Mitchell, John C., editor, Naor, Moni, editor, Nierstrasz, Oscar, editor, Pandu Rangan, C., editor, Steffen, Bernhard, editor, Sudan, Madhu, editor, Terzopoulos, Demetri, editor, Tygar, Dough, editor, Vardi, Moshe Y., editor, Weikum, Gerhard, editor, Carbonell, Jaime G., editor, Siekmann, Jörg, editor, Miksch, Silvia, editor, Hunter, Jim, editor, and Keravnou, Elpida T., editor

Published
2005
Full Text
View/download PDF

10. Neuropsychological assessment in acute stroke patients

Author

Pasotti, F, Magnani, F, Gallucci, M, Salvato, G, Ovadia, D, Scotto, M, Merolla, S, Beretta, S, Micieli, G, Agostoni, E, Beretta, G, Bottini, G, Pasotti F., Magnani F. G., Gallucci M., Salvato G., Ovadia D., Scotto M., Merolla S., Beretta S., Micieli G. R., Agostoni E. C., Beretta G., Bottini G., Pasotti, F, Magnani, F, Gallucci, M, Salvato, G, Ovadia, D, Scotto, M, Merolla, S, Beretta, S, Micieli, G, Agostoni, E, Beretta, G, Bottini, G, Pasotti F., Magnani F. G., Gallucci M., Salvato G., Ovadia D., Scotto M., Merolla S., Beretta S., Micieli G. R., Agostoni E. C., Beretta G., and Bottini G.

Abstract

Background and purpose: The number of people suffering from stroke is strongly increasing, giving rise to multiple cognitive deficits which frequently prevent a full recovery. The identification of both spared and impaired cognitive domains has a key role to plan adequate interventions. However, the existing standard tests are either too expensive in terms of time and efforts for patients in acute stage or they derived from instruments addressing different pathologies such as dementia. Methods: We developed a brief neuropsychological battery (mental performance in acute stroke, MEPS) to assess different cognitive domains (language, memory, praxis, visual perception) in acute stroke patients. MEPS was validated by enrolling a sample of 204 patients suffering from stroke in acute stage, and 263 healthy controls participants. Results: The results indicated an adequate construct validity and a high ability in discriminating patients from healthy controls. Conclusions: MEPS can be considered a simple and highly valuable bedside battery, easy to administer, with values of sensitivity and specificity suitable to be proposed as a screening tool for patients with acute stroke.

Published
2020

11. Guidelines-Based Workflow Systems

Author

Quaglini, S., Mossa, C., Fassino, C., Stefanelli, M., Cavallini, A., Micieli, G., Goos, G., editor, Hartmanis, J., editor, van Leeuwen, J., editor, Carbonell, J. G., editor, Siekmann, J., editor, Horn, Werner, editor, Shahar, Yuval, editor, Lindberg, Greger, editor, Andreassen, Steen, editor, and Wyatt, Jeremy, editor

Published
1999
Full Text
View/download PDF

16. Strategia, Principi attuativi ed Analisi dell’impatto socio-economico del Percorso Ictus in Italia

Author

Bellantone, R, Moriconi, S, Gensini, G, Mennini, F, Bramanti, P, Miragliotta, F, Ferrara, N, Segreto, G, Landolfi, R, Alagna, B, Cisari, C, Cotroneo, E, Fiore, P, Francesco, F, Gangemi, M, Gemignani, V, Mancardi, G, Letizia Mauro, G, Mercuro, G, Micieli, G, Pistarini, C, Provinciali, L, Reale, N, Romeo, F, Rossini, P, Santalucia, P, Tavarnelli, M, Toni, D, and Tuccillo, R

Subjects
Settore SECS-P/03
Published
2021

17. Risk Factors for Intracerebral Hemorrhage in Patients with Atrial Fibrillation on Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention

Author

Paciaroni, M. Agnelli, G. Giustozzi, M. Caso, V. Toso, E. Angelini, F. Canavero, I. Micieli, G. Antonenko, K. Rocco, A. Diomedi, M. Katsanos, A.H. Shoamanesh, A. Giannopoulos, S. Ageno, W. Pegoraro, S. Putaala, J. Strbian, D. Sallinen, H. Mac Grory, B.C. Furie, K.L. Stretz, C. Reznik, M.E. Alberti, A. Venti, M. Mosconi, M.G. Vedovati, M.C. Franco, L. Zepponi, G. Romoli, M. Zini, A. Brancaleoni, L. Riva, L. Silvestrelli, G. Ciccone, A. Zedde, M.L. Giorli, E. Kosmidou, M. Ntais, E. Palaiodimou, L. Halvatsiotis, P. Tassinari, T. Saia, V. Ornello, R. Sacco, S. Bandini, F. Mancuso, M. Orlandi, G. Ferrari, E. Pezzini, A. Poli, L. Cappellari, M. Forlivesi, S. Rigatelli, A. Yaghi, S. Scher, E. Frontera, J.A. Masotti, L. Grifoni, E. Caliandro, P. Zauli, A. Reale, G. Marcheselli, S. Gasparro, A. Terruso, V. Arnao, V. Aridon, P. Abdul-Rahim, A.H. Dawson, J. Saggese, C.E. Palmerini, F. Doronin, B. Volodina, V. Toni, D. Risitano, A. Schirinzi, E. Del Sette, M. Lochner, P. Monaco, S. Mannino, M. Tassi, R. Guideri, F. Acampa, M. Martini, G. Lotti, E.M. Padroni, M. Pantoni, L. Rosa, S. Bertora, P. Ntaios, G. Sagris, D. Baldi, A. D'Amore, C. Mumoli, N. Porta, C. Denti, L. Chiti, A. Corea, F. Acciarresi, M. Flomin, Y. Popovic, N. Tsivgoulis, G.

Subjects
cardiovascular diseases
Abstract

Background and Purpose: Clinical trials on stroke prevention in patients with atrial fibrillation have consistently shown clinical benefit from either warfarin or non-vitamin K antagonist oral anticoagulants (NOACs). NOAC-treated patients have consistently reported to be at lower risk for intracerebral hemorrhage (ICH) than warfarin-treated patients. The aims of this prospective, multicenter, multinational, unmatched, case-control study were (1) to investigate for risk factors that could predict ICH occurring in patients with atrial fibrillation during NOAC treatment and (2) to evaluate the role of CHA2DS2-VASc and HAS-BLED scores in the same setting. Methods: Cases were consecutive patients with atrial fibrillation who had ICH during NOAC treatment. Controls were consecutive patients with atrial fibrillation who did not have ICH during NOAC treatment. As within the CHA2DS2-VASc and HAS-BLED scores there are some risk factors in common, several multivariable logistic regression models were performed to identify independent prespecified predictors for ICH events. Results: Four hundred nineteen cases (mean age, 78.8±8.1 years) and 1526 controls (mean age, 76.0±10.3 years) were included in the study. From the different models performed, independent predictors of ICH were increasing age, concomitant use of antiplatelet agents, active malignancy, high risk of fall, hyperlipidemia, low clearance of creatinine, peripheral artery disease, and white matter changes. Low doses of NOACs (given according to label or not) and congestive heart failure were inversely associated with the risk of ICH. HAS-BLED and CHA2DS2-VASc scores performed poorly in predicting ICH with areas under the curves of 0.496 (95% CI, 0.468-0.525) and 0.530 (95% CI, 0.500-0.560), respectively. Conclusions: Several risk factors were associated to ICH in patients treated with NOACs for stroke prevention but not HAS-BLED and CHA2DS2-VASc scores. © 2021 Lippincott Williams and Wilkins. All rights reserved.

Published
2021

18. Clinical Features of Patients with Cervical Artery Dissection and Fibromuscular Dysplasia

Author

Bonacina, S., Grassi, M., Zedde, M., Zini, A., Bersano, A., Gandolfo, Cinzia, Silvestrelli, G., Baracchini, C., Cerrato, P., Lodigiani, C., Marcheselli, S., Paciaroni, M., Rasura, M., Cappellari, M., Del Sette, M., Cavallini, A., Morotti, A., Micieli, G., Lotti, E. M., Delodovici, M. L., Gentile, Marino, Magoni, M., Azzini, C., Calloni, M. V., Giorli, E., Braga, M., La Spina, P., Melis, F., Tassi, R., Terruso, V., Calabro, R. S., Piras, V., Giossi, A., Locatelli, Martina, Mazzoleni, Valeria, Pezzini, D., Sanguigni, S., Zanferrari, C., Mannino, Maria, Colombo, Ilaria, Dallocchio, C., Nencini, P., Bignamini, V., Adami, A., Magni, Eugenio, Bella, R., Padovani, A., Pezzini, A., Gandolfo C., Gentile M., Locatelli M., Mazzoleni V., Mannino M., Colombo I., Magni E. (ORCID:0000-0002-2235-2280), Bonacina, S., Grassi, M., Zedde, M., Zini, A., Bersano, A., Gandolfo, Cinzia, Silvestrelli, G., Baracchini, C., Cerrato, P., Lodigiani, C., Marcheselli, S., Paciaroni, M., Rasura, M., Cappellari, M., Del Sette, M., Cavallini, A., Morotti, A., Micieli, G., Lotti, E. M., Delodovici, M. L., Gentile, Marino, Magoni, M., Azzini, C., Calloni, M. V., Giorli, E., Braga, M., La Spina, P., Melis, F., Tassi, R., Terruso, V., Calabro, R. S., Piras, V., Giossi, A., Locatelli, Martina, Mazzoleni, Valeria, Pezzini, D., Sanguigni, S., Zanferrari, C., Mannino, Maria, Colombo, Ilaria, Dallocchio, C., Nencini, P., Bignamini, V., Adami, A., Magni, Eugenio, Bella, R., Padovani, A., Pezzini, A., Gandolfo C., Gentile M., Locatelli M., Mazzoleni V., Mannino M., Colombo I., and Magni E. (ORCID:0000-0002-2235-2280)

Abstract

Background and Purpose: Observational studies have suggested a link between fibromuscular dysplasia and spontaneous cervical artery dissection (sCeAD). However, whether patients with coexistence of the two conditions have distinctive clinical characteristics has not been extensively investigated. Methods: In a cohort of consecutive patients with first-ever sCeAD, enrolled in the setting of the multicenter IPSYS CeAD study (Italian Project on Stroke in Young Adults Cervical Artery Dissection) between January 2000 and June 2019, we compared demographic and clinical characteristics, risk factor profile, vascular pathology, and midterm outcome of patients with coexistent cerebrovascular fibromuscular dysplasia (cFMD; cFMD+) with those of patients without cFMD (cFMD-). Results: A total of 1283 sCeAD patients (mean age, 47.8±11.4 years; women, 545 [42.5%]) qualified for the analysis, of whom 103 (8.0%) were diagnosed with cFMD+. In multivariable analysis, history of migraine (odds ratio, 1.78 [95% CI, 1.13-2.79]), the presence of intracranial aneurysms (odds ratio, 8.71 [95% CI, 4.06-18.68]), and the occurrence of minor traumas before the event (odds ratio, 0.48 [95% CI, 0.26-0.89]) were associated with cFMD. After a median follow-up of 34.0 months (25th to 75th percentile, 60.0), 39 (3.3%) patients had recurrent sCeAD events. cFMD+ and history of migraine predicted independently the risk of recurrent sCeAD (hazard ratio, 3.40 [95% CI, 1.58-7.31] and 2.07 [95% CI, 1.06-4.03], respectively) in multivariable Cox proportional hazards analysis. Conclusions: Risk factor profile of sCeAD patients with cFMD differs from that of patients without cFMD. cFMD and migraine are independent predictors of midterm risk of sCeAD recurrence.

Published
2021

39. Adherence to recommendations and clinical outcomes of patients hospitalized for stroke: the role of the admission ward—a real-life investigation from Italy

Author

Rea, F, Micieli, G, Musicco, M, Cavallini, A, Santucci, C, Merlino, L, Ieva, F, Ferrarese, C, Corrao, G, Rea, F, Micieli, G, Musicco, M, Cavallini, A, Santucci, C, Merlino, L, Ieva, F, Ferrarese, C, and Corrao, G

Abstract

Objective: To determine whether out-of-hospital healthcare and adverse outcomes are better in stroke patients admitted to a neurology ward compared with those admitted to general wards. Methods: Beneficiaries of the National Health Service from the Italian Lombardy Region who were discharged alive after hospital admission during the year 2009 for ischemic stroke (9776 patients) or intracerebral or subarachnoid hemorrhage (1102 patients) entered into the cohort and were followed until 2012. Exposure of interest was the ward type where inpatients were admitted (neuro vs. general wards). Outcomes were out-of-hospital healthcare (i.e., drug prescriptions, diagnostic procedures, and laboratory clinical evaluations) and adverse clinical outcomes (i.e., all-cause death and hospital readmission). Exposure-outcome associations were investigated. High-dimensional propensity score methodology was used for taking into account confounders. Mediation analysis was used to verify whether the association between ward type and clinical outcomes is mediated by out-of-hospital adherence to healthcare. Results: Better adherence to out-of-hospital healthcare received from patients discharged from neuro, rather than general, wards was observed being the proportions of adherent patients 42.4% and 39.5%, respectively. Compared with general wards, discharge from neuro was associated with reduced 3-year emergency admissions (from 50.1 to 47.5% among ischemic stroke patients) and reduced 3-year mortality (from 37.5 to 27.0% among hemorrhagic stroke patients). From 10 to 15% of outcome risk, reductions were mediated by better adherence to out-of-hospital healthcare. Conclusions: For patients with acute ischemic and hemorrhagic stroke, admission to neuro vs. general wards is associated with better out-of-hospital healthcare and long-term adverse outcomes.

Published
2019

46. Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy

Author

Costa, P., Grassi, M., Iacoviello, L., Zedde, M., Marcheselli, S., Silvestrelli, G., Delodovici, M. L., Sessa, M., Zini, A., Paciaroni, M., Azzini, C., Gamba, M., Del Sette, M., Toriello, A., Gandolfo, C., Bonifati, D. M., Tassi, R., Cavallini, A., Chiti, A., Calabro, R. S., Grillo, F., Bovi, P., Tomelleri, G., Di Castelnuovo, A., Ritelli, M., Agnelli, G., De Vito, A., Pugliese, N., Martini, G., Lodigiani, C., Morotti, A., Poli, L., Degiuli, V., Caria, F., Cornali, C., Degaetano, G., Colombi, M., Padovani, A., Pezzini, A., D'Amore, C., Acciarresi, M., Caso, V., Alberti, A., Venti, M., Vandelli, L., Dell'Acqua, M. L., Simone, A. M., Nichelli, P. F., Lanari, A., Ciccone, A., Del Zotto, E., Gilberti, N., Magoni, M., Zucco, G., Massucco, D., Finocchi, C., Balestrino, M., Carletti, M., Zivelonghi, C., Casella, C., La Spina, P., Musolino, R., Bramanti, P., Princiotta Cariddi, L., Giorli, E., Strambo, D., Giacalone, G., Glielmi, A., Volpe, G., Micieli, G., Montano, V., Padroni, Marotta, G., Malferrari, G., Marcello, N., Cucurachi, L., and Giossi, A.

Subjects
Male, medicine.medical_specialty, Alcohol Drinking, Alcohol, Intracerebral hemorrhage, Elderly, 03 medical and health sciences, 0302 clinical medicine, Elderly, Risk Factors, Internal medicine, medicine, 80 and over, Humans, cardiovascular diseases, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, Cerebral Hemorrhage, Intracerebral hemorrhage, Aged, 80 and over, business.industry, Case-control study, Case-Control Studies, Female, Italy, Middle Aged, Self Report, Odds ratio, medicine.disease, Confidence interval, nervous system diseases, Cohort, Alcohol intake, Observational study, Neurology (clinical), business, Alcohol, 030217 neurology & neurosurgery
Abstract

ObjectiveTo investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding.MethodsWe performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH.ResultsWe analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36–2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17–1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77–1.32).ConclusionsIn white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

Published
2018

47. The role of clinical and neuroimaging features in the diagnosis of CADASIL

Author

Bersano, A, Bedini, G, Markus, H, Vitali, P, Colli-Tibaldi, E, Taroni, F, Gellera, C, Baratta, S, Mosca, L, Carrera, P, Ferrari, M, Cereda, C, Grieco, G, Lanfranconi, S, Mazucchelli, F, Zarcone, D, De Lodovici, M, Bono, G, Boncoraglio, G, Parati, E, Calloni, M, Perrone, P, Bordo, B, Motto, C, Agostoni, E, Pezzini, A, Padovani, A, Micieli, G, Cavallini, A, Molini, G, Sasanelli, F, Sessa, M, Comi, G, Checcarelli, N, Carmerlingo, M, Corato, M, Marcheselli, S, Fusi, L, Grampa, G, Uccellini, D, Beretta, S, Ferrarese, C, Incorvaia, B, Tadeo, C, Adobbati, L, Silani, V, Faragò, G, Trobia, N, Grond-Ginsbach, C, Candelise, L, Mazzucchelli, F, Guidotti, M, Riva, M, Iurlaro, S, Maria, B, Braga, M, Meola, G, Carpo, M, Camerlingo, M, Borutti, G, Delodovici, M, Verrengia, E, Tancredi, L, Terruzzi, A, Magoni, M, Del Zotto, E, Bassi, P, Lattuada, P, Ballabio, E, Gambaro, P, Corrà, B, Canavero, I, Arbustini, E, Grasso, M, Corti, S, Ronchi, D, Merlini, G, Obici, L, Bassi, M, Tagliavini, F, Ginsbach, C, Bersano, Anna, BEDINI, GLORIA, Markus, Hugh Stephen, Vitali, Paolo, Colli-Tibaldi, Enrico, Taroni, Franco, Gellera, Cinzia, Baratta, Silvia, Mosca, Lorena, Carrera, Paola, FERRARI, MAURIZIO, Cereda, Cristina, Grieco, Gaetano, Lanfranconi, Silvia, Mazucchelli, Franca, Zarcone, Davide, De Lodovici, Maria Luisa, Bono, Giorgio, Boncoraglio, Giorgio Battista, Parati, Eugenio Agostino, Calloni, Maria Vittoria, Perrone, Patrizia, Bordo, Bianca Maria, Motto, Cristina, Agostoni, Elio, Pezzini, Alessandro, Padovani, Alessandro, Micieli, Giuseppe, Cavallini, Anna, Molini, Graziella, Sasanelli, Francesco, Sessa, Maria, Comi, Giancarlo, Checcarelli, Nicoletta, Carmerlingo, Massimo, CORATO, MANUEL, Marcheselli, Simona, Fusi, Laura, Grampa, Giampiero, Uccellini, Davide, Beretta, Simone, Ferrarese, Carlo, Incorvaia, Barbara, Tadeo, Carlo Sebastiano, Adobbati, Laura, Silani, Vincenzo, Faragò, Giuseppe, Trobia, Nadia, Grond-Ginsbach, Caspar, Candelise, Livia, Mazzucchelli, Franca, Guidotti, Mario, Riva, Maurizio, Iurlaro, Simona, Maria, Bianca Bordo, Braga, Massimiliano, Meola, Giovanni, Carpo, Marinella, Camerlingo, Massimo, Borutti, Giuseppina, Delodovici, Marialuisa, Verrengia, Elena Pinuccia, Tancredi, Lucia, Terruzzi, Alessandro, Magoni, Mauro, Del Zotto, Elisabetta, Bassi, Pietro, Lattuada, Patrizia, Ballabio, Elena, Gambaro, Paola, Lanfranconi, Sivia, Corrà, Barbara, Canavero, Isabella, Arbustini, Eloisa, Grasso, Maurizia, Comi, Giacomo Pietro, Corti, Stefania, Ronchi, Dario, Merlini, Giampaolo, Obici, Laura, Bassi, Maria Teresa, Tagliavini, Fabrizio, Ginsbach, Caspar Grond, Bersano, A, Bedini, G, Markus, H, Vitali, P, Colli-Tibaldi, E, Taroni, F, Gellera, C, Baratta, S, Mosca, L, Carrera, P, Ferrari, M, Cereda, C, Grieco, G, Lanfranconi, S, Mazucchelli, F, Zarcone, D, De Lodovici, M, Bono, G, Boncoraglio, G, Parati, E, Calloni, M, Perrone, P, Bordo, B, Motto, C, Agostoni, E, Pezzini, A, Padovani, A, Micieli, G, Cavallini, A, Molini, G, Sasanelli, F, Sessa, M, Comi, G, Checcarelli, N, Carmerlingo, M, Corato, M, Marcheselli, S, Fusi, L, Grampa, G, Uccellini, D, Beretta, S, Ferrarese, C, Incorvaia, B, Tadeo, C, Adobbati, L, Silani, V, Faragò, G, Trobia, N, Grond-Ginsbach, C, Candelise, L, Mazzucchelli, F, Guidotti, M, Riva, M, Iurlaro, S, Maria, B, Braga, M, Meola, G, Carpo, M, Camerlingo, M, Borutti, G, Delodovici, M, Verrengia, E, Tancredi, L, Terruzzi, A, Magoni, M, Del Zotto, E, Bassi, P, Lattuada, P, Ballabio, E, Gambaro, P, Corrà, B, Canavero, I, Arbustini, E, Grasso, M, Corti, S, Ronchi, D, Merlini, G, Obici, L, Bassi, M, Tagliavini, F, Ginsbach, C, Bersano, Anna, BEDINI, GLORIA, Markus, Hugh Stephen, Vitali, Paolo, Colli-Tibaldi, Enrico, Taroni, Franco, Gellera, Cinzia, Baratta, Silvia, Mosca, Lorena, Carrera, Paola, FERRARI, MAURIZIO, Cereda, Cristina, Grieco, Gaetano, Lanfranconi, Silvia, Mazucchelli, Franca, Zarcone, Davide, De Lodovici, Maria Luisa, Bono, Giorgio, Boncoraglio, Giorgio Battista, Parati, Eugenio Agostino, Calloni, Maria Vittoria, Perrone, Patrizia, Bordo, Bianca Maria, Motto, Cristina, Agostoni, Elio, Pezzini, Alessandro, Padovani, Alessandro, Micieli, Giuseppe, Cavallini, Anna, Molini, Graziella, Sasanelli, Francesco, Sessa, Maria, Comi, Giancarlo, Checcarelli, Nicoletta, Carmerlingo, Massimo, CORATO, MANUEL, Marcheselli, Simona, Fusi, Laura, Grampa, Giampiero, Uccellini, Davide, Beretta, Simone, Ferrarese, Carlo, Incorvaia, Barbara, Tadeo, Carlo Sebastiano, Adobbati, Laura, Silani, Vincenzo, Faragò, Giuseppe, Trobia, Nadia, Grond-Ginsbach, Caspar, Candelise, Livia, Mazzucchelli, Franca, Guidotti, Mario, Riva, Maurizio, Iurlaro, Simona, Maria, Bianca Bordo, Braga, Massimiliano, Meola, Giovanni, Carpo, Marinella, Camerlingo, Massimo, Borutti, Giuseppina, Delodovici, Marialuisa, Verrengia, Elena Pinuccia, Tancredi, Lucia, Terruzzi, Alessandro, Magoni, Mauro, Del Zotto, Elisabetta, Bassi, Pietro, Lattuada, Patrizia, Ballabio, Elena, Gambaro, Paola, Lanfranconi, Sivia, Corrà, Barbara, Canavero, Isabella, Arbustini, Eloisa, Grasso, Maurizia, Comi, Giacomo Pietro, Corti, Stefania, Ronchi, Dario, Merlini, Giampaolo, Obici, Laura, Bassi, Maria Teresa, Tagliavini, Fabrizio, and Ginsbach, Caspar Grond

Abstract

Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common familial cerebral small vessel disease, caused by NOTCH3 gene mutations. The aim of our study was to identify clinical and neuroradiological features which would be useful in identifying which patients presenting with lacunar stroke and TIA are likely to have CADASIL. Methods: Patients with lacunar stroke or TIA were included in the present study. For each patient, demographic and clinical data were collected. MRI images were centrally analysed for the presence of lacunar infarcts, microbleeds, temporal lobe involvement, global atrophy and white matter hyperintensities. Results: 128 patients (mean age 56.3 ± 12.4 years) were included. A NOTCH3 mutation was found in 12.5% of them. A family history of stroke, the presence of dementia and external capsule lesions on MRI were the only features significantly associated with the diagnosis of CADASIL. Although thalamic, temporal pole gliosis and severe white matter hyperintensities were less specific for CADASIL diagnosis, the combination of a number of these factors together with familial history for stroke result in a higher positive predictive value and specificity. Conclusions: A careful familial history collection and neuroradiological assessment can identify patients in whom NOTCH3 genetic testing has a higher yield.

Published
2018

49. A Multicentric Prospective Incidence Study of Guillain-Barré Syndrome in Italy. The ITANG Study

Author

Benedetti, M, Pugliatti, M, Dalessandro, R, BEGHI, ETTORE, Chiò, A, Logroscino, G, Filippini, G, Galeotti, F, Massari, M, Santuccio, C, Raschetti, R, Abruzzi, L, Agazzi, E, Agostoni, E, Ambrogio, L, Amidei, S, Arbasino, C, Argentiero, V, Arnaboldi, M, Baldini, D, Barki, R, Bassi, P, Basso, F, Belcastro, V, Bellotti, M, Bersano, E, Besana, R, Bettoni, L, Bezzi, G, Bianconi, C, Bondavalli, M, Bonometti, A, Borghi, AM, Borsato, C, Bortolotto, S, Bottacchi, EF, Bresolin, N, Bruno, S, Burlina, A, Cafasso, G, Callegarini, C, Calvo, A, Candeloro, E, Casano, A, Cattaneo, SI, Cavallo, R, Cheldi, A, Ciardo, G, Cirignotta, F, Clerici, AM, Clerici, R, Comi, G, Conti, R, Coppo, F, Covelli, V, Crespi, V, Currò Dossi, M, Curtò, NA, D'Adda, E, Dallocchio, C, D'Anna, S, De Massis, P, De Toni Franceschini, L, Di Vito, N, Didonè, G, Dileone, M, Donati, E, Dotta, M, Fazio, R, Federico, F, FERRARESE, CARLO, Ferrazzini, F, Ferrero, B, Filosto, M, Frasson, E, Fusina, S, Galbussera, A, Gastaldo, E, Geda, C, Ghiglione, P, Giometto, B, Gionco, M, Giorgetti, A, Giussani, G, Gobbin, F, Grampa, G, Granieri, E, Greco, G, Guidetti, D, Guidi, C, Guidotti, M, Gusmaroli, G, Imperiale, D, Internò, S, Jann, S, La Spina, I, Leo, A, Leone, M, Leoni, S, Leotta, D, Lerario, R, Liotta, G, Livrea, P, Luda di Cortemiglio, E, Maggio, B, Magni, E, Magnoni, A, Maistrelli, J, Manca, D, Mandrioli, J, Manera, U, Marcello, N, Marchi, P, Marchini, C, Marconi, S, Mattioli, M, Mauro, A, Mazzaglia, G, Medici, D, Meineri, P, Meola, G, Micaglio, G, Michelucci, R, Michieli, G, Micieli, G, Minardi, C, Moglia, C, Monaco, S, Montanari, E, Moretto, G, Munerati, V, Mura, G, Mussutto, V, Nascimbene, C, Neri, W, Nichelli, P, Nobile Orazio, E, Oddenino, E, Onorato, S, Padovani, A, Palermo, M, Papurello, DM, Passarella, B, Pavesi, G, Penza, MT, Perini, M, Perini, F, Perla, F, Perlotto, N, Perrone, P, Pignatta, P, Pisano, F, Poglio, F, Polo, A, Poloni, M, Porazzi, D, Pradotto, L, Previdi, P, Quatrale, R, Rasi, F, Ravasio, A, Ravetti, C, Repaci, M, Riccardi, T, Riguzzi, P, Rinaldi, R, Riva, M, Romeo, V, Romorini, A, Rosso, T, Rotondo, G, Sacquegna, T, Sanson, F, Santamato, V, Santoro, D, Sartori, V, Sasanelli, F, Savio, K, Serena, M, Silani, V, Silvestri, L, Simioni, V, Squintani, GM, Suardelli, M, Tartagla, L, Terenghi, F, Terlizzi, E, Terzano, M, Tesser, F, Testa, L, Ticca, A, Ticozzi, N, Tiriticco, M, Tola, MR, Tonietti, S, Trianni, G, Trojano, M, Trotta, F, Turatti, M, Ursino, E, Vanotti, A, Vercellino, M, Villani, A, Vitelli, E, Zambito Marsala, S, Zanette, G, Zarcone, D, Zimatore, G, Zoccolella, S., Benedetti, Md, Pugliatti, M, D'Alessandro, R, Beghi, E, Chiò, A, Logroscino, G, Filippini, G, Galeotti, F, Massari, M, Santuccio, C, Comi, Giancarlo, Raschetti, R, ITANG Study, Group, Giometto, B, Benedetti, M, Dalessandro, R, Abruzzi, L, Agazzi, E, Agostoni, E, Ambrogio, L, Amidei, S, Arbasino, C, Argentiero, V, Arnaboldi, M, Baldini, D, Barki, R, Bassi, P, Basso, F, Belcastro, V, Bellotti, M, Bersano, E, Besana, R, Bettoni, L, Bezzi, G, Bianconi, C, Bondavalli, M, Bonometti, A, Borghi, A, Borsato, C, Bortolotto, S, Bottacchi, E, Bresolin, N, Bruno, S, Burlina, A, Cafasso, G, Callegarini, C, Calvo, A, Candeloro, E, Casano, A, Cattaneo, S, Cavallo, R, Cheldi, A, Ciardo, G, Cirignotta, F, Clerici, A, Clerici, R, Comi, G, Conti, R, Coppo, F, Covelli, V, Crespi, V, Currò Dossi, M, Curtò, N, D'Adda, E, Dallocchio, C, D'Anna, S, De Massis, P, De Toni Franceschini, L, Di Vito, N, Didonè, G, Dileone, M, Donati, E, Dotta, M, Fazio, R, Federico, F, Ferrarese, C, Ferrazzini, F, Ferrero, B, Filosto, M, Frasson, E, Fusina, S, Galbussera, A, Gastaldo, E, Geda, C, Ghiglione, P, Gionco, M, Giorgetti, A, Giussani, G, Gobbin, F, Grampa, G, Granieri, E, Greco, G, Guidetti, D, Guidi, C, Guidotti, M, Gusmaroli, G, Imperiale, D, Internò, S, Jann, S, La Spina, I, Leo, A, Leone, M, Leoni, S, Leotta, D, Lerario, R, Liotta, G, Livrea, P, Luda di Cortemiglio, E, Maggio, B, Magni, E, Magnoni, A, Maistrelli, J, Manca, D, Mandrioli, J, Manera, U, Marcello, N, Marchi, P, Marchini, C, Marconi, S, Mattioli, M, Mauro, A, Mazzaglia, G, Medici, D, Meineri, P, Meola, G, Micaglio, G, Michelucci, R, Michieli, G, Micieli, G, Minardi, C, Moglia, C, Monaco, S, Montanari, E, Moretto, G, Munerati, V, Mura, G, Mussutto, V, Nascimbene, C, Neri, W, Nichelli, P, Nobile Orazio, E, Oddenino, E, Onorato, S, Padovani, A, Palermo, M, Papurello, D, Passarella, B, Pavesi, G, Penza, M, Perini, M, Perini, F, Perla, F, Perlotto, N, Perrone, P, Pignatta, P, Pisano, F, Poglio, F, Polo, A, Poloni, M, Porazzi, D, Pradotto, L, Previdi, P, Quatrale, R, Rasi, F, Ravasio, A, Ravetti, C, Repaci, M, Riccardi, T, Riguzzi, P, Rinaldi, R, Riva, M, Romeo, V, Romorini, A, Rosso, T, Rotondo, G, Sacquegna, T, Sanson, F, Santamato, V, Santoro, D, Sartori, V, Sasanelli, F, Savio, K, Serena, M, Silani, V, Silvestri, L, Simioni, V, Squintani, G, Suardelli, M, Tartagla, L, Terenghi, F, Terlizzi, E, Terzano, M, Tesser, F, Testa, L, Ticca, A, Ticozzi, N, Tiriticco, M, Tola, M, Tonietti, S, Trianni, G, Trojano, M, Trotta, F, Turatti, M, Ursino, E, Vanotti, A, Vercellino, M, Villani, A, Vitelli, E, Zambito Marsala, S, Zanette, G, Zarcone, D, Zimatore, G, and Zoccolella, S

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Epidemiology, Population, Guillain-Barre Syndrome, Rate ratio, NO, Young Adult, Axonal and demyelinating GBS, Guillain-Barré syndrome, Incidence, Prospective study, Trend, Neurology (clinical), Aged, Aged, 80 and over, Female, Humans, Italy, Middle Aged, 80 and over, medicine, Young adult, education, Prospective cohort study, education.field_of_study, Guillain-Barre syndrome, business.industry, Medicine (all), Incidence (epidemiology), medicine.disease, Vaccination, Settore MED/26 - NEUROLOGIA, business, Human
Abstract

Background: To assess Guillain-Barré syndrome (GBS) incidence we relied on the Italian Network for the study of GBS (ITANG) established in 2010 in 7 Italian regions to analyse the association between influenza vaccination and GBS. Methods: All individuals aged ≥18 years, presenting with clinical manifestations that suggested GBS according to the universally accepted Asbury's diagnostic criteria (1990) were prospectively notified to a centralised database by ITANG neurologists over the period October 1, 2010-September 30, 2011. Through a telephone survey, 9 trained interviewers followed up the cases to diagnosis and then for 1 year since hospital discharge. Validation of case reporting was performed with the support of administrative data in 5 regions. Results: We found 365 cases fulfilling the definition for GBS or one of its variants over 19,846,068 population ≥18 years of age, yielding an annual incidence rate of 1.84 per 100,000 (95% CI 1.65-2.03), 2.30 (95% CI 1.99-2.60) in men and 1.41 (95% CI 1.18-1.64) in women. A highly significant peak of incidence was observed in February 2011 as compared to reference month (September 2011, rate ratio 3.3:1, p < 0.01). Conclusions: In Italy, GBS incidence was among the highest reported in Europe and higher than previously observed in Italian studies.

Published
2015

Catalog

Books, media, physical & digital resources
See catalog results