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1. Are strong opioids equally effective and safe in the treatment of chronic cancer pain? A multicenter randomized phase IV ‘real life’ trial on the variability of response to opioids

Author

Monfredo, M., Mistretta, R., di Salemi, P.O., Zecca, E., Cartoni, C., Brunetti, G.A., Tassinari, D., Drudi, F., Rizzi, F., Pizzuto, M., Formaglio, F., Luzi, M., Narducci, F., Boscolo, G., Mangiapia, M., Artioli, F., Lazzari, M., Dauri, M., Diodati, M., Cupaiolo, A., Mameli, S., Preti, P., Ferrari, P., Vasini, G., Roy, M.T., Piva, L., Nardi, L.F., Montanari, L., Reina, V., Fusco, F., Orsi, L., Molinari, E., Corli, O., Floriani, I., Roberto, A., Montanari, M., Galli, F., Greco, M.T., Caraceni, A., Kaasa, S., Dragani, T.A., Azzarello, G., Luzzani, M., Cavanna, L., Bandieri, E., Gamucci, T., Lipari, G., Di Gregorio, R., Valenti, D., Reale, C., Pavesi, L., Iorno, V., Crispino, C., Pacchioni, M., and Apolone, G.

Published
2016
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2. Are strong opioids equally effective and safe in the treatment of chronic cancer pain? A multicenter randomized phase IV ‘real life’ trial on the variability of response to opioids

Author

Corli, O., Floriani, I., Roberto, A., Montanari, M., Galli, F., Greco, M. T., Caraceni, A., Kaasa, S., Dragani, T. A., Azzarello, G., Luzzani, M., Cavanna, L., Bandieri, E., Gamucci, T., Lipari, G., Di Gregorio, R., Valenti, D., Reale, C., Pavesi, L., Iorno, V., Crispino, C., Pacchioni, M., Apolone, G., Monfredo, M., Mistretta, R., di Salemi, P.O., Zecca, E., Cartoni, C., Brunetti, G.A., Tassinari, D., Drudi, F., Rizzi, F., Pizzuto, M., Formaglio, F., Luzi, M., Narducci, F., Boscolo, G., Mangiapia, M., Artioli, F., Lazzari, M., Dauri, M., Diodati, M., Cupaiolo, A., Mameli, S., Preti, P., Ferrari, P., Vasini, G., Roy, M.T., Piva, L., Nardi, L.F., Montanari, L., Reina, V., Fusco, F., Orsi, L., and Molinari, E.

Published
2016
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8. Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) (2016) Pharmacological and non-pharmacological strategies in the integrated treatment of pain in neurorehabilitation. Evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

Author

Tamburin, S., Lacerenza, M. R., Castelnuovo, Gianluca, Agostini, M., Paolucci, S., Bartolo, M., Bonazza, S., Federico, A., Formaglio, F., Giusti, Emanuele Maria, Manzoni, G. M., Mezzarobba, S., Pietrabissa, Giada, Polli, A., Turolla, A., and Sandrini, G.

Subjects
Settore M-PSI/08 - PSICOLOGIA CLINICA, pain in neurorehabilitation
Published
2016

