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1. Status update and interim results from the asymptomatic carotid surgery trial-2 (ACST-2)

Author: Bulbulia, R, Gray, W, Naughten, A, den Hartog, A, Delmestri, A, Wallis, C, le Conte, S, Macdonald, S, Radak, D, Nessi, F, Torsello, G, Hendriks, J, Bjorses, K, Davidovic, L, Tusini, N, Gillgren, P, Casana, R, Tolva, V, Bausback, Y, Mehrzad, A, Gottsäter, A, Esisi, B, Cras, P, Hendriks, Jm, Lauwers, P, Hertoghs, M, Van Schil, P, De Jaegher, L, Peeters, P, Verbist, J, Dendooven, D, De Letter, J, Vanhooren, G, Astarci, P, Capron, I, Choghari, C, Hammer, F, Lacroix, V, Peeters, A, Verhelst, R, Bosiers, M, De Meester, K, Deloose, K, Van Buggenhout, E, Vinck, E, Geenens, M, Hemelsoet, D, Van Herzeele, I, Vermassen, F, De Koster, G, Desiron, Q, Maertens de Noordhout, A, Malmendier, D, Massoz, M, Saad, G, Cirelli, S, Dormal, P, Lerut, P, Thues, E, Coutts, S, Demchuk, A, Hill, M, Hudon, M, Klein, G, Mcclelland, M, Morrish, W, Samis, G, Sutherland, G, Watson, T, Wong, J, Liu, B, Liu, Cw, Barankova, L, Chlouba, V, Fiedler, J, Priban, V, Sterba, L, Kalabova, L, Kriz, Z, Krupa, P, Privara, M, Reif, M, Souckova, L, Staffa, R, Vlachovsky, R, Vojtisek, B, Hrbac, T, Kuliha, M, Prochazka, V, Roubec, M, Skoloudik, D, Abd Allah, F, Eldessoki, Mh, Kassem, Hh, Gharieb, Hs, Cardon, Jm, Le Gallou Wittenberg, A, Allaire, E, Becquemin, Jp, Cochennec, F, Desgranges, P, Hosseini, H, Kobeiter, H, Marzelle, J, Bergeron, P, Padovani, R, Trastour, Jc, Biermaier, B, Gissler, Hm, Klotzsch, C, Pfeiffer, T, Schneider, R, Soehl, L, Wennrih, M, Botsios, S, Branzan, D, Braunlich, S, Holzer, H, Lenzer, J, Reichenbecher, C, Piorkowski, C, Schuster, J, Scheinert, D, Schmidt, A, Ulrich, M, Werner, M, Coster, A, Engelhardt, A, Ratusinski, Cm, Berekoven, B, Frerker, K, Gordon, V, Bellenis, I, Polydorou, A, Polydorou, V, Tavernarakis, A, Ioannou, N, Terzoudi, M, Chatzinikou, E, Giannoukas, A, Hadjigeorgiou, G, Koutsias, S, Ralli, S, Rousas, N, Nemes, B, Jàrànyi, Z, Szabo, A, Varga, D, Barzo, P, Bodosi, M, Fako, E, Fulop, B, Kuncz, A, Nagy, E, Nemeth, T, Pazdernyik, S, Skoba, K, Voros, E, Haider, Sn, Harbison, J, Madhavan, P, Moore, D, Beyar, R, Hoffman, A, Karram, T, Kerner, A, Nikolsky, E, Nitecki, S, Amatucci, G, Vittorio, P, Frederico, Marinazzo, D, Regina, G, Giaquinta, A, Patti, F, Veroux, M, Veroux, P, Adobbati, L, Bertoni, G, Bianchi, P, Cireni, L, Martello, L, Arcuri, L, Casoni, F, Coppi, G, Moratto, R, Veronesi, J, Bajardi, G, Savettieri, G, Corbetta, R, Odero, A, Quaretti, P, Thyrion, Z, Cao, P, Caso, V, Derango, P, Farchioni, L, Parlani, G, Malferrari, G, Strozzi, F, Vecchiati, E, Biello, Antonella, Capoccia, Laura, Menna, Danilo, Rizzo, ANNA RITA, Sbarigia, Enrico, Speziale, Francesco, Toni, D, Giovanni, M, Meola, G, Nano, G, Occiuto, Mt, Stegher, S, Tealdi, D, Accrocca, F, Ambrogi, C, Barbazza, R, Marcucci, G, Cappelli, A, de Donato, G, Palasciano, G, Pieragalli, D, Setacci, C, Settaci, F, Labate, C, Ferrero, E, Ferri, M, Viazzo, A, Castelli, P, Delodovici, Ml, Ferrario, M, Piffaretti, G, Tomei, G, Furui, E, Inoue, T, Kondo, R, Matsumoto, Y, Shimizu, H, Aidashova, B, Kospanov, N, Lyssenko, R, Mussagaliev, D, De Borst GJ, Den Hartog AG, Lo, R, Moll, F, Toorop, R, Van Der Worp HB, Vonken, Ej, Bakke, S, Krohg Sorensen, K, Skjelland, M, Andziak, P, Drelichowski, S, Dratwicki, M, Gil, R, Iwanowski, W, Koncewicz, K, Nowicki, M, Pniewski, J, Rzezak, J, Seweryniak, P, Bialek, P, Biejat, Z, Czepel, W, Czlonkowska, A, Dowzenko, A, Jedzrejewska, J, Kobayashi, A, Leszezyuski, J, Malek, A, Polanski, J, Proczka, R, Skorski, M, Szostek, M, Aleksic, N, Babic, S, Kolar, J, Sagic, D, Tanaskovic, S, Colic, M, Jovanovic, D, Koncar, I, Bartko, D, Beno, P, Rusnak, F, Zelenak, K, Gasparini, M, Grad, A, Kompara, I, Milosevic, Z, Flis, V, Matela, J, Miksic, K, Milotic, F, Mrdja, B, Stirn, B, Tetickovic, E, Chamorro, A, Obach, V, Riambau, V, Roman, S, Blanco, E, Izquierdo, Ay, Guerra, M, Campbell, E, Lindgren, H, Nyberg, J, Plate, G, Parsson, H, Qvarfordt, P, Acosta, S, Brandt, K, Dias, N, Gottsater, A, Holst, J, Kristmundsson, T, Kuhme, T, Kolbel, T, Lindblad, B, Lindh, M, Malina, M, Ohrlander, T, Resch, T, Rönnle, V, Sonesson, B, Warvsten, M, Zdanowski, Z, Bengt, B, Delle, M, Formgren, J, Jarl, L, Kall, Tb, Konrad, P, Nyman, N, Skioldebrand, C, Steuer, J, Takolander, R, Ahlhelm, Fj, Bonati, L, Engelter, Ss, Eugster, T, Gensicke, H, Lyrer, P, Mariani, L, Stierli, P, Stippich, C, Wolff, T, Brown, E, Butler, N, Day, Dj, Hayes, P, Higgins, N, Jumilla, E, Martin, P, Mitchell, J, Varty, K, Birt, A, Davies, P, George, J, Graham, A, Jonker, L, Joseph, T, Kelsall, N, Potts, C, Wilson, T, Davey, P, Hayman, R, Tervitt, G, Abdul Hamiq, A, Bryce, J, Chetter, I, Ettles, D, Lakshminarayan, R, Mitchelsonm, K, Rhymes, C, Robinson, G, Scott, P, Vickers, A, Baht, H, Balogun, I, Burger, I, Cowie, L, Gunathilagan, G, Hargroves, D, Insall, R, Jones, S, Rudenko, H, Senaratne, J, Thomas, G, Thomson, A, Enevoldson, P, Nahser, H, O'Brian, I, Torella, F, Watling, D, White, R, Clifton, A, Eley, C, Khanom, N, O'Reilly, J, Pereira, A, Bicknell, C, Cheshire, N, Gibbs, R, Hamady, M, James, A, Jenkins, M, Lacey, A, Mireskandari, M, Sachs, T, Wolfe, J, Hardy, D, Justin, F, Phiri, L, Sekaran, L, Sethuraman, S, Tate, L, Akyea Mensah, J, Chrisopoulou, A, Smyth, Jv, Nichol, I, Parry, A, Young, G, Clarke, M, Davis, M, Dixit, A, Dyker, A, Ford, G, Jackson, R, Kappadath, S, Lambert, D, Lees, T, Louw, S, Parr, N, Stansby, G, Wales, L, Wealleans, V, Wilson, L, Wyatt, M, Dorman, P, Hughes, A, Jones, D, Mendelow, Ad, Rodgers, H, Macsweeney, S, Mcconachie, N, Southam, A, Sunman, W, Briley, D, Darby, C, Handa, A, Hands, L, Kuker, W, Michael, K, Perkins, J, Schulz, U, Smith, D, Teal, R, Donnelly, M, D'Souza, S, Asehosem Egun, A, Gregory, B, Kelly, C, Punekar, S, Raj, S, Seriki, D, Thomson, G, Beard, J, Cleveland, T, Humphreys, J, Jenkins, A, King, C, Lonsdale, R, Nair, R, Nawaz, S, Okhuoya, F, Turner, D, Venables, G, Brown, J, Durairajan, R, Guyler, P, Harman, P, Jakeways, M, Khuoge, C, Kundu, A, Loganathan, T, Sinha, D, Thompson, V, Tysoe, S, Barer, Brown, A, Crawford, S, Dunlop, P, Majmudar, Mitchell, D, O'Brien, O'Connell, Scott, Vetrivel, S, Ashleigh, R, Butterfield, S, Gamble, G, Ghosh, J, Mccollum, C, Welch, M, Welsh, S, Kazan, V, Nazzal, M, Ramsey Williams, V, Halliday, A, Davies, C, Peto, R, Gray, A, Mihaylova, B, Potter, J, Flather, M, Mansfield, A, Farrell, B, Rahimi, K, Simpson, D, Thomas, D, Gough, M, Rothwell, P, Giles, M, Leopold, P, Belli, A, Sandercock, P, Gray, R, Shearman, C, Molyneux, A, Hayter, E, Lay, M, Munday, A, Young, A, Delmestri, A., Halliday, A, Bulbulia, R, Gray, W, Naughten, A, den Hartog, A, Delmestri, A, Wallis, C, le Conte, S, Macdonald, S, Tolva, V, Cras, Patrick, Hendriks, Jeroen, Lauwers, Patrick, van Schil, Paul, ACST-2 Collaborative Group, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, UCL - (SLuc) Service de radiologie, and UCL - (SLuc) Service de neurologie
Subjects: Male, Time Factors, Carotid artery stenosis, Carotid artery stenting, Carotid endarterectomy, Randomized controlled trial, Stroke, medicine.medical_treatment, Myocardial Infarction, Severity of Illness Index, law.invention, law, Risk Factors, MED/22 - CHIRURGIA VASCOLARE, Carotid Stenosis, Endarterectomy, Endarterectomy, Carotid, Middle Aged, Treatment Outcome, Female, Stents, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Aged, Angioplasty, Asymptomatic Diseases, Cardiovascular Agents, Humans, Patient Selection, Risk Assessment, Asymptomatic, medicine, Carotid, business.industry, Vascular surgery, medicine.disease, Surgery, Cardiovascular agent, Human medicine, business
Abstract: Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Published: 2016

2. The Italian Multiple Sclerosis Database Network (MSDN): The risk of worsening according to IFNβ exposure in multiple sclerosis

Author: Trojano, M, Russo, P, Fuiani, A, Paolicelli, D, DI MONTE, E, Granieri, Enrico Gavino Giuseppe, Rosati, G, Savettieri, G, Comi, G, Livrea, P, MSDN STUDY GROUP, TROJANO M, RUSSO P, FUIANI A, PAOLICELLI D, DI MONTE E, GRANIERI E, ROSATI G, SAVETTIERI G, COMI G, LIVREA P, MSDN STUDY GROUP, Trojano, M, Russo, P, Fuiani, A, Paolicelli, D, DI MONTE, E, Granirei, E, Rosati, G, Savettieri, G, Comi, Giancarlo, Livrea, P, and MSDN STUDY, Group
Subjects: Adult, Male, Time Factors, computer.software_genre, Central nervous system disease, Cohort Studies, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, Adjuvants, Immunologic, medicine, Humans, Immunologic Factors, 030212 general & internal medicine, Risk factor, MULTIPLE SCLEROSIS, Demography, Proportional Hazards Models, RISK, Analysis of Variance, Database, business.industry, Proportional hazards model, Multiple sclerosis, Interferon-beta, IFNP, Long term effectiveness, Observational studies, Middle Aged, medicine.disease, Treatment Outcome, Neurology, Databases as Topic, Italy, Propensity score matching, Disease Progression, Regression Analysis, Observational study, Female, Neurology (clinical), Analysis of variance, business, computer, 030217 neurology & neurosurgery, Cohort study
Abstract: We evaluated the risk of worsening according to the length of exposure to interferon beta (IFNβ)ina large cohort of 2090 multiple sclerosis patients collected by the Italian MS Database Network. Overall 44-140 patient-visits with a follow-up of 22-143 patient-years were evaluated. Forty-one per cent of patients were exposed to IFNβ for up to 2 years, 39% for 2- 4 years and 20% for more than 4 years. A Cox regression model was used to analyse two clinical outcomes: disability progression and worsening of relapse rate. The technique of propensity score was applied to reduce bias in the comparison of non-randomized groups. The risks of disability progression (HR=0.23; 95% CI: 0.17 - 0.30) and worsening of relapse rate (HR=0.19; 95% CI: 0.14 - 0.27) were reduced by about 4- 5- fold in patients exposed to IFNβ for more than four years, compared with patients exposed for up to two years. The propensity score technique confirmed the findings. The proportion of days covered by IFNβ treatment was lower ( P
Published: 2006

3. Accuracy of death certificates for amyotrophic lateral sclerosis varies significantly from north to south of Italy: Implications for mortality studies

Author: Ragonese, P, Filippini, G, Salemia, G, Beghi, E, Citterio, A, D'Alessandro, R, Marini, C, Monsurro, Mr, Aiello, I, Morgante, L, Tempestini, A, Fratti, C, Ragno, M, Pugliatti, Maura, Epifanio, A, Testa, D, Savettieri, G, RI Savettieri Giovanni/E 8411 2012, RAGONESE P, FILIPPINI G, SALEMI G, BEGHI E, CITTERIO A, D'ALESSANDRO R, MARINI C, MONSURRO MR, AIELLO I, MORGANTE L, TEMPESTINI A, FRATTI C, RAGNO M, PUGLIATTI M, EPIFANIO A, TESTA D, SAVETTIERI G, D'ALESSANDRO R., SAVETTIERI G., Ragonese, P., Filippini, G., Salerni, G., Beghi, E., Citterio, A., D'Alessandro, R., Marini, C., Monsurro', Maria Rosaria, Aiello, I., Morgante, L., Tempestini, A., Fratti, C., Ragno, M., Pugliatti, M., Epifanio, A., Testa, D., and Savettieri, G.
Subjects: Adult, Male, Gerontology, Pediatrics, medicine.medical_specialty, Epidemiology, MEDLINE, Death Certificates, Cause of Death, medicine, Humans, Mortality, Amyotrophic lateral sclerosis, Aged, Cause of death, Aged, 80 and over, business.industry, Incidence, Incidence (epidemiology), Amyotrophic Lateral Sclerosis, Reproducibility of Results, Middle Aged, medicine.disease, Death certificate, Italy, Female, Neurology (clinical), business
Abstract: Objective: To evaluate the accuracy of death certificates (DCs) for amyotrophic lateral sclerosis (ALS) in different parts of Italy. Studies based on DC diagnosis for ALS have shown a reduced mortality comparing northern with southern Italy. These data are in contrast with results from other surveys on the incidence of ALS performed in Italy and other countries. Methods: Archives of neurological clinics from northern (Milano, Monza, Pavia, and Bologna) and southern Italy including islands (Napoli, Sassari, Palermo, and Messina) were searched for patients discharged with a diagnosis of ALS in the period 1970–1995. Subjects affected by definite/probable ALS according to the Scottish Motor Neuron Disease Research Group diagnostic criteria were included. DCs were obtained from the vital statistic bureau. True positive rates (TPRs) and 95% confidence intervals (CIs) for proportions were calculated for northern and southern Italy separately. Multiple logistic regression analysis was performed according to gender, age at onset, age and year of death, and interval between onset and death. Results: We found 651 patients affected by definite/probable ALS; 573 of them had died by December 31, 1996. DCs were available for 566 subjects (411 from northern Italy and 155 from southern Italy). TPR was 66.7% (95% CI 61.9–71.2) for northern Italy and 51.6% (95% CI 43.5–59.7) for southern Italy (χ2 = 10.9, p = 0.001). Logistic regression analysis showed an association between a lower accuracy of DCs and the interval between onset of symptoms and death. TPR calculations considering different death periods (1970–1982 and 1983–1996) showed comparable rates of accuracy over time. Conclusions: Mortality statistics based on official death records do not accurately reflect interregional mortality for ALS in Italy.
Published: 2004

4. An exploration of anger phenomenology in multiple sclerosis

Author: Nocentini U, Tedeschi G, Migliaccio R, Dinacci D, Lavorgna L, Bonavita S, Comanducci G, Coniglio G, Livrea P, Mannu R, Orefice G, Paciello M, Patti F, Quattrone A, Salemi G, Savettieri G, Simone IL, Valentino P, Zappia M, Bonavita V, Musicco M, Caltagirone C., BRESCIA MORRA, VINCENZO, Nocentini, U, Tedeschi, Gioacchino, Migliaccio, R, Dinacci, D, Lavorgna, L, Bonavita, Simona, Bresciamorra, V, Comanducci, G, Coniglio, G, Livrea, P, Mannu, R, Orefice, G, Paciello, M, Patti, F, Quattrone, A, Salemi, G, Savettieri, G, Simone, I, Valentino, P, Zappia, M, Bonavita, V, Musicco, M, Caltagirone, C., Tedeschi, G, Bonavita, S, Simone, IL, Caltagirone, C, BRESCIA MORRA, Vincenzo, and Simone, Il
Subjects: Adult, Male, Adolescent, anger, Middle Aged, Neuropsychological Tests, anxiety, multiple sclerosis, Anger, Young Adult, Female, Depression, Humans, Anxiety, Aged, Multiple Sclerosis, disability, depression, Multiple sclerosi, Settore MED/26 - Neurologia
Abstract: Multiple sclerosis (MS) patients are often emotionally disturbed. We investigated anger in these patients in relation to demographic, clinical, and mood characteristics.About 195 cognitively unimpaired MS patients (150 relapsing-remitting and 45 progressive) were evaluated with the State Trait Anger Expression Inventory, the Chicago Multiscale Depression Inventory, and the State Trait Anxiety Inventory. The patients' anger score distribution was compared with that of the normal Italian population. Correlation coefficients among scale scores were calculated and mean anger scores were compared across different groups of patients by analysis of variance.Of the five different aspects of anger, levels of withheld and controlled Anger were respectively higher and lower than what is expected in the normal population. Although anger was correlated with anxiety and depression, it was largely independent from these mood conditions. Mean anger severity scores were not strongly influenced by individual demographic characteristics and were not higher in more severe patients.The presence of an altered pattern of anger, unrelated to the clinical severity of MS, suggests that anger is not an emotional reaction to disease stress. An alteration of anger mechanisms might be a direct consequence of the demyelination of the connections among the amygdale, the basal ganglia and the medial prefrontal cortex.
Published: 2009

5. Door-to-door prevalence survey of epilepsy in three Sicilian municipalities

Author: Rocca, Wa, Savettieri, G, Anderson, Dw, Meneghini, F, Grigoletto, F, Morgante, L, Reggio, A, Salemi, G, Patti, Francesco, DI PERRI, R, SICILIAN NEURO EPIDEMIOLOGIC STUDY SNES GROUP, Rocca, W., Savettieri, G., Anderson, D., Meneghini, F., Grigoletto, F., Morgante, L., Reggio, A., Salemi, G., Patti, F., and Di Perri, R.
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, Epidemiology, Population, Epilepsy, Seizures, Prevalence, Medicine, Humans, education, Survey, Child, Sicily, Aged, Aged, 80 and over, education.field_of_study, business.industry, Age Factors, Prevalence survey, Middle Aged, medicine.disease, Health Surveys, language.human_language, Child, Preschool, language, Screening, Settore MED/26 - Neurologia, Female, Neurology (clinical), business, Sicilian
Abstract: A door-to-door prevalence survey of epilepsy was conducted in 3 Sicilian municipalities, as of November 1, 1987. In phase 1, the screening by questionnaire of 24,496 eligible subjects (participation = 92%) identified 544 suspected to have epilepsy. In phase 2, neurological evaluation of the 544 subjects yielded 111 with epilepsy. Of the 111 subjects, 103 (93%) had been previously diagnosed, 68 (61%) were taking antiepileptic medication, and 81 (73%) had active epilepsy. Referring to the 81 subjects with active epilepsy, the seizure type was generalized in 60 (74%), partial in 19 (23%) and undetermined in 2 (3%). The prevalence of active epilepsy (per 1,000 population) was 3.3 overall, 3.5 for men and 3.2 for women. The age-specific patterns for active epilepsy differed by sex, with higher figures for men at younger ages (5-19 years) and older ages (50-99 years). The age-specific prevalence figures for active epilepsy were lower than those from previous Italian surveys. Copyright © 2001 S. Karger AG, Basel.
Published: 2001

6. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial

Author: GALA Trial Collaborative Group, C Lewis, S, P Warlow, C, R Bodenham, A, Colam, B, M Rothwell, P, Torgerson, D, Dellagrammaticas, D, Horrocks, M, Liapis, C, P Banning, A, Gough, M, J Gough, M, Fraser, A, Grant, S, Hunter, J, Leigh-Brown, A, Paterson, M, Soosay, V, Young, A, Williamson, A, Dean, Z, Mazzoli, T, Ricci, S, Valenti, D, Bamford, J, Beard, J, Dearden, M, Murray, G, Ruckley, V, E Norman, P, Sedivy, P, Idla, A, Schmitz-Rixen, T, Maritati, G, Bodenham, A, Cokic, N, Doppler, W, Hlatky, P, Koelblinger, C, Raith, C, Zölss, C, Dimmitt, S, Gharbi, R, Hankey, G, Maden, A, P Mwipatayi, B, Sieunarine, K, Tan, A, Turner, G, Wesseldine, A, T M, E Davis, Audzei, P, Davidovski, I, Dedul, D, Hetsiuk, A, Kornievich, S, Gao, J, Y-G, Huang, Jing, G, H, Li, Y-J, Li, Liu, B, C-W, Liu, J-D, Wu, W, Ye, C-H, Yu, Ban, T, Buljan, K, Candrlic, K, Dapic, D, Ilijasevic, M, Istvanic, T, Kovac, B, Kvolik, S, Lehner, V, Pinotic, K, Hudorović, N, Ivanec, Z, Lovricević, I, Mazul-Sunko, B, Novotny, Z, D De Syo, Vuković, V, Biebl, O, Dolecek, L, C El Samman, Kalasova, H, Kubricht, V, Matous, P, Michalek, P, Stajnrt, M, Stern, M, Svec, M, Vitasek, P, Vrzal, J, Weiss, K, Janousek, L, Kieslichova, E, Mazarova, V, Piza, P, Vychodil, P, Dulovcova, V, Fiksa, J, Hruby, J, Maresch, M, Mathias, M, Rubes, D, Tosenovsky, P, Vidim, T, Henzl, M, Riman, J, Ziegler, Z, Drabek, P, Hrbac, T, Reguli, S, Stigler, J, Bachleda, P, Drac, P, Hudecek, M, Koutna, J, Sanak, D, Utikal, P, Goldemund, D, Gregor, Z, Pavlikova, J, Podlaha, J, Privara, M, Staffa, R, Vlachovsky, R, Barankova, L, Chlouba, V, Fiedler, J, Prazak, P, Priban, V, Wierer, A, Ellervee, T, Järve, H, Sell, A, Taba, P, Kolbassov, V, Kullamaa, S, Paavel, T, Abramishvili, N, Bokuchava, M, Kachapuridze, N, Kipiani, K, Papashvili, K, Pargalava, N, Adili, F, Dietz, A, Neidhart, G, Nentwig, G, M Sitzer, O, Beno, M, Essink-Hassels, M, Lander, K, Ruemenapf, G, Breuer, P, Heldt, R, Melichar, G, Rieper, J, H Eckstein, H, Poppert, H, Schneider, G, Andrikopoulos, V, Angel, A, Bakogiannis, K, Dermitzaki, M, Georgakis, P, Lioupis, C, Maras, D, G Moulakakis, K, Sfyroeras, G, Arato, E, Gyevnar, Z, Hardi, P, Kasza, G, Kollar, L, Menyhei, G, Pal, E, Sinay, L, Verzar, Z, Volgyi, E, S Elmakias, S, Harah, E, Kristal, K, Lebi, D, Leonty, Y, Levy, D, Milo, R, Yoffe, B, Bissi, M, Cappellini, B, Cassamali, T, Corino, L, Denkewitz, T, Ghilardi, G, Massetto, N, P Di Mauro, Tommasino, C, Bartolucci, R, Buffa, V, M Corsi, F, D'Avino, E, F Di Cesare, L Di Pirro, Lappa, A, Luzzi, S, Menichetti, A, Nesi, F, Pannone, A, Picozzi, P, Pogany, G, Rabitti, G, Severi, L, Avella, R, Biandolino, P, P Giomarelli, P, R Monfregola, M, Palasciano, G, Peccianti, V, Pieragalli, D, Setacci, C, Setacci, F, Sirignano, P, Bordoni, M, Casadei, V, Cugnasca, M, A De Troia, Geremia, L, Guffanti, P, G Lo Guercio, V Maniaci, M, Mauri, Morbidelli, A, Aletta, A, Costanzo, E, D'Arrigo, G, F Di Stefano, Lomeo, A, Maugeri, S, C Monea, M, Scardavilli, G, Scolaro, A, Aloisi, P, Ciccozzi, A, Manno, M, Marrelli, A, Martinazzo, C, Mastromarino, A, Petrassi, C, Piroli, A, Spartera, C, Ventura, M, Alessandrini, F, Carissimi, C, M Centritto, E, Cinelli, G, C De Filippo, Liberatoscioli, G, Modugno, P, Rossi, M, T Attanzio, M, Bajardi, G, Bellisi, M, Machi, P, Salemi, S, Savettieri, G, A Crea, M, V di Lazzaro, Ferrante, A, Guarneri, S, Manni, R, Snider, F, Stefanuto, C, Berardi, G, Bianchi, A, Comis, M, Cumbo, P, Fadde, M, Ferrero, E, Ferri, M, Filardo, A, Gaggiano, A, Ganzaroli, M, Labate, C, Maggio, D, Mennuti, G, Minicucci, S, Musso, A, Nessi, F, Pasquino, M, Perretta, L, Piazza, S, Verdecchia, C, Viazzo, A, Antico, A, Battan, E, Ciarlo, M, Giardini, G, G Luca Iob, Marinello, C, Piccolo, D, Bove, R, Castrucci, T, Lorido, A, Sammarco, S, Bruzzone, B, Cannata, D, Colotto, P, Finocchi, C, Giudici, N, Mambrini, S, Mazzei, R, Palombo, D, Pellegrino, A, Rousas, N, Viacava, A, Ermirio, D, Faga, D, Simoni, G, Benedetti-Valentini, F, Gabrielli, R, Garofano, R, Gossetti, B, Guerricchio, R, Irace, L, Lenzi, G, Gedins, M, Kisis, K, Krievins, D, Krustina, I, Lietuvietis, E, Malina, M, Morlata, N, Rits, J, Thor, S, Ivanova, P, Kikule, I, Liepa, V, Ligers, A, Stengrevica, N, Vnukova, N, Zvirgzdins, V, P J A, M Brouwers, H Geelkerken, R, Stam, A, M A, M Simon, T den Hoed, P, Oltmans, M, Rettig, H, F Veen, H, Zuidgeest, D, Feldo, M, Kesik, J, Kobusiewicz, W, Łatkiewicz, D, Myślinski, W, Przywara, S, Terlecki, P, Wroński, J, Zubilewicz, T, Alfonso, G, Azevedo, E, R de Albuquerque, Mansilha, A, Al-Salman, M, K Aldaif, A, A Alnasr, T, A El Dawlatly, A, Elkayali, A, M Rabee, H, Chudikova, E, Chudá, I, Dulka, T, Goldenberg, Z, Lofaj, P, Pavlikova, M, Pisar, M, Sefranek, V, Slysko, R, Tomka, J, Tóthová, Z, Zita, Z, A Cairols, M, Iborra, E, Mercadal, M, Rubio, F, Canovas, D, Cobo, L, Gimenez-Gaibar, A, Gonzalez, E, Gonzalo, B, Guilera, N, Hospedales, J, J Laso, M, Perez, J, Solanich, T, Hensater, M, Karlström, L, Kjällman, L, Rosengren, L, C-A, Ewaldsson, Gillgren, P, T-B, Käll, Konrad, P, Lindkvist, M, Nilsson, L, Takolander, R, E von Zweigbergk, Cinar, B, Coruh, T, Kurc, E, Ozsoy, D, Sargin, M, Tutkavul, K, Yekeler, I, Aksoy, M, Aksoy, S, Kurtoglu, M, Arar, C, Canbaz, S, Celik, Y, Ege, T, Ketenc, S, Sunar, H, Unal, S, Asik, I, Bengisun, U, Koksoy, C, Yucemen, N, C Berridge, D, Caldicott, L, Cooper, J, Cross, M, Ford, H, Fuller, R, Gamlin, F, Homer-Vanniasinkum, S, Howell, S, Kent, P, Lumb, A, A I, D Mavor, D J, A Scott, Shah, M, Wanklyn, P, S Budd, J, Mcateer, P, Shaw, L, Dewar, R, H Lewis, M, Potter, C, Richards, H, Roberts, R, Townsend, E, Wagle, A, Woodford, P, Hall, G, Holdsworth, R, Macleod, M, Michels, L, P A, G Sandercock, Sudlow, C, Woods, A, S Abraham, J, Bukhari, M, Bush, A, Calvey, J, Chadwick, I, Krishnaprasad, K, Oldham, T, Tomlinson, M, Vickers, A, Wilson, D, Wilson, P, Greystone, S, C Grocott, E, Hayes, W, Haynes, S, Jenkins, C, Jenkins, D, Moore, W, Nyamekye, I, Overstall, P, Riseboro, S, Williams, H, Boyle, J, Duane, D, Gaunt, M, J Kirkpatrick, P, Martin, P, E Risdall, J, Scurrah, N, L Turner, C, Varty, K, T Ferguson, I, Horsfall, S, C Mitchell, D, Robinson, S, Frankel, J, E Morris, G, Phillips, M, Sansome, A, J Sparkes, D, Williams, J, Ashton, W, Baker, S, Clark, M, G Darke, S, Dunnill, R, Hargreaves, M, Jenkinson, D, Thomson, C, White, N, D Wijesinghe, L, Bapat, P, A Barrett, J, D Blair, S, Chandrasekar, R, Lawrence, G, Lowe, D, Sangster, G, Smith, M, M Van Miert, K Das, S, Malik, O, Nel, M, Rakowicz, W, Aukett, M, Carmichael, M, Colchester, A, R Taylor, P, Wood, C, Ageed, A, J Boom, S, Ghosh, S, Godfrey, J, Hewitt-Gray, J, Mcdiarmid, I, Yousif, S, Ziarkowski, A, Al-Din, A, Carpenter, M, Ch'Ng, K, J Curley, P, Davey, R, Henderson, B, F Hossain, J, D Irvine, C, Loizou, L, Main, A, Stanners, A, Muldoon, T, V Soong, C, Wiggam, I, P Armon, M, Burrows, M, Holmes, L, K Metcalf, A, Nunn, D, Abdul-Hamid, A, Akomalafe, B, Bryce, J, Chetter, I, Samaan, A, Briley, D, Collin, J, Darby, C, Dobson, M, Foex, P, Grange, C, Handa, A, Hands, L, E Higham, H, J M, T Perkins, Sear, J, Stoneham, M, Hamilton, G, Judge, C, Morris-Vincent, P, Pegg, M, A Wilson, L, I Aldoori, M, B E, A Dafalla, Kumar, N, I F, C Hay, Jefferson, P, Muir, I, Peel, W, Rutherford, J, Sathianathan, J, Wight, S, Williams, D, Wrathall, W, Bachoo, P, Brittenden, J, Counsell, C, Patey, R, Read, J, L de Cossart, K Dimitri, S, Edwards, P, Fergusson, N, Jameson, P, Somauroo, J, Taylor, V, D Aravindan, P, Brocklehurst, I, Mirza, S, N Namushi, R, O Oshodi, T, Ruff, D, A Solomon, S, Vassallo, J, Egbe, M, Halstead, G, Onwudike, M, Putland, A, Roberts, N, A Salaman, R, Watson, D, Caine, S, Day, J, Lamont, P, J Murphy, P, Smith, F, Beacham, K, J Dorman, P, Lambert, D, Rodgers, H, Collas, D, Sarin, S, Shah, J, S Baht, H, Banks, J, Cowie, L, Gunathilagan, G, Hargroves, D, Insall, R, G Smithard, D, K Chadha, D, R Pillay, W, Rashid, J, Sayles, J, Hill, S, Lawton, G, M Lloyd, C, Marsh, A, Clarke, G, J Lonsdale, R, Venables, G, Cross, R, Lord, B, Mcilmoyle, J, Y Osman, H, Robinson, J, Chant, H, Mate, A, Sim, D, Upton, P, Thomas, D, H Wolfe, J, Mccollum, C, O'Neill, P, Bernatsky, V, Bondar, L, Karpenko, A, Mamonova, M, Muz, N, and Yavorsky, V
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Carotid endarterectomy, general anesthesia, local anesthesia, carotid surgery, Anesthesia, General, law.invention, Postoperative Complications, Randomized controlled trial, law, medicine, Humans, Carotid Stenosis, General anaesthesia, general anaesthesia, Stroke, Aged, Endarterectomy, Endarterectomy, Carotid, local anaesthesia, Intention-to-treat analysis, business.industry, General Medicine, Perioperative, Vascular surgery, medicine.disease, Surgery, Anesthesia, Female, business, Anesthesia, Local
Abstract: BACKGROUND: The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under general anaesthesia. METHODS: We undertook a parallel group, multicentre, randomised controlled trial of 3526 patients with symptomatic or asymptomatic carotid stenosis from 95 centres in 24 countries. Participants were randomly assigned to surgery under general (n=1753) or local (n=1773) anaesthesia between June, 1999 and October, 2007. The primary outcome was the proportion of patients with stroke (including retinal infarction), myocardial infarction, or death between randomisation and 30 days after surgery. Analysis was by intention to treat. The trial is registered with Current Control Trials number ISRCTN00525237. FINDINGS: A primary outcome occurred in 84 (4.8%) patients assigned to surgery under general anaesthesia and 80 (4.5%) of those assigned to surgery under local anaesthesia; three events per 1000 treated were prevented with local anaesthesia (95% CI -11 to 17; risk ratio [RR] 0.94 [95% CI 0.70 to 1.27]). The two groups did not significantly differ for quality of life, length of hospital stay, or the primary outcome in the prespecified subgroups of age, contralateral carotid occlusion, and baseline surgical risk. INTERPRETATION: We have not shown a definite difference in outcomes between general and local anaesthesia for carotid surgery. The anaesthetist and surgeon, in consultation with the patient, should decide which anaesthetic technique to use on an individual basis. FUNDING: The Health Foundation (UK) and European Society of Vascular Surgery.
Published: 2008

7. Low Ankle-brachial index predicts an adverse 1-year outcome after acute coronary and cerebrovascular events

Author: Agnelli, G., Cimminiello, C., Meneghetti, G., Urbinati, S., Cappielo, E., Bazzi, P., Arpaia, G., Santamaria, M. G., Tassara, R. I., Rebuttato, A. I., Perna, G. P., Gabrielli, D., Ruga, O., Moretti, L., Gregori, G., Marconi, M. K., Burali, A., DE LUCA, I. M., Ciriello, N. M., Ciampa, G. N., Pitscheider, W., Tomaino, M., Poma, E., Poggio, G., Spissu, A., Melis, A., Pinna, L., Lastilla, M., Bonaventura, A. R., Visonà, A. S., Tonello, D. S., Pennisi, G., Bella, R, Santonocito, D., Borrello, G. U., Mazza, M. L., Mattoscio, N., Garzaro, L., Pinneri, F., Zarcone, D., Lanfranchi, S., Moretti, V., Busettini, G., Bordin, P., Delfino, R. Z., Zingarelli, A., Caroppo, E. A., Puccetti, I. A., Orlandi, M., Losi, L., DE CAROLIS, P., Zanini, R., Cionini, F., Viecca, M., Lazzaroni, A., Satta, T., Manenti, V., Basile, G., Tuccillo, B., Accadia, M., Piatto, A., Annunziata, L., Mandarini, A., Androne, V. A., Traccis, S. A., Ottina, M., D'Angelo, A., Fazio, M., Damiani, L. A., Lupo, I., Savettieri, G., DEL PINTO, M., Notaristefano, S., Imberti, D., Tartarin, G., Lucarini, A., Topi, A., D'Anna, S., Saccardi, M., Paciello, M. A., Tordini, G., D'Arienzo, E., Piovaccari, G., Pesaresi, A., Amabile, G., Fiermonte, G., Gallù, M. C., Fontana, L., Ferri, F., Curatola, L., Gobbato, R., Paci, C., Simone, P., DI VIESTI, P., Tonizzo, M., LI VOLSI, P., Gionco, M., Onofri, M., Scorzoni, D., Grimoldi, P., Dentali, F., Ageno, W., Venco, A., and Grillo, G.
Subjects: Male, Brachial Artery, Myocardial Infarction, Blood Pressure, Coronary Disease, Cohort Studies, Angina, Odds Ratio, Prospective Studies, Myocardial infarction, Transient ischemic attack, Prospective cohort study, Stroke, Acute myocardial infarction, Ankle-brachial index, Atherosclerosis, Unstable angina, Acute Disease, Aged, Angina, Unstable, Ankle, Cerebrovascular Disorders, Female, Follow-Up Studies, Hospitalization, Humans, Ischemic Attack, Transient, Italy, Predictive Value of Tests, Prognosis, Regression Analysis, Survival Analysis, Syndrome, Hematology, Ischemic Attack, Transient, Predictive value of tests, cardiovascular system, Cardiology, medicine.symptom, medicine.medical_specialty, Unstable, Asymptomatic, Internal medicine, medicine, cardiovascular diseases, business.industry, Odds ratio, medicine.disease, body regions, business, human activities
Abstract: Summary. Background: Low ankle–brachial Index (ABI) identifies patients with symptomatic and asymptomatic peripheral arterial disease. The aim of this study was to correlate ABI value (normal or low) with 1-year clinical outcome in patients hospitalized for acute coronary syndromes or cerebrovascular diseases (CVD). Methods: ABI was measured in consecutive patients hospitalized because of acute myocardial infarction, unstable angina, stroke or transient ischemic attack (TIA). An ABI lower than or equal to 0.90 was considered abnormal. The primary outcome of the study was the composite of non-fatal acute myocardial infarction, non-fatal ischemic stroke, and death from any cause during the year following the index event. Results: An abnormal ABI was found in 27.2% of 1003 patients with acute coronary syndromes, and in 33.5% of 755 patients with acute CVD. After a median follow-up of 372 days, the frequency of the primary outcome was 10.8% (57/526) in patients with abnormal ABI and 5.9% (73/1232) in patients with normal ABI [odds ratio (OR) 1.96; 95% CI 1.36–2.81]. Death was more common in patients with abnormal ABI (OR 2.05; 95% CI 1.31–3.22). Cardiovascular mortality accounted for 81.7% of overall mortality. ABI was predictive of adverse outcome after adjustment for vascular risk factors in the logistic regression analysis (OR 1.93; 95% CI 1.24–3.01). The predictive value of ABI was mainly accounted for by patients hospitalized for acute coronary syndromes (adverse outcome: 12.8% in patients with abnormal ABI and 5.9% in patients with normal ABI, OR 2.35; 95% CI 1.47–3.76). Conclusions: An abnormal ABI can be found in one-third of patients hospitalized for acute coronary or cerebrovascular events and is a predictor of an adverse 1-year outcome.
Published: 2006

8. Prevalence of lumbosacral radiculopathy in two Sicilian municipalities. Sicilian Neuro-Epidemiologic Study (SNES) Group

Author: Savettieri G, Giuseppe Salemi, Wa, Rocca, Meneghini F, D'Arpa A, Morgante L, Ma, Coraci, Reggio A, Grigoletto F, and Di Perri R
Subjects: Adult, Aged, 80 and over, Male, Sex Factors, Age Factors, Lumbosacral Region, Prevalence, Humans, Peripheral Nervous System Diseases, Female, Middle Aged, Sicily, Aged
Abstract: As part of a door-to-door survey of neurologic diseases, we investigated the prevalence of lumbosacral radiculopathy (LR) in two Sicilian municipalities (N = 14,540, as of November 1, 1987).During phase 1, we administered a brief screening instrument to subjects in the study population. In phase 2, study neurologists using specified diagnostic criteria investigated those subjects who screened positive. Our case finding was restricted to subjects who manifested symptoms of LR in the six months preceding the prevalence day.We found 143 subjects affected by LR (112 definite, 31 possible) yielding a crude prevalence of 9.8 cases per 1,000 population. Age-specific prevalence was generally higher in men; it increased to a peak at age 50-59 years and decreased steadily thereafter. At the peak, prevalence was higher in factory workers, housewives, and clerks compared to workers in other occupations.LR is a common neurologic disease in the general population.

9. Autosomal dominant hereditary spastic paraplegia: report of a large italian family with R581X spastin mutation

Author: G. Savettieri, Paolo Ragonese, M. De Fusco, Giorgio Casari, D. Lo Coco, Giuseppe Salemi, Paolo Aridon, ARIDON P, RAGONESE P, DE FUSCO M, LO COCO D, SALEMI G, CASARI G, SAVETTIERI G, Aridon, P, Ragonese, P, De Fusco, M, Lo Coco, D, Salemi, G, Casari, GIORGIO NEVIO, Savettieri, G., Aridon P., Ragonese P, Melone, M, and Casari, G
Subjects: Adult, Male, Spastin, Genotype, Sequence analysis, Hereditary spastic paraplegia, DNA Mutational Analysis, Nonsense mutation, Locus (genetics), Dermatology, Biology, Arginine, Exon, Hereditary spastic paraplegia Spastin Neurological disease, medicine, Humans, Gene, Aged, Adenosine Triphosphatases, Family Health, Genetics, Spastic Paraplegia, Hereditary, General Medicine, Middle Aged, medicine.disease, Molecular biology, Penetrance, Psychiatry and Mental health, Italy, Mutation, Female, Neurology (clinical), Lod Score
Abstract: We describe a large kindred with a typical pure form of autosomal dominant hereditary spastic paraplegia (ADHSP). On the basis of maximum LOD score of 1.94 at theta (max)=0 with marker D2S367, we obtained suggestive evidence for linkage of ADHSP to SPG4 locus. Denaturing high-performance liquid chromatography (DHPLC) and direct sequence analysis allowed us to identify a nonsense mutation (1741* C > T) in exon 17 of the Spastin gene. This transition, carried by all the affected family members and two apparently healthy individuals, lead to truncation of the last 36 amino acids in the C-terminus of the protein. These results confirm the existence of mutation in the SPG4 gene with a reduced penetrance, indicating that other genetic or environmental factors are required to trigger full-blown disease.
Published: 2007

10. Lesion load may predict long-term cognitive dysfunction in multiple sclerosis patients

Author: Gioacchino Tedeschi, Sabrina Realmuto, Damiano Paolicelli, Giovanni Savettieri, Vincenzo Brescia Morra, Alessandro d’Ambrosio, Silvia Messina, Veria Vacchiano, Mario Zappia, Maria Buccafusca, Bruno Alfano, Roberta Lanzillo, Domenico Ippolito, Paola Valentino, Antonio Gallo, Luigi Lavorgna, Manuela De Stefano, Francesco Patti, Rosa Gemma Viterbo, Patrizia Montella, Isabella Laura Simone, Clara Grazia Chisari, G. Coniglio, Simona Bonavita, Patti, F, De Stefano, M, Lavorgna, L, Messina, S, Chisari, C. G, Ippolito, D, Lanzillo, Roberta, Vacchiano, V, Realmuto, S, Valentino, P, Coniglio, G, Buccafusca, M, Paolicelli, D, D'Ambrosio, A, Montella, P, BRESCIA MORRA, Vincenzo, Savettieri, Giovanni, Alfano, B, Gallo, A, Simone, I, Viterbo, R, Zappia, M, Bonavita, S, Tedeschi, G., Chisari, Cg, Lanzillo, R, D'Ambrosio, Alessandro, Brescia Morra, V, Savettieri, G, Gallo, Antonio, Bonavita, Simona, Tedeschi, Gioacchino, Patti, F., De Stefano, M., Lavorgna, L., Messina, S., Chisari, C., Ippolito, D., Lanzillo, R., Vacchiano, V., Realmuto, S., Valentino, P., Coniglio, G., Buccafusca, M., Paolicelli, D., D'Ambrosio, A., Montella, P., Brescia Morra, V., Savettieri, G., Alfano, B., Gallo, A., Simone, I., Viterbo, R., Zappia, M., and Bonavita, S.
Subjects: EMTREE medical terms: Article, recall, lcsh:Medicine, Audiology, Neuropsychological Tests, Nerve Fibers, Myelinated, 030218 nuclear medicine & medical imaging, Cohort Studies, 0302 clinical medicine, cognitive defect, nuclear magnetic resonance imaging, lcsh:Science, Modified Card Sorting Test, Multidisciplinary, neuroimaging, Semantically Related Word List Test, Multiple Sclerosis, Cognitive Dysfunction, MRI, medicine.diagnostic_test, predictive value, Brain, Cognition, Neuropsychological test, gray matter, Middle Aged, Prognosis, Magnetic Resonance Imaging, Memory, Short-Term, female, brain size, multiple sclerosi, Cohort, Disease Progression, Settore MED/26 - Neurologia, white matter, Research Article, Adult, medicine.medical_specialty, Multiple Sclerosis, Paced Auditory Serial Addition Test, verbal memory, cerebrospinal fluid, working memory, 03 medical and health sciences, male, medicine, Humans, controlled study, human, Recall, business.industry, Multiple sclerosis, lcsh:R, Magnetic resonance imaging, medicine.disease, major clinical study, attention, executive function, Symbol Digit Modalities Test, neuropsychological test, lcsh:Q, Verbal memory, business, Cognition Disorders, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract: Background: Magnetic Resonance Imaging (MRI) techniques provided evidences into the understanding of cognitive impairment (CIm) in Multiple Sclerosis (MS). Objectives: To investigate the role of white matter (WM) and gray matter (GM) in predicting long-term CIm in a cohort of MS patients. Methods: 303 out of 597 patients participating in a previous multicenter clinical-MRI study were enrolled (49.4% were lost at follow-up). The following MRI parameters, expressed as fraction (f) of intracranial volume, were evaluated: cerebrospinal fluid (CSF-f), WM-f, GM-f and abnormal WM (AWM-f), a measure of lesion load. Nine years later, cognitive status was assessed in 241 patients using the Symbol Digit Modalities Test (SDMT), the Semantically Related Word List Test (SRWL), the Modified Card Sorting Test (MCST), and the Paced Auditory Serial Addition Test (PASAT). In particular, being SRWL a memory test, both immediate recall and delayed recall were evaluated. MCST scoring was calculated based on the number of categories, number of perseverative and non-perseverative errors. Results: AWM-f was predictive of an impaired performance 9 years ahead in SDMT (OR 1.49, CI 1.12-1.97 p = 0.006), PASAT (OR 1.43, CI 1.14-1.80 p = 0.002), SRWL-immediate recall (OR 1.72 CI 1.35-2.20 p
Published: 2015

11. Lack of association between estrogen receptor 1 gene polymorphisms and multiple sclerosis in southern Italy in humans

Author: Paolo Ragonese, Rita Cittadella, Giovanni Savettieri, Virginia Andreoli, Aldo Quattrone, Paola Valentino, Gaetana La Porta, Antonella La Russa, S. Bonavita, Ida Manna, Gioacchino Tedeschi, D. Pirritano, Francesca Ruscica, Savettieri G., Cittadella R., Valentino P., Manna I., Andreoli V., La Russa A., La Porta G., Ruscica F., Ragonese P., Pirritano D., Bonavita S., Tedeschi G., Quattrone A., Savettieri, G, Cittadella, R, Valentino, P, Manna, I, Andreoli, V, LA RUSSA, A, LA PORTA, G, Ruscica, F, Ragonese, P, Bonavita, Simona, Tedeschi, Gioacchino, and Quattrone, A.
Subjects: Adult, Male, Multiple Sclerosis, Adolescent, Genotype, Population, Estrogen receptor, Biology, Gene Frequency, Polymorphism (computer science), medicine, Genetic predisposition, Humans, Genetic Predisposition to Disease, Allele, education, Aged, education.field_of_study, Polymorphism, Genetic, General Neuroscience, Multiple sclerosis, Estrogen Receptor alpha, Estrogen receptor, Genetic susceptibility, Italians, Multiple sclerosis, Polymorphism, Middle Aged, medicine.disease, Italy, Receptors, Estrogen, Immunology, Female, Estrogen receptor alpha
Abstract: Estrogen receptor 1 gene polymorphisms (ESR1) have been found to be associated with multiple sclerosis (MS) in both Japanese and Finnish populations. We investigated the association between ESR1 polymorphisms (PvuII and XbaI) and MS in a study of 132 MS patients and 129 controls from the same geographic background (southern Italy). Allelic and genotypic frequencies were not different between MS patients and population controls for either the PvuII or XbaI polymorphism. This result suggests that the association between a given disease and a genomic characteristic must be confirmed by separate investigations in different populations. © 2002 Elsevier Science Ireland Ltd. All rights reserved.
Published: 2002

12. Acute myeloid leukemia in Italian patients with multiple sclerosis treated with mitoxantrone

Author: Martinelli, V., Cocco, E., Capra, R., Salemi, G., Gallo, P., Capobianco, M., Pesci, I., Ghezzi, A., Pozzilli, Carlo, Lugaresi, A., Bellantonio, P., Amato, M. P., Grimaldi, L. M., Trojano, M., Mancardi, G. L., Bergamaschi, R., Gasperini, Claudio, Rodegher, M., Straffi, L., Ponzio, M., Comi, G., For The Italian Mitoxantrone Group, Radaelli, M, Esposito, F, Moiola, L, Colombo, B, Rossi, P, Marrosu, Mg, Frau, J, Lorefice, L, Coghe, G, Savettieri, Giovanni, Ragonese, P, Cusimano, V, Perini, P, Rinaldi, F, Vidali, A, Bertolotto, A, Malucchi, S, Di Sapio, A, Montanari, E, Guareschi, A, Rizzo, A, Zaffaroni, M, Baldini, S, De Rossi, N, Cordioli, C, Rasia, S, Salvetti, M, Buttinelli, C, AUSILI CEFARO, Luca, De Luca, G, Tommaso, D, Farina, D, Fantozzi, R, Ruggieri, S, Amato, Mp, Hakiki, B, Zipoli, V, Portaccio, E, Bartolozzi, Ml, Scandellari, C, Stecchi, S, Marchello, Lp, Palmeri, B, Vitello, G, Iaffaldano, P, Lucchese, G, Dattola, V, Buccafusca, M, Sola, P, Simone, Am, Barreca, F, Patti, F, Laisa, P, Cavalla, P, Masera, S, Tavazzi, E, Galgani, S, Tedeschi, G, Sacco, R, Provinciali, L, Maura, D, Lus, G, Alfieri, G, Ticca, A, Piras, Ml, Maimone, D, Bianca, M, Iudice, A, Giro, Me, Galeotti, M, Florio, C, Spitalieri, P, La Mantia, L, Motti, L, Rottoli, Mr, Granella, F, Solaro, C, Scarpini, E, Servillo, G, Cavaletti, G., Martinelli, V., Cocco, E., Capra, R., Salemi, G., Gallo, P., Capobianco, M., Pesci, I., Ghezzi, A., Pozzilli, C., Lugaresi, A., Bellantonio, P., Amato, M. P., Grimaldi, L. M., Trojano, M., Mancardi, G. L., Bergamaschi, R., Gasperini, C., Rodegher, M., Straffi, L., Ponzio, M., Comi, G., Radaelli, M., Esposito, F., Moiola, L., Colombo, B., Rossi, P., Marrosu, M. G., Frau, J., Lorefice, L., Coghe, G., Savettieri, G., Ragonese, P., Cusimano, V., Perini, P., Rinaldi, F., Vidali, A., Bertolotto, A., Malucchi, S., Di Sapio, A., Montanari, E., Guareschi, A., Rizzo, A., Zaffaroni, M., Baldini, S., De Rossi, N., Cordioli, C., Rasia, S., Salvetti, M., Buttinelli, C., Ausili Cefaro, L., De Luca, Giovanna, Tommaso, D., Farina, D., Fantozzi, R., Ruggieri, S., Hakiki, B., Zipoli, V., Portaccio, E., Bartolozzi, M. L., Scandellari, C., Stecchi, S., Marchello, L. P., Palmeri, B., Vitello, G., Iaffaldano, P., Lucchese, G., Dattola, V., Buccafusca, M., Sola, P., Simone, A. M., Barreca, F., Patti, F., Laisa, P., Cavalla, P., Masera, S., Tavazzi, E., Galgani, S., Tedeschi, G., Sacco, R., Provinciali, L., Maura, D., Lus, G., Alfieri, G., Ticca, A., Piras, M. L., Maimone, D., Bianca, M., Iudice, A., Giro, M. E., Galeotti, M., Florio, C., Spitalieri, P., La Mantia, L., Motti, L., Rottoli, M. R., Granella, F., Solaro, C., Scarpini, E., Servillo, G., Cavaletti, G., Radaelli, M, Esposito, F, Moiola, L, Colombo, B, Rossi, P, Marrosu, MG, Frau, J, Lorefice, L, Coghe, G, Savettieri, G, Ragonese, P, Cusimano, V, Perini, P, Rinaldi, F, Vidali, A, Bertolotto, A, Malucchi, S, Di Sapio, A, Montanari, E, Guareschi, A, Rizzo, A, Zaffaroni, M, Baldini, S, De Rossi, N, Cordioli, C, Rasia, S, Salvetti, M, Buttinelli, C, Ausili Cefaro, L, De Luca, G, Tommaso, D, Farina, D, Fantozzi, R, Ruggieri, S, Amato, MP, Hakiki, B, Zipoli, V, Portaccio, E, Bartolozzi, ML, Scandellari, C, Stecchi, S, Marchello, LP, Palmeri, B, Vitello, G, Iaffaldano, P, Lucchese G, Dattola V, Buccafusca M, Sola, P, Simone, AM, Barreca, F, Patti, F, Laisa, P, Cavalla, P, Masera, S, Tavazzi, E, Galgani, S, Tedeschi, G, Sacco, R, Provinciali, L, Maura, D, Lus, G, Alfieri, G, Ticca, A, Piras, ML, Maimone, D, Bianca, M, Iudice, A, Giro, ME, Galeotti, M, Florio, C, Spitalieri, P, La Mantia, L, Motti, L, Rottoli, MR, Granella, F, Solaro, C, Scarpini, E, Servillo, G, Cavalletti, G, Salemi, G, Martinelli, V, Cocco, E, Capra, R, Gallo, P, Capobianco, M, Pesci, I, Ghezzi, A, Pozzilli, C, Lugaresi, A, Bellantonio, P, Amato, M, Grimaldi, L, Trojano, M, Mancardi, G, Bergamaschi, R, Gasperini, C, Rodegher, M, Straffi, L, Ponzio, M, Comi, G, Cavaletti, G, and DIPARTIMENTO DI SCIENZE BIOMEDICHE E NEUROMOTORIE
Subjects: Male, medicine.medical_specialty, Myeloid, mitoxantrone, acute myelocytic leukemia, multiple sclerosis, Population, Statistics, Nonparametric, Follow-Up Studie, Arts and Humanities (miscellaneous), Retrospective Studie, Internal medicine, Multiple Sclerosi, medicine, Humans, multiple sclerosis, leukemia, mitoxantrone, Prospective cohort study, education, Retrospective Studies, Aged, Analgesics, education.field_of_study, Mitoxantrone, Cumulative dose, business.industry, Multiple sclerosis, Incidence (epidemiology), leukemia, Myeloid leukemia, Retrospective cohort study, medicine.disease, Confidence interval, Surgery, Leukemia, Leukemia, Myeloid, Acute, medicine.anatomical_structure, Italy, Cohort, Settore MED/26 - Neurologia, Analgesic, Female, Neurology (clinical), business, Follow-Up Studies, medicine.drug, Human
Abstract: none 25 no Abstract OBJECTIVES: To evaluate the incidence and dose-dependency of mitoxantrone (MTX)-associated acute myelocytic leukemia (AML) in the network of Italian multiple sclerosis (MS) clinics. METHODS: We performed a multicenter retrospective cohort study of patients treated with MTX in MS centers under the Italian national health care system between 1998 and 2008. Demographic, disease, treatment, and follow-up information were collected using hospital records. RESULTS: Data were available for 3,220 patients (63% women) from 40 Italian centers. Follow-up (mean ± SD) was 49 ± 29 months (range 12-140 months). We observed 30 cases of AML (incidence 0.93% [95% confidence interval 0.60%-1.26%]). The mean cumulative dose was higher in patients with AML (78 vs 65 mg/m(2), p = 0.028). The median interval from the start of therapy to AML diagnosis was longer than expected at 33 months (range 13-84 months); 8 patients (27%) developed AML 4 years or more after the first MTX infusion. The rate of mortality associated with AML was 37%. CONCLUSIONS: This higher than expected risk of AML and related mortality requires that treatment decisions must be made jointly between clinicians and patients who understand their prognosis, treatment options, and treatment-related risks. The now large exposed MS population must be monitored for hematologic abnormalities for at least 6 years from the end of therapy, to ensure the rapid actions needed for early diagnosis and treatment of AML. none Martinelli V; Cocco E; Capra R; Salemi G; Gallo P; Capobianco M; Pesci I; Ghezzi A; Pozzilli C; Lugaresi A; Bellantonio P; Amato MP; Grimaldi LM; Trojano M; Mancardi GL; Bergamaschi R; Gasperini C; Rodegher M; Straffi L; Ponzio M; Comi G; For The Italian Mitoxantrone Group; De Luca G; Di Tommaso V; Farina D Martinelli V; Cocco E; Capra R; Salemi G; Gallo P; Capobianco M; Pesci I; Ghezzi A; Pozzilli C; Lugaresi A; Bellantonio P; Amato MP; Grimaldi LM; Trojano M; Mancardi GL; Bergamaschi R; Gasperini C; Rodegher M; Straffi L; Ponzio M; Comi G; For The Italian Mitoxantrone Group; De Luca G; Di Tommaso V; Farina D
Published: 2011

13. Brain atrophy evolution and lesion load accrual in multiple sclerosis: a 2-year follow-up study

Author: Paolo Livrea, V. Bonavita, Bruno Alfano, Marco D'Amelio, V. Brescia Morra, M. Paciello, Mario Quarantelli, Giovanni Savettieri, Giuseppe Salemi, Anna Prinster, Marco Salvatore, Isabella Laura Simone, Marco Comerci, Francesco Patti, Gioacchino Tedeschi, A. Di Costanzo, Aldo Quattrone, G. Coniglio, A. Bellacosa, D. Dinacci, Simona Bonavita, Arturo Brunetti, Giuseppe Orefice, Luigi Lavorgna, Paola Valentino, G. Servillo, Tedeschi, G, Dinacci, D, Comerci, M, Lavorgna, L, Savettieri, G, Quattrone, A, Livrea, P, Patti, F, Morra, VB, Servillo, G, Orefice, G, Paciello, M, Prinster, A, Coniglio, G, Bonavita, S, Di Costanzo, A, Bellacosa, A, Valentino, P, Quarantelli, M, Brunetti, A, Salemi, G, D'Amelio, M, Simone, I, Salvatore, M, Bonavita, V, Alfano, B., Tedeschi, Gioacchino, Morra, V, Bonavita, Simona, DI COSTANZO, A, Tedeschi, G., Dinacci, D., Comerci, M., Lavorgna, L., Savettieri, G., Quattrone, A., Livrea, P., Patti, F., BRESCIA MORRA, Vincenzo, Servillo, Giuseppe, Orefice, Giuseppe, Paciello, M., Prinster, A., Coniglio, G., Bonavita, S., Di Costanzo, A., Bellacosa, A., Valentino, P., Quarantelli, M., Brunetti, Arturo, Salemi, G., D'Amelio, M., Simone, I., Salvatore, Marco, and Bonavita, Vincenzo
Subjects: Adult, Male, Pathology, medicine.medical_specialty, Adolescent, Central nervous system, multiple sclerosis, Severity of Illness Index, Lesion load, White matter, Central nervous system disease, Young Adult, Degenerative disease, Atrophy, Multiple Sclerosis, Relapsing-Remitting, atrophy, Risk Factors, T2 lesions, medicine, follow up, Humans, Aged, medicine.diagnostic_test, business.industry, Multiple sclerosis, Brain Atrophy, Brain, Magnetic resonance imaging, Middle Aged, Multiple Sclerosis, Chronic Progressive, lesion load, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Cross-Sectional Studies, Logistic Models, Neurology, multiple sclerosi, Multivariate Analysis, Disease Progression, Female, Settore MED/26 - Neurologia, Neurology (clinical), business, Follow-Up Studies, MRI
Abstract: Background To investigate in a large cohort of patients with multiple sclerosis (MS), lesion load and atrophy evolution, and the relationship between clinical and magnetic resonance imaging (MRI) correlates of disease progression. Methods Two hundred and sixty-seven patients with MS were studied at baseline and two years later using the same MRI protocol. Abnormal white matter fraction, normal appearing white matter fraction, global white matter fraction, gray matter fraction and whole brain fraction, T2-hyperintense, and T1-hypointense lesions were measured at both time points. Results The majority of patients were clinically stable, whereas MRI-derived brain tissue fractions were significantly different after 2 years. The correlation between MRI data at baseline and their variation during the follow-up showed that lower basal gray matter atrophy was significantly related with higher progression of gray matter atrophy during follow-up. The correlation between MRI parameters and disease duration showed that gray matter atrophy rate decreased with increasing disease duration, whereas the rate of white matter atrophy had a constant pattern. Lower basal gray matter atrophy was associated with increased probability of developing gray matter atrophy at follow-up, whereas gray matter atrophy progression over 2 years and new T2 lesion load were risk factors for whole brain atrophy progression. Conclusions In MS, brain atrophy occurs even after a relatively short period of time and in patients with limited progression of disability. Short-term brain atrophy progression rates differ across tissue compartments, as gray matter atrophy results more pronounced than white matter atrophy and appears to be a early phenomenon in the MS-related disease progression.
Published: 2009

14. How many parkinsonian patients are suitable candidates for deep brain stimulation of subthalamic nucleus? Results of a questionnaire

Author: Maria Gabriella Ceravolo, Giovanni Savettieri, L. Capus, Angelo Antonini, Elena Moro, Marco D'Amelio, Paolo Barone, Letterio Morgante, Paolo Ragonese, Paolo Girlanda, Francesca Morgante, Ubaldo Bonuccelli, Maria Fiorella Contarino, A. Epifanio, Roberto Marconi, Roberto Ceravolo, MORGANTE L, MORGANTE F, MORO E, EPIFANIO A, GIRLANDA P, RAGONESE P, ANTONINI A, BARONE P, BONUCCELLI U, CONTARINO MF, CAPUS L, CERAVOLO MG, MARCONI R, CERAVOLO R, D'AMELIO M, SAVETTIERI G, Morgante, L, Morgante, F, Moro, E, Epifanio, A, Girlanda, P, Ragonese, P, Antonini, A, Barone, Paolo, Bonuccelli, U, Contarino, Mf, Capus, L, Ceravolo, Mg, Marconi, R, Ceravolo, R, D'Amelio, M, Savettieri, G., and Neurology
Subjects: Adult, Male, medicine.medical_specialty, Parkinson's disease, Movement disorders, Neurology, Deep brain stimulation, Deep Brain Stimulation, medicine.medical_treatment, Parkinson Desease, Deep Brain Stimulation, Audiology, behavioral disciplines and activities, Disease severity, Parkinsonian Disorders, Subthalamic Nucleus, Surveys and Questionnaires, medicine, Humans, Aged, Chi-Square Distribution, business.industry, Patient Selection, Middle Aged, medicine.disease, nervous system diseases, Subthalamic nucleus, surgical procedures, operative, nervous system, CAPSIT, Questionnaire, STN DBS, Female, Aging, Neurology (clinical), Physical therapy, Settore MED/26 - Neurologia, medicine.symptom, Geriatrics and Gerontology, Psychology, business, therapeutics, Neuroscience
Abstract: We used a CAPSIT-based questionnaire to estimate the percentage of parkinsonian patients suitable for subthalamic nucleus (STN) deep brain stimulation (DBS) in a movement disorders clinic. We found that out of 641 consecutive PD patients only 1.6% fulfilled strict STN-DBS criteria. When we applied more flexible criteria, the percentage of eligibility increased to 4.5%. Most patients (60%) were ineligible because they did not satisfy multiple questionnaire items. Items related to disease severity were responsible for the largest number of exclusions. This knowledge will help make decisions on resource allocation in centres wishing to start DBS surgery.
Published: 2007

15. Correlation between fatigue and brain atrophy and lesion load in multiple sclerosis patients independent of disability

Author: Vincenzo Bresciamorra, Gioacchino Tedeschi, Corrado Messina, P. Livrea, Giuseppe Orefice, Giuseppe Salemi, A. Quattrone, S. Bonavita, Bruno Alfano, Anna Prinster, Vincenzo Bonavita, Enrico Cammarata, Paola Valentino, G. Servillo, M. Paciello, Mario Quarantelli, Arturo Reggio, Marco Salvatore, Giovanni Savettieri, Andrea Paolillo, Arturo Brunetti, Alfonso Di Costanzo, Luigi Lavorgna, Isabella Laura Simone, G. Coniglio, A. Bellacosa, D. Dinacci, Francesco Patti, TEDESCHI G, DINACCI D, LAVORGNA L, PRINSTER A, SAVETTIERI G, QUATTRONE A, LIVREA P, MESSINA C, REGGIO A, SERVILLO G, BRESCIAMORRA V, OREFICE G, PACIELLO M, BRUNETTI A, PAOLILLO A, CONIGLIO G, BONAVITA S, DI COSTANZO A, BELLACOSA A, VALENTINO P, QUARANTELLI M, PATTI F, SALEMI G, CAMMARATA E, SIMONE I, SALVATORE M, BONAVITA V, ALFANO B, Tedeschi, Gioacchino, Dinacci, D., Lavorgna, L., Prinster, A., Savettieri, G., Quattrone, A., Livrea, P., Messina, C., Reggio, A., Servillo, G., Bresciamorra, V., Orefice, G., Paciello, M., Brunetti, A., Paolillo, A., Coniglio, G., Bonavita, Simona, DI COSTANZO, A., Bellacosa, A., Valentino, P., Quarantelli, M., Patti, F., Salemi, G., Cammarata, E., Simone, I., Salvatore, M., Bonavita, V., Alfano, B., Tedeschi, G, Dinacci, D, Lavorgna, L, Prinster, A, Savettieri, G, Quattrone, A, Livrea, P, Messina, C, Reggio, A, Servillo, Giuseppe, BRESCIA MORRA, Vincenzo, Orefice, Giuseppe, Paciello, M, Brunetti, Arturo, Paolillo, A, Coniglio, G, Bonavita, S, Di Costanzo, A, Bellacosa, A, Valentino, P, Quarantelli, M, Patti, F, Salemi, G, Cammarata, E, Simone, I, Salvatore, Marco, and Bonavita, Vincenzo
Subjects: Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Statistics as Topic, Grey matter, Lesion, White matter, Central nervous system disease, Disability Evaluation, Atrophy, Internal medicine, medicine, Image Processing, Computer-Assisted, Humans, Risk factor, Fatigue, Analysis of Variance, Brain Mapping, business.industry, Multiple sclerosis, Brain, medicine.disease, Magnetic Resonance Imaging, Surgery, Oxygen, Multiple Sclerosis, fatigue, medicine.anatomical_structure, Neurology, multiple sclerosi, Female, Neurology (clinical), Analysis of variance, medicine.symptom, business, brain atrophy, MRI
Abstract: Background Fatigue is a major problem in multiple sclerosis (MS), and its association with MRI features is debated. Objective To study the correlation between fatigue and lesion load, white matter (WM), and grey matter (GM), in MS patients independent of disability. Methods We studied 222 relapsing remitting MS patients with low disability (scores ≤ 2 at the Kurtzke Expanded Disability Status Scale). Lesion load, WM and GM were measured by fully automated, operator-independent, multi-parametric segmentation method. T1 and T2 lesion volume were also measured by a semi-automated method. Fatigue was assessed by the Fatigue Severity Scale (FSS), and patients divided in high-fatigue (FSS ≥ 5; n = 197) and low-fatigue groups (FSS ≤ 4; n = 25). Results High-fatigue patients showed significantly higher abnormal white matter fraction (AWM-f), T1 and T2 lesion loads, and significant lower WM-f, and GM-f. Multivariate analysis showed that high FSS was significantly associated with lower WM-f, and GM-f. Females and highly educated patients were significantly less fatigued. Conclusion These results suggest that among MS patients with low disability those with high-fatigue show higher WM and GM atrophy and higher lesion load, and that female sex and higher levels of education may play a protective role towards fatigue. Furthermore, they suggest that in MS, independent of disability, WM and GM atrophy is a risk factor to have fatigue.
Published: 2007

16. Brain atrophy and lesion load in a large population of patients with multiple sclerosis

Author: Pierluigi Russo, Anna Prinster, Arturo Reggio, A. Quattrone, Vincenzo Bresciamorra, Arturo Brunetti, Paola Valentino, Giuseppe Salemi, A. Di Costanzo, Luigi Lavorgna, Isabella Laura Simone, M. Paciello, Giuseppe Orefice, Corrado Messina, Francesco Patti, V. Bonavita, E. Cammarata, Mario Quarantelli, G. Coniglio, Bruno Alfano, P. Livrea, A. Bellacosa, D. Dinacci, Giovanni Savettieri, Gioacchino Tedeschi, Marco Salvatore, S. Bonavita, TEDESCHI G, LAVORGNA L, RUSSO P, PRINSTER A, DINACCI D, SAVETTIERI G, QUATTRONE A, LIVREA P, MESSINA C, REGGIO A, BRESCIAMORRA V, OREFICE G, PACIELLO M, BRUNETTI A, CONIGLIO G, BONAVITA S, DI COSTANZO A, BELLACOSA A, VALENTINO P, QUARANTELLI M, PATTI F, SALEMI G, CAMMARATA E, SIMONE IL, SALVATORE M, BONAVITA V, ALFANO B, Tedeschi, Gioacchino, Lavorgna, L., Russo, P., Prinster, A., Dinacci, D., Savettieri, G., Quattrone, A., Livrea, P., Messina, C., Reggio, A., Bresciamorra, V., Orefice, G., Paciello, M., Brunetti, A., Coniglio, G., Bonavita, Simona, DI COSTANZO, A., Bellacosa, A., Valentino, P., Quarantelli, M., Patti, F., Salemi, G., Cammarata, E., Simone, I., Salvatore, M., Bonavita, V., Alfano, B., Tedeschi, G, Lavorgna, L, Russo, P, Prinster, A, Dinacci, D, Savettieri, G, Quattrone, A, Livrea, P, Messina, C, Reggio, A, BRESCIA MORRA, Vincenzo, Orefice, Giuseppe, Paciello, M, Brunetti, Arturo, Coniglio, G, Bonavita, S, DI COSTANZO, A, Bellacosa, A, Valentino, P, Quarantelli, M, Patti, F, Salemi, G, Cammarata, E, Simone, Il, Salvatore, Marco, and Bonavita, Vincenzo
Subjects: Adult, Male, Pathology, medicine.medical_specialty, Adolescent, Brain mapping, Nerve Fibers, Myelinated, Central nervous system disease, White matter, Multiple sclerosis, Atrophy, Sex Factors, Predictive Value of Tests, Neural Pathways, medicine, Humans, Age of Onset, Multiple Sclerosis/physiopathology, Aged, Cross-Sectional Studie, Brain Mapping, Expanded Disability Status Scale, medicine.diagnostic_test, Brain/physiopathology, business.industry, Brain, Magnetic resonance imaging, Interferon-beta, Middle Aged, medicine.disease, Prognosis, lesion load, Magnetic Resonance Imaging, Multiple Sclerosis/diagnosi, medicine.anatomical_structure, Cross-Sectional Studies, multiple sclerosi, Linear Models, Disease Progression, Educational Status, Female, Neurology (clinical), Age of onset, business, Multiple Sclerosis/complication, brain atrophy, MRI
Abstract: Objective: To measure white matter (WM) and gray matter (GM) atrophy and lesion load in a large population of patients with multiple sclerosis (MS) using a fully automated, operator-independent, multiparametric segmentation method. Methods: The study population consisted of 597 patients with MS and 104 control subjects. The MRI parameters were abnormal WM fraction (AWM-f), global WM-f (gWM-f), and GM fraction (GM-f). Results: Significant differences between patients with MS and control subjects included higher AWM-f and reduced gWM-f and GM-f. MRI data showed significant differences between patients with relapsing-remitting and secondary progressive forms of MS. Significant correlations between MRI parameters and between MRI and clinical data were found. Conclusions: Patients with multiple sclerosis have significant atrophy of both white matter (WM) and gray matter (GM); secondary progressive patients have significantly more atrophy of both WM and GM than do relapsing-remitting patients and a significantly higher lesion load (abnormal WM fraction); lesion load is related to both WM and even more to GM atrophy; lesion load and WM and GM atrophy are significantly related to Expanded Disability Status Scale score and age at onset (suggesting that the younger the age at disease onset, the worse the lesion load and brain atrophy); and GM atrophy is the most significant MRI variable in determining the final disability.
Published: 2005

17. Gender-related effect of clinical and genetic variables on the cognitive impairment in multiple sclerosis

Author: Rita Cittadella, Aldo Quattrone, Demetrio Messina, Alessandra Lugaresi, Giuseppe Salemi, Francesco Le Pira, Paolo Girlanda, Arturo Reggio, Giovanni Savettieri, Gioacchino Tedeschi, Carlo Caltagirone, S. Bonavita, D. Farina, Virginia Andreoli, Paola Valentino, Maria Trojano, Maria Liguori, Maria Fazio, Ugo Nocentini, SAVETTIERI G, MESSINA D, ANDREOLI V, BONAVITA S, CALTAGIRONE C, CITTADELLA R, FARINA D, FAZIO MC, GIRLANDA P, LE PIRA F, LIGUORI M, LUGARESI A, NOCENTINI U, REGGIO A, SALEMI G, TEDESCHI G, TROJANO M, VALENTINO P, QUATTRONE A, Savettieri, G, Messina, D, Andreoli, V, Bonavita, Simona, Caltagirone, C, Cittadella, R, Farina, D, Fazio, Mc, Girlanda, P, LE PIRA, F, Liguori, M, Lugaresi, A, Nocentini, U, Reggio, A, Salemi, G, Tedeschi, Gioacchino, Trojano, M, Valentino, P, Quattrone, A., G. SAVETTIERI, D. MESSINA, V. ANDREOLI, S. BONAVITA, C. CALTAGIRONE, R CITTADELLA, D. FARINA, MC FAZIO, P. GIRLANDA, F. LE PIRA, M. LIGUORI, A. LUGARESI, U. NOCENTINI, A. REGGIO, G. SALEMI, G. TEDESCHI, M. TROJANO, P. VALENTINO, and A. QUATTRONE
Subjects: Apolipoprotein E, Adult, Male, medicine.medical_specialty, Pediatrics, Neurology, Multiple Sclerosis, Messenger, Late onset, Disease, Neuropsychological Tests, Apolipoproteins E, medicine, Odds Ratio, Humans, RNA, Messenger, Cognitive decline, Allele, Psychiatry, cognitive impairment, APOE, Cognitive impairment, Multiple sclerosis, Analysis of Variance, Sex Characteristics, Chi-Square Distribution, Reverse Transcriptase Polymerase Chain Reaction, Cognitive disorder, Genetic Variation, Middle Aged, medicine.disease, multiple sclerosis, cognitive impairment, gender, genetic, Cognition Disorders, Female, RNA, Settore MED/26 - Neurologia, Neurology (clinical), Psychology, multiple sclerosis · cognitive impairment · APOE
Abstract: BACKGROUND: Cognitive impairment may occur at any time during the course of multiple sclerosis (MS), and it is often a major cause of disability in patients with the disease. The APOE-epsilon4 allele is the major known genetic risk factor for late onset familial and sporadic Alzheimer's Disease (AD), and it seems to be implicated in cognitive decline in normal elderly persons. OBJECTIVE: To investigate the clinical and genetic variables that can be associated with the cognitive decline in patients with MS. METHODS: Five-hundred and three patients with clinically definite MS underwent a battery of neuropsychological tests and, according to the number of failed tests, were divided into cognitively normal and impaired. All patients were genotyped for APOE gene polymorphisms. RESULTS: Fifty-six percent of MS patients showed, to different extents, cognitive impairment. Cognitive decline was predominant in men and was associated with disease duration, Kurtzke Expanded Disability Status Scale (EDSS) score, a low level of education, and, interestingly, the epsilon4 allele of the APOE gene. By contrast, cognitive impairment in women was independent of any investigated variable. CONCLUSION: The findings demonstrate that clinical and genetic factors play a role in men affected by MS developing cognitive impairment.
Published: 2004

18. Apolipoprotein E genotype does not influence the progression of multiple sclerosis

Author: Giovanni Savettieri, Rita Cittadella, Arturo Reggio, Francesco Le Pira, Virginia Andreoli, S. Bonavita, Carlo Caltagirone, Maria Liguori, Alessandra Lugaresi, Lucia Toma, Paolo Serra, Giuseppe Salemi, Maria Trojano, Maria Fazio, Aldo Quattrone, Gioacchino Tedeschi, Paola Valentino, Paolo Girlanda, Ugo Nocentini, Giancarlo Logroscino, Savettieri, G., Andreoli, V., Bonavita, S., Cittadella, R., Caltagirone, C., Fazio, M., Girlanda, P., Le Pira, F., Liguori, M., Logroscino, G., Lugaresi, A., Nocentini, U., Reggio, A., Salemi, G., Serra, P., Tedeschi, G., Toma, L., Trojano, M., Valentino, P., Quattrone, A., Savettieri, G, Andreoli, V, Bonavita, Simona, Cittadella, R, Caltagirone, C, Fazio, Mc, Girlanda, P, LE PIRA, F, Liguori, M, Logroscino, G, Lugaresi, A, Nocentini, U, Reggio, A, Salemi, G, Serra, P, Tedeschi, Gioacchino, Toma, L, Trojano, M, and Valentino, P
Subjects: Oncology, Apolipoprotein E, Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Genotype, Adolescent, Odds Ratio, Polymorphism, Genetic, Chi-Square Distribution, Humans, Disease Progression, Apolipoproteins E, Confidence Intervals, Statistics, Nonparametric, Female, Population, APOE polymorphism, Biology, Genetic, Polymorphism (computer science), Internal medicine, Multiple Sclerosi, medicine, Nonparametric, Polymorphism, education, Genotyping, APOE promoter, education.field_of_study, Expanded Disability Status Scale, MS progression, Statistics, Odds ratio, Neurology, Immunology, Population study, lipids (amino acids, peptides, and proteins), Settore MED/26 - Neurologia, Neurology (clinical), Confidence Interval, Human
Abstract: OBJECTIVE: To investigate the association between apolipoprotein E (APOE) polymorphisms and the progression of MS. METHODS: We investigated 428 subjects affected by clinically defined MS, with a disease duration of at least three years. We collected data concerning the age at onset of MS, clinical type, disease duration and disability according to the expanded disability status scale (EDSS). We also calculated the progression index (PI) to evaluate disease progression. APOE genotyping and the -491 A/T polymorphism of the APOE promoter were determined. RESULTS: No association was observed between the APOE epsilon4 allele and clinical characteristics of our study population. We also investigated the -491 A/T APOE promoter polymorphism in 236 MS subjects and did not find any association between the -491 A/T polymorphism and the selected clinical variables. CONCLUSIONS: In our population the APOE epsilon4 allele and the -491 A/T APOE promoter polymorphism are not associated with a more rapid course of MS.
Published: 2003

19. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Author: Alison Halliday, Richard Bulbulia, Leo H Bonati, Johanna Chester, Andrea Cradduck-Bamford, Richard Peto, Hongchao Pan, John Potter, Hans Henning Eckstein, Barbara Farrell, Marcus Flather, Averil Mansfield, Boby Mihaylova, Kazim Rahimi, David Simpson, Dafydd Thomas, Peter Sandercock, Richard Gray, Andrew Molyneux, Cliff P Shearman, Peter Rothwell, Anna Belli, Will Herrington, Parminder Judge, Peter Leopold, Marion Mafham, Michael Gough, Piergiorgio Cao, Sumaira MacDonald, Vasha Bari, Clive Berry, S Bradshaw, Wojciech Brudlo, Alison Clarke, Robin Cox, Susan Fathers, Kamran Gaba, Mo Gray, Elizabeth Hayter, Constance Holliday, Rijo Kurien, Michael Lay, Steffi le Conte, Jessica McManus, Zahra Madgwick, Dylan Morris, Andrew Munday, Sandra Pickworth, Wiktor Ostasz, Michiel Poorthuis, Sue Richards, Louisa Teixeira, Sergey Tochlin, Lynda Tully, Carol Wallis, Monique Willet, Alan Young, Renato Casana, Chiara Malloggi, Andrea Odero Jr, Vincenzo Silani, Gianfranco Parati, Giuseppe Malchiodi, Giovanni Malferrari, Francesco Strozzi, Nicola Tusini, Enrico Vecchiati, Gioacchino Coppi, Antonio Lauricella, Roberto Moratto, Roberto Silingardi, Jessica Veronesi, Andrea Zini, Emanuele Ferrero, Michelangelo Ferri, Andrea Gaggiano, Carmelo Labate, Franco Nessi, Daniele Psacharopulo, Andrea Viazzo, Giovanni Malacrida, Daniela Mazzaccaro, Giovanni Meola, Alfredo Modafferi, Giovanni Nano, Maria Teresa Occhiuto, Paolo Righini, Silvia Stegher, Stefano Chiarandini, Filippo Griselli, Sandro Lepidi, Fabio Pozzi Mucelli, Marcello Naccarato, Mario D'Oria, Barbara Ziani, Andrea Stella, Mortalla Dieng, Gianluca Faggioli, Mauro Gargiulo, Sergio Palermo, Rodolfo Pini, Giovanni Maria Puddu, Andrea Vacirca, Domenico Angiletta, Claudio Desantis, Davide Marinazzo, Giovanni Mastrangelo, Guido Regina, Raffaele Pulli, Paolo Bianchi, Lea Cireni, Elisabetta Coppi, Rocco Pizzirusso, Filippo Scalise, Giovanni Sorropago, Valerio Tolva, Valeria Caso, Enrico Cieri, Paola DeRango, Luca Farchioni, Giacomo Isernia, Massimo Lenti, Gian Battista Parlani, Guglielmo Pupo, Grazia Pula, Gioele Simonte, Fabio Verzini, Federico Carimati, Maria Luisa Delodovici, Federico Fontana, Gabriele Piffaretti, Matteo Tozzi, Efrem Civilini, Giorgio Poletto, Bernhard Reimers, Barbara Praquin, Sonia Ronchey, Laura Capoccia, Wassim Mansour, Enrico Sbarigia, Francesco Speziale, Pasqualino Sirignano, Danilo Toni, Roberto Galeotti, Vincenzo Gasbarro, Francesco Mascoli, Tiberio Rocca, Elpiniki Tsolaki, Giulia Bernardini, Ester DeMarco, Alessia Giaquinta, Francesco Patti, Massimiliano Veroux, Pierfrancesco Veroux, Carla Virgilio, Nicola Mangialardi, Matteo Orrico, Vincenzo Di Lazzaro, Nunzio Montelione, Francesco Spinelli, Francesco Stilo, Carlo Cernetti, Sandro Irsara, Giuseppe Maccarrone, Diego Tonello, Adriana Visonà, Beniamino Zalunardo, Emiliano Chisci, Stefano Michelagnoli, Nicola Troisi, Maela Masato, Massimo Dei Negri, Andrea Pacchioni, Salvatore Saccà, Giovanni Amatucci, Alfredo Cannizzaro, Federico Accrocca, Cesare Ambrogi, Renzo Barbazza, Giustino Marcucci, Andrea Siani, Guido Bajardi, Giovanni Savettieri, Angelo Argentieri, Riccardo Corbetta, Attilio Odero, Pietro Quaretti, Federico Z Thyrion, Alessandro Cappelli, Domenico Benevento, Gianmarco De Donato, Maria Agnese Mele, Giancarlo Palasciano, Daniela Pieragalli, Alessandro Rossi, Carlo Setacci, Francesco Setacci, Domenico Palombo, Maria Cecilia Perfumo, Edoardo Martelli, Aldo Paolucci, Santi Trimarchi, Viviana Grassi, Luigi Grimaldi, Giuliana La Rosa, Domenico Mirabella, Matteo Scialabba, Leonildo Sichel, Costantino L D'Angelo, Gian Franco Fadda, Holta Kasemi, Mario Marino, Francesco Burzotta, Francesco Alberto Codispoti, Angela Ferrante, Giovanni Tinelli, Yamume Tshomba, Claudio Vincenzoni, Deborah Amis, Dawn Anderson, Martin Catterson, Mike Clarke, Michelle Davis, Anand Dixit, Alexander Dyker, Gary Ford, Ralph Jackson, Sreevalsan Kappadath, David Lambert, Tim Lees, Stephen Louw, James McCaslin, Noala Parr, Rebecca Robson, Gerard Stansby, Lucy Wales, Vera Wealleans, Lesley Wilson, Michael Wyatt, Hardeep Baht, Ibrahim Balogun, Ilse Burger, Tracy Cosier, Linda Cowie, Gunaratnam Gunathilagan, David Hargroves, Robert Insall, Sally Jones, Hannah Rudenko, Natasha Schumacher, Jawaharlal Senaratne, George Thomas, Audrey Thomson, Tom Webb, Ellen Brown, Bernard Esisi, Ali Mehrzad, Shane MacSweeney, Norman McConachie, Alison Southam, Wayne Sunman, Ahmed Abdul-Hamiq, Jenny Bryce, Ian Chetter, Duncan Ettles, Raghuram Lakshminarayan, Kim Mitchelson, Christopher Rhymes, Graham Robinson, Paul Scott, Alison Vickers, Ray Ashleigh, Stephen Butterfield, Ed Gamble, Jonathan Ghosh, Charles N McCollum, Mark Welch, Sarah Welsh, Leszek Wolowczyk, Mary Donnelly, Stephen D'Souza, Anselm A Egun, Bindu Gregary, Thomas Joseph, Christine Kelly, Shuja Punekar, M Asad Rahi, Sonia Raj, Dare Seriki, George Thomson, James Brown, Ragunath Durairajan, Iris Grunwald, Paul Guyler, Paula Harman, Matthew Jakeways, Christopher Khuoge, Ashish Kundu, Thayalini Loganathan, Nisha Menon, Raji O Prabakaran, Devesh Sinha, Vicky Thompson, Sharon Tysoe, Dennis Briley, Chris Darby, Linda Hands, Dominic Howard, Wilhelm Kuker, Ursula Schulz, Rachel Teal, David Barer, Andrew Brown, Susan Crawford, Paul Dunlop, Ramesh Krishnamurthy, Nikhil Majmudar, Duncan Mitchell, Min P Myint, Richard O'Brien, Janice O'Connell, Naweed Sattar, Shanmugam Vetrivel, Jonathan Beard, Trevor Cleveland, Peter Gaines, John Humphreys, Alison Jenkins, Craig King, Daniel Kusuma, Ralph Lindert, Robbie Lonsdale, Raj Nair, Shah Nawaz, Faith Okhuoya, Douglas Turner, Graham Venables, Paul Dorman, Andrea Hughes, Deborah Jones, David Mendelow, Helen Rodgers, Aidas Raudoniitis, Peter Enevoldson, Hans Nahser, Imelda O'Brien, Francesco Torella, Dave Watling, Richard White, Pauline Brown, Dipankar Dutta, Lorraine Emerson, Paula Hilltout, Sachin Kulkarni, Jackie Morrison, Keith Poskitt, Fiona Slim, Sarah Smith, Amanda Tyler, Joanne Waldron, Mark Whyman, Milda Bajoriene, Lucy Baker, Amanda Colston, Bekky Eliot-Jones, Gita Gramizadeh, Catherine Lewis-Clarke, Laura McCafferty, Deborah Oliver, Debbie Palmer, Abhijeet Patil, Suzannah Pegler, Gopi Ramadurai, Aisling Roberts, Tracey Sargent, Shivaprasad Siddegowda, Ravi Singh-Ranger, Akintunde Williams, Lucy Williams, Steve Windebank, Tadas Zuromskis, Lanka Alwis, Jane Angus, Asaipillai Asokanathan, Caroline Fornolles, Diana Hardy, Sophy Hunte, Frances Justin, Duke Phiri, Marie Mitabouana-Kibou, Lakshmanan Sekaran, Sakthivel Sethuraman, Margaret L Tate, Joyce Akyea-Mensah, Stephen Ball, Angela Chrisopoulou, Elizabeth Keene, Alison Phair, Steven Rogers, John V Smyth, Colin Bicknell, Jeremy Chataway, Nicholas Cheshire, Andrew Clifton, Caroline Eley, Richard Gibbs, Mohammad Hamady, Beth Hazel, Alex James, Michael Jenkins, Nyma Khanom, Austin Lacey, Maz Mireskandari, Joanna O'Reilly, Antony Pereira, Tina Sachs, John Wolfe, Philip Davey, Gill Rogers, Gemma Smith, Gareth Tervit, Ian Nichol, Andrew Parry, Gavin Young, Simon Ashley, James Barwell, Francis Dix, Azlisham M Nor, Chris Parry, Angela Birt, Paul Davies, Jim George, Anne Graham, Leon Jonker, Nicci Kelsall, Caroline Potts, Toni Wilson, Jamie Crinnion, Larissa Cuenoud, Nikola Aleksic, Srdan Babic, Nenad Ilijevski, Đorde Radak, Dragan Sagic, Slobodan Tanaskovic, Momcilo Colic, Vladimir Cvetic, Lazar Davidovic, Dejana R Jovanovic, Igor Koncar, Perica Mutavdžic, Miloš Sladojevic, Ivan Tomic, Eike S Debus, Ulrich Grzyska, Dagmar Otto, Götz Thomalla, Jessica Barlinn, Johannes Gerber, Kathrin Haase, Christian Hartmann, Stefan Ludwig, Volker Pütz, Christian Reeps, Christine Schmidt, Norbert Weiss, Sebastian Werth, Simon Winzer, Janine Gemper, Albrecht Günther, Bianka Heiling, Elisabeth Jochmann, Panagiota Karvouniari, Carsten Klingner, Thomas Mayer, Julia Schubert, Friederike Schulze-Hartung, Jürgen Zanow, Yvonne Bausback, Franka Borger, Spiridon Botsios, Daniela Branzan, Sven Bräunlich, Henryk Hölzer, Janin Lenzer, Christopher Piorkowski, Nadine Richter, Johannes Schuster, Dierk Scheinert, Andrej Schmidt, Holger Staab, Matthias Ulrich, Martin Werner, Hermann Berger, Gábor Biró, Hans-Henning Eckstein, Michael Kallmayer, Kornelia Kreiser, Alexander Zimmermann, Bärbel Berekoven, Klaus Frerker, Vera Gordon, Giovanni Torsello, Sebastian Arnold, Cora Dienel, Martin Storck, Bernhard Biermaier, Hans Martin Gissler, Christof Klötzsch, Tomas Pfeiffer, Ralph Schneider, Leander Söhl, Michael Wennrich, Angelika Alonso, Michael Keese, Christoph Groden, Andreas Cöster, Andreas Engelhardt, Christoph-Maria Ratusinski, Bengt Berg, Martin Delle, Johan Formgren, Peter Gillgren, Lotta Jarl, Torbjörn B Kall, Peter Konrad, Niklas Nyman, Claes Skiöldebrand, Johnny Steuer, Rabbe Takolander, Jonas Malmstedt, Stefan Acosta, Katarina Björses, Kerstin Brandt, Nuno Dias, Anders Gottsäter, Jan Holst, Thorarinn Kristmundsson, Tobias Kühme, Tilo Kölbel, Bengt Lindblad, Mats Lindh, Martin Malina, Tomas Ohrlander, Tim Resch, Viola Rönnle, Björn Sonesson, Margareta Warvsten, Zbigniew Zdanowski, Erik Campbell, Per Kjellin, Hans Lindgren, Johan Nyberg, Björn Petersen, Gunnar Plate, Håkan Pärsson, Peter Qvarfordt, Pavel Ignatenko, Andrey Karpenko, Vladimir Starodubtsev, Mikhail A Chernyavsky, Maria S Golovkova, Boris B Komakha, Nikolay N Zherdev, Andrey Belyasnik, Pavel Chechulov, Dmitry Kandyba, Igor Stepanishchev, Csaba Csobay-Novák, Edit Dósa, László Entz, Balázs Nemes, Zoltán Szeberin, Pál Barzó, Mihaly Bodosi, Eniko Fákó, Béla Fülöp, Tamás Németh, Szilárd Pazdernyik, Krisztina Skoba, Erika Vörös, Eleni Chatzinikou, Athanasios Giannoukas, Christos Karathanos, Stylianos Koutsias, Georgios Kouvelos, Miltiadis Matsagkas, Styliani Ralli, Christos Rountas, Nikolaos Rousas, Konstantinos Spanos, Elias Brountzos, John D Kakisis, Andreas Lazaris, Konstantinos G Moulakakis, Leonidas Stefanis, Georgios Tsivgoulis, Spyros Vasdekis, Constantine N Antonopoulos, Ion Bellenis, Dimitrios Maras, Antonios Polydorou, Victoria Polydorou, Antonios Tavernarakis, Nikolaos Ioannou, Maria Terzoudi, Miltos Lazarides, Michalis Mantatzis, Kostas Vadikolias, Lukasz Dzieciuchowicz, Marcin Gabriel, Zbigniew Krasinski, Grzegorz Oszkinis, Fryderyk Pukacki, Maciej Slowinski, Michal-Goran Stanišic, Ryszard Staniszewski, Jolanta Tomczak, Maciej Zielinski, Piotr Myrcha, Dorota Rózanski, Stanislaw Drelichowski, Wojciech Iwanowski, Katarzyna Koncewicz, Pawel Bialek, Zbigniew Biejat, Wojciech Czepel, Anna Czlonkowska, Anatol Dowzenko, Julia Jedrzejewska, Adam Kobayashi, Jerzy Leszczynski, Andrzej Malek, Jerzy Polanski, Robert Proczka, Maciej Skorski, Mieczyslaw Szostek, Piotr Andziak, Maciej Dratwicki, Robert Gil, Miroslaw Nowicki, Jaroslaw Pniewski, Jaroslaw Rzezak, Piotr Seweryniak, Pawel Dabek, Michal Juszynski, Grzegorz Madycki, Bartosz Pacewski, Witold Raciborski, Piotr Slowinski, Walerian Staszkiewicz, Martin Bombic, Vladimír Chlouba, Jirí Fiedler, Karel Hes, Petr Koštál, Jindrich Sova, Zdenek Kríž, Mojmír Prívara, Michal Reif, Robert Staffa, Robert Vlachovský, Bohuslav Vojtíšek, Tomáš Hrbác, Martin Kuliha, Václav Procházka, Martin Roubec, David Školoudík, David Netuka, Anna Šteklácová, Vladimír Beneš III, Pavel Buchvald, Ladislav Endrych, Miroslav Šercl, Walter Campos Jr, Ivan B Casella, Nelson de Luccia, André E V Estenssoro, Calógero Presti, Pedro Puech-Leão, Celso R B Neves, Erasmo S da Silva, Cid J Sitrângulo Jr, José A T Monteiro, Gisela Tinone, Marcelo Bellini Dalio, Edwaldo E Joviliano, Octávio M Pontes Neto, Mauricio Serra Ribeiro, Patrick Cras, Jeroen M H Hendriks, Mieke Hoppenbrouwers, Patrick Lauwers, Caroline Loos, Laetitia Yperzeele, Mia Geenens, Dimitri Hemelsoet, Isabelle van Herzeele, Frank Vermassen, Parla Astarci, Frank Hammer, Valérie Lacroix, André Peeters, Robert Verhelst, Silvana Cirelli, Pol Dormal, Annelies Grimonprez, Bart Lambrecht, Philipe Lerut, Eddy Thues, Guy De Koster, Quentin Desiron, Alain Maertens de Noordhout, Danielle Malmendier, Mireille Massoz, Georges Saad, Marc Bosiers, Joren Callaert, Koen Deloose, Estrella Blanco Cañibano, Beatriz García Fresnillo, Mercedes Guerra Requena, Pilar C Morata Barrado, Miguel Muela Méndez, Antonio Yusta Izquierdo, Fernando Aparici Robles, Paula Blanes Orti, Luis García Dominguez, Rafael Martínez López, Manuel Miralles Hernández, José I Tembl Ferrairo, Ángel Chamorro, Juan Macho, Víctor Obach, Vincent Riambau, Luis San Román, Frank J Ahlhelm, Kristine Blackham, Stefan Engelter, Thomas Eugster, Henrik Gensicke, Lorenz Gürke, Philippe Lyrer, Luigi Mariani, Marina Maurer, Edin Mujagic, Mandy Müller, Marios Psychogios, Peter Stierli, Christoph Stippich, Christopher Traenka, Thomas Wolff, Benjamin Wagner, Martina M Wiegert, Sandra Clarke, Michael Diepers, Ernst Gröchenig, Philipp Gruber, Andrej Isaak, Timo Kahles, Regula Marti, Krassen Nedeltchev, Luca Remonda, Nadir Tissira, Martina Valença Falcão, Gert J de Borst, Rob H Lo, Frans L Moll, Raechel Toorop, Bart H van der Worp, Evert J Vonken, Jaap L Kappelle, Ommid Jahrome, Floris Vos, Wouter Schuiling, Hendrik van Overhagen, Rudolf W M Keunen, Bob Knippenberg, Jan J Wever, Jan W Lardenoije, Michel Reijnen, Luuk Smeets, Steven van Sterkenburg, Gustav Fraedrich, Elke Gizewski, Ingrid Gruber, Michael Knoflach, Stefan Kiechl, Barbara Rantner, Timur Abdulamit, Patrice Bergeron, Raymond Padovani, Jean-Christophe Trastour, Jean-Marie Cardon, Anne Le Gallou-Wittenberg, Eric Allaire, Jean-Pierre Becquemin, Frédéric Cochennec-Paliwoda, Pascal Desgranges, Hassan Hosseini, Hicham Kobeiter, Jean Marzelle, Mohammed A Almekhlafi, Simerpreet Bal, Phillip A Barber, Shelagh B Coutts, Andrew M Demchuk, Muneer Eesa, Michelle Gillies, Mayank Goyal, Michael D Hill, Mark E Hudon, Anitha Jambula, Carol Kenney, Gary Klein, Marie McClelland, Alim Mitha, Bijoy K Menon, William F Morrish, Steven Peters, Karla J Ryckborst, Greg Samis, Supriya Save, Eric E Smith, Peter Stys, Suresh Subramaniam, Garnette R Sutherland, Tim Watson, John H Wong, L Zimmel, Vojko Flis, Jože Matela, Kazimir Miksic, Franko Milotic, Božidar Mrdja, Barbara Stirn, Erih Tetickovic, Mladen Gasparini, Anton Grad, Ingrid Kompara, Zoren Miloševic, Veronika Palmiste, Toomas Toomsoo, Balzhan Aidashova, Nursultan Kospanov, Roman Lyssenko, Daulet Mussagaliev, Rafi Beyar, Aaron Hoffman, Tony Karram, Arthur Kerner, Eugenia Nikolsky, Samy Nitecki, Silva Andonova, Chavdar Bachvarov, Vesko Petrov, Ivan Cvjetko, Vinko Vidjak, Damir Halužan, Mladen Petrunic, Bao Liu, Chang-Wei Liu, Daniel Bartko, Peter Beno, František Rusnák, Kamil Zelenák, Masayuki Ezura, Takashi Inoue, Naoto Kimura, Ryushi Kondo, Yasushi Matsumoto, Hiroaki Shimizu, Hidenori Endo, Eisuke Furui, Søren Bakke, Kristen Krohg-Sørensen, Terje Nome, Mona Skjelland, Bjørn Tennøe, João Albuquerque e Castro, Gonçalo Alves, Frederico Bastos Gonçalves, José de Aragão Morais, Ana C Garcia, Hugo Valentim, Leonor Vasconcelos, Fernando Belcastro, Fernando Cura, Patricio Zaefferer, Foad Abd-Allah, Mohamed H Eldessoki, Hussein Heshmat Kassem, Haytham Soliman Gharieb, Mary P Colgan, Syed N Haider, Joe Harbison, Prakash Madhavan, Dermot Moore, Gregor Shanik, Viviane Kazan, Munier Nazzal, Vicki Ramsey-Williams, ACST-2 Collaborative Group, Group, ACST-2 Collaborative, Halliday A., Bulbulia R., Bonati L.H., Chester J., Cradduck-Bamford A., Peto R., Pan H., Potter J., Henning Eckstein H., Farrell B., Flather M., Mansfield A., Mihaylova B., Rahimi K., Simpson D., Thomas D., Sandercock P., Gray R., Molyneux A., Shearman C.P., Rothwell P., Belli A., Herrington W., Judge P., Leopold P., Mafham M., Gough M., Cao P., MacDonald S., Bari V., Berry C., Bradshaw S., Brudlo W., Clarke A., Cox R., Fathers S., Gaba K., Gray M., Hayter E., Holliday C., Kurien R., Lay M., le Conte S., McManus J., Madgwick Z., Morris D., Munday A., Pickworth S., Ostasz W., Poorthuis M., Richards S., Teixeira L., Tochlin S., Tully L., Wallis C., Willet M., Young A., Casana R., Malloggi C., Odero A., Silani V., Parati G., Malchiodi G., Malferrari G., Strozzi F., Tusini N., Vecchiati E., Coppi G., Lauricella A., Moratto R., Silingardi R., Veronesi J., Zini A., Ferrero E., Ferri M., Gaggiano A., Labate C., Nessi F., Psacharopulo D., Viazzo A., Malacrida G., Mazzaccaro D., Meola G., Modafferi A., Nano G., Occhiuto M.T., Righini P., Stegher S., Chiarandini S., Griselli F., Lepidi S., Pozzi Mucelli F., Naccarato M., D'Oria M., Ziani B., Stella A., Dieng M., Faggioli G., Gargiulo M., Palermo S., Pini R., Puddu G.M., Vacirca A., Angiletta D., Desantis C., Marinazzo D., Mastrangelo G., Regina G., Pulli R., Bianchi P., Cireni L., Coppi E., Pizzirusso R., Scalise F., Sorropago G., Tolva V., Caso V., Cieri E., DeRango P., Farchioni L., Isernia G., Lenti M., Parlani G.B., Pupo G., Pula G., Simonte G., Verzini F., Carimati F., Delodovici M.L., Fontana F., Piffaretti G., Tozzi M., Civilini E., Poletto G., Reimers B., Praquin B., Ronchey S., Capoccia L., Mansour W., Sbarigia E., Speziale F., Sirignano P., Toni D., Galeotti R., Gasbarro V., Mascoli F., Rocca T., Tsolaki E., Bernardini G., DeMarco E., Giaquinta A., Patti F., Veroux M., Veroux P., Virgilio C., Mangialardi N., Orrico M., Di Lazzaro V., Montelione N., Spinelli F., Stilo F., Cernetti C., Irsara S., Maccarrone G., Tonello D., Visona A., Zalunardo B., Chisci E., Michelagnoli S., Troisi N., Masato M., Dei Negri M., Pacchioni A., Sacca S., Amatucci G., Cannizzaro A., Accrocca F., Ambrogi C., Barbazza R., Marcucci G., Siani A., Bajardi G., Savettieri G., Argentieri A., Corbetta R., Quaretti P., Thyrion F.Z., Cappelli A., Benevento D., De Donato G., Mele M.A., Palasciano G., Pieragalli D., Rossi A., Setacci C., Setacci F., Palombo D., Perfumo M.C., Martelli E., Paolucci A., Trimarchi S., Grassi V., Grimaldi L., La Rosa G., Mirabella D., Scialabba M., Sichel L., D'Angelo C.L., Fadda G.F., Kasemi H., Marino M., Burzotta F., Codispoti F.A., Ferrante A., Tinelli G., Tshomba Y., Vincenzoni C., Amis D., Anderson D., Catterson M., Clarke M., Davis M., Dixit A., Dyker A., Ford G., Jackson R., Kappadath S., Lambert D., Lees T., Louw S., McCaslin J., Parr N., Robson R., Stansby G., Wales L., Wealleans V., Wilson L., Wyatt M., Baht H., Balogun I., Burger I., Cosier T., Cowie L., Gunathilagan G., Hargroves D., Insall R., Jones S., Rudenko H., Schumacher N., Senaratne J., Thomas G., Thomson A., Webb T., Brown E., Esisi B., Mehrzad A., MacSweeney S., McConachie N., Southam A., Sunman W., Abdul-Hamiq A., Bryce J., Chetter I., Ettles D., Lakshminarayan R., Mitchelson K., Rhymes C., Robinson G., Scott P., Vickers A., Ashleigh R., Butterfield S., Gamble E., Ghosh J., McCollum C.N., Welch M., Welsh S., Wolowczyk L., Donnelly M., D'Souza S., Egun A.A., Gregary B., Joseph T., Kelly C., Punekar S., Rahi M.A., Raj S., Seriki D., Thomson G., Brown J., Durairajan R., Grunwald I., Guyler P., Harman P., Jakeways M., Khuoge C., Kundu A., Loganathan T., Menon N., Prabakaran R.O., Sinha D., Thompson V., Tysoe S., Briley D., Darby C., Hands L., Howard D., Kuker W., Schulz U., Teal R., Barer D., Brown A., Crawford S., Dunlop P., Krishnamurthy R., Majmudar N., Mitchell D., Myint M.P., O'Brien R., O'Connell J., Sattar N., Vetrivel S., Beard J., Cleveland T., Gaines P., Humphreys J., Jenkins A., King C., Kusuma D., Lindert R., Lonsdale R., Nair R., Nawaz S., Okhuoya F., Turner D., Venables G., Dorman P., Hughes A., Jones D., Mendelow D., Rodgers H., Raudoniitis A., Enevoldson P., Nahser H., O'Brien I., Torella F., Watling D., White R., Brown P., Dutta D., Emerson L., Hilltout P., Kulkarni S., Morrison J., Poskitt K., Slim F., Smith S., Tyler A., Waldron J., Whyman M., Bajoriene M., Baker L., Colston A., Eliot-Jones B., Gramizadeh G., Lewis-Clarke C., McCafferty L., Oliver D., Palmer D., Patil A., Pegler S., Ramadurai G., Roberts A., Sargent T., Siddegowda S., Singh-Ranger R., Williams A., Williams L., Windebank S., Zuromskis T., Alwis L., Angus J., Asokanathan A., Fornolles C., Hardy D., Hunte S., Justin F., Phiri D., Mitabouana-Kibou M., Sekaran L., Sethuraman S., Tate M.L., Akyea-Mensah J., Ball S., Chrisopoulou A., Keene E., Phair A., Rogers S., Smyth J.V., Bicknell C., Chataway J., Cheshire N., Clifton A., Eley C., Gibbs R., Hamady M., Hazel B., James A., Jenkins M., Khanom N., Lacey A., Mireskandari M., O'Reilly J., Pereira A., Sachs T., Wolfe J., Davey P., Rogers G., Smith G., Tervit G., Nichol I., Parry A., Young G., Ashley S., Barwell J., Dix F., Nor A.M., Parry C., Birt A., Davies P., George J., Graham A., Jonker L., Kelsall N., Potts C., Wilson T., Crinnion J., Cuenoud L., Aleksic N., Babic S., Ilijevski N., Radak, Sagic D., Tanaskovic S., Colic M., Cvetic V., Davidovic L., Jovanovic D.R., Koncar I., Mutavdzic P., Sladojevic M., Tomic I., Debus E.S., Grzyska U., Otto D., Thomalla G., Barlinn J., Gerber J., Haase K., Hartmann C., Ludwig S., Putz V., Reeps C., Schmidt C., Weiss N., Werth S., Winzer S., Gemper J., Gunther A., Heiling B., Jochmann E., Karvouniari P., Klingner C., Mayer T., Schubert J., Schulze-Hartung F., Zanow J., Bausback Y., Borger F., Botsios S., Branzan D., Braunlich S., Holzer H., Lenzer J., Piorkowski C., Richter N., Schuster J., Scheinert D., Schmidt A., Staab H., Ulrich M., Werner M., Berger H., Biro G., Eckstein H.-H., Kallmayer M., Kreiser K., Zimmermann A., Berekoven B., Frerker K., Gordon V., Torsello G., Arnold S., Dienel C., Storck M., Biermaier B., Gissler H.M., Klotzsch C., Pfeiffer T., Schneider R., Sohl L., Wennrich M., Alonso A., Keese M., Groden C., Coster A., Engelhardt A., Ratusinski C.-M., Berg B., Delle M., Formgren J., Gillgren P., Jarl L., Kall T.B., Konrad P., Nyman N., Skioldebrand C., Steuer J., Takolander R., Malmstedt J., Acosta S., Bjorses K., Brandt K., Dias N., Gottsater A., Holst J., Kristmundsson T., Kuhme T., Kolbel T., Lindblad B., Lindh M., Malina M., Ohrlander T., Resch T., Ronnle V., Sonesson B., Warvsten M., Zdanowski Z., Campbell E., Kjellin P., Lindgren H., Nyberg J., Petersen B., Plate G., Parsson H., Qvarfordt P., Ignatenko P., Karpenko A., Starodubtsev V., Chernyavsky M.A., Golovkova M.S., Komakha B.B., Zherdev N.N., Belyasnik A., Chechulov P., Kandyba D., Stepanishchev I., Csobay-Novak C., Dosa E., Entz L., Nemes B., Szeberin Z., Barzo P., Bodosi M., Fako E., Fulop B., Nemeth T., Pazdernyik S., Skoba K., Voros E., Chatzinikou E., Giannoukas A., Karathanos C., Koutsias S., Kouvelos G., Matsagkas M., Ralli S., Rountas C., Rousas N., Spanos K., Brountzos E., Kakisis J.D., Lazaris A., Moulakakis K.G., Stefanis L., Tsivgoulis G., Vasdekis S., Antonopoulos C.N., Bellenis I., Maras D., Polydorou A., Polydorou V., Tavernarakis A., Ioannou N., Terzoudi M., Lazarides M., Mantatzis M., Vadikolias K., Dzieciuchowicz L., Gabriel M., Krasinski Z., Oszkinis G., Pukacki F., Slowinski M., Stanisic M.-G., Staniszewski R., Tomczak J., Zielinski M., Myrcha P., Rozanski D., Drelichowski S., Iwanowski W., Koncewicz K., Bialek P., Biejat Z., Czepel W., Czlonkowska A., Dowzenko A., Jedrzejewska J., Kobayashi A., Leszczynski J., Malek A., Polanski J., Proczka R., Skorski M., Szostek M., Andziak P., Dratwicki M., Gil R., Nowicki M., Pniewski J., Rzezak J., Seweryniak P., Dabek P., Juszynski M., Madycki G., Pacewski B., Raciborski W., Slowinski P., Staszkiewicz W., Bombic M., Chlouba V., Fiedler J., Hes K., Kostal P., Sova J., Kriz Z., Privara M., Reif M., Staffa R., Vlachovsky R., Vojtisek B., Hrbac T., Kuliha M., Prochazka V., Roubec M., Skoloudik D., Netuka D., Steklacova A., Benes III V., Buchvald P., Endrych L., Sercl M., Campos W., Casella I.B., de Luccia N., Estenssoro A.E.V., Presti C., Puech-Leao P., Neves C.R.B., da Silva E.S., Sitrangulo C.J., Monteiro J.A.T., Tinone G., Bellini Dalio M., Joviliano E.E., Pontes Neto O.M., Serra Ribeiro M., Cras P., Hendriks J.M.H., Hoppenbrouwers M., Lauwers P., Loos C., Yperzeele L., Geenens M., Hemelsoet D., van Herzeele I., Vermassen F., Astarci P., Hammer F., Lacroix V., Peeters A., Verhelst R., Cirelli S., Dormal P., Grimonprez A., Lambrecht B., Lerut P., Thues E., De Koster G., Desiron Q., Maertens de Noordhout A., Malmendier D., Massoz M., Saad G., Bosiers M., Callaert J., Deloose K., Blanco Canibano E., Garcia Fresnillo B., Guerra Requena M., Morata Barrado P.C., Muela Mendez M., Yusta Izquierdo A., Aparici Robles F., Blanes Orti P., Garcia Dominguez L., Martinez Lopez R., Miralles Hernandez M., Tembl Ferrairo J.I., Chamorro A., Macho J., Obach V., Riambau V., San Roman L., Ahlhelm F.J., Blackham K., Engelter S., Eugster T., Gensicke H., Gurke L., Lyrer P., Mariani L., Maurer M., Mujagic E., Muller M., Psychogios M., Stierli P., Stippich C., Traenka C., Wolff T., Wagner B., Wiegert M.M., Clarke S., Diepers M., Grochenig E., Gruber P., Isaak A., Kahles T., Marti R., Nedeltchev K., Remonda L., Tissira N., Valenca Falcao M., de Borst G.J., Lo R.H., Moll F.L., Toorop R., van der Worp B.H., Vonken E.J., Kappelle J.L., Jahrome O., Vos F., Schuiling W., van Overhagen H., Keunen R.W.M., Knippenberg B., Wever J.J., Lardenoije J.W., Reijnen M., Smeets L., van Sterkenburg S., Fraedrich G., Gizewski E., Gruber I., Knoflach M., Kiechl S., Rantner B., Abdulamit T., Bergeron P., Padovani R., Trastour J.-C., Cardon J.-M., Le Gallou-Wittenberg A., Allaire E., Becquemin J.-P., Cochennec-Paliwoda F., Desgranges P., Hosseini H., Kobeiter H., Marzelle J., Almekhlafi M.A., Bal S., Barber P.A., Coutts S.B., Demchuk A.M., Eesa M., Gillies M., Goyal M., Hill M.D., Hudon M.E., Jambula A., Kenney C., Klein G., McClelland M., Mitha A., Menon B.K., Morrish W.F., Peters S., Ryckborst K.J., Samis G., Save S., Smith E.E., Stys P., Subramaniam S., Sutherland G.R., Watson T., Wong J.H., Zimmel L., Flis V., Matela J., Miksic K., Milotic F., Mrdja B., Stirn B., Tetickovic E., Gasparini M., Grad A., Kompara I., Milosevic Z., Palmiste V., Toomsoo T., Aidashova B., Kospanov N., Lyssenko R., Mussagaliev D., Beyar R., Hoffman A., Karram T., Kerner A., Nikolsky E., Nitecki S., Andonova S., Bachvarov C., Petrov V., Cvjetko I., Vidjak V., Haluzan D., Petrunic M., Liu B., Liu C.-W., Bartko D., Beno P., Rusnak F., Zelenak K., Ezura M., Inoue T., Kimura N., Kondo R., Matsumoto Y., Shimizu H., Endo H., Furui E., Bakke S., Krohg-Sorensen K., Nome T., Skjelland M., Tennoe B., Albuquerque e Castro J., Alves G., Bastos Goncalves F., de Aragao Morais J., Garcia A.C., Valentim H., Vasconcelos L., Belcastro F., Cura F., Zaefferer P., Abd-Allah F., Eldessoki M.H., Heshmat Kassem H., Soliman Gharieb H., Colgan M.P., Haider S.N., Harbison J., Madhavan P., Moore D., Shanik G., Kazan V., Nazzal M., Ramsey-Williams V., and Gargiulo M
Subjects: Male, medicine.medical_specialty, Time Factors, Time Factor, medicine.medical_treatment, Carotid Stenosi, MEDLINE, Carotid endarterectomy, Rate ratio, Risk Assessment, Asymptomatic, law.invention, Randomized controlled trial, law, Risk Factors, carotid artery stenting (CAS), carotid endarterectomy (CEA), Stent, medicine, Humans, Carotid Stenosis, Stroke, Endarterectomy, Aged, Endarterectomy, Carotid, business.industry, carotid artery, Risk Factor, Articles, General Medicine, trial, medicine.disease, Settore MED/22 - CHIRURGIA VASCOLARE, Surgery, Stenosis, Treatment Outcome, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Female, Stents, Human medicine, medicine.symptom, business, Human
Abstract: Summary Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding UK Medical Research Council and Health Technology Assessment Programme.
Published: 2021

20. Effect of organizational features on patient satisfaction with care in Italian multiple sclerosis centres

Author: Maurizio Leone, Vittorio Martinelli, G. Savettieri, Alessandra Solari, Claudio Solaro, Corrado Zenesini, M. R. Tola, Maria Pia Amato, Raffaello D'Alessandro, G. L. Mancardi, Katia Mattarozzi, Elisa Baldin, Mattarozzi, K, Baldin, E, Zenesini, C, Solari, A, Amato, MP, Leone, M, Mancardi, G, Martinelli, V, Savettieri, G, Solaro, C, Tola, MR, and D'Alessandro, R
Subjects: Adult, Male, medicine.medical_specialty, media_common.quotation_subject, Psychological intervention, Nice, health professional-patient relationship, multiple sclerosis, care organization, patients’ satisfaction, psychological support, 03 medical and health sciences, 0302 clinical medicine, Patient satisfaction, Care organization, Excellence, Surveys and Questionnaires, Health care, medicine, Humans, 030212 general & internal medicine, computer.programming_language, media_common, Physician-Patient Relations, business.industry, Multiple sclerosis, Middle Aged, medicine.disease, Confidence interval, Italy, Neurology, Patient Satisfaction, Family medicine, Female, Neurology (clinical), business, Delivery of Health Care, Care Organization Health professional–Patient Relationship Multiple Sclerosis Patients’ Satisfaction Psychological Support, computer, 030217 neurology & neurosurgery
Abstract: Background and purpose Receiving clear, complete and up-to-date information and having a satisfying relationship with the health professional (HP) are of primary importance for MS patients. Healthcare organization plays a key role in promoting an effective relationship and communication between patients and HPs. The present study aims to explore which care organization and service characteristics provided by Italian MS centres best predict patients’ satisfaction with healthcare. Methods Eighty-one centres and 707 patients (502 women, mean age 40.5 years, SD 10.2; mean education 12.2 years, SD 3.6; time since diagnosis 5.9 years, SD 1.5) were included in the analysis. The care organization and service provided by each centre were evaluated in comparison with the National Institute for Health and Care Excellence (NICE) guidelines on management of MS. Patients’ satisfaction with care was measured using the patient self-assessed questionnaire ‘Comunicazione medico-paziente nella Sclerosi Multipla, revised’ section 2 (COSM-R section 2). Results The clinical characteristics of patients significantly affected their satisfaction. A multivariate regression model showed that higher patients’ satisfaction (COSM-R score) was inversely associated with hospital size (number of patients under care) (β = −0.21, 95% confidence interval −0.35; −0.07) and directly associated with psychological interventions (β = 2.44, 95% confidence interval 0.29; 4.59). Conclusions Multiple sclerosis patients from larger hospitals are less satisfied with the information received and the relationship with HPs. Building an individualized relationship between patients and HPs and tailoring the communication of information improve patients’ satisfaction. Such a goal is probably less likely to be accomplished in larger centres with many incoming patients. Moreover, when the centres also provide structured psychological interventions, the patients are more satisfied.
Published: 2017

21. Identification of Biomarkers in Cerebrospinal Fluid and Serum of Multiple Sclerosis Patients by Immunoproteomics Approach

Author: Maria Antonietta Mazzola, Paolo Ragonese, Simona Fontana, Giuseppe Salemi, Marilisa Barranca, Paolo Colomba, Claudia Lo Sicco, Riccardo Alessandro, Giovanni Savettieri, Giovanni Duro, Giacomo De Leo, Colomba, P, Fontana, S, Salemi, G, Barranca, M, Lo Sicco, C, Mazzola, MA, Ragonese, P, Savettieri, G, De Leo, G, Alessandro, R, and Duro, G
Subjects: Adult, Male, Proteomics, Pathology, medicine.medical_specialty, Immunoproteins, immunoproteome, Central nervous system, Disease, Biology, multiple sclerosis, Article, cerebrospinal fluid, Catalysis, Immunoproteomics, lcsh:Chemistry, Inorganic Chemistry, Cerebrospinal fluid, Settore BIO/13 - Biologia Applicata, medicine, Humans, Physical and Theoretical Chemistry, lcsh:QH301-705.5, Molecular Biology, Spectroscopy, Multiple sclerosis, Organic Chemistry, Transferrin, Case-control study, General Medicine, Middle Aged, medicine.disease, Computer Science Applications, medicine.anatomical_structure, lcsh:Biology (General), lcsh:QD1-999, Case-Control Studies, multiple sclerosi, serum biomarker, Immunology, anti-transferrin autoantibodies, biology.protein, Female, Settore MED/26 - Neurologia, anti-transferrin autoantibodie, Antibody, Biomarkers
Abstract: Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating disease of the central nervous system. At present, the molecular mechanisms causing the initiation, development and progression of MS are poorly understood, and no reliable proteinaceous disease markers are available. In this study, we used an immunoproteomics approach to identify autoreactive antibodies in the cerebrospinal fluid of MS patients to use as candidate markers with potential diagnostic value. We identified an autoreactive anti-transferrin antibody that may have a potential link with the development and progression of MS. We found this antibody at high levels also in the serum of MS patients and created an immunoenzymatic assay to detect it. Because of the complexity and heterogeneity of multiple sclerosis, it is difficult to find a single marker for all of the processes involved in the origin and progression of the disease, so the development of a panel of biomarkers is desirable, and anti-transferrin antibody could be one of these.
Published: 2014

22. Clinical features and lifestyle of patients with amyotrophic lateral sclerosis in Campania: brief overview of an Italian database

Author: Nicola Vanacore, Francesca Trojsi, Giovanni Savettieri, Gioacchino Tedeschi, Giovanni Piccirillo, Anna Sagnelli, Maria Rosaria Monsurrò, Anna Laiola, Alfonso Di Costanzo, Luca Daniele, Francesco Izzo, Trojsi, F, Sagnelli, A, Vanacore, N, Piccirillo, G, Daniele, L, Izzo, F, Laiola, A, Di Costanzo, A, Savettieri, G, Monsurrò, MR, Tedeschi, G, Trojsi, Francesca, Monsurro', Maria Rosaria, and Tedeschi, Gioacchino
Subjects: Male, sclerosi laterale amiotrofica, Databases, Factual, esposizione occupazionale, Occupational Exposure, Humans, Medicine, Occupations, Amyotrophic lateral sclerosis, Life Style, database clinico, Aged, Life style, business.industry, lcsh:Public aspects of medicine, Amyotrophic Lateral Sclerosis, Disease progression, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, General Medicine, Middle Aged, medicine.disease, Italy, Disease Progression, Amyotrophic lateral sclerosis, motor neuron diseases, clinical database, occupational exposure, Settore MED/26 - Neurologia, Female, Occupational exposure, business, malattie del motoneurone, Humanities, Sports
Abstract: Background. Physical activity and occupational exposures appeared to play a relevant role in pathogenesis of amyotrophic lateral sclerosis (ALS), a neurodegenerative disease of unknown origin. Materials and methods. We aimed to make an overview of the clinical characteristics and life - style (occupation and sport) of a population of 395 patients with ALS from campania, in southern Italy. Results. ALS onset resulted anticipated of about 11 years in industry workers, whilst the more frequent site of onset among farmers was upper limbs. compared to non-athletes, athletes, particu- larly soccer players, showed a 7 years anticipation of ALS onset, with higher mortality after 5 years. Discussion and conclusions. We suggest that subjects genetically prone to abnormal response to hy - poxia during strenuous physical activity or exposed to neurotoxic agents, such as athletes, farmers or industry workers, might present increased risk to develop ALS. Future case-control and follow-up studies on our population should be implemented to deepen the present results. Riassunto (Caratteristiche cliniche e stile di vita di pazienti con sclerosi laterale amiotrofica in Campania: breve panoramica di un database italiano). Introduzione. Attivita fisica ed esposizione professionale a sostanze tossiche sembrano svolgere un ruolo rilevante nella patogenesi della sclerosi laterale amiotrofica (SLA), una malattia neurodegenerativa di origine sconosciuta. Materiali e metodi. ci siamo proposti di effettuare una panoramica delle caratteristiche cliniche e dello stile di vita (attivita lavorativa e sport) di una popolazione di 395 pazienti affetti da SLA provenienti dalla regione campania, in Italia meridionale. Risultati. L'insorgenza della SLA e risultata anticipata di circa 11 anni nei lavoratori dell'industria, mentre il sito piu frequente di insorgenza tra i contadini era caratterizzato dagli arti superiori. Rispetto ai non- sportivi, gli sportivi, soprattutto i calciatori, hanno mostrato un'anticipazione di 7 anni nell'insorgenza della SLA, con maggiore mortalita a 5 anni. Discussione e conclusioni. Abbiamo ipotizzato che i soggetti geneticamente predisposti a risposte anomale all'ipossia durante l'attivita fisica intensa o esposti ad agenti neurotossici, come gli sportivi, gli agricoltori o i lavoratori dell'industria, possano presentare un aumen - tato rischio di sviluppare la SLA. Futuri studi caso-controllo e di follow-up sulla nostra popolazione dovrebbero essere effettuati per approfondire i risultati attuali.
Published: 2012

23. Incidence of amyotrophic lateral sclerosis in Sicily: A population based study

Author: D. Maimone, La Bella, Paolo Ragonese, Paolo Aridon, Alfonsa Claudia Taiello, Eleonora Cellura, Marco D'Amelio, Giovanni Savettieri, Rossella Spataro, Ragonese, P., Cellura, E., Aridon, P., D'Amelio, M., Spataro, R., Taiello, A., Maimone, D., LA BELLA, V., and Savettieri, G.
Subjects: Adult, Male, Gerontology, medicine.medical_specialty, Adolescent, Population, Prevalence, Young Adult, Age Distribution, Epidemiology, medicine, Humans, sicily, amyotrophic lateral sclerosi, Young adult, Amyotrophic lateral sclerosis, Child, education, Aged, Aged, 80 and over, Sex Characteristics, education.field_of_study, business.industry, Incidence (epidemiology), Amyotrophic Lateral Sclerosis, Infant, General Medicine, Middle Aged, medicine.disease, population-based, Population based study, Italy, Neurology, amyotrophic lateral sclerosis, incidence, epidemiology, Child, Preschool, Female, Settore MED/26 - Neurologia, Neurology (clinical), business, Demography, Sex characteristics
Abstract: Our objective was to investigate incidence of amyotrophic lateral sclerosis (ALS) in Sicily, southern Italy, by means of a population based study. We included people with ALS resident in fi ve Sicilian provinces, whose onset occurred in the two-year period 2005 2006 (population at 31 December 2006: 3,481,096 inhabitants). A multisource case-fi nding procedure was adopted and patients were classifi ed as affected by ALS according to revised El Escorial criteria. During the two-year surveillance period, 97 patients meeting eligibility criteria included 57 males (58.8%) and 40 females (41.2%). Crude annual incidence rate was 1.4/100,000 person years (95% CI 1.33 1.47). The incidence rate was higher in males (1.71/100,000; CI 1.61 1.81) than in females (1.11/100,000; CI 1.01 1.21). Standardized incidence rate for the total population in the 45 74-years-old age group was 3.22 (CI 3.11 3.33). Prevalence rate was 6.0/100,000 (CI 5.97 6.03), higher in males (7.1/100,000; CI 7.02 7.18) than females (4.9/100,000; CI 4.86 4.94). In conclusion, ALS rates observed in the present study are higher in males than females, with a peak of incidence at 70 years of age in both genders. These fi ndings are consistent with those of other population based European studies
Published: 2012

24. Diabetes preceding Parkinson's disease onset. A case–control study

Author: Norma Di Benedetto, Paolo Ragonese, Graziella Callari, Marco D'Amelio, Giovanni Savettieri, Giuseppe Salemi, Giorgia Famoso, Valeria Terruso, Paolo Aridon, Barbara Palmeri, D'Amelio, M, Ragonese, P, Callari, G, Di Benedetto, N, Palmeri, B, Terruso, V, Salemi, G, Famoso, G, Aridon, P, and Savettieri, G
Subjects: Male, medicine.medical_specialty, Parkinson's disease, Multivariate analysis, case-control study, Comorbidity, Disease, Diabete, Risk Factors, Diabetes mellitus, Internal medicine, Epidemiology, Diabetes Mellitus, medicine, Humans, Parkinson's Disease, business.industry, Case-control study, Parkinson Disease, Odds ratio, Middle Aged, medicine.disease, Neurology, Case-Control Studies, Settore MED/26 - Neurologia, Female, Neurology (clinical), Geriatrics and Gerontology, business, Body mass index
Abstract: Objective To assess the association between diabetes preceding Parkinson's disease (PD) and PD. Methods PD individuals were matched to PD free individuals randomly selected from people in the same municipality as the cases. Occurrence of diabetes preceding PD onset among cases and controls was assessed through a structured questionnaire. Information regarding current and past medical treatment and other variables was also collected. We used univariate and multivariate logistic models to calculate crude and adjusted odds ratios (OR). Covariates are adjusted for included education, smoking habit, alcohol and coffee consumption. Results 318 PD individuals (165 women, 153 men) and 318 matched controls were included in the study. PD patients had a mean age at interview of 66.7 years. Mean age at PD onset was 60.8 years and mean PD duration 5.9 years. We found an inverse association between PD and diabetes preceding PD onset in all groups stratified by gender, age at PD onset, body mass index (BMI), smoking habit, alcohol and coffee consumption. Multivariate analysis yielded the same findings after controlling for the variables (adjusted OR 0.4; 95% CI, 0.2–0.8). Conclusions Our findings provide additional support for a potential link between diabetes and PD.
Published: 2009

25. Motor intracortical inhibition in PD: L-DOPA modulation of high-frequency rTMS effects

Author: Marco D'Amelio, Lupo I, Paolo Ragonese, Giovanni Savettieri, Ornella Daniele, Filippo Brighina, Brigida Fierro, Antonio Palermo, FIERRO B, BRIGHINA F, D'AMELIO M, DANIELE O, LUPO I, RAGONESE P, PALERMO A, and SAVETTIERI G
Subjects: Male, medicine.medical_specialty, Neurology, Deep brain stimulation, CORTICAL SILENT PERIOD, medicine.medical_treatment, Stimulation, Motor Activity, Inhibitory postsynaptic potential, PAIRED-PULSE INHIBITION, Antiparkinson Agents, Levodopa, Degenerative disease, EVOKED-POTENTIALS, medicine, Humans, CORTEX EXCITABILITY, Aged, Aged, 80 and over, SUBTHALAMIC NUCLEUS, PARKINSONS-DISEASE PATIENTS, General Neuroscience, Dopaminergic, Motor Cortex, Neural Inhibition, Parkinson Disease, Middle Aged, medicine.disease, FACILITATION, Combined Modality Therapy, Transcranial Magnetic Stimulation, Transcranial magnetic stimulation, BRAIN-STIMULATION, medicine.anatomical_structure, Settore MED/26 - Neurologia, Female, REPETITIVE TMS, Psychology, Neuroscience, Motor cortex
Abstract: Dopaminergic drugs and deep brain stimulation restore cortical inhibition in Parkinson disease (PD) patients. High-frequency rTMS was also found to increase cortical inhibition in PD but its therapeutic effect is still controversial. Here we hypothesize that, if dopaminergic drugs reverse to normal cortical excitability in M1, the effect of high-frequency (hf)-rTMS in PD patients could depend on whether they are in a medicated or unmedicated state. The present study aims to explore the lasting effects of sub-threshold hf rTMS trains over M1 on cortical inhibition in patients with "on" and without "off" L-DOPA treatment. Fourteen PD patients were examined twice while "on" and "off" medication. In both conditions, a paired-pulse paradigm was used to evaluate short intracortical inhibition (SICI) and long intracortical inhibition (LICI) that were evaluated before and after hf rTMS trains applied on the motor cortex. The results were compared with those obtained from normal controls. In baseline condition, SICI and LICI were significantly reduced in "off" compared to "on" patients and controls. hf-rTMS over the motor cortex significantly increased SICI and LICI in "off" medication PD patients. Magnetic stimulation proved to be ineffective when the same patients were in "on" state. The results showed that hf-rTMS affected intracortical inhibition (ICI) only in unmedicated patients. By restoring cortical inhibitory circuits dopaminergic drugs, normalize the excitability changes in M1 subsequent to motor rTMS. Whether patients are in a medicated or an unmedicated state would therefore appear to be critical for rTMS effects in PD patients. If a positive correlation exists between increased cortical inhibition and clinical improvement, hf-rTMS during the "off" state could be regarded as a potential add-on treatment to reduce the need of L-dopa and thus delay the adverse effects of its chronic use.
Published: 2007

26. In patient’s with Parkinson disease, autonomic symptoms are frequent and associated with other non-motor symptoms

Author: Valentina Arnao, Marco D'Amelio, Valentina Perini, Sergio Mastrilli, Sabrina Realmuto, Antonio Cinturino, Francesca Valentino, Gabriele Bellavia, Giovanni Savettieri, Arnao, V, Cinturino, A, Valentino, F, Perini, V, Mastrilli, S, Bellavia, G, Savettieri, G, Realmuto, S, and D’Amelio, M
Subjects: Male, medicine.medical_specialty, Levodopa, Neurology, Parkinson's disease, Disease, Autonomic symptom, Non-motor symptom, Rating scale, Internal medicine, medicine, Humans, Depression (differential diagnoses), Aged, Endocrine and Autonomic Systems, business.industry, Epworth Sleepiness Scale, Parkinson Disease, Sleep disorders, Middle Aged, medicine.disease, Comorbidity, Cross-Sectional Studies, Autonomic Nervous System Diseases, Parkinson’s disease, Female, Settore MED/26 - Neurologia, Neurology (clinical), business, medicine.drug
Abstract: Background: Autonomic symptoms and sleep disorders are common non-motor symptoms of Parkinson disease (PD), which are correlated with poor quality of life for patients. Purpose: To assess the frequency of autonomic symptoms in a consecutive series of PD patients and to correlate them with other motor and non-motor symptoms. Methods: All consecutive non-demented PD patients who underwent an extensive evaluation including Hoehn and Yahr staging, Unified Parkinson’s Disease Rating Scale, Beck’s Depression Inventory, Neuropsychiatric Inventory, PDQ-39 Scale, the Parkinson’s diseases Sleep Scale, the Epworth Sleepiness Scale and SCOPA-AUT scale were enrolled. Comorbidity has been also considered. Supine to standing position blood pressure and cardiac frequency changes were also measured. Results: 135 PD patients were included (mean age at interview 67.7; mean disease duration: 5.3 years). Patients were stratified according to mean SCOPA-AUT scale score (13.1). Those with higher SCOPA-AUT scale score were significantly older, had longer disease duration, worse disease stage, worse quality of sleep, were more severely affected, and were also taking a higher dosage of levodopa. At multivariate analysis, older age, longer disease duration, and worse quality of sleep were independently associated with higher SCOPA-AUT scale scores. Conclusions: Our results remark the role of autonomic symptoms in PD. In our patient population, characterized by mild to moderate disease severity, most of the patients complained of autonomic nervous system involvement (84 %). A significant association between autonomic symptoms and sleep disorders was also observed.
Published: 2015

27. Pisa syndrome after rasagiline therapy in a patient with Parkinson’s disease

Author: Giovanni Savettieri, Brigida Fierro, Sergio Mastrilli, Marco D'Amelio, Giuseppe Cosentino, Francesca Valentino, Sabrina Realmuto, Valentino, F., Cosentino, G., Fierro, B., Realmuto, S., Mastrilli, S., Savettieri, G., and D’Amelio, M.
Subjects: Pediatrics, medicine.medical_specialty, Parkinson's disease, Neurology, Dermatology, Antiparkinson Agents, chemistry.chemical_compound, Dopamine, medicine, Humans, Monoamine Oxidase Type B, Dystonia, Rasagiline, Antiparkinsonian drugs, business.industry, Parkinson Disease, General Medicine, medicine.disease, Psychiatry and Mental health, Pisa syndrome, chemistry, Indans, Female, Neurology (clinical), business, medicine.drug
Abstract: Dear Editor, We have read with interest comments by Solla et al. [1] regarding our Letter to the Editor published in NeurologicalSciences titled ‘‘Insidious onset of Pisa Syndrome afterrasagiline therapy in a patient with Parkinson’s Disease’’[2]. We thank the authors for their interest in our paper, but we think it is necessary to make some clarifications regarding the temporal relationship between the onset of Pisa Syndrome (PS) and rasagiline therapy. PS occurred in fact after and not before rasagiline treatment as stated by Solla et al. In particular, PS occurred after a time interval of 6–12 months and anyway after rasagiline was added to patient’s therapy. This long time interval is one of the elements that makes the case interesting (time period longer than previously described). Temporal relationship is fundamental for the interpretation of clinical and electrophysiological findings in our case. Rasagiline is an inhibitor of monoamine oxidase type B, and although different mechanisms of action have been advocated, its effect is primarily dopamine mediated [3]. This means that occurrence of Pisa syndrome in our case was likely related not only to the specific mechanisms of action of the drug but also to increased dopamine extracellular levels at the striatal synapses, and thus to the total dopamine agonism load. To conclude, though it is likely that concomitant use of other antiparkinsonian drugs could have contributed to the onset of PS in our patient, it is noteworthy that PS was not evident before rasagiline was started, it became evident after rasagiline was initiated, and it was not anymore evident after rasagiline was stopped.
Published: 2015

28. High Prevalence and Fast Rising Incidence of Multiple Sclerosis in Caltanissetta, Sicily, Southern Italy

Author: Luigi M.E. Grimaldi, Roberto Grimaldi, Marco D'Amelio, Gaetano Vitello, Paolo Ragonese, Giovanni Savettieri, Giuseppe Salemi, Barbara Palmeri, Giuseppe Giglia, GRIMALDI, LM, PALMERI, B, SALEMI, G, GIGLIA, G, D'AMELIO, M, GRIMALDI, R, VITELLO, G, RAGONESE, P, and SAVETTIERI, G
Subjects: Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Adolescent, Multiple sclerosis incidence, Prevalence, Sicily, Epidemiology, Age Distribution, Prevalence, medicine, Humans, Sex Distribution, Sicily, Aged, High prevalence, business.industry, Incidence, Multiple sclerosis, Incidence (epidemiology), Urban Health, Middle Aged, medicine.disease, Health Surveys, humanities, Female, Settore MED/26 - Neurologia, Neurology (clinical), business, Mediterranean Islands, Follow-Up Studies, Demography
Abstract: Background: Epidemiological studies conducted in Sicily and Sardinia, the two major Mediterranean islands, showed elevated incidence and prevalence of multiple sclerosis (MS)and a recent increase in disease frequency. Objective: To confirm the central highlands of Sicily as areas of increasing MS prevalence and elevated incidence, we performed a follow-up study based on the town of Caltanissetta (Sicily), southern Italy. Methods: We made a formal diagnostic reappraisal of all living patients found in the previous study performed in 1981. All possible information sources were used to search for patients affected by MS diagnosed according to the Poser criteria. We calculated prevalence ratios, for patients affected by MS who were living and resident in the study area on December 31, 2002. Crude and age- and sex-specific incidence ratios were computed for the period from January 1, 1993, to December 31, 2002. Results: The prevalence of definite MS rose in 20 years from 69.2 (retrospective prevalence rate) to 165.8/100,000 population. We calculated the incidence of definite MS for the period 1970–2000. These rates calculated for 5-year periods increased from 2.3 to 9.2/100,000/year. Conclusion: This survey shows the highest prevalence and incidence figures of MS in the Mediterranean area and confirms central Sicily as a very-high-risk area for MS.
Published: 2006

29. A novel mutation of the extracellular matrix protein 1 gene (ECM1) in a patient with lipoid proteinosis (Urbach-Wiethe disease) from Sicily

Author: Maurizio Averna, Vincenza Valenti, Davide Noto, Ornella Daniele, Rosolino Camarda, Maria Rita Bongiorno, Giovanni Savettieri, Angelo B. Cefalù, Lupo I, Mario Arico, LUPO, I, CEFALU', AB, BONGIORNO, MR, DANIELE, O, VALENTI, V, NOTO, D, CAMARDA, R, SAVETTIERI, G, ARICO', M, and AVERNA M
Subjects: Adult, Pathology, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Biopsy, Molecular Sequence Data, Nonsense mutation, Dermatology, Biology, Urbach–Wiethe disease, medicine.disease_cause, Polymerase Chain Reaction, Frameshift mutation, Extracellular matrix protein 1, Exon, medicine, Humans, education, Sicily, Gene, Extracellular Matrix Proteins, education.field_of_study, Mutation, Base Sequence, Genodermatosis, Skin Diseases, Genetic, medicine.disease, Pedigree, ECM1 gene, lipoid proteinosis, mutation, Settore MED/03 - Genetica Medica, Codon, Nonsense, Lipoid Proteinosis of Urbach and Wiethe, Settore MED/26 - Neurologia, Female
Abstract: Summary Background Lipoid proteinosis (LP), also known as Urbach–Wiethe disease, is a rare autosomal recessive disorder characterized by a hoarse voice, warty skin infiltration and scarring. Mutations within the extracellular matrix protein 1 (ECM1) gene cause LP. Objectives We report the molecular analysis of the ECM1 gene in a Sicilian patient with LP in order to extend the mutation spectrum of this genodermatosis. Methods We studied a 32-year-old female born from consanguineous parents who was diagnosed at the age of 11 years as having LP. She has a clinical phenotype corresponding to Urbach–Wiethe disease characterized by papules/nodules, indurated plaques and sometimes ulcerated lesions primarily involving the skin and mucous membranes, and extracutaneous features such as epilepsy, hoarseness of the voice and neuropsychiatric abnormalities. Samples of clinically affected skin obtained by biopsies were analysed after staining with haematoxylin and eosin, periodic acid–Schiff (PAS), and PAS–diastase. The whole ECM1 gene was analysed by direct sequencing. Results We identified a homozygous nonsense mutation in exon 6 of the ECM1 gene, C589T (Q197Ter). Conclusions Over 60% of mutations occur in exons 6 and 7. Exon 7 is alternatively spliced and frameshift mutations in exon 7 lead to ablation of the ECM1a transcript, but not the shorter ECM1b transcript that normally lacks this exon. Homozygous nonsense or frameshift mutations in exon 6 are predicted to affect both full-length ECM1a and ECM1b transcripts, whereas ECM1b should be unaffected for similar types of mutation in exon 7. It has been suggested that individuals with mutations in exon 7 have a slightly milder phenotype than those with exon 6 mutations. This is the first report with respect to a novel mutation of the ECM1 gene responsible for recessive LP in Sicily.
Published: 2005

30. The relapse rate of multiple sclerosis changes during pregnancy: a cohort study

Author: Graziella Callari, Paolo Ragonese, Matilde Gammino, Giuseppe Salemi, Giovanni Savettieri, Marco D'Amelio, E. Cammarata, Battaglieri F, G. Cuccia, Lupo I, SALEMI G, CALLARI G, GAMMINO M, BATTAGLIERI F, CAMMARATA E, CUCCIA G, D'AMELIO M, LUPO I, RAGONESE P, and SAVETTIERI G
Subjects: Adult, medicine.medical_specialty, Adolescent, Population, Comorbidity, Cohort Studies, Multiple Sclerosis, Relapsing-Remitting, Pregnancy, Recurrence, Risk Factors, Humans, Medicine, puerperium, education, Retrospective Studies, education.field_of_study, biology, business.industry, Obstetrics, Multiple sclerosis, General Medicine, Middle Aged, medicine.disease, biology.organism_classification, Confidence interval, Surgery, Pregnancy Complications, Italy, Neurology, multiple sclerosi, Relative risk, Tasa, Pregnancy in Adolescence, Gestation, Female, Neurology (clinical), relapse rate, business, Cohort study
Abstract: Objective – To evaluate the influence of pregnancy and puerperium on the relapse rate of multiple sclerosis (MS). Methods – We determined retrospectively the yearly mean relapse rate (MRR) during pregnancies occurring in the course of relapsing–remitting MS. We compared the MRR of pregnancy-time with that of non-pregnancy time by paired t-test. Relative risk (RR) of relapses during the pregnancy-time was also compared with that of non-pregnancy time by χ2 analysis and 95% confidence intervals. Results – From a population of 351 women affected by clinically definite MS, only 70 reported pregnancies during their relapsing–remitting phase of MS for a total of 98 pregnancies. Both MRR (P = 0.006) and RR (RR = 0.63, 95% CI = 0.40–0.94) decreased during the three trimesters of pregnancy. RR increased in the first 3 months of puerperium, although this was not statistically significant (RR = 1.36, 95% CI = 0.79–2.20). Conclusion – Our study confirms that in MS the relapse rate decreases throughout pregnancy and increases during puerperium. This suggests a complex interplay between hormonal and immune factors.
Published: 2004

31. Migraine and cranial autonomic symptoms in children and adolescents: a clinical study

Author: D. Buffa, Marco D'Amelio, Giuliana Giordano, G. Savettieri, Vincenzo Raieli, Giuseppe Santangelo, Francesca Vanadia, Consolo F, C. Spitaleri, Raieli, V, Giordano, G, Spitaleri, C, Consolo, F, Buffa, D, Santangelo, G, Savettieri, G, Vanadia, F, and D'Amelio, M
Subjects: Male, Pediatrics, medicine.medical_specialty, Adolescent, Migraine Disorders, Primary headache, children, Surveys and Questionnaires, cranial autonomic symptoms, migraine, primary headaches, trigemino-autonomic reflex, medicine, Humans, Longitudinal Studies, Child, Chi-Square Distribution, business.industry, primary headache, Odds ratio, medicine.disease, Confidence interval, Pathophysiology, Migraine, Autonomic Nervous System Diseases, Anesthesia, Pediatrics, Perinatology and Child Health, cranial autonomic symptom, Reflex, Autonomic symptoms, Female, Neurology (clinical), Headaches, medicine.symptom, business
Abstract: The frequency of cranial autonomic symptoms in children affected by primary headaches is uncertain. The aim of our study was to estimate the frequency of symptoms in pediatric headaches and correlate it with main migraine characteristics. A questionnaire investigating the presence of cranial autonomic symptoms was administered to all children with primary headache for 2 years. A total of 230 children with primary headache (105 males, 125 females) were included. Two hundred two children were affected by migraine and 28 (12.2%) by other primary headaches. Cranial autonomic symptoms were significantly complained by migraineurs (55% vs 17.8%) ( P < .001) and by children with higher frequency of migraine attacks (odds ratio = 2.6, confidence interval = 1.4-4.7, P = .001). Our findings show that cranial autonomic symptoms are rather common during pediatric migraine attacks. The association between cranial autonomic symptoms and higher frequency of attacks might suggest the role of the trigeminal-autonomic reflex in migraine pathophysiology.
Published: 2014

32. Prevalence and incidence of multiple sclerosis in the city of Monreale, Italy

Author: Paolo Ragonese, Paolo Aridon, Giovanni Savettieri, Giovanna Randisi, Giovanni Scola, Giuseppe Salemi, Savettieri, G., Salemi, G., Ragonese, P., Aridon, P., Scola, G., and Randisi, G.
Subjects: Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Adolescent, Epidemiology, Population, Age Distribution, Lag time, Prevalence, medicine, Humans, Multiple sclerosi, Sex Distribution, Child, education, Aged, education.field_of_study, business.industry, Incidence, Multiple sclerosis, Incidence (epidemiology), Infant, Newborn, Infant, Middle Aged, medicine.disease, Health Surveys, Italy, Neurology, Child, Preschool, Settore MED/26 - Neurologia, Female, Neurology (clinical), business, Demography
Abstract: The prevalence and incidence of multiple sclerosis (MS) in the city of Monreale, southern Italy were ascertained 10 years after a preliminary study in the same area. The study was undertaken in a population of 26,256 people. The patients were classified according to Poser’s criteria. The prevalence of MS on 31 December 1991 was 72.4 per 100,000 population. The incidence of MS for the period 1981–1991 was 3.3/100,000 per year. The mean period between onset and diagnosis of MS was 4.9 years for those patients found during this survey and 9.2 years for those in the first study. This study shows an increase of MS prevalence in Monreale city and a high incidence. The findings parallel the reduction of the lag time between onset and diagnosis.
Published: 1997

33. Clinical and magnetic resonance imaging predictors of disease progression in multiple sclerosis: a nine-year follow-up study

Author: Mario Zappia, G. Tedeschi, G. Coniglio, Francesco Patti, Simona Bonavita, Roberta Lanzillo, Giuseppe Salemi, Antonio Gallo, Isabella Laura Simone, Bruno Alfano, Maria Buccafusca, Paola Valentino, Alessandro d’Ambrosio, Domenico Ippolito, Luigi Lavorgna, Vincenzo Bresciamorra, Damiano Paolicelli, Giovanni Savettieri, Lavorgna, L, Bonavita, Simona, Ippolito, D, Lanzillo, R, Salemi, G, Patti, F, Valentino, P, Coniglio, G, Buccafusca, M, Paolicelli, D, D'Ambrosio, Alessandro, Bresciamorra, V, Savettieri, G, Zappia, M, Alfano, B, Gallo, Antonio, Simone, I, Tedeschi, Gioacchino, Bonavita, S, D'Ambrosio, A, Gallo, A, Tedeschi, G, Lanzillo, Roberta, BRESCIA MORRA, Vincenzo, and Tedeschi, G.
Subjects: Adult, Male, medicine.medical_specialty, Magnetic resonance imaging, follow-up, multiple sclerosis, clinical predictors, gray matter atrophy, predictor, multiple sclerosis, Disease course, Disability Evaluation, Multiple Sclerosis, Relapsing-Remitting, Internal medicine, follow-up, medicine, Humans, Secondary progressive, Expanded Disability Status Scale, medicine.diagnostic_test, business.industry, Multiple sclerosis, Disease progression, Follow up studies, Magnetic resonance imaging, clinical predictors, Middle Aged, medicine.disease, Magnetic Resonance Imaging, gray matter atrophy, Cross-Sectional Studies, Neurology, multiple sclerosi, Disease Progression, Settore MED/26 - Neurologia, Female, Neurology (clinical), business, Nuclear medicine, Clinical progression, MRI, Follow-Up Studies
Abstract: Objective: The objective of this paper is to identify clinical or magnetic resonance imaging (MRI) predictors of long-term clinical progression in a large cohort of multiple sclerosis (MS) patients. Methods: A total of 241 relapsing–remitting (RR) MS patients were included in a nine-year follow-up (FU) study. The reference MRIs were acquired at baseline (BL) as part of a multicenter, cross-sectional, clinical-MRI study. Volumetric MRI metrics were measured by a fully automated, operator-independent, multi-parametric segmentation method. Clinical progression was evaluated as defined by: conversion from RR to secondary progressive (SP) disease course; progression of Expanded Disability Status Scale (EDSS); achievement and time to reach EDSS 4. Results: We concluded that conversion from RR to SP (OR 0.79; CI 0.7–0.9), progression of EDSS (OR 0.85; CI 0.77–0.93), achievement of EDSS 4 (OR 0.8; CI 0.7–0.9), and time to reach EDSS 4 (HR 0.88; CI 0.82–0.94) were all predicted by BL gray matter (GM) volume and, except for progression of EDSS, by BL EDSS (respectively: (OR 2.88; CI 1.9–4.36), (OR 2.7; CI 1.7–4.2), (HR 3.86; CI 1.94–7.70)). Conclusions: BL GM volume and EDSS are the best long-term predictors of disease progression in RRMS patients with a relatively long and mild disease.
Published: 2013

34. Sleep quality in caregivers of patients with Alzheimer’s disease and Parkinson’s disease and its relationship to quality of life

Author: Chiara, Cupidi, Sabrina, Realmuto, Gianluca, Lo Coco, Antonio, Cinturino, Simona, Talamanca, Valentina, Arnao, Valentina, Perini, Tommaso, Piccoli, Marco, D'Amelio, Giovanni, Savettieri, Daniele, Lo Coco, Cupidi, C, Realmuto, S, Lo Coco, G, Cinturino, A, Talamanca, S, Arnao, V, Perini, V, D’Amelio, M, Savettieri, G, and Lo Coco D
Subjects: Male, Sleep Wake Disorders, Coping (psychology), medicine.medical_specialty, Parkinson's disease, Disease, Severity of Illness Index, Pittsburgh Sleep Quality Index, Cost of Illness, Alzheimer Disease, Sickness Impact Profile, Surveys and Questionnaires, Severity of illness, Medicine, Humans, Aged, Aged, 80 and over, Alzheimer’s disease, Parkinson’s disease, neurodegenerative disorders, caregivers, sleep, depression, quality of life, business.industry, Depression, Parkinson Disease, Middle Aged, medicine.disease, Psychiatry and Mental health, Clinical Psychology, Sleep deprivation, Caregivers, Italy, Physical therapy, Quality of Life, Regression Analysis, Sleep Deprivation, Female, Settore MED/26 - Neurologia, Self Report, Geriatrics and Gerontology, medicine.symptom, Alzheimer's disease, business, Gerontology, Stress, Psychological
Abstract: Background: Knowledge about sleep complaints of caregivers of patients with Alzheimer's disease (AD) and Parkinson's disease (PD) is limited, and we lack information about the relationship between caregivers’ sleep problems and their quality of life (QoL).Methods: We evaluated subjective sleep quality and its relationship to QoL in a group of 80 caregivers of patients with AD (ADCG, n = 40) and PD (PDCG, n = 40), and in 150 controls. Information about night-time complaints was collected using the Pittsburgh Sleep Quality Index (PSQI). QoL was measured using the McGill QoL Questionnaire.Results: Eighteen ADCG (45%), 22 PDCG (55%), and 45 (30%) controls reported poor sleep quality. Mean global PSQI score of PDCG (6.25 ± 3.9) was not significantly different from that of ADCG (5.8 ± 3.5; p = 0.67). However, both PDCG and ADCG scored significantly higher than control group (4.3 ± 3.1; p < 0.01). ADCG frequently reported difficulties falling asleep (72.5%) and disturbed sleep (100%). PDCG reported reduced subjective sleep quality (80%) and increased sleep disturbances (100%). Poor sleep quality was associated with depressive symptoms and correlated with QoL in caregivers of both groups, particularly the psychological symptoms domain.Conclusions: Among caregivers of patients with AD and PD, poor sleep quality is frequent and significantly linked to QoL and depressive symptoms. Identifying the nature of sleep disturbances not only in patients but also in their caregivers is important as appropriate treatment may lead to a better management of the needs of families coping with these patients.
Published: 2013

35. Dentatorubral-pallidoluysian atrophy: haplotype of Asian origin in 2 Italian families

Author: Paolo Aridon, Aldo Quattrone, Paolo Ragonese, Patrizia Tarantino, Antonio Scarpitta, Giovanni Savettieri, Giuseppe Salemi, Antono Cinturino, Marco D'Amelio, Monica Gagliardi, Vincenzina Lo Re, Antonio Gambardella, Grazia Annesi, Aridon, P, Tarantino, P, Ragonese, P, D'Amelio, M, Cinturino, A, Salemi, G, Gagliardi, M, Lo Re, V, Scarpitta, A, Gambardella, A, Quattrone, A, Annesi, G, and Savettieri, G
Subjects: Asian origin, Male, Nerve Tissue Proteins, Biology, Dentatorubral-pallidoluysian atrophy, Polymorphism, Single Nucleotide, Genetic, Asian People, Polymorphism (computer science), medicine, Humans, Genetic Association Studies, Family health, Genetics, Family Health, Haplotype, medicine.disease, Myoclonic Epilepsies, Progressive, Italian families, Neurology, Haplotypes, Italy, Settore MED/26 - Neurologia, Female, Neurology (clinical), Microsatellite Repeats
Published: 2011

36. Cholesterol levels and risk of hemorrhagic transformation after acute ischemic stroke

Author: Giorgia Famoso, Giovanni Savettieri, Paolo Aridon, Marco D'Amelio, Valeria Terruso, Paolo Ragonese, D'Amelio, M, Terruso, V, Famoso, G, Ragonese, P, Aridon, P, and Savettieri G
Subjects: Male, medicine.medical_specialty, Down-Regulation, Risk Assessment, Brain Ischemia, chemistry.chemical_compound, Risk Factors, Cholesterol levels, hemorrhagic transformation, Internal medicine, medicine, Odds Ratio, Humans, Risk factor, Acute ischemic stroke, Aged, Retrospective Studies, Chi-Square Distribution, business.industry, Cholesterol, Cholesterol, LDL, Prognosis, Stroke, Transformation (genetics), Logistic Models, Neurology, chemistry, Italy, Ischemic stroke, Physical therapy, Cardiology, Disease Progression, Settore MED/26 - Neurologia, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Intracranial Hemorrhages, Biomarkers
Abstract: Background: The association between cholesterol levels and hemorrhagic transformation (HT) is still controversial. Studies investigating this issue are influenced by treatments as some are characterized by a higher risk of HT. The aim of our study was to evaluate, in a hospital-based series of patients not treated with thrombolysis, the relationship between cholesterol levels and HT. Methods: We retrospectively collected information about total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC) levels at admission in a consecutive series of 240 patients with anterior ischemic stroke (IS). The TC and LDLC levels were arranged in 3 groups according to their percentile distribution. Results: TC levels were available for 215 patients (89.6%), while LDLC levels were available for 184 patients (76.7%). The risk of HT significantly increased with decreasing levels of TC (p for trend = 0.03) and LDLC (p for trend = 0.01). In multivariate analysis, the risk of HT was significantly higher in the groups of patients with the lowest TC (OR 2.8, 95% CI 1.0–8.9, p = 0.05) and LDLC (OR 5.0, 95% CI 1.2–20.1, p = 0.002) values compared to those with the highest ones. Conclusion: We confirm that lower TC and lower LDLC levels are associated with an increased risk of HT. As none of our patients received thrombolytic therapy, the results of our study provide baseline information about the natural history of HT.
Published: 2011

37. A population-based survey of cognitive performance in a Sicilian elderly community

Author: Maria Antonietta Mazzola, Paolo Ragonese, Paolo Aridon, Sabrina Realmuto, Marco D'Amelio, Giovanni Savettieri, Giuseppe Salemi, Fabio Aiello, Ragonese, P, Aridon, P, D'Amelio, M, Aiello, F, Mazzola, MA, Realmuto, S, Salemi, G, and Savettieri, G
Subjects: Gerontology, Male, Percentile, Epidemiology, Survey population-based, Population, Cohort Studies, Cognition, Residence Characteristics, medicine, Dementia, Humans, education, Cognitive performance, Socioeconomic status, Sicily, Aged, Aged, 80 and over, education.field_of_study, Mini–Mental State Examination, medicine.diagnostic_test, business.industry, Age Factors, Regression analysis, medicine.disease, Italy, Population Surveillance, Cohort, Female, Settore MED/26 - Neurologia, Neurology (clinical), business, Cognition Disorders, Mental Status Schedule
Abstract: Background: The global burden of neurodegenerative diseases is increasing. Previous studies reported differences related to age, gender and socioeconomic status. We calculated the cognitive performances of a Sicilian population aged 65 years or older, by means of a door-to-door population-based survey in Bagheria city, Sicily. Methods: A door-to-door survey was carried out in the city of Bagheria, Sicily (prevalence day September 30, 2006). A cohort of 2,200 persons was randomly stratified, obtaining a 25% sample of the whole population. Cognitive function was assessed by Mini Mental State Examination (MMSE). Percentile distributions by age, gender, education and working activity were calculated. Regression models were used to analyze the relationship between the investigated variables and cognitive performance. Results: A total of 1,837 persons agreed to participate (1,062 women and 775 men). Distribution of MMSE showed a highly significant inverse linear trend related to the increasing age (p < 0.0001) and to the degree of education (p < 0.0001), both in men and women. We observed a significant association between higher education and a better cognitive performance (OR 6.91; CI 3.24–14.76) and an inverse association between manual kind of occupation versus not manual and a poorer cognitive status (OR 0.82; CI 0.67–0.997). Height was associated with decreased cognitive performances in women (OR = 1.03; CI = 1.01–1.05) but not in men (OR = 0.997; CI = 0.993–1.002). Conclusions: These findings provide a feature of cognitive performances in Sicily, measured by MMSE scores in individuals aged 65 years or older.
Published: 2011

38. Three years of experience : the Italian registry and safety data update

Author: Giovanni Luigi Mancardi, Laura Periotto, Pier Giuseppe Rossi, M. De Rosa, R. Iommelli, Nicola Vanacore, Carlo Piccinni, Clara Milanese, Patrizia Popoli, Alice Laroni, Carlo Tomino, Roberto D’Alessandro, Maria Giovanna Marrosu, Filippo Drago, M. R. Tola, G. Comi, A. Covezzoli, Antonio Bertolotto, Giovanni Savettieri, Gioacchino Tedeschi, Nicola Montanaro, Maria Pia Amato, Carlo Pozzilli, L.M.E. Grimaldi, Leandro Provinciali, Mancardi, Gl, Tedeschi, G, Amato, Mp, D’Alessandro, R, Drago, F, Milanese, C, Popoli, P, Rossi, P, Savettieri, G, Tola, Mr, Comi, Giancarlo, Pozzilli, C, Bertolotto, A, Marrosu, Mg, Grimaldi, Lm, Laroni, A, Vanacore, N, Covezzoli, A, De Rosa, M, Piccinni, C, Montanaro, N, Pernotto, L, Iommelli, R, Tomino, C, Provinciali, L., Mancardi, GL, Amato,MP, D'Alessandro,R, Drago,F, Rossi,P, Tola, MR, Comi, G, Bertolotto,A, Marrosu,MG, Grimaldi, LM, Periotto, L, Tomino. C, Tedeschi, Gioacchino, D'Alessandro, R, DE ROSA, M, G.L. Mancardi, G. Tedeschi, M.P. Amato, R. D’Alessandro, F. Drago, C. Milanese, P. Popoli, P. Rossi, G. Savettieri, M.R. Tola, G. Comi, C. Pozzilli, A. Bertolotto, M.G. Marrosu, L.M.E. Grimaldi, A. Laroni, N. Vanacore, A. Covezzoli, M. De Rosa, C. Piccinni, N. Montanaro, L. Periotto, R. Iommelli, C. Tomino, and L. Provinciali
Subjects: Adult, Male, medicine.medical_specialty, Pediatrics, Multiple Sclerosis, Dermatology, Disease, Antibodies, Monoclonal, Humanized, Natalizumab, Pharmacovigilance, Product Surveillance, Postmarketing, medicine, Humans, Registries, Adverse effect, business.industry, Multiple sclerosis, General Medicine, medicine.disease, Psychiatry and Mental health, Italy, PHARMACOVIGILANCE, REGISTRY, surveillance program, pharmacovigilance, multiple sclerosis, natalizumab, Physical therapy, Female, Settore MED/26 - Neurologia, Neurology (clinical), Neurosurgery, business, Multiple sclerosis, Natalizumab,Surveillance program, Pharmacovigilance, medicine.drug
Abstract: At the end of 2006, a pharmacovigilance program on natalizumab was settled by the Italian Pharmaceutical Agency, and on January 2007, multiple sclerosis patients poorly responding to the immunomodulating therapies or with an aggressive clinical form of disease from onset initiated to be registered and to receive the medication. On February 2010, almost 3,000 cases have been treated with natalizumab. The drop-out rate is 10%. Almost 800 cases received cycles of natalizumab for more than 18 months. One case of PML was reported and other adverse events are similar to those described in phase III studies. The majority of cases remained stable, while in 25% of cases, an improvement of disability was documented.
Published: 2011

39. Prevalence of red ear syndrome in juvenile primary headaches

Author: Vincenzo Raieli, Marco D'Amelio, Domenico Puma, G La Franca, Giovanni Savettieri, D. Ragusa, A. Compagno, Filippo Brighina, Raieli, V, Compagno, A, Brighina, F, La Franca, G, Puma, D, Ragusa, D, Savettieri, G, and D'Amelio, M.
Subjects: Pediatric migraine, Male, medicine.medical_specialty, Adolescent, Red ear syndrome, business.industry, Migraine Disorders, General Medicine, medicine.disease, Dermatology, Primary headache, Anesthesia, Child, Preschool, medicine, Prevalence, Juvenile, Red ear syndrome, pediatric migraine, trigeminal autonomic cephalgias, parasympathetic system, trigeminal-autonomic reflex, Humans, Settore MED/26 - Neurologia, Female, Neurology (clinical), Trigeminal autonomic reflex, business, Child, Ear Diseases
Abstract: Background: Previous studies have suggested a relationship between ‘red ear syndrome’ (RES) and pediatric migraine. Aims of this study were (i) to assess the frequency, specificity and sensitivity of RES in a population of pediatric migraineurs and (ii) to establish the pathophysiological mechanisms of RES associated with migraine. Methods and results: A total of 226 children suffering from headache (aged 4–17 years) were enrolled. One hundred and seventy-two (76.4%) were affected by migraine, the remaining 54 (23.6%) by other primary headaches. RES was followed significantly more frequently by migraine (23.3%; p Conclusions: Our study showed that (i) in children, RES is a highly specific sign for migraine. In addition, the evidence of an association of RES with some migraine features partially provoked by the parasympathetic system supports the hypothesis of a shared pathophysiological background (e.g. via the activation of the trigeminal-autonomic reflex).
Published: 2010

40. Frequency and determinants for hemorrhagic transformation of cerebral infarction

Author: Marco D'Amelio, Paolo Ragonese, Giorgia Famoso, Lupo I, Paolo Aridon, Maria Antonietta Mazzola, Valentina Saia, Norma Di Benedetto, Giovanni Savettieri, Caterina Sarno, Valeria Terruso, Terruso V, D'Amelio M, Di Benedetto N, Lupo I, Saia V, Famoso G, Mazzola MA, Aridon P, Sarno C, Ragonese P, and Savettieri G.
Subjects: Male, medicine.medical_specialty, Time Factors, Epidemiology, MEDLINE, Text mining, Risk Factors, Medicine, Humans, Aged, Cerebral Hemorrhage, Retrospective Studies, Aged, 80 and over, hemorrhagic transformation , ischemic stroke, business.industry, Cerebral infarction, Follow up studies, Retrospective cohort study, Cerebral Infarction, Middle Aged, medicine.disease, Surgery, Emergency medicine, Ischemic stroke, Female, Neurology (clinical), business, Complication, Follow-Up Studies
Abstract: Background: Frequency and associated risk factors for hemorrhagic transformation (HT), a worrying complication of ischemic stroke (IS), are not clearly defined. Our aim was to estimate the overall frequency and risk factors for HT in a hospital-based population. Methods: A retrospective review of medical records of patients discharged from our department during the period 2004–2006 with a diagnosis of anterior IS. Demographic, clinical and hematological information was collected. Uni- and multivariate logistic regression analyses were used to estimate risk for spontaneous HT. Results: We included 240 patients (125 males, 52%), mean age at admission was 72.5 years. HT was observed in 29 patients (12%). At univariate analysis, consciousness impairment at admission (OR 5.6, 95% CI 1.3–28.2), the presence of early CT signs (OR 2.4, 95% CI 1.1–5.3), infarcts of medium-large size (OR 11.3, 95% CI 4.1–30.8), cardioembolic stroke (OR 2.3, 95% CI 1.1–5.2) and low total cholesterol levels (OR 3.3, 95% CI 1.3–8.2) were significantly associated with HT. At multivariate analysis, only infarct size (OR 10.2, 95% CI 3.2–32.1) was still significantly associated with HT. Conclusions: Frequency of HT in our study was 12%. Consistently with previous results, HT was associated with the size of ischemic area. As patients included in our study did not receive thrombolytic therapy, our results are applicable to those patients whom clinicians, working in a hospital setting, usually deal with.
Published: 2009

41. Further evidence of genetic heterogeneity in familial essential tremor

Author: Giuseppe Salemi, Paolo Aridon, Maurizio De Fusco, Giorgio Casari, Giovanni Savettieri, Paolo Ragonese, ARIDON, P, RAGONESE, P, DE FUSCO, M, SALEMI, G, CASARI, G, SAVETTIERI, G, Aridon, P, Ragonese, P, De Fusco, M, Salemi, G, Casari, GIORGIO NEVIO, and Savettleri, G.
Subjects: Adult, Male, Genetic Linkage, Locus (genetics), Disease, Biology, Genetic analysis, Genetic Heterogeneity, Genetic linkage, medicine, Humans, Age of Onset, Aged, Genetics, Essential tremor, Genetic heterogeneity, Middle Aged, medicine.disease, Phenotype, Pedigree, Neurology, Settore MED/03 - Genetica Medica, Disease Progression, Female, Settore MED/26 - Neurologia, Neurology (clinical), Geriatrics and Gerontology, Age of onset, Linkage analysi, Neurological disease
Abstract: Familial essential tremor (FET) is a common hereditary movement disorder with phenotypic variability and genetic heterogeneity. To date, linkage analyses revealed three loci associated to essential tremor (ET) (ETM1 on 3q13, ETM2 on 2p22-25, and a locus on 6p23). We performed a genetic analysis of these candidate chromosomal regions in a fifth-generation Italian kindred with autosomal-dominant ET. Of the 22 clinically evaluated family members, nine were affected by ET. The genetic study indicates that the ET in this family is not associated to any of the known ET loci. These findings support evidence of further genetic heterogeneity for such disease. (C) 2007 Elsevier Ltd. All rights reserved.
Published: 2008

42. Diabetic and non-diabetic subjects with ischemic stroke: Differences, subtype distribution and outcome

Author: Giuseppe Salemi, Giuseppe Licata, Giovanni Savettieri, Antonino Tuttolomondo, Paolo Ragonese, Riccardo Di Sciacca, Antonio Pinto, Paola Fernandez, Domenico Di Raimondo, TUTTOLOMONDO A, PINTO A, SALEMI G, DI RAIMONDO D, DI SCIACCA R, FERNANDEZ P, RAGONESE P, SAVETTIERI G, and LICATA G
Subjects: Male, TOAST Classification, Time Factors, Settore MED/09 - Medicina Interna, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Severity of Illness Index, Brain Ischemia, Recurrence, Risk Factors, Odds Ratio, Prevalence, Medicine, Stroke, Aged, 80 and over, Nutrition and Dietetics, diabetes mellitu, Middle Aged, Prognosis, Acute Disease, Hypertension, Cardiology, Female, Settore MED/26 - Neurologia, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Lacunar stroke, Risk Assessment, Diabetes Complications, TOAST classification, Diabetes mellitus, Internal medicine, Severity of illness, ischemic stroke, Humans, cardiovascular diseases, Aged, business.industry, Case-control study, Recovery of Function, Odds ratio, medicine.disease, SSS, Logistic Models, Diabetes Mellitus, Type 2, Case-Control Studies, Physical therapy, Scandinavian Stroke Scale, business, Follow-Up Studies
Abstract: Background and aim Diabetes mellitus increases the risk of stroke, and pathophysiological changes of diabetic cerebral vessels may differ in comparison with non-diabetic ones; nonetheless, the clinical and prognostic profile of stroke in diabetic patients is not yet fully understood. On this basis, the aim of our study was to evaluate cerebrovascular risk factor prevalence in diabetic stroke patients in comparison with non-diabetics, to analyze whether diabetics have a different prevalence of stroke subtypes as classified by the TOAST classification, and determine whether diabetics and non-diabetics have a different prognosis. Methods and results We enrolled 102 diabetics and 204 non-diabetic subjects with acute ischemic stroke, matched by sex and age (± 3 years). We used as outcome indicators the Scandinavian Stroke Scale (SSS) score at admission and the modified Rankin disability scale at discharge and at a 6-month follow-up. We classified ischemic stroke according to the TOAST classification. Diabetes was associated with lacunar ischemic stroke subtype, with a record of hypertension, and with a better SSS score at admission. The association of diabetes with lacunar stroke remained significant even after adjustment for hypertension or for large artery atherosclerotic and cardioembolic stroke subtypes. Conclusion Our study shows some significant differences in acute ischemic stroke among diabetics in comparison with non-diabetics (higher frequency of hypertension, higher prevalence of lacunar stroke subtype, lower neurological deficit at admission in diabetics).
Published: 2008

43. BODY MASS INDEX DOES NOT CHANGE BEFORE PARKINSON'S DISEASE ONSET

Author: Graziella Callari, Marco D'Amelio, Barbara Palmeri, Valeria Terruso, Paolo Ragonese, Maria Antonietta Mazzola, Paolo Aridon, Giuseppe Salemi, N Di Benedetto, Giovanni Savettieri, RAGONESE P, D'AMELIO M, CALLARI G, DI BENEDETTO N, PALMERI B, MAZZOLA MA, TERRUSO V, SALEMI G, SAVETTIERI G, and ARIDON P
Subjects: Adult, Male, medicine.medical_specialty, Parkinson's disease, Hypercholesterolemia, Population, Comorbidity, Weight Gain, Coffee, Body Mass Index, Risk Factors, Internal medicine, Diabetes mellitus, Weight Loss, Epidemiology, Diabetes Mellitus, medicine, Humans, Obesity, Age of Onset, education, Aged, Aged, 80 and over, Hypertriglyceridemia, education.field_of_study, business.industry, Smoking, Case-control study, nutritional and metabolic diseases, Parkinson Disease, Middle Aged, Overweight, medicine.disease, Neurology, Case-Control Studies, Healthy individuals, anthropometrical measures, body mass index, case–control study, epidemiology, Parkinson's disease, risk factors, Physical therapy, Female, Settore MED/26 - Neurologia, Neurology (clinical), business, Body mass index
Abstract: Background and purpose: Previous studies on the association between Parkinson’s disease (PD) and body mass index (BMI) have reported conflicting results. We investigated the relationship between PD and BMI by a case–control study. Methods: PD patients were randomly matched to healthy individuals by sex and age. BMI distribution in cases has been compared with BMI of controls and odd ratios (ORs) with 95% CI were calculated. Results: We included 318 PD patients and 318 controls. We observed no association between PD and BMI. BMI distribution in cases and controls was similar also when we adjusted for diabetes, hypercholesterolemia and the time elapsed between PD onset and the interview (OR = 0.99; CI = 0.94–1.03; P = 0.51). Conclusions: These results did not confirm the previously reported association between PD and BMI. Population characteristics and methodological issues may partially account for the differences observed between the present study and the others.
Published: 2008

44. MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis

Author: DURELLI L, BARBERO P, BERGUI M, VERSINO E, BASSANO MA, VERDUN E, RIVOIRO C, FERRERO C, PICCO E, RIPELLINO P, GIULIANI G, MONTANARI E, CLERICO M, ITALIAN MULTIPLE SCLEROSIS STUDY GROUP DURELLI L, FERRERO B, PIPIERI A, RICCI A, CUCCI A, FESTA E, ROVERA A, TAVELLA A, CONTESSA G, DELFICO L, ZHONG JJ, ROTTOLI M, MORONI S, TEATINI F, SCHOENHUBER R, SPISSU A, REGGIO A, LO FERMO S, LIBERTO A, PERLA F, GRASSO E, PESCI I, MANNESCHI L, GHEZZI A, ZAFFARONI M, CAROLEI A, TOTARO R, PUCCI, Enzo, CARTECHINI E, SCARPINI E, CLERICI R, PROTTI A, ERMINIO C, COTRUFO R, LUS G, SAVETTIERI, Giovanni, SALEMI, Giuseppe, BERGAMASCHI R, ROMANI A, POLICRETI A, IUDICE A, FRITTELLI C, MOTTI L, MARCELLO N, MEOLA G, ROBOTTI M, CAVALLO R, RAVETTI C, DEOTTO L., DURELLI L, BARBERO P, BERGUI M, VERSINO E, BASSANO MA, VERDUN E, RIVOIRO C, FERRERO C, PICCO E, RIPELLINO P, GIULIANI G, MONTANARI E, CLERICO M, ITALIAN MULTIPLE SCLEROSIS STUDY GROUP DURELLI L, FERRERO B, PIPIERI A, RICCI A, CUCCI A, FESTA E, ROVERA A, TAVELLA A, CONTESSA G, DELFICO L, ZHONG JJ, ROTTOLI M, MORONI S, TEATINI F, SCHOENHUBER R, SPISSU A, REGGIO A, LO FERMO S, LIBERTO A, PERLA F, GRASSO E, PESCI I, MANNESCHI L, GHEZZI A, ZAFFARONI M, CAROLEI A, TOTARO R, PUCCI E, CARTECHINI E, SCARPINI E, CLERICI R, PROTTI A, ERMINIO C, COTRUFO R, LUS G, SAVETTIERI G, SALEMI G, BERGAMASCHI R, ROMANI A, POLICRETI A, IUDICE A, FRITTELLI C, MOTTI L, MARCELLO N, MEOLA G, ROBOTTI M, CAVALLO R, RAVETTI C, and DEOTTO L
Subjects: Male, Neutralising antibody, MULTICENTER, PLACEBO-CONTROLLED TRIAL, GUIDELINES, Gastroenterology, DOUBLE-BLIND, Interferon β, MAGNETIC-RESONANCE, Prospective Studies, Neurologic Examination, biology, Brain, IMPAIRMENT, Middle Aged, Predictive value, Magnetic Resonance Imaging, Recombinant Proteins, Psychiatry and Mental health, Treatment Outcome, Settore MED/26 - Neurologia, Female, Antibody, Interferon beta-1b, Adult, medicine.medical_specialty, DIAGNOSTIC-CRITERIA, Injections, Subcutaneous, Antibodies, Drug Administration Schedule, Disease activity, Multiple Sclerosis, Relapsing-Remitting, Adjuvants, Immunologic, Neutralization Tests, Internal medicine, medicine, Humans, Interferon beta, business.industry, Multiple sclerosis, DISABILITY, MS, Interferon-beta, medicine.disease, Confidence interval, Surgery, biology.protein, Neurology (clinical), business, Follow-Up Studies
Abstract: Objective: To prospectively validate MRI activity and neutralising anti-interferon antibody (NAb) during the first 6 months of interferon β treatment as response indicators in multiple sclerosis (MS). Methods: Patients with relapsing–remitting MS were followed during the first 2 years of treatment. Neurological assessments were performed every 3 months or when a relapse was suspected. MRI scans performed at baseline and at 3, 4, 5 and 6 months after the start of treatment were assessed centrally for disease activity: new T2 or gadolinium enhancing T1 lesions. NAb were assessed using the MxA protein assay; positivity was defined as two consecutive titres ⩾20 NU/ml. We evaluated the predictivity of an active scan, NAb positivity, or both, during the first 6 months of treatment, on the occurrence of clinical disease activity in the following 18 months. Results: 147 patients were assessed at 16 centres. Predictivity parameters (with confidence intervals) were as follows: active scan, sensitivity (SN) 52% (34–69%), specificity (SP) 80% (65–91%), negative predictive value (NPV) 73% (58–77%), positive predictive value (PPV) 62% (42–79%), p = 0.002; NAb positivity, SN 71% (45–88%), SP 66% (55–76%), NPV 92% (82–97%), PPV 29% (16–45%), p = 0.01; active scan and NAb positivity, SN 71% (38–91%), SP 86% (73–94%), NPV 94% (86–98%), PPV 50% (29–70%), p = 0.0003. Conclusions: MRI activity and NAb occurrence during the first 6 months of interferon β treatment were reliable predictors of long term clinical response, particularly when combined. Patients with negative predictors showed a less than 10% risk of developing clinical activity. Patients with positive predictors showed a 50% risk of further clinical activity. These patients need to be followed carefully with further MRI and NAb tests.
Published: 2008

45. Long-term survival and outcome after first stroke in the Sicilian Aeolian Island Archipelago population

Author: Rocco Salvatore Calabrò, Paolo Postorino, Giovanni Savettieri, Paolino La Spina, Rosa Musolino, Letterio Morgante, S. Serra, Rodolfo Savica, LA SPINA P, SAVICA R, SERRA S, CALABRÒ RS, POSTORINO P, MORGANTE L, SAVETTIERI G, and MUSOLINO R
Subjects: Male, medicine.medical_specialty, Neurology, Population, Dermatology, survival, Health Services Accessibility, Cohort Studies, Interviews as Topic, Mediterranean Islands, Medicine, Humans, cardiovascular diseases, Survivors, education, Stroke, Sicily, Neuroradiology, Aged, Aged, 80 and over, geography, education.field_of_study, geography.geographical_feature_category, business.industry, Incidence, General Medicine, Middle Aged, medicine.disease, language.human_language, Survival Rate, Psychiatry and Mental health, Cerebrovascular Disorders, Archipelago, language, Aeolian processes, Settore MED/26 - Neurologia, Female, Neurology (clinical), Neurosurgery, business, Sicilian, Demography, Follow-Up Studies
Abstract: Background: Only a restricted number of population studies based on long-term prognosis after a stroke have been published. We analyzed long-term survival and outcome in insular first-ever stroke population from the Aeolian Archipelago. Subjects and methods: From 1 July, 1999 to 30 June 2002, 62 patients with first-ever stroke were recruited to evaluate short-term incidence and outcome. Information for every patient was collected by phone interviews after 3 months, 1 year, and 4 years. Results: 30 days case fatality rate was 24.2% (95% C.I. 14.22 to 36.75). Fifty-one percent (95% C.I. 35.8 to 66.3) of patients died before last survey and 39.1% died during the first year of follow-up. Annual approximate death risk amounted to about 10%. Results: The cerebrovascular causes were the most frequent causes of death (65.2%). A high level of invalidity at 4 years was present in many survivors (40%). Results: None of the deceased had followed physio-kinesitherapy, or applied for equipment or services. Conclusion: More attentive medical care for stroke patients could help improve outcome, reducing mortality for patients from the Aeolian island, who already showed a low incidence.
Published: 2007

46. Myocardial 123metaiodobenzylguanidine uptake in genetic Parkinson's disease

Author: Aldo Quattrone, Marco D'Amelio, Giuseppe Nicoletti, Patrizia Tarantino, Innocenza Claudia Cirò Candiano, Giovanni Savettieri, Mario Zappia, Maurizio Morelli, Piercostanzo Loizzo, Donatella Civitelli, Fabiana Novellino, Grazia Annesi, Letterio Morgante, Francesca E. Rocca, Ferdinanda Annesi, Antonio Bagnato, Francesca Condino, Alfredo Petrone, QUATTRONE A, BAGNATO A, ANNESI G, NOVELLINO F, MORGANTE L, SAVETTIERI G, ZAPPIA M, TARANTINO P, CANDIANO IC, ANNESI F, CIVITELLI D, ROCCA FE, D'AMELIO M, NICOLETTI G, MORELLI M, PETRONE A, LOIZZO P, and CONDINO F
Subjects: Adult, Male, medicine.medical_specialty, Parkinson's disease, Genotype, Ubiquitin-Protein Ligases, DNA Mutational Analysis, Protein Deglycase DJ-1, PINK1, Gene mutation, Protein Serine-Threonine Kinases, medicine.disease_cause, Leucine-Rich Repeat Serine-Threonine Protein Kinase-2, Severity of Illness Index, Parkin, Central nervous system disease, Diagnosis, Differential, Degenerative disease, Parkinsonian Disorders, Internal medicine, Surveys and Questionnaires, medicine, Humans, Point Mutation, Promoter Regions, Genetic, Genetic PD, Myocardial scintigraphy, Oncogene Proteins, Tomography, Emission-Computed, Single-Photon, Mutation, Movement Disorders, business.industry, Myocardium, Intracellular Signaling Peptides and Proteins, Parkinson Disease, Galvanic Skin Response, Middle Aged, medicine.disease, LRRK2, nervous system diseases, 3-Iodobenzylguanidine, Endocrinology, Neurology, Settore MED/26 - Neurologia, Female, Neurology (clinical), Radiopharmaceuticals, business, Protein Kinases
Abstract: Myocardial (123)Metaiodobenzylguanidine (MIBG) enables the assessment of postganglionic sympathetic cardiac innervation. MIBG uptake is decreased in nearly all patients with Parkinson's disease (PD). Our objective was to evaluate MIBG uptake in patients with genetic PD. We investigated MIBG uptake in 14 patients with PD associated with mutations in different genes (Parkin, DJ-1, PINK], and leucine-rich repeat kinase 2 -LRRK2), in 15 patients with idiopathic PD, and 10 control subjects. The myocardial MIGB uptake was preserved in 3 of the 4 Parkin-associated Parkinsonisms, in I of the 2 patients with DJ-1 mutations, in 1 of the 2 brothers with PINK] mutations, in 3 of the 6 unrelated patients with Gly2019Ser mutation in the LRRK2 gene, whereas it was impaired in all patients with idiopathic PD. MIBG was preserved in all control subjects. Our study shows that myocardial MIGB uptake was normal in 8 of 14 patients with genetic PD, suggesting that cardiac sympathetic denervation occurs less frequently in genetic PD than in idiopathic PD. Our findings also demonstrate that MIGB uptake has a heterogeneous pattern in genetic PD, because it was differently impaired in patients with different mutations in the same gene or with the same gene mutation. (c) 2007 Movement Disorder Society.
Published: 2007

47. Prevalence of Parkinson's disease and other types of parkinsonism in the Aeolian Archipelago, Sicily

Author: Alessandra Nicoletti, Giovanni Savettieri, Rodolfo Savica, Letterio Morgante, Ubaldo Bonuccelli, Mario Zappia, Donatella Contrafatto, A. Epifanio, Roberto Marconi, Marco D'Amelio, P. La Spina, Salvatore Lanzafame, R. Musolino, NICOLETTI A, ZAPPIA M, EPIFANIO A, CONTRAFFATTO D, SAVICA R, LANZAFAME S, MUSOLINO R, LA SPINA P, BONUCCELLI U, MARCONI R, D'AMELIO M, SAVETTIERI G, MORGANTE L, and CONTRAFATTO D
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Parkinson's disease, Population, Medical information, Disease, Severity of Illness Index, Parkinsonian Disorders, Epidemiology, Epidemiology, parkinsonism, prevalence, medicine, Humans, education, Sicily, Aeolian archipelago, Aged, Aged, 80 and over, education.field_of_study, business.industry, Parkinsonism, Parkinson Disease, Middle Aged, medicine.disease, Health Surveys, Screening questionnaire, Neurology, Physical therapy, Female, Neurology (clinical), Geriatrics and Gerontology, business
Abstract: Objective To estimate prevalence of Parkinson's disease (PD) and other types of parkinsonism in the Aeolian Archipelago, Sicily. Methods We studied the frequency of PD and other types of parkinsonism in the Aeolian Archipelago (population 13,431). All potential cases were identified from available medical information sources. To ensure the completeness of the case-findings, a screening questionnaire was also mailed to residents aged 40 years and over. Subjects were considered prevalent if they fulfilled the SNES diagnostic criteria for PD, on prevalence day (January 1, 2001). Results We identified 17 patients with parkinsonism from medical sources, and 4 from mail-survey. Prevalence for all types of parkinsonism was 156.3/100,000 (95% CI 99.4–234.8). Fourteen subjects fulfilled diagnostic criteria for PD giving a crude prevalence of 104.2/100,000 (95% CI 59.4–170.7) and 422.5/100,000 in the population aged 60 years and over. Conclusions Prevalence of all types of parkinsonism and PD found in the Aeolian Archipelago is lower than that previously reported in Sicily.
Published: 2007

48. Dropped head as an unusual presenting sign of myasthenia gravis

Author: Marco D'Amelio, Brigida Fierro, Ornella Daniele, Paolo Ragonese, N Di Benedetto, Giovanni Savettieri, Filippo Brighina, D'AMELIO M, DI BENEDETTO N, RAGONESE P, DANIELE O, BRIGHINA F, FIERRO B, and SAVETTIERI G
Subjects: medicine.medical_specialty, Weakness, Neurology, Abnormal flexion, Dermatology, Neck Muscles, Myasthenia Gravis, medicine, Humans, Neuroradiology, Muscle Weakness, business.industry, General Medicine, Recovery of Function, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Myasthenia gravis, Psychiatry and Mental health, Treatment Outcome, Dropped head, Cervical Vertebrae, Female, Neurology (clinical), Neurosurgery, Cholinesterase Inhibitors, medicine.symptom, business, Head, Sign (mathematics), Pyridostigmine Bromide
Abstract: Prominent or isolated weakness of cervical extensor muscles is a relatively rare clinical sign. Commonly, this is known as "dropped-head syndrome". This abnormal flexion of the head may occur in a variety of neuromuscular diseases and in a few non-neurological disorders as well. The case we describe concerns a 61-year-old woman with dropped-head syndrome as the unique complaint of myasthenia gravis.
Published: 2006

49. Heterogeneity at the HLA-DRB1 locus and risk for multiple sclerosis

Author: Carolyn Deloa, Bruce C.A. Cree, Lisa F. Barcellos, Giovanni Savettieri, Antonio Uccelli, Stephen Sawcer, Jorge R. Oksenberg, Farren B.S. Briggs, Xavier Montalban, Patricia P. Ramsay, Margaret A. Pericak-Vance, Glenys Thomson, Pablo Villoslada, Ann B. Begovich, Robin R. Lincoln, Stephen L. Hauser, Jonathan L. Haines, Sergio E. Baranzini, Alastair Compston, BARCELLOS LF, SAWCER S, RAMSAY PP, BARANZINI SE, THOMSON G, BRIGGS F, CREE BC, BEGOVICH AB, VILLOSLADA P, MONTALBAN X, UCCELLI A, SAVETTIERI G, LINCOLN RR, DELOA C, HAINES JL, PERICAK-VANCE MA, COMPSTON A, HAUSER SL, and OKSENBERG JR
Subjects: Models, Molecular, Male, Sequence Homology, immune system diseases, Models, Risk Factors, Databases, Genetic, Adult, Alleles, Amino Acid Sequence, Databases, Genetic, Female, Genetic Variation, Genotype, HLA-DR Antigens, chemistry/genetics, HLA-DRB1 Chains, Humans, Male, Middle Aged, Models, Molecular, Molecular Sequence Data, Multiple Sclerosis, Chronic Progressive, genetics/immunology, Multiple Sclerosis, genetics/immunology, Phenotype, Risk Factors, Sequence Homology, Amino Acid, skin and connective tissue diseases, HLA-DRB1, Genetics (clinical), Genetics, General Medicine, Multiple Sclerosis, Chronic Progressive, Middle Aged, Phenotype, Female, musculoskeletal diseases, Adult, Multiple Sclerosis, Genotype, Molecular Sequence Data, Locus (genetics), Human leukocyte antigen, Biology, Databases, Alleles, phenotype, heterogeneity, human leukocyte antigens, age of onset, chromosomes, genes, genotype, haplotypes,multiple sclerosis, relapsing-remitting, genetics, disability, primary progressive multiple sclerosis, hla-drb1 gene, illness length, severity of illness, Genetic, Genetic variation, medicine, Humans, Amino Acid Sequence, Allele, Molecular Biology, Alleles, Sequence Homology, Amino Acid, Multiple sclerosis, Haplotype, Genetic Variation, Molecular, HLA-DR Antigens, medicine.disease, genetics/immunology, chemistry/genetics, Immunology, Age of onset, HLA-DRB1 Chains
Abstract: Variation in major histocompatibility complex genes on chromosome 6p21.3, specifically the human leukocyte antigen HLA-DR2 or DRB1*1501-DQB1*0602 extended haplotype, confers risk for multiple sclerosis (MS). Previous studies of DRB1 variation and both MS susceptibility and phenotypic expression have lacked statistical power to detect modest genotypic influences, and have demonstrated conflicting results. Results derived from analyses of 1339 MS families indicate DRB1 variation influences MS susceptibility in a complex manner. DRB1*15 was strongly associated in families (P=7.8x10(-31)), and a dominant DRB1*15 dose effect was confirmed (OR=7.5, 95% CI=4.4-13.0, P
Published: 2006

50. Multiple sclerosis severity score: Using disability and disease duration to rate disease severity

Author: Maria José Sá, Justin P. Rubio, Bianca Miterski, S. R. Seaman, Jörg T. Epplen, Iuliana Achiti, Monica Marta, M. Coustans, Sandra Vukusic, G V McDonnell, Annette Bang Oturai, Richard Roxburgh, Maria Edite Rio, Pablo Villoslada, Bénédicte Dubois, Fabiana Tesser, Maurizio Leone, Christian Confavreux, T Masterman, Marcin P. Mycko, Gilles Edan, N. Téllez Lara, Ana Martins da Silva, Alexandra Weber, Stephen Sawcer, E. Le Page, Giuseppe Salemi, Giovanni Savettieri, P. Soelberg Sørensen, Anke Hensiek, Xavier Montalban, D. A. S. Compston, Maria Giovanna Marrosu, Helmut Butzkueven, Krzysztof Selmaj, Frauke Zipp, Maria Liguori, Isabel Leite, Stanley Hawkins, Elisabeth Gulowsen Celius, Jan Hillert, Maria Trojano, Trevor J. Kilpatrick, Eleonora Cocco, Chemical Biology 2, ROXBURGH RHSR, SEAMAN SR, MASTERMAN T, HENSIEK AE, SAWCER SJ, VUKUSIC S, ACHITI I, CONFAVREUX C, COUSTANS M, LE PAGE E, EDAN G, MCDONNELL GV, HAWKINS S, TROJANO M, LIGUORI M, COCCO E, MARROSU MG, TESSERE F, LEONE MA, WEBER A, ZIPP F, MITERSKI B, EPPLEN JT, OTURAI A, SOELBERG-SORENSEN P, CELIUS EG, TELLEZ LARA N, MONTALBAN X, VILLOSLADA P, SILVA AM, MARTA M, LEITE I, DUBOIS B, RUBIO J, BUTZKUEVEN H, KILPATRICK T, MYCKO MP, SELMAJ KW, RIO ME, SA M, SALEMI G, SAVETTIERI G, HILLERT J, and COMPSTON DAS
Subjects: Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Databases, Factual, Cross-sectional study, Models, Neurological, Disease, SUSCEPTIBILITY, Severity of Illness Index, Cohort Studies, Disability Evaluation, Predictive Value of Tests, Recurrence, Severity of illness, medicine, Humans, Longitudinal Studies, Age of Onset, Models, Statistical, Expanded Disability Status Scale, business.industry, Multiple sclerosis, OUTCOME MEASURE, Reproducibility of Results, NATURAL-HISTORY, Middle Aged, Prognosis, medicine.disease, Cross-Sectional Studies, Predictive value of tests, Disease Progression, Physical therapy, Female, France, Neurology (clinical), Age of onset, business, Cohort study
Abstract: Background: There is no consensus method for determining progression of disability in patients with multiple sclerosis (MS) when each patient has had only a single assessment in the course of the disease. Methods: Using data from two large longitudinal databases, the authors tested whether cross-sectional disability assessments are representative of disease severity as a whole. An algorithm, the Multiple Sclerosis Severity Score (MSSS), which relates scores on the Expanded Disability Status Scale (EDSS) to the distribution of disability in patients with comparable disease durations, was devised and then applied to a collection of 9,892 patients from 11 countries to create the Global MSSS. In order to compare different methods of detecting such effects the authors simulated the effects of a genetic factor on disability. Results: Cross-sectional EDSS measurements made after the first year were representative of overall disease severity. The MSSS was more powerful than the other methods the authors tested for detecting different rates of disease progression. Conclusion: The Multiple Sclerosis Severity Score (MSSS) is a powerful method for comparing disease progression using single assessment data. The Global MSSS can be used as a reference table for future disability comparisons. While useful for comparing groups of patients, disease fluctuation precludes its use as a predictor of future disability in an individual.
Published: 2005

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