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492 results on '"Paperini, A."'

1. Transvenous lead extraction: Efficacy and safety of the procedure in female patients

Author

Luca Segreti, MD, Maria Grazia Bongiorni, MD, Valentina Barletta, MD, PhD, Matteo Parollo, MD, Andrea Di Cori, MD, Federico Fiorentini, MD, Mario Giannotti Santoro, MD, Raffaele De Lucia, MD, Stefano Viani, MD, Gino Grifoni, MD, Luca Paperini, MD, Ezio Sodati, MD, Lorenzo Mazzocchetti, MD, Antonio Maria Canu, MD, and Giulio Zucchelli, MD, PhD

Subjects
Transvenous lead extraction, Sex differences, Female sex, Safety outcomes, Complication, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: Existing data on the impact of sex differences on transvenous lead extraction (TLE) outcomes in cardiac device patients are limited. Objective: The purpose of this study was to evaluate the safety and efficacy of mechanical TLE in female patients. Methods: A retrospective evaluation was performed on 3051 TLE patients (group 1: female; group 2: male) from a single tertiary referral center. All individuals received treatment using single sheath mechanical dilation and various venous approaches as required. Results: Our analysis included 3051 patients (group 1: 750; group 2: 2301), with a total of 5515 leads handled with removal. Female patients were younger, had a higher left ventricular ejection fraction, and lower prevalences of coronary artery disease and diabetes mellitus. Infection was more common in male patients, whereas lead malfunction or abandonment were more frequent in female patients. Radiologic success was lower in female patients (95.8% vs 97.5%; P = .003), but there was no significant difference in clinical success between groups (97.2% vs 97.5%; P = .872). However, major complications (1.33% vs 0.60%; P

Published
2023
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2. Trunk Control Test as a Main Predictor of the Modified Barthel Index Score at Discharge From Intensive Post-acute Stroke Rehabilitation: Results From a Multicenter Italian Study

Author

Pellicciari, Leonardo, Basagni, Benedetta, Paperini, Anita, Campagnini, Silvia, Sodero, Alessandro, Hakiki, Bahia, Castagnoli, Chiara, Politi, Angela Maria, Avila, Lucia, Barilli, Manuele, Romano, Emanuela, Pancani, Silvia, Mannini, Andrea, Sensoli, Federico, Salvadori, Emilia, Poggesi, Anna, Grippo, Antonello, Macchi, Claudio, Baccini, Marco, Carrozza, Maria Chiara, and Cecchi, Francesca

Published
2024
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4. Trunk Control Test as a Main Predictor of the Modified Barthel Index Score at Discharge From Intensive Post-acute Stroke Rehabilitation: Results From a Multicenter Italian Study

Author

Pellicciari, L, Basagni, B, Paperini, A, Campagnini, S, Sodero, A, Hakiki, B, Castagnoli, C, Politi, A, Avila, L, Barilli, M, Romano, E, Pancani, S, Mannini, A, Sensoli, F, Salvadori, E, Poggesi, A, Grippo, A, Macchi, C, Baccini, M, Carrozza, M, Cecchi, F, Pellicciari L., Basagni B., Paperini A., Campagnini S., Sodero A., Hakiki B., Castagnoli C., Politi A. M., Avila L., Barilli M., Romano E., Pancani S., Mannini A., Sensoli F., Salvadori E., Poggesi A., Grippo A., Macchi C., Baccini M., Carrozza M. C., Cecchi F., Pellicciari, L, Basagni, B, Paperini, A, Campagnini, S, Sodero, A, Hakiki, B, Castagnoli, C, Politi, A, Avila, L, Barilli, M, Romano, E, Pancani, S, Mannini, A, Sensoli, F, Salvadori, E, Poggesi, A, Grippo, A, Macchi, C, Baccini, M, Carrozza, M, Cecchi, F, Pellicciari L., Basagni B., Paperini A., Campagnini S., Sodero A., Hakiki B., Castagnoli C., Politi A. M., Avila L., Barilli M., Romano E., Pancani S., Mannini A., Sensoli F., Salvadori E., Poggesi A., Grippo A., Macchi C., Baccini M., Carrozza M. C., and Cecchi F.

Abstract

Objectives: To verify whether trunk control test (TCT) upon admission to intensive inpatient post-stroke rehabilitation, combined with other confounding variables, is independently associated with discharge mBI. Design: Multicentric retrospective observational cohort study. Setting: Two Italian inpatient rehabilitation units. Participants: A total of 220 post-stroke adult patients, within 30 days from the acute event, were consecutively enrolled. Interventions: Not applicable. Main Outcome Measure: The outcome measure considered was the modified Barthel Index (mBI), one of the most widely recommended tools for assessing stroke rehabilitation functional outcomes. Results: All variables collected at admission and significantly associated with mBI at discharge in the univariate analysis (TCT, mBI at admission, pre-stroke modified Rankin Scale [mRS], sex, age, communication ability, time from the event, Cumulative Illness Rating Scale, bladder catheter, and pressure ulcers) entered the multivariate analysis. TCT, mBI at admission, premorbid disability (mRS), communication ability and pressure ulcers (P<.001) independently predicted discharge mBI (adjusted R2=68.5%). Concerning the role of TCT, the model with all covariates and without TCT presented an R2 of 65.1%. On the other side, the model with the TCT only presented an R2 of 53.1%. Finally, with the inclusion of both TCT and all covariates, the model showed an R2 increase up to 68.5%. Conclusions: TCT, with other features suggesting functional/clinical complexity, collected upon admission to post-acute intensive inpatient stroke rehabilitation, independently predicted discharge mBI.

Published
2024

5. 12-month survival in nonagenarians inside the Mugello study: on the way to live a century

Author

Silvia Pancani, Gemma Lombardi, Francesco Sofi, Anna Maria Gori, Roberta Boni, Chiara Castagnoli, Anita Paperini, Guido Pasquini, Federica Vannetti, Raffaello Molino Lova, Claudio Macchi, and Francesca Cecchi

Subjects
Longevity, Physical activity, Cognitive impairments, Functional status, Nonagenarians, Geriatrics, RC952-954.6
Abstract

Abstract Background Life expectancy has increased over the last century and a growing number of people is reaching age 90 years and over. However, data on nonagenarians’ health trends are scarce due to difficulties in investigating this specific population. This study aims to identify risk factors for one-year mortality in nonagenarians using data collected within the “Mugello Study”. Methods Complete information on sociodemographic data, cognitive and functional status, lifestyle, medical history, and drug use was collected from 433 nonagenarians, as well as information about survival after 1 year from the interview. Results The sample included 314 women (72.5%) and 119 men (27.5%) with a median age of 92 years (range 90-99 years). The mortality rate was 20.3% (88 deaths). After adjustment for age and sex, a significantly higher risk of dying within 12 months was observed in individuals with more severe cognitive impairment (HR = 5.011, p

Published
2022
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6. Critical issue on the extinction and inattention subtest of NIHSS scale: an analysis on post-acute stroke patients attending inpatient rehabilitation

Author

Benedetta Basagni, Bahia Hakiki, Silvia Campagnini, Emilia Salvadori, Antonello Grippo, Anita Paperini, Chiara Castagnoli, Ines Hochleitner, Angela Maria Politi, Paola Gemignani, Irene Eleonora Mosca, Azzurra Franceschini, Enrico Bacci Bonotti, Alessandro Sodero, Andrea Mannini, Leonardo Pellicciari, Anna Poggesi, Claudio Macchi, Maria Chiara Carrozza, and Francesca Cecchi

Subjects
Stroke, NIHSS, Hemineglect, Heminattention, Visual field, Rehabilitation, Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract Objectives This study aims to evaluate the diagnostic performance of NIHSS extinction and inattention item, compared to the results of the Oxford Cognitive Screen (OCS) heart subtest. Additionally, the possible role of the NIHSS visual field subtest on the NIHSS extinction and inattention subtest performance is explored and discussed. Methods We analysed scores on NIHSS extinction and inattention subtest, NIHSS visual field subtest, and OCS heart subtest on a sample of 118 post-stroke patients. Results Compared to OCS heart subtest, the results on NIHSS extinction and inattention subtest showed an accuracy of 72.9% and a moderate agreement level (Cohen’s kappa = 0.404). Furthermore, a decrease in NIHSS accuracy detecting neglect (61.1%) was observed in patients with pathological scores in NIHSS visual field item. Conclusions Extreme caution is recommended for the diagnostic performance of extinction and inattention item of NIHSS. Signs of neglect may not be detected by NIHSS, and may be confused with visual field impairment. Trial registration This study refers to an observational study protocol submitted to ClinicalTrials.gov with identifier: NCT03968627 . The name of the registry is “Development of a National Protocol for Stroke Rehabilitation in a Multicenter Italian Institution” and the date of the registration is the 30th May 2019.

Published
2021
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7. Design and implementation of a Stroke Rehabilitation Registry for the systematic assessment of processes and outcomes and the development of data-driven prediction models: The STRATEGY study protocol

Author

Marco Chiavilli, Silvia Campagnini, Teresa Baretta, Chiara Castagnoli, Anita Paperini, Angela Maria Politi, Leonardo Pellicciari, Marco Baccini, Benedetta Basagni, Sara Marignani, Donata Bardi, Alessandro Sodero, Gemma Lombardi, Erika Guolo, Jorge Solano Navarro, Silvia Galeri, Angelo Montesano, Lucia Falco, Marco Giuseppe Rovaris, Maria Chiara Carrozza, Claudio Macchi, Andrea Mannini, and Francesca Cecchi

Subjects
stroke, rehabilitation, registry, functional recovery, decision support tools, machine learning, Neurology. Diseases of the nervous system, RC346-429
Abstract

BackgroundStroke represents the second preventable cause of death after cardiovascular disease and the third global cause of disability. In countries where national registries of the clinical quality of stroke care have been established, the publication and sharing of the collected data have led to an improvement in the quality of care and survival of patients. However, information on rehabilitation processes and outcomes is often lacking, and predictors of functional outcomes remain poorly explored. This paper describes a multicenter study protocol to implement a Stroke rehabilitation Registry, mainly based on a multidimensional assessment proposed by the Italian Society of Physical and Rehabilitation Medicine (PMIC2020), in a pilot Italian cohort of stroke survivors undergoing post-acute inpatient rehabilitation, to provide a systematic assessment of processes and outcomes and develop data-driven prediction models of functional outcomes.MethodsAll patients with a diagnosis of ischemic or haemorrhagic stroke confirmed by clinical assessment, admitted to intensive rehabilitation units within 30 days from the acute event, aged 18+, and providing informed consent will be enrolled. Measures will be taken at admission (T0), at discharge (T1), and at follow-up, 3 months (T2) and 6 months (T3) after the stroke. Assessment variables include anamnestic data, clinical and nursing complexity information and measures of body structures and function, activity and participation (PMIC2020), rehabilitation interventions, adverse events and discharge data. The modified Barthel Index will be our primary outcome. In addition to classical biostatistical analysis, learning algorithms will be cross-validated to achieve data-driven prognosis prediction models.ConclusionsThis study will test the feasibility of a stroke rehabilitation registry in the Italian health context and provide a systematic assessment of processes and outcomes for quality assessment and benchmarking. By the development of data-driven prediction models in stroke rehabilitation, this study will pave the way for the development of decision support tools for patient-oriented therapy planning and rehabilitation outcomes maximization.Clinical tial registrationThe registration on ClinicalTrials.gov is ongoing and under review. The identification number will be provided when the review process will be completed.

Published
2022
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9. Muscle strength is related to mental and physical quality of life in the oldest old

Author

Boni, Roberta, Castagnoli, Chiara, Cecchi, Francesca, Cesari, Francesca, Epifani, Francesco, Frandi, Roberta, Giusti, Betti, Luisi, Maria Luisa Eliana, Marcucci, Rossella, Molino-Lova, Raffaello, Paperini, Anita, Razzolini, Lorenzo, Sofi, Francesco, Turcan, Nona, Valecchi, Debora, Laudisio, Alice, Giovannini, Silvia, Finamore, Panaiotis, Loreti, Claudia, Vannetti, Federica, Coraci, Daniele, Incalzi, Raffaele Antonelli, Zuccal, Giuseppe, Macchi, Claudio, and Padua, Luca

Published
2020
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10. Early vs. late lead extraction in CIED infections: evaluating the interplay of infection type, timing, and comorbidities

Author

Tamborrino, P P, primary, Segreti, L, additional, Barletta, V, additional, Fiorentini, F, additional, Torre, M, additional, Di Cori, A, additional, De Lucia, R, additional, Viani, S M, additional, Paperini, L, additional, Grifoni, G, additional, Soldati, E, additional, Parollo, M, additional, Bongiorni, M G, additional, and Zucchelli, G, additional

Published
2024
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14. Association of Body Fat With Health-Related Quality of Life and Depression in Nonagenarians: The Mugello Study

Author

Bonaccorsi, Guglielmo, Boni, Roberta, CastagnolI, Chiara, Cecchi, Francesca, Cesari, Francesca, Epifani, Francesco, Frandi, Roberta, Giusti, Betti, Luisi, Maria Luisa Eliana, Marcucci, Rossella, Molino-Lova, Raffaello, Paperini, Anita, Razzolini, Lorenzo, Sofi, Francesco, Turcan, Nona, Valecchi, Debora, Giovannini, Silvia, Macchi, Claudio, Liperoti, Rossella, Laudisio, Alice, Coraci, Daniele, Loreti, Claudia, Vannetti, Federica, Onder, Graziano, and Padua, Luca

Published
2019
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15. Factors influencing trunk control recovery after intensive rehabilitation in post-stroke patients: a multicentre prospective study

Author

Pellicciari, L, Sodero, A, Campagnini, S, Guolo, E, Basagni, B, Castagnoli, C, Hochleitner, I, Paperini, A, Gnetti, B, Avila, L, Romano, E, Grippo, A, Hakiki, B, Carrozza, M, Mannini, A, Macchi, C, Cecchi, F, Pellicciari L., Sodero A., Campagnini S., Guolo E., Basagni B., Castagnoli C., Hochleitner I., Paperini A., Gnetti B., Avila L., Romano E., Grippo A., Hakiki B., Carrozza M. C., Mannini A., Macchi C., Cecchi F., Pellicciari, L, Sodero, A, Campagnini, S, Guolo, E, Basagni, B, Castagnoli, C, Hochleitner, I, Paperini, A, Gnetti, B, Avila, L, Romano, E, Grippo, A, Hakiki, B, Carrozza, M, Mannini, A, Macchi, C, Cecchi, F, Pellicciari L., Sodero A., Campagnini S., Guolo E., Basagni B., Castagnoli C., Hochleitner I., Paperini A., Gnetti B., Avila L., Romano E., Grippo A., Hakiki B., Carrozza M. C., Mannini A., Macchi C., and Cecchi F.

Abstract

Background: Trunk control plays a crucial role in the stroke rehabilitation, but it is unclear which factors could influence the trunk control after an intensive rehabilitation treatment. Objectives: To study which demographic, clinical and functional variables could predict the recovery of trunk control after intensive post-stroke inpatient rehabilitation. Methods: Subjects with acute, first-ever stroke were enrolled and clinical and data were collected at admission and discharge. The primary outcome was considered the trunk control measured by the Trunk Control Test (TCT). The data were analyzed by a univariate and multivariate logistic regressions. Results: Two hundred forty-one post-stroke patients were included. All baseline variables significantly associated to TCT at discharge in the univariate analysis (i.e. gender, NIHSS neglect item at admission, presence of several complexity markers, TCT total score at admission, NIHSS total score, pre-stroke modified Rankin Scale, Fugl-Meyer Assessment motor and sensitivity score) were entered in the multivariate analysis. The multivariate regression showed that age (p = .003), admission NIHSS total score (p = .001), admission TCT total score (p < .001) and presence of depression (p = .027) independently influenced the TCT total score at discharge (R 2 = 61.2%). Conclusions: Age, admission neurological impairment (NIHSS total score), trunk control at the admission (TCT total score), and presence of depression independently influenced the TCT at discharge. These factors should be carefully assessed at the baseline to plan a tailoring rehabilitation treatment achieving the best trunk control performance at discharge.

Published
2023

16. Intra- and inter-rater reliability of the Italian Fugl-Meyer assessment of upper and lower extremity

Author

Hochleitner, I, Pellicciari, L, Castagnoli, C, Paperini, A, Politi, A, Campagnini, S, Pancani, S, Basagni, B, Gerli, F, Carrozza, M, Macchi, C, Alt Murphy, M, Cecchi, F, Hochleitner I., Pellicciari L., Castagnoli C., Paperini A., Politi A. M., Campagnini S., Pancani S., Basagni B., Gerli F., Carrozza M. C., Macchi C., Alt Murphy M., Cecchi F., Hochleitner, I, Pellicciari, L, Castagnoli, C, Paperini, A, Politi, A, Campagnini, S, Pancani, S, Basagni, B, Gerli, F, Carrozza, M, Macchi, C, Alt Murphy, M, Cecchi, F, Hochleitner I., Pellicciari L., Castagnoli C., Paperini A., Politi A. M., Campagnini S., Pancani S., Basagni B., Gerli F., Carrozza M. C., Macchi C., Alt Murphy M., and Cecchi F.

Abstract

Purpose: To assess the intra- and inter-rater reliability motor and sensory functioning, balance, joint range of motion and joint pain subscales of the Italian Fugl-Meyer Assessment (FMA) Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) at the item- subtotal- and total-level in patients with sub-acute stroke. Materials and methods: The FMA was administered to 60 patients with sub-acute stroke (mean age ± SD = 75.4 ± 10.7 years; 58.3% men) and independently rated by two physiotherapists on two consecutive days. Intra- and inter-reliability was studied by a rank-based statistical method for paired ordinal data to detect any systematic or random disagreement. Results: The item-level intra- and inter-rater reliability was satisfactory (>70%). Reliability level >70% was achieved at subscale and total score level when one- or two-points difference was considered. Systematic disagreements were reported for five items of the FMA-UE, but not for FMA-LE. Conclusions: The Italian version of the FMA showed to be a reliable instrument that can therefore be recommended for clinical and research purposes.Implications for rehabilitation The FMA is the gold standard for assessing stroke patients’ sensorimotor impairment worldwide. The Italian Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) is substantially reliable within and between two raters at the item, subtotal, and total score level in patients with sub-acute stroke. The use of FMA in the Italian context will provide an opportunity for international comparisons and research collaborations.

Published
2023

17. Intermuscular technique for implantation of the subcutaneous implantable defibrillator: a propensity-matched case-control study

Author

Botto, G, Ziacchi, M, Nigro, G, D'Onofrio, A, Dello Russo, A, Francia, P, Viani, S, Pisano, E, Bisignani, G, Caravati, F, Migliore, F, De Filippo, P, Ottaviano, L, Rordorf, R, Manzo, M, Canevese, F, Lovecchio, M, Valsecchi, S, Checchi, L, Casale, M, Schintu, B, Scalone, A, Tola, G, Setzu, A, Curcio, A, Santoro, A, Baiocchi, C, Gentilini, R, Lunghetti, S, Solimene, F, Shopova, G, Schillaci, V, Arestia, A, Agresta, A, Bianchi, S, Rossi, P, Cauti, F, La Greca, C, Pecora, D, Ammirati, F, Santini, L, Mahfouz, K, Colaiaco, C, Vicentini, A, Savastano, S, Petracci, B, Sanzo, A, Baldi, E, Casula, M, Perego, G, Rella, V, Bianchi, V, Tavoletta, V, De Vivo, S, Palmisano, P, Accogli, M, Milanese, G, Pepi, P, Nicolis, D, Mariani, M, Pagani, M, Bonfantino, M, Caccavo, V, Grimaldi, M, Katsouras, G, Forleo, G, Chieffo, E, Tavarelli, E, Brambilla, R, Pani, A, Giammaria, M, Lucciola, M, Amellone, C, Uran, C, Baroni, M, Ferrari, P, Leidi, C, Drago, F, Silvetti, M, Pazzano, V, Russo, S, Remoli, R, Battipaglia, I, Cazzoli, I, Saputo, F, Devecchi, C, Barbonaglia, L, Viscusi, M, Brignoli, M, Mattera, A, Pedretti, S, Lupi, A, Tommasi, S, Kol, A, Gatto, M, Persi, A, Gonella, A, Rossetti, G, Menardi, E, Rossini, R, Notarstefano, P, Nesti, M, Fraticelli, A, Carreras, G, Donzelli, S, Marini, C, Tordini, A, Lazzari, L, Sartori, P, Di Donna, P, Mascia, G, Capogrosso, P, Magliano, P, Colimodio, M, Sala, S, Mazzone, P, Della Bella, P, Coppolino, A, Arena, G, Borrello, V, Ratti, M, Bartoli, C, Palano, F, Adduci, C, Torriglia, A, Laffi, M, Esposito, C, Giano, A, Franculli, F, Pangallo, A, De Bonis, S, Sarubbi, B, Colonna, D, Correra, A, Romeo, E, Rapacciuolo, A, Liguori, V, Viggiano, A, Strisciullo, T, Biffi, M, Diemberger, I, Martignani, C, Piro, A, Lavalle, C, Magnocavallo, M, Ricciardi, D, Calabrese, V, Gioia, F, Picarelli, F, Licciardello, G, Busacca, G, Calvi, V, Lamberti, F, Lumia, G, Bellini, C, Bianchi, C, Savarese, G, Andreoli, C, Pimpinicchio, L, Pellegrini, D, Giorgi, D, Bovenzi, Busoni, F, Daleffe, E, Facchin, D, Rebellato, L, Stifano, G, Magliano, G, Sergi, D, Barone, L, Morgagni, R, Casella, M, Guerra, F, Cipolletta, L, Molini, S, De Lucia, R, Di Cori, A, Grifoni, G, Paperini, L, Segreti, L, Soldati, E, Zucchelli, G, Russo, V, Rago, A, Ammendola, E, Papa, A, Pieragnoli, P, Ricciardi, G, Perrotta, L, Botto G. L., Ziacchi M., Nigro G., D'Onofrio A., Dello Russo A., Francia P., Viani S., Pisano E., Bisignani G., Caravati F., Migliore F., De Filippo P., Ottaviano L., Rordorf R., Manzo M., Canevese F. L., Lovecchio M., Valsecchi S., Checchi L., Casale M. C., Schintu B., Scalone A., Tola G., Setzu A., Curcio A., Santoro A., Baiocchi C., Gentilini R., Lunghetti S., Solimene F., Shopova G., Schillaci V., Arestia A., Agresta A., Bianchi S., Rossi P., Cauti F. M., La Greca C., Pecora D., Ammirati F., Santini L., Mahfouz K., Colaiaco C., Vicentini A., Savastano S., Petracci B., Sanzo A., Baldi E., Casula M., Perego G. B., Rella V., Bianchi V., Tavoletta V., De Vivo S., Palmisano P., Accogli M., Milanese G., Pepi P., Nicolis D., Mariani M., Pagani M., Bonfantino M. V., Caccavo V., Grimaldi M., Katsouras G., Forleo G. B., Chieffo E., Tavarelli E., Brambilla R., Pani A., Giammaria M., Lucciola M. T., Amellone C., Uran C., Baroni M., Ferrari P., Leidi C., Drago F., Silvetti M. S., Pazzano V., Russo S., Remoli R., Battipaglia I., Cazzoli I., Saputo F., Devecchi C., Barbonaglia L., Viscusi M., Brignoli M., Mattera A., Pedretti S., Lupi A., Tommasi S., Kol A., Gatto M. C., Persi A., Gonella A., Rossetti G., Menardi E., Rossini R., Notarstefano P., Nesti M., Fraticelli A., Carreras G., Donzelli S., Marini C., Tordini A., Lazzari L., Sartori P., Di Donna P., Mascia G., Capogrosso P., Magliano P., Colimodio M., Sala S., Mazzone P., Della Bella P., Coppolino A., Arena G., Borrello V., Ratti M., Bartoli C., Palano F., Adduci C., Torriglia A., Laffi M., Esposito C., Giano A., Franculli F., Pangallo A., De Bonis S., Sarubbi B., Colonna D., Correra A., Romeo E., Rapacciuolo A., Liguori V., Viggiano A., Strisciullo T., Biffi M., Diemberger I., Martignani C., Piro A., Lavalle C., Magnocavallo M., Mariani M. V., Ricciardi D., Calabrese V., Gioia F., Picarelli F., Licciardello G., Busacca G., Calvi V. I., Lamberti F., Lumia G., Bellini C., Bianchi C., Savarese G., Andreoli C., Pimpinicchio L., Pellegrini D., Giorgi D., Busoni F., Daleffe E., Facchin D., Rebellato L., Stifano G., Magliano G., Sergi D., Barone L., Morgagni R., Casella M., Guerra F., Cipolletta L., Molini S., De Lucia R., Di Cori A., Grifoni G., Paperini L., Segreti L., Soldati E., Zucchelli G., Russo V., Rago A., Ammendola E., Papa A., Pieragnoli P., Ricciardi G., Perrotta L., Botto, G, Ziacchi, M, Nigro, G, D'Onofrio, A, Dello Russo, A, Francia, P, Viani, S, Pisano, E, Bisignani, G, Caravati, F, Migliore, F, De Filippo, P, Ottaviano, L, Rordorf, R, Manzo, M, Canevese, F, Lovecchio, M, Valsecchi, S, Checchi, L, Casale, M, Schintu, B, Scalone, A, Tola, G, Setzu, A, Curcio, A, Santoro, A, Baiocchi, C, Gentilini, R, Lunghetti, S, Solimene, F, Shopova, G, Schillaci, V, Arestia, A, Agresta, A, Bianchi, S, Rossi, P, Cauti, F, La Greca, C, Pecora, D, Ammirati, F, Santini, L, Mahfouz, K, Colaiaco, C, Vicentini, A, Savastano, S, Petracci, B, Sanzo, A, Baldi, E, Casula, M, Perego, G, Rella, V, Bianchi, V, Tavoletta, V, De Vivo, S, Palmisano, P, Accogli, M, Milanese, G, Pepi, P, Nicolis, D, Mariani, M, Pagani, M, Bonfantino, M, Caccavo, V, Grimaldi, M, Katsouras, G, Forleo, G, Chieffo, E, Tavarelli, E, Brambilla, R, Pani, A, Giammaria, M, Lucciola, M, Amellone, C, Uran, C, Baroni, M, Ferrari, P, Leidi, C, Drago, F, Silvetti, M, Pazzano, V, Russo, S, Remoli, R, Battipaglia, I, Cazzoli, I, Saputo, F, Devecchi, C, Barbonaglia, L, Viscusi, M, Brignoli, M, Mattera, A, Pedretti, S, Lupi, A, Tommasi, S, Kol, A, Gatto, M, Persi, A, Gonella, A, Rossetti, G, Menardi, E, Rossini, R, Notarstefano, P, Nesti, M, Fraticelli, A, Carreras, G, Donzelli, S, Marini, C, Tordini, A, Lazzari, L, Sartori, P, Di Donna, P, Mascia, G, Capogrosso, P, Magliano, P, Colimodio, M, Sala, S, Mazzone, P, Della Bella, P, Coppolino, A, Arena, G, Borrello, V, Ratti, M, Bartoli, C, Palano, F, Adduci, C, Torriglia, A, Laffi, M, Esposito, C, Giano, A, Franculli, F, Pangallo, A, De Bonis, S, Sarubbi, B, Colonna, D, Correra, A, Romeo, E, Rapacciuolo, A, Liguori, V, Viggiano, A, Strisciullo, T, Biffi, M, Diemberger, I, Martignani, C, Piro, A, Lavalle, C, Magnocavallo, M, Ricciardi, D, Calabrese, V, Gioia, F, Picarelli, F, Licciardello, G, Busacca, G, Calvi, V, Lamberti, F, Lumia, G, Bellini, C, Bianchi, C, Savarese, G, Andreoli, C, Pimpinicchio, L, Pellegrini, D, Giorgi, D, Bovenzi, Busoni, F, Daleffe, E, Facchin, D, Rebellato, L, Stifano, G, Magliano, G, Sergi, D, Barone, L, Morgagni, R, Casella, M, Guerra, F, Cipolletta, L, Molini, S, De Lucia, R, Di Cori, A, Grifoni, G, Paperini, L, Segreti, L, Soldati, E, Zucchelli, G, Russo, V, Rago, A, Ammendola, E, Papa, A, Pieragnoli, P, Ricciardi, G, Perrotta, L, Botto G. L., Ziacchi M., Nigro G., D'Onofrio A., Dello Russo A., Francia P., Viani S., Pisano E., Bisignani G., Caravati F., Migliore F., De Filippo P., Ottaviano L., Rordorf R., Manzo M., Canevese F. L., Lovecchio M., Valsecchi S., Checchi L., Casale M. C., Schintu B., Scalone A., Tola G., Setzu A., Curcio A., Santoro A., Baiocchi C., Gentilini R., Lunghetti S., Solimene F., Shopova G., Schillaci V., Arestia A., Agresta A., Bianchi S., Rossi P., Cauti F. M., La Greca C., Pecora D., Ammirati F., Santini L., Mahfouz K., Colaiaco C., Vicentini A., Savastano S., Petracci B., Sanzo A., Baldi E., Casula M., Perego G. B., Rella V., Bianchi V., Tavoletta V., De Vivo S., Palmisano P., Accogli M., Milanese G., Pepi P., Nicolis D., Mariani M., Pagani M., Bonfantino M. V., Caccavo V., Grimaldi M., Katsouras G., Forleo G. B., Chieffo E., Tavarelli E., Brambilla R., Pani A., Giammaria M., Lucciola M. T., Amellone C., Uran C., Baroni M., Ferrari P., Leidi C., Drago F., Silvetti M. S., Pazzano V., Russo S., Remoli R., Battipaglia I., Cazzoli I., Saputo F., Devecchi C., Barbonaglia L., Viscusi M., Brignoli M., Mattera A., Pedretti S., Lupi A., Tommasi S., Kol A., Gatto M. C., Persi A., Gonella A., Rossetti G., Menardi E., Rossini R., Notarstefano P., Nesti M., Fraticelli A., Carreras G., Donzelli S., Marini C., Tordini A., Lazzari L., Sartori P., Di Donna P., Mascia G., Capogrosso P., Magliano P., Colimodio M., Sala S., Mazzone P., Della Bella P., Coppolino A., Arena G., Borrello V., Ratti M., Bartoli C., Palano F., Adduci C., Torriglia A., Laffi M., Esposito C., Giano A., Franculli F., Pangallo A., De Bonis S., Sarubbi B., Colonna D., Correra A., Romeo E., Rapacciuolo A., Liguori V., Viggiano A., Strisciullo T., Biffi M., Diemberger I., Martignani C., Piro A., Lavalle C., Magnocavallo M., Mariani M. V., Ricciardi D., Calabrese V., Gioia F., Picarelli F., Licciardello G., Busacca G., Calvi V. I., Lamberti F., Lumia G., Bellini C., Bianchi C., Savarese G., Andreoli C., Pimpinicchio L., Pellegrini D., Giorgi D., Busoni F., Daleffe E., Facchin D., Rebellato L., Stifano G., Magliano G., Sergi D., Barone L., Morgagni R., Casella M., Guerra F., Cipolletta L., Molini S., De Lucia R., Di Cori A., Grifoni G., Paperini L., Segreti L., Soldati E., Zucchelli G., Russo V., Rago A., Ammendola E., Papa A., Pieragnoli P., Ricciardi G., and Perrotta L.

Abstract

Aims A previous randomized study demonstrated that the subcutaneous implantable cardioverter defibrillator (S-ICD) was noninferior to transvenous ICD with respect to device-related complications and inappropriate shocks. However, that was performed prior to the widespread adoption of pulse generator implantation in the intermuscular (IM) space instead of the traditional subcutaneous (SC) pocket. The aim of this analysis was to compare survival from device-related complications and inappropriate shocks between patients who underwent S-ICD implantation with the generator positioned in an IM position in comparison with an SC pocket. Methods and results We analysed 1577 consecutive patients who had undergone S-ICD implantation from 2013 to 2021 and were followed up until December 2021. Subcutaneous patients (n = 290) were propensity matched with patients of the IM group (n = 290), and their outcomes were compared. : During a median follow-up of 28 months, device-related complications were reported in 28 (4.8%) patients and inappropriate shocks were reported in 37 (6.4%) patients. The risk of complication was lower in the matched IM group than in the SC group [hazard ratio 0.41, 95% confidence interval (CI) 0.17-0.99, P = 0.041], as well as the composite of complications and inappropriate shocks (hazard ratio 0.50, 95% CI 0.30-0.86, P = 0.013). The risk of appropriate shocks was similar between groups (hazard ratio 0.90, 95% CI 0.50-1.61, P = 0.721). There was no significant interaction between generator positioning and variables such as gender, age, body mass index, and ejection fraction. Conclusion Our data showed the superiority of the IM S-ICD generator positioning in reducing device-related complications and inappropriate shocks.

Published
2023

18. Predicting the functional outcome of intensive inpatient rehabilitation after stroke: results from the RIPS Study

Author

SODERO, Alessandro, primary, CAMPAGNINI, Silvia, additional, PAPERINI, Anita, additional, CASTAGNOLI, Chiara, additional, HOCHLEITNER, Ines, additional, POLITI, Angela M., additional, BARDI, Donata, additional, BASAGNI, Benedetta, additional, BARRETTA, Teresa, additional, GUOLO, Erika, additional, TRAMONTI, Caterina, additional, PANCANI, Silvia, additional, HAKIKI, Bahia, additional, GRIPPO, Antonello, additional, MANNINI, Andrea, additional, NACMIAS, Benedetta, additional, BACCINI, Marco, additional, MACCHI, Claudio, additional, and CECCHI, Francesca, additional

Published
2024
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19. Improvement on the Coma Recovery Scale–Revised During the First Four Weeks of Hospital Stay Predicts Outcome at Discharge in Intensive Rehabilitation After Severe Brain Injury

Author

Atzori, Tiziana, Binazzi, Barbara, Boni, Roberta, Borsotti, Marco, Carrai, Riccardo, Castagnoli, Chiara, Cecchi, Francesca, Croci, Loredana, Di Renzone, Martina, Gallì, Irene, Grippo, Antonello, Hakiki, Bahia, Lippi, Elena, Macchi, Claudio, Marella, Andrea, Mazzucchi, Anna, Molino Lova, Raffaello, Morrocchesi, Azzurra, Portaccio, Emilio, Romoli, Anna Maria, Sorbi, Sandro, Tofani, Ariela, Paperini, Anita, Pasquini, Guido, Scarpino, Maenia, Taglioli, Maria Pia, and Vannetti, Federica

Published
2018
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20. Predictors of Function, Activity, and Participation of Stroke Patients Undergoing Intensive Rehabilitation: A Multicenter Prospective Observational Study Protocol

Author

Bahia Hakiki, Anita Paperini, Chiara Castagnoli, Ines Hochleitner, Sonia Verdesca, Antonello Grippo, Maenia Scarpino, Antonio Maiorelli, Irene Eleonora Mosca, Paola Gemignani, Marco Borsotti, Maria Assunta Gabrielli, Emilia Salvadori, Anna Poggesi, Giulia Lucidi, Catiuscia Falsini, Monica Gentilini, Monica Martini, Maria Luisa Eliana Luisi, Barbara Biffi, Paolo Mainardi, Teresa Barretta, Silvia Pancani, Andrea Mannini, Silvia Campagnini, Silvia Bagnoli, Assunta Ingannato, Benedetta Nacmias, Claudio Macchi, Maria Chiara Carrozza, and Francesca Cecchi

Subjects
stroke, rehabilitation, functional recovery, biomarkers, neurophysiology, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: The complex nature of stroke sequelae, the heterogeneity in rehabilitation pathways, and the lack of validated prediction models of rehabilitation outcomes challenge stroke rehabilitation quality assessment and clinical research. An integrated care pathway (ICP), defining a reproducible rehabilitation assessment and process, may provide a structured frame within investigated outcomes and individual predictors of response to treatment, including neurophysiological and neurogenetic biomarkers. Predictors may differ for different interventions, suggesting clues to personalize and optimize rehabilitation. To date, a large representative Italian cohort study focusing on individual variability of response to an evidence-based ICP is lacking, and predictors of individual response to rehabilitation are largely unexplored. This paper describes a multicenter study protocol to prospectively investigate outcomes and predictors of response to an evidence-based ICP in a large Italian cohort of stroke survivors undergoing post-acute inpatient rehabilitation.Methods: All patients with diagnosis of ischemic or hemorrhagic stroke confirmed both by clinical and brain imaging evaluation, admitted to four intensive rehabilitation units (adopting the same stroke rehabilitation ICP) within 30 days from the acute event, aged 18+, and providing informed consent will be enrolled (expected sample: 270 patients). Measures will be taken at admission (T0), at discharge (T1), and at follow-up 6 months after a stroke (T2), including clinical data, nutritional, functional, neurological, and neuropsychological measures, electroencephalography and motor evoked potentials, and analysis of neurogenetic biomarkers.Statistics: In addition to classical multivariate logistic regression analysis, advanced machine learning algorithms will be cross-validated to achieve data-driven prognosis prediction models.Discussion: By identifying data-driven prognosis prediction models in stroke rehabilitation, this study might contribute to the development of patient-oriented therapy and to optimize rehabilitation outcomes.Clinical Trial Registration:ClinicalTrials.gov, NCT03968627. https://www.clinicaltrials.gov/ct2/show/NCT03968627?term=Cecchi&cond=Stroke&draw=2&rank=2.

Published
2021
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22. Lipomatous metaplasia is the best CT predictor for conducting channel localization in scar-related ventricular tachycardia ablation

Author

Zucchelli, G, primary, Parollo, M, additional, Mazzocchetti, L, additional, Segreti, L, additional, Barletta, V, additional, De Lucia, R, additional, Grifoni, G, additional, Sbragi, S, additional, Canu, A, additional, Viani, S, additional, Paperini, L, additional, Soldati, E, additional, and Di Cori, A, additional

Published
2023
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23. Transvenous lead extraction: Efficacy and safety of the procedure in female patients

Author

Segreti, Luca, primary, Bongiorni, Maria Grazia, additional, Barletta, Valentina, additional, Parollo, Matteo, additional, Di Cori, Andrea, additional, Fiorentini, Federico, additional, Giannotti Santoro, Mario, additional, De Lucia, Raffaele, additional, Viani, Stefano, additional, Grifoni, Gino, additional, Paperini, Luca, additional, Sodati, Ezio, additional, Mazzocchetti, Lorenzo, additional, Canu, Antonio Maria, additional, and Zucchelli, Giulio, additional

Published
2023
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24. Recurring lacustrine depositional successions in the Wilkins Peak Member, Green River Formation

Author

Elizabeth Klonowski, Tim Lowenstein, Alan Carroll, M. Elliot Smith, Matteo Paperini, and Jeffrey Pietras

Subjects
General Medicine
Abstract

Mineralogy, petrographic textures, and sedimentary structures from the world’s largest trona deposit, the Wilkins Peak Member (WPM) of the early Eocene Green River Formation (GRF), Bridger subbasin, Wyoming, provide key data about depositional conditions and paleoenvironments. The 250 m-long WPM interval in the Solvay S-34-1 drill core analyzed in this study contains a detailed record of sedimentation in the Bridger subbasin at the deepest area of a hydrologically-closed basin during peak Cenozoic atmospheric CO2 concentrations. Large accumulations of trona (Na3(HCO3)(CO3)·2H2O), shortite (Na2Ca2(CO3)3), northupite (Na3Mg (CO3)2Cl), and halite (NaCl; now replaced by trona), occur in the lower half of the WPM. Modern saline lake environments such as Lake Magadi, Kenya, and the Dead Sea, Israel-Jordan, are useful analogues for interpreting paleolake conditions associated with evaporite deposition in the Solvay S-34-1 core. Solvay saline lake deposits are organized into meter-scale shallowing-upward successions, beginning with (1) oil shale overlain by (2) trona, in places interbedded with oil shale, followed by (3) peloidal dolomite grainstone and/or silty dolomitic mudstone, and (4) massive mudstone with disruption features or desiccation cracks, and/or siliciclastic sandstone with ripple cross-stratification. Based on observations of modern hypersaline lake environments, WPM evaporite deposition at the basin depocenter is interpreted to be controlled by inflow water composition and volume, evaporative concentration, and seasonally-driven lake temperature fluctuations, resulting in recurrent patterns in evaporite mineralogies and textures.

Published
2022
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25. Trunk Control Test as a main predictor of the modified Barthel Index score at discharge from intensive post-acute stroke rehabilitation: results from a multicentre Italian study

Author

Pellicciari, Leonardo, primary, Basagni, Benedetta, additional, Paperini, Anita, additional, Campagnini, Silvia, additional, Sodero, Alessandro, additional, Hakiki, Bahia, additional, Castagnoli, Chiara, additional, Politi, Angela Maria, additional, Avila, Lucia, additional, Barilli, Manuele, additional, Romano, Emanuela, additional, Pancani, Silvia, additional, Mannini, Andrea, additional, Sensoli, Federico, additional, Salvadori, Emilia, additional, Poggesi, Anna, additional, Grippo, Antonello, additional, Macchi, Claudio, additional, Baccini, Marco, additional, Carrozza, Maria Chiara, additional, and Cecchi, Francesca, additional

Published
2023
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27. Design and implementation of a Stroke Rehabilitation Registry for the systematic assessment of processes and outcomes and the development of data-driven prediction models: The STRATEGY study protocol

Author

Chiavilli, M, Campagnini, S, Baretta, T, Castagnoli, C, Paperini, A, Politi, A, Pellicciari, L, Baccini, M, Basagni, B, Marignani, S, Bardi, D, Sodero, A, Lombardi, G, Guolo, E, Navarro, J, Galeri, S, Montesano, A, Falco, L, Rovaris, M, Carrozza, M, Macchi, C, Mannini, A, Cecchi, F, Chiavilli M., Campagnini S., Baretta T., Castagnoli C., Paperini A., Politi A. M., Pellicciari L., Baccini M., Basagni B., Marignani S., Bardi D., Sodero A., Lombardi G., Guolo E., Navarro J. S., Galeri S., Montesano A., Falco L., Rovaris M. G., Carrozza M. C., Macchi C., Mannini A., Cecchi F., Chiavilli, M, Campagnini, S, Baretta, T, Castagnoli, C, Paperini, A, Politi, A, Pellicciari, L, Baccini, M, Basagni, B, Marignani, S, Bardi, D, Sodero, A, Lombardi, G, Guolo, E, Navarro, J, Galeri, S, Montesano, A, Falco, L, Rovaris, M, Carrozza, M, Macchi, C, Mannini, A, Cecchi, F, Chiavilli M., Campagnini S., Baretta T., Castagnoli C., Paperini A., Politi A. M., Pellicciari L., Baccini M., Basagni B., Marignani S., Bardi D., Sodero A., Lombardi G., Guolo E., Navarro J. S., Galeri S., Montesano A., Falco L., Rovaris M. G., Carrozza M. C., Macchi C., Mannini A., and Cecchi F.

Abstract

Background: Stroke represents the second preventable cause of death after cardiovascular disease and the third global cause of disability. In countries where national registries of the clinical quality of stroke care have been established, the publication and sharing of the collected data have led to an improvement in the quality of care and survival of patients. However, information on rehabilitation processes and outcomes is often lacking, and predictors of functional outcomes remain poorly explored. This paper describes a multicenter study protocol to implement a Stroke rehabilitation Registry, mainly based on a multidimensional assessment proposed by the Italian Society of Physical and Rehabilitation Medicine (PMIC2020), in a pilot Italian cohort of stroke survivors undergoing post-acute inpatient rehabilitation, to provide a systematic assessment of processes and outcomes and develop data-driven prediction models of functional outcomes. Methods: All patients with a diagnosis of ischemic or haemorrhagic stroke confirmed by clinical assessment, admitted to intensive rehabilitation units within 30 days from the acute event, aged 18+, and providing informed consent will be enrolled. Measures will be taken at admission (T0), at discharge (T1), and at follow-up, 3 months (T2) and 6 months (T3) after the stroke. Assessment variables include anamnestic data, clinical and nursing complexity information and measures of body structures and function, activity and participation (PMIC2020), rehabilitation interventions, adverse events and discharge data. The modified Barthel Index will be our primary outcome. In addition to classical biostatistical analysis, learning algorithms will be cross-validated to achieve data-driven prognosis prediction models. Conclusions: This study will test the feasibility of a stroke rehabilitation registry in the Italian health context and provide a systematic assessment of processes and outcomes for quality assessment and benchmarking. By the

Published
2022

28. Italian translation and transcultural validation of an assessment tool for community ambulation in stroke survivors: the modified Functional Walking Categories (mFWC).

Author

Barbato, Carmen, Antonucci, Laura, Pellicciari, Leonardo, Castagnoli, Chiara, Hochleitner, Ines, Paperini, Anita, Pancani, Silvia, Verdesca, Sonia, Basagni, Benedetta, Macchi, Claudio, and Cecchi, Francesca

Subjects
REHABILITATION centers, RESEARCH evaluation, CONFIDENCE intervals, FUNCTIONAL status, RESEARCH methodology evaluation, RESEARCH methodology, GAIT in humans, CULTURAL pluralism, MEDICAL care, HEALTH outcome assessment, INTER-observer reliability, MULTITRAIT multimethod techniques, PSYCHOMETRICS, STROKE patients, INDEPENDENT living, WALKING, DIAGNOSIS, STROKE rehabilitation, DESCRIPTIVE statistics, DATA analysis software, TRANSLATIONS
Abstract

Community ambulation ability is one of the most important functional loss after stroke. The assessment of the level of community walking plays an important role in the multidimensional bio-psycho-social approach, to improve quality of life and social participation of stroke survivors. The modified Functional Walking Categories (mFWC) is a worldwide widely used tool to assess community ambulation in stroke survivors, but no Italian version is yet available. To cross-culturally adapt the mFWC into Italian and to assess its validity and reliability. According to the international guidelines, a multistep translation and cultural adaptation were conducted and revised by a committee of experts. Patients admitted to intensive inpatient rehabilitation with a sub-acute stroke were recruited. Inter- and intra-rater reliability and construct validity were studied. Sixty patients with sub-acute stroke were prospectively enrolled in this study. Findings showed almost perfect intra- and inter-rater reliability (k = 1.000 [95% CI 1.000–1.000] and k = 0.984 [95% CI 0.955–1.000], respectively). The construct validity of the scale was satisfactory, as 100.0% a-priori hypotheses were met. The Italian mFWC offers a valid tool for measuring community ambulation in stroke patients. Our work provides a validated and a cross-cultural adapted Italian version of the mFWC to accurately measure community ambulation both in clinical and research settings in Italy. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Ventricular tachycardia site of origin prediction by a QRS axis-based algorithm confirmed by heterogenous tissue channel localization obtained from artificial-intelligence-powered CMR analysis

Author

Mazzocchetti, L, primary, Parollo, M, additional, Sbragi, S, additional, Barletta, V, additional, Segreti, L, additional, Di Cori, A, additional, De Lucia, R, additional, Grifoni, G, additional, Soldati, E, additional, Viani, S, additional, Branchitta, G, additional, Carluccio, M, additional, Canu, A, additional, Paperini, L, additional, and Zucchelli, G, additional

Published
2023
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30. Noninvasive continuous arterial pressure monitoring shortens atrial fibrillation ablation procedural duration

Author

Parollo, M, primary, Di Cori, A, additional, Fiorentini, F, additional, De Lucia, R, additional, Barletta, V, additional, Viani, S, additional, Paperini, L, additional, Canu, A, additional, Mazzocchetti, L, additional, Sbragi, S, additional, Segreti, L, additional, Grifoni, G, additional, Soldati, E, additional, and Zucchelli, G, additional

Published
2023
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31. P255 A GOOD PERSPECTIVE NEEDS TWO POINT OF VIEW: TRANSVENOUS CRT–D LEAD EXTRACTION COMPLICATED BY INTRAOSSEUS COURSE OF THE CORONARY SINUS LEAD

Author

Sbragi, S, primary, Parollo, M, additional, Segreti, L, additional, Del Corso, A, additional, Carluccio, M, additional, Di Cori, A, additional, Barletta, V, additional, Mazzocchetti, L, additional, Paperini, L, additional, De Lucia, R, additional, Viani, S, additional, Canu, A, additional, Grifoni, G, additional, Cellamaro, T, additional, Branchitta, G, additional, Soldati, E, additional, and Zucchelli, G, additional

Published
2023
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32. Feasibility and Accuracy of Noninvasive Continuous Arterial Pressure Monitoring during Transcatheter Atrial Fibrillation Ablation

Author

Di Cori, Andrea, primary, Parollo, Matteo, additional, Fiorentini, Federico, additional, Della Volpe, Salvatore, additional, Mazzocchetti, Lorenzo, additional, Barletta, Valentina, additional, Segreti, Luca, additional, Viani, Stefano, additional, De Lucia, Raffaele, additional, Paperini, Luca, additional, Canu, Antonio, additional, Grifoni, Gino, additional, Soldati, Ezio, additional, Bongiorni, Maria Grazia, additional, and Zucchelli, Giulio, additional

Published
2023
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34. Noninvasive continuous arterial pressure monitoring shortens atrial fibrillation ablation procedural duration

Author

M Parollo, A Di Cori, F Fiorentini, R De Lucia, V Barletta, S Viani, L Paperini, A Canu, L Mazzocchetti, S Sbragi, L Segreti, G Grifoni, E Soldati, and G Zucchelli

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: None. Introduction Transcatheter atrial fibrillation (AF) ablation is in most centres commonly carried out with continuous invasive radial arterial blood pressure (BP) monitoring. Novel devices enable continuous non-invasive BP monitoring, with acceptable agreement and optimal safety profile when compared to standard of care invasive BP monitoring, leading to improved patient comfort in the electrophysiology lab. Purpose Aim of the study was to assess in terms of procedural efficiency continuous non-invasive BP monitoring during transcatheter atrial fibrillation ablation. Methods We prospectively enrolled 42 consecutive patients (age 61±9 years, 80% male) undergoing transcatheter AF ablation (60% paroxysmal, 40% persistent) at our centre undergoing AF ablation with continuous BP measurement using a non-invasive finger volume clamp device. We then compared them with an historical cohort of 42 consecutive patients undergoing AF ablation (62% paroxysmal, 38% persistent) with standard of care invasive BP monitoring with a radial cannula. We compared the two groups in terms of total procedural duration (in and out from the EP lab). Results Mean total procedural duration was 165,29±54,95 minutes in the non-invasive group and 196,55±46,67 minutes in the invasive group (P=0,006). Conclusion In patients undergoing AF ablation, non-invasive finger volume-clamp continuous BP monitoring allowed for a significant reduction of total procedural duration when compared to standard of care invasive BP monitoring. Larger studies are needed to confirm these results.

Published
2023
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35. Ventricular tachycardia site of origin prediction by a QRS axis-based algorithm confirmed by heterogenous tissue channel localization obtained from artificial-intelligence-powered CMR analysis

Author

L Mazzocchetti, M Parollo, S Sbragi, V Barletta, L Segreti, A Di Cori, R De Lucia, G Grifoni, E Soldati, S Viani, G Branchitta, M Carluccio, A Canu, L Paperini, and G Zucchelli

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: None. Introduction A previously validated algorithm allows to accurately identify ventricular tachycardia (VT) exit site in a 17-segments American Heart Association left ventricle model in patients with structural heart disease (SHD). ADAS3D is a novel artificial-intelligence cardiac magnetic resonance (CMR) post-processing software which enables heterogeneous tissue channel (HTC) identification. Purpose The aim of this study is to compare inferred VT exit site between QRS-axis based model and HTC identification from CMR post-processing. Methods All subjects allocated to a CMR-guided or aided approach from a multicenter randomized clinical trial were analyzed. Patients with available 12-lead ECG of clinical VT obtained before ablation were analyzed in terms of concordance between VT site of origin inferred from a QRS-axis and location of HTCs in a 17-segments model. Results 10 out of 15 patients had 12-lead ECG of clinical VT (80% male, 60% with ischemic cardiomyopathy, mean age 63,5±16,95 years, mean tachycardia cycle length 373,7±99,55 ms). 7 out of 10 patients (70,00%) had at least one HTC located at VT exit site as predicted by a QRS axis-based algorithm. In all remaining cases (3 out of 10) HTC location was found in a segment adjacent to ECG-derived exit site. All patients underwent CMR-guided or CMR-aided VT ablation with acute clinical success (noninducibility of the clinical VT). Conclusion VT site of origin prediction via a QRS axis-based algorithm allows for reasonable prediction of HTC presence at inferred site of origin. Larger studies are needed in order to confirm such findings and their potential clinical implications.

Published
2023
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36. Feasibility and Accuracy of Noninvasive Continuous Arterial Pressure Monitoring during Transcatheter Atrial Fibrillation Ablation

Author

Andrea Di Cori, Matteo Parollo, Federico Fiorentini, Salvatore Della Volpe, Lorenzo Mazzocchetti, Valentina Barletta, Luca Segreti, Stefano Viani, Raffaele De Lucia, Luca Paperini, Antonio Canu, Gino Grifoni, Ezio Soldati, Maria Grazia Bongiorni, and Giulio Zucchelli

Subjects
atrial fibrillation ablation, arterial pressure, blood pressure, ClearSight, noninvasive continuous arterial pressure monitoring, General Medicine
Abstract

Introduction: Transcatheter atrial fibrillation (AF) ablation is still carried out with continuous invasive radial arterial blood pressure (IBP) monitoring in many centers. Continuous noninvasive blood pressure (CNBP) measurement using the volume-clamp method is a noninvasive alternative method used in ICU. No data on CNBP reliability are available in the electrophysiology lab during AF ablation, where rhythm variations are common. Background: The objective of the present study was to compare continuous noninvasive arterial pressure measured with the ClearSight device (Edwards Lifesciences, Irvine, CA, USA) with invasive radial artery pressure used as the reference method during AF ablation. Methods: We prospectively enrolled 55 consecutive patients (age 62 ± 11 years, 80% male) undergoing transcatheter AF ablation (62% paroxysmal, 38% persistent) at our center. Standard of care IBP monitoring via a radial cannula and a contralateral noninvasive finger volume-clamp CNBP measurement device were positioned simultaneously in all patients for the entire procedure. Bland-Altman analysis was used to analyze the agreement between the two techniques. Results: A total of 1219 paired measurements for systolic, diastolic, and mean arterial pressure were obtained in 55 subjects, with a mean (SD) of 22 (9) measurements per patient. The mean bias (SD) was −12.97 (13.89) mmHg for systolic pressure (level of agreement −14.24–40.20; correlation coefficient 0.84), −1.85 (8.52) mmHg for diastolic pressure (level of agreement −18.54–14.84; correlation coefficient 0.77) and 2.31 (8.75) mmHg for mean pressure (level of agreement −14.84–19.46; correlation coefficient 0.85). Conclusion: In patients undergoing AF ablation, CNBP monitoring with the ClearSight device showed acceptable agreement with IBP monitoring. Larger studies are needed to confirm the potential clinical implications of continuous noninvasive BP monitoring during AF ablation.

Published
2023
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37. Hemoglobin concentration is associated with self-reported disability and reduced physical performance in a community dwelling population of nonagenarians: the Mugello Study

Author

Cecchi, Francesca, Pancani, Silvia, Vannetti, Federica, Boni, Roberta, Castagnoli, Chiara, Paperini, Anita, Pasquini, Guido, Sofi, Francesco, Molino-Lova, Raffaele, Macchi, Claudio, Gori, Annamaria, Turcan, Nona, Valecchi, Debora, Frandi, Roberta, Razzolini, Lorenzo, Fabbri, Valentina, Bonaccorsi, Guglielmo, Lorini, Chiara, and Mugello Study Working Group

Published
2017
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38. Factors influencing trunk control recovery after intensive rehabilitation in post-stroke patients: a multicentre prospective study

Author

Leonardo Pellicciari, Alessandro Sodero, Silvia Campagnini, Erika Guolo, Benedetta Basagni, Chiara Castagnoli, Ines Hochleitner, Anita Paperini, Benedetta Gnetti, Lucia Avila, Emanuela Romano, Antonello Grippo, Bahia Hakiki, Maria Chiara Carrozza, Andrea Mannini, Claudio Macchi, and Francesca Cecchi

Subjects
Community and Home Care, Rehabilitation, Neurology (clinical)
Abstract

Trunk control plays a crucial role in the stroke rehabilitation, but it is unclear which factors could influence the trunk control after an intensive rehabilitation treatment.To study which demographic, clinical and functional variables could predict the recovery of trunk control after intensive post-stroke inpatient rehabilitation.Subjects with acute, first-ever stroke were enrolled and clinical and data were collected at admission and discharge. The primary outcome was considered the trunk control measured by the Trunk Control Test (TCT). The data were analyzed by a univariate and multivariate logistic regressions.Two hundred forty-one post-stroke patients were included. All baseline variables significantly associated to TCT at discharge in the univariate analysis (i.e. gender, NIHSS neglect item at admission, presence of several complexity markers, TCT total score at admission, NIHSS total score, pre-stroke modified Rankin Scale, Fugl-Meyer Assessment motor and sensitivity score) were entered in the multivariate analysis. The multivariate regression showed that age (Age, admission neurological impairment (NIHSS total score), trunk control at the admission (TCT total score), and presence of depression independently influenced the TCT at discharge. These factors should be carefully assessed at the baseline to plan a tailoring rehabilitation treatment achieving the best trunk control performance at discharge.

Published
2022
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41. His-bundle pacing to treat an unusual case of chest pain after pacemaker implant

Author

Mario Giannotti Santoro, Giulio Zucchelli, M Parollo, Maria Grazia Bongiorni, Valentina Barletta, and Luca Paperini

Subjects
Cardiac resynchronization therapy, medicine.medical_specialty, Unusual case, business.industry, Case Report, Pacemaker implant, His-bundle pacing, Chest pain, Dyssynchrony, Bundle, Internal medicine, medicine, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Case report
Abstract

A 63-year-old man with hypertension and 3-vessel coronary artery disease previously treated with coronary artery bypass graft was admitted to our emergency room complaining of chest pain. He had undergone pacemaker implant 5 months before due to paroxysmal advanced atrioventricular block. Electrocardiography and troponin testing were unremarkable. Echocardiography and chest X-ray ruled out lead displacement and perforation. Interrogation showed normal parameters [right atrium: impedance 550 Ohm bipolar, sensing 2.4 mV bipolar; threshold 0.50 V/0.4 ms bipolar; right ventricle (RV): impedance 580 Ohm bipolar, sensing > 25 mV bipolar; threshold 1.5 V/0.4 ms bipolar and 0.4 V/0.4 ms unipolar]. Pain was evoked only during RV pacing. An electrophysiology study demonstrated painful RV pacing from multiple sites. We hypothesized that pain was associated with pacing-induced dyssynchrony. His-bundle pacing (HBP) was considered as a solution. We achieved HBP with a bipolar fixed-screw catheter connected to a cardiac resynchronization therapy pacemaker generator. During HBP above threshold (4.00 V/1.00 ms) the patient did not complain of any pain. He was discharged 3 days later pain-free with His-bundle lead amplitude set at 5.00 V/1.00 ms. After 6 months the patient was asymptomatic, with the device showing normal functioning. This is the first clinical experience of painful RV pacing treated with HBP.

Published
2022
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42. Intra- and inter-rater reliability of the Italian Fugl-Meyer assessment of upper and lower extremity.

Author

Hochleitner, Ines, Pellicciari, Leonardo, Castagnoli, Chiara, Paperini, Anita, Politi, Angela Maria, Campagnini, Silvia, Pancani, Silvia, Basagni, Benedetta, Gerli, Filippo, Carrozza, Maria Chiara, Macchi, Claudio, Alt Murphy, Margit, and Cecchi, Francesca

Subjects
LEG physiology, ARM physiology, EXPERIMENTAL design, RESEARCH evaluation, SENSORIMOTOR integration, PHYSICAL therapy services, CONFIDENCE intervals, RESEARCH methodology evaluation, RESEARCH methodology, PHYSICAL therapy, HEALTH outcome assessment, MEDICAL care, INTER-observer reliability, PSYCHOMETRICS, STROKE rehabilitation, STROKE patients, RESEARCH funding, DESCRIPTIVE statistics, REHABILITATION, EVALUATION
Abstract

To assess the intra- and inter-rater reliability motor and sensory functioning, balance, joint range of motion and joint pain subscales of the Italian Fugl-Meyer Assessment (FMA) Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) at the item- subtotal- and total-level in patients with sub-acute stroke. The FMA was administered to 60 patients with sub-acute stroke (mean age ± SD = 75.4 ± 10.7 years; 58.3% men) and independently rated by two physiotherapists on two consecutive days. Intra- and inter-reliability was studied by a rank-based statistical method for paired ordinal data to detect any systematic or random disagreement. The item-level intra- and inter-rater reliability was satisfactory (>70%). Reliability level >70% was achieved at subscale and total score level when one- or two-points difference was considered. Systematic disagreements were reported for five items of the FMA-UE, but not for FMA-LE. The Italian version of the FMA showed to be a reliable instrument that can therefore be recommended for clinical and research purposes. The FMA is the gold standard for assessing stroke patients' sensorimotor impairment worldwide. The Italian Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) is substantially reliable within and between two raters at the item, subtotal, and total score level in patients with sub-acute stroke. The use of FMA in the Italian context will provide an opportunity for international comparisons and research collaborations. [ABSTRACT FROM AUTHOR]

Published
2023
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44. Critical issue on the extinction and inattention subtest of NIHSS scale: an analysis on post-acute stroke patients attending inpatient rehabilitation

Author

Basagni, B, Hakiki, B, Campagnini, S, Salvadori, E, Grippo, A, Paperini, A, Castagnoli, C, Hochleitner, I, Politi, A, Gemignani, P, Mosca, I, Franceschini, A, Bonotti, E, Sodero, A, Mannini, A, Pellicciari, L, Poggesi, A, Macchi, C, Carrozza, M, Cecchi, F, Basagni B., Hakiki B., Campagnini S., Salvadori E., Grippo A., Paperini A., Castagnoli C., Hochleitner I., Politi A. M., Gemignani P., Mosca I. E., Franceschini A., Bonotti E. B., Sodero A., Mannini A., Pellicciari L., Poggesi A., Macchi C., Carrozza M. C., Cecchi F., Basagni, B, Hakiki, B, Campagnini, S, Salvadori, E, Grippo, A, Paperini, A, Castagnoli, C, Hochleitner, I, Politi, A, Gemignani, P, Mosca, I, Franceschini, A, Bonotti, E, Sodero, A, Mannini, A, Pellicciari, L, Poggesi, A, Macchi, C, Carrozza, M, Cecchi, F, Basagni B., Hakiki B., Campagnini S., Salvadori E., Grippo A., Paperini A., Castagnoli C., Hochleitner I., Politi A. M., Gemignani P., Mosca I. E., Franceschini A., Bonotti E. B., Sodero A., Mannini A., Pellicciari L., Poggesi A., Macchi C., Carrozza M. C., and Cecchi F.

Abstract

Objectives: This study aims to evaluate the diagnostic performance of NIHSS extinction and inattention item, compared to the results of the Oxford Cognitive Screen (OCS) heart subtest. Additionally, the possible role of the NIHSS visual field subtest on the NIHSS extinction and inattention subtest performance is explored and discussed. Methods: We analysed scores on NIHSS extinction and inattention subtest, NIHSS visual field subtest, and OCS heart subtest on a sample of 118 post-stroke patients. Results: Compared to OCS heart subtest, the results on NIHSS extinction and inattention subtest showed an accuracy of 72.9% and a moderate agreement level (Cohen’s kappa = 0.404). Furthermore, a decrease in NIHSS accuracy detecting neglect (61.1%) was observed in patients with pathological scores in NIHSS visual field item. Conclusions: Extreme caution is recommended for the diagnostic performance of extinction and inattention item of NIHSS. Signs of neglect may not be detected by NIHSS, and may be confused with visual field impairment. Trial registration: This study refers to an observational study protocol submitted to ClinicalTrials.gov with identifier: NCT03968627. The name of the registry is “Development of a National Protocol for Stroke Rehabilitation in a Multicenter Italian Institution” and the date of the registration is the 30th May 2019.

Published
2021

45. Design and implementation of a Stroke Rehabilitation Registry for the systematic assessment of processes and outcomes and the development of data-driven prediction models: The STRATEGY study protocol

Author

Chiavilli, Marco, primary, Campagnini, Silvia, additional, Baretta, Teresa, additional, Castagnoli, Chiara, additional, Paperini, Anita, additional, Politi, Angela Maria, additional, Pellicciari, Leonardo, additional, Baccini, Marco, additional, Basagni, Benedetta, additional, Marignani, Sara, additional, Bardi, Donata, additional, Sodero, Alessandro, additional, Lombardi, Gemma, additional, Guolo, Erika, additional, Navarro, Jorge Solano, additional, Galeri, Silvia, additional, Montesano, Angelo, additional, Falco, Lucia, additional, Rovaris, Marco Giuseppe, additional, Carrozza, Maria Chiara, additional, Macchi, Claudio, additional, Mannini, Andrea, additional, and Cecchi, Francesca, additional

Published
2022
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46. Transvenous removal of pacing and ICD leads: single Italian referral center experience

Author

Segreti, L, primary, Fiorentini, F, additional, Giannotti Santoro, M, additional, Barletta, V, additional, Di Cori, A, additional, Viani, S, additional, De Lucia, R, additional, Grifoni, G, additional, Paperini, L, additional, Soldati, E, additional, Cellamaro, T, additional, Carluccio, M, additional, Branchitta, G, additional, Zucchelli, G, additional, and Bongiorni, M G, additional

Published
2022
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49. Intra- and inter-rater reliability of the Italian Fugl-Meyer assessment of upper and lower extremity

Author

Ines Hochleitner, Leonardo Pellicciari, Chiara Castagnoli, Anita Paperini, Angela Maria Politi, Silvia Campagnini, Silvia Pancani, Benedetta Basagni, Filippo Gerli, Maria Chiara Carrozza, Claudio Macchi, Margit Alt Murphy, and Francesca Cecchi

Subjects
Rehabilitation
Abstract

To assess the intra- and inter-rater reliability motor and sensory functioning, balance, joint range of motion and joint pain subscales of the Italian Fugl-Meyer Assessment (FMA) Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) at the item- subtotal- and total-level in patients with sub-acute stroke. The FMA was administered to 60 patients with sub-acute stroke (mean age ± SD = 75.4 ± 10.7 years; 58.3% men) and independently rated by two physiotherapists on two consecutive days. Intra- and inter-reliability was studied by a rank-based statistical method for paired ordinal data to detect any systematic or random disagreement. The item-level intra- and inter-rater reliability was satisfactory (>70%). Reliability level >70% was achieved at subscale and total score level when one- or two-points difference was considered. Systematic disagreements were reported for five items of the FMA-UE, but not for FMA-LE. The Italian version of the FMA showed to be a reliable instrument that can therefore be recommended for clinical and research purposes.Implications for rehabilitationThe FMA is the gold standard for assessing stroke patients’ sensorimotor impairment worldwide.The Italian Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) is substantially reliable within and between two raters at the item, subtotal, and total score level in patients with sub-acute stroke.The use of FMA in the Italian context will provide an opportunity for international comparisons and research collaborations. The FMA is the gold standard for assessing stroke patients’ sensorimotor impairment worldwide. The Italian Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) is substantially reliable within and between two raters at the item, subtotal, and total score level in patients with sub-acute stroke. The use of FMA in the Italian context will provide an opportunity for international comparisons and research collaborations.

Published
2022

50. Italian translation and transcultural validation of an assessment tool for community ambulation in stroke survivors: the modified Functional Walking Categories (mFWC)

Author

Carmen Barbato, Laura Antonucci, Leonardo Pellicciari, Chiara Castagnoli, Ines Hochleitner, Anita Paperini, Silvia Pancani, Sonia Verdesca, Benedetta Basagni, Claudio Macchi, and Francesca Cecchi

Subjects
Physical Therapy, Sports Therapy and Rehabilitation
Abstract

Community ambulation ability is one of the most important functional loss after stroke. The assessment of the level of community walking plays an important role in the multidimensional bio-psycho-social approach, to improve quality of life and social participation of stroke survivors. The modified Functional Walking Categories (mFWC) is a worldwide widely used tool to assess community ambulation in stroke survivors, but no Italian version is yet available.To cross-culturally adapt the mFWC into Italian and to assess its validity and reliability.According to the international guidelines, a multistep translation and cultural adaptation were conducted and revised by a committee of experts. Patients admitted to intensive inpatient rehabilitation with a sub-acute stroke were recruited. Inter- and intra-rater reliability and construct validity were studied.Sixty patients with sub-acute stroke were prospectively enrolled in this study. Findings showed almost perfect intra- and inter-rater reliability (k = 1.000 [95% CI 1.000-1.000] and k = 0.984 [95% CI 0.955-1.000], respectively). The construct validity of the scale was satisfactory, as 100.0%The Italian mFWC offers a valid tool for measuring community ambulation in stroke patients. Our work provides a validated and a cross-cultural adapted Italian version of the mFWC to accurately measure community ambulation both in clinical and research settings in Italy.

Published
2022

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