9. Trauma and amyotrophic lateral sclerosis: a case-control study from a population-based registry

Author

Pupillo, E., Messina, P., Logroscino, G., Zoccolella, S., Chio, A., Calvo, A., Corbo, M., Lunetta, C., Micheli, A., Millul, A., Vitelli, E., Beghi, E., Bissolati, M., Formaglio, F., Gerardi, F., Giussani, G., Maestri, E., Prelle, A., Protti, A., Riva, N., Santoro, D., Al-Chalabi, A., Berro, A. C., De Mercanti, S., Giacone, S., Ilardi, A., Hardiman, O., Capozzo, R., Ludolph, A., Mitchell, D., Preux, P. -M., Swingler, R., van den Berg, L., Alvisi, E., Cereda, C., Ceroni, M., Citterio, A., di Poggio, M. B., Caponnetto, C., Buzzi, P., Colombo, I., Cotelli, M. S., Filosto, M., Padovani, A., De Lodovici, L., Ferrarese, C., Tremolizzo, L., Fetoni, V., Palazzini, E., Guaita, M. C., Perrone, P., Secchi, P., Lorusso, L., Sidoti, V., Perini, M., Tavernelli, F., Rigamonti, A., Pupillo, E, Messina, P, Logroscino, G, Zoccolella, S, Chiò, A, Calvo, A, Corbo, M, Lunetta, C, Micheli, A, Millul, A, Vitelli, E, Beghi, E, Bissolati, M, Formaglio, F, Gerardi, F, Giussani, G, Maestri, E, Prelle, A, Protti, A, Riva, N, Santoro, D, Al Chalabi, A, Berro, A, De Mercanti, S, Giacone, S, Ilardi, A, Hardiman, O, Capozzo, R, Ludolph, A, Mitchell, D, Preux, P, Swingler, R, van den Berg, L, Alvisi, E, Cereda, C, Ceroni, M, Citterio, A, di Poggio, M, Caponnetto, C, Buzzi, P, Colombo, I, Cotelli, M, Filosto, M, Padovani, A, De Lodovici, L, Ferrarese, C, Tremolizzo, L, Fetoni, V, Palazzini, E, Guaita, M, Perrone, P, Secchi, P, Lorusso, L, Sidoti, V, Perini, M, Tavernelli, F, and Rigamonti, A

Subjects
Male, ALS, trauma, risk, medicine.medical_specialty, Pediatrics, Epidemiology, Population, Poison control, Trauma, 03 medical and health sciences, 0302 clinical medicine, Injury prevention, Humans, Medicine, Registries, 030212 general & internal medicine, Amyotrophic lateral sclerosis, education, Aged, education.field_of_study, business.industry, Amyotrophic Lateral Sclerosis, Case-control study, Odds ratio, Middle Aged, medicine.disease, 3. Good health, Risk factors, Neurology, Case-Control Studies, Multivariate Analysis, Physical therapy, Wounds and Injuries, Population study, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

BACKGROUND AND PURPOSE: Published reports on the association between amyotrophic lateral sclerosis (ALS) and trauma are controversial suggesting the need for a new case-control study done in a large population. METHODS: A case-control study was undertaken in Italy to assess this association. Cases were patients with newly diagnosed ALS from four population-based registries. For each case, two hospital controls were selected, matched for age, sex, and province of residence, one with a neurological (non-degenerative) disease and one with a non-neurological disease (other than orthopedic or surgical). Traumatic events (defined as accidental events causing injuries requiring medical care) were recorded with details on type, site, timing, severity, and complications. The risks were assessed as odds ratios (ORs) with 95% confidence intervals (CI), crude and adjusted for age, sex, education, interviewee (patient or surrogate), physical activity, smoking, alcohol, and coffee. RESULTS: The study population comprised 377 patients in each of the three groups. One or more traumatic events were reported by 225 cases (59.7%), 191 neurological controls (50.7%), and 179 non-neurological controls (47.5%) (P

Published
2012

10. Time for a Consensus Conference on pain in neurorehabilitation

Author

Sandrini, Giorgio, Tamburin, Stefano, Paolucci, Stefano, Boldrini, Paolo, Saraceni, Vincenzo M, Smania, Nicola, Agostini, M, Alfonsi, E, Aloisi, Am, Alvisi, E, Aprile, I, Armando, M, Avenali, M, Azicnuda, E, Barale, F, Bartolo, M, Bergamaschi, R, Berlangieri, M, Berlincioni, V, Berliocchi, L, Berra, E, Berto, G, Bonadiman, S, Bonazza, S, Bressi, F, Brugnera, A, Brunelli, S, Buzzi, Mg, Cacciatori, C, Calvo, A, Cantarella, C, Caraceni, At, Carone, R, Carraro, E, Casale, R, Castellazzi, P, Castelnuovo, G, Castino, A, Cella, M, Cerbo, R, Chiò, A, Ciotti, C, Cisari, C, Coraci, D, Dalla Toffola, E, Defazio, G, De Icco, R, Del Carro, U, Dell’Isola, A, De Tanti, A, D’Ippolito, M, Fazzi, E, Federico, A, Ferrari, A, Ferrari, S, Ferraro, F, Formaglio, F, Formisano, R, Franzoni, S, Gajofatto, F, Gandolfi, M, Gardella, B, Geppetti, P, Giammò, A, Gimigliano, R, Giusti, Em, Greco, E, Ieraci, V, Invernizzi, M, Jacopetti, M, Jedrychowska, I, Lacerenza, M, La Cesa, S, Lobba, D, Magrinelli, F, Mandrini, S, Manera, U, Manzoni, Gm, Marchettini, P, Marchioni, E, Mariotto, S, Martinuzzi, A, Masciullo, M, Mezzarobba, S, Miotti, D, Modenese, A, Molinari, M, Monaco, S, Morone, G, Nappi, R, Negrini, S, Pace, A, Padua, L, Pagliano, E, Palmerini, V, Paolucci, S, Pazzaglia, C, Pecchioli, C, Pietrabissa, G, Picelli, A, Polli, A, Porro, Ca, Porru, D, Romano, M, Roncari, L, Rosa, R, Saccavini, M, Sacerdote, P, Sandrini, G, Saviola, D, Schenone, A, Schweiger, V, Scivoletto, G, Smania, N, Solaro, C, Spallone, V, Springhetti, I, Tamburin, S, Tassorelli, C, Tinazzi, M, Togni, R, Torre, M, Torta, R, Traballesi, M, Trabucco, E, Tramontano, M, Truini, A, Tugnoli, V, Turolla, A, Valeriani, M, Vallies, G, Verzini, E, Vottero, M, Mario, P., Castelnuovo G (ORCID:0000-0003-2633-9822), Giusti EM (ORCID:0000-0001-5767-8785), Padua L (ORCID:0000-0003-2570-9326), Pietrabissa G (ORCID:0000-0002-5911-5748), Sandrini, Giorgio, Tamburin, Stefano, Paolucci, Stefano, Boldrini, Paolo, Saraceni, Vincenzo M, Smania, Nicola, Agostini, M, Alfonsi, E, Aloisi, Am, Alvisi, E, Aprile, I, Armando, M, Avenali, M, Azicnuda, E, Barale, F, Bartolo, M, Bergamaschi, R, Berlangieri, M, Berlincioni, V, Berliocchi, L, Berra, E, Berto, G, Bonadiman, S, Bonazza, S, Bressi, F, Brugnera, A, Brunelli, S, Buzzi, Mg, Cacciatori, C, Calvo, A, Cantarella, C, Caraceni, At, Carone, R, Carraro, E, Casale, R, Castellazzi, P, Castelnuovo, G, Castino, A, Cella, M, Cerbo, R, Chiò, A, Ciotti, C, Cisari, C, Coraci, D, Dalla Toffola, E, Defazio, G, De Icco, R, Del Carro, U, Dell’Isola, A, De Tanti, A, D’Ippolito, M, Fazzi, E, Federico, A, Ferrari, A, Ferrari, S, Ferraro, F, Formaglio, F, Formisano, R, Franzoni, S, Gajofatto, F, Gandolfi, M, Gardella, B, Geppetti, P, Giammò, A, Gimigliano, R, Giusti, Em, Greco, E, Ieraci, V, Invernizzi, M, Jacopetti, M, Jedrychowska, I, Lacerenza, M, La Cesa, S, Lobba, D, Magrinelli, F, Mandrini, S, Manera, U, Manzoni, Gm, Marchettini, P, Marchioni, E, Mariotto, S, Martinuzzi, A, Masciullo, M, Mezzarobba, S, Miotti, D, Modenese, A, Molinari, M, Monaco, S, Morone, G, Nappi, R, Negrini, S, Pace, A, Padua, L, Pagliano, E, Palmerini, V, Paolucci, S, Pazzaglia, C, Pecchioli, C, Pietrabissa, G, Picelli, A, Polli, A, Porro, Ca, Porru, D, Romano, M, Roncari, L, Rosa, R, Saccavini, M, Sacerdote, P, Sandrini, G, Saviola, D, Schenone, A, Schweiger, V, Scivoletto, G, Smania, N, Solaro, C, Spallone, V, Springhetti, I, Tamburin, S, Tassorelli, C, Tinazzi, M, Togni, R, Torre, M, Torta, R, Traballesi, M, Trabucco, E, Tramontano, M, Truini, A, Tugnoli, V, Turolla, A, Valeriani, M, Vallies, G, Verzini, E, Vottero, M, Mario, P., Castelnuovo G (ORCID:0000-0003-2633-9822), Giusti EM (ORCID:0000-0001-5767-8785), Padua L (ORCID:0000-0003-2570-9326), and Pietrabissa G (ORCID:0000-0002-5911-5748)

Abstract

Time for a Consensus Conference on pain in neurorehabilitation.

Published
2016

12. Coffee and Amyotrophic Lateral Sclerosis: A Possible Preventive Role

Author

Beghi, E., Pupillo, E., Messina, P., Giussani, G., Chio, A., Zoccolella, S., Moglia, C., Corbo, M., Logroscino, G., Al-Chalabi, A., Hardiman, O., Ludolph, A., Mitchell, D., Preux, P. -M., Swingler, R., Traynor, B. J., Alvisi, E., Cereda, C., Ceroni, M., Citterio, A., di Poggio, M. B., Caponnetto, C., Bissolati, M., Buzzi, P., Colombo, I., Formaglio, F., Lunettam, C., Maestri, E., Millul, A., Prelle, A., Protti, A., Riva, N., Santoro, D., Capozzo, R., Berro, A. C., Cammarosano, S., Giacone, S., Ilardi, A., Cotelli, M. S., Filosto, M., Micheli, A., Padovani, A., De Lodovici, L., Ferrarese, C., Tremolizzo, L., Fetoni, V., Palazzini, E., Guaita, M. C., Perrone, P., Secchi, P., Lorusso, L., Sidoti, V., Perini, M., Tavernelli, F., Rigamonti, A., Vitelli, E., Beghi, E, Pupillo, E, Messina, P, Giussani, G, Chiò, A, Zoccolella, S, Moglia, C, Corbo, M, Logroscino, G, Ferrarese, C, and Tremolizzo, L

Subjects
amyotrophic lateral sclerosis, coffee, motor neuron disease, Adult, Male, medicine.medical_specialty, Epidemiology, Coffee, Young Adult, Risk Factors, Internal medicine, Coffee intake, medicine, Odds Ratio, Humans, Young adult, Amyotrophic lateral sclerosis, Inverse correlation, Aged, Aged, 80 and over, business.industry, Risk Factor, Amyotrophic Lateral Sclerosis, Case-control study, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Surgery, Italy, Case-Control Studies, Cohort, Female, business, Case-Control Studie, Human, Amyotrophic Lateral Sclerosi
Abstract

The relation between coffee intake and risk of amyotrophic lateral sclerosis (ALS) was investigated in 377 newly diagnosed ALS patients from 4 Italian population-based registries in the European ALS Consortium (EURALS Group) (2007-2010). For each patient, 2 age- and sex-matched hospital controls were selected, one from a neurology department and one from a nonneurologic department. Two additional healthy control groups were identified from local general practitioners' (GPs') lists (n = 99) and residents of the same area as a cancer cohort (n = 7,057). Coffee intake was defined in terms of status (ever consuming coffee daily for ≥6 months vs. never), duration, and history (never, former, or current). Ever coffee drinkers comprised 74.7% of ALS patients, 80.4% of neurologic controls, 85.6% of nonneurologic controls (P = 0.0004), 88.9% of GP controls (P = 0.0038), and 86.0% of cancer cohort controls (P < 0.0001). Current coffee drinkers comprised 60.2% of ALS patients, 70.2% of neurologic controls (P = 0.0294), 76.4% of nonneurologic controls (P < 0.0001), and 82.3% of GP controls (P = 0.0002); duration of intake was ≥30 years for 62.3%, 67.7%, 74.7%, and 72.6%. ALS patients had lower lifetime coffee exposure: Odds ratios were 0.7 (95% confidence interval (CI): 0.5, 1.1), 0.6 (95% CI: 0.4, 0.8), and 0.4 (95% CI: 0.2, 0.9) in comparison with neurologic, nonneurologic, and GP controls, respectively. In current (vs. never) coffee drinkers, odds ratios were 0.7 (95% CI: 0.5, 1.0), 0.5 (95% CI: 0.3, 0.7), and 0.4 (95% CI: 0.2, 0.8), respectively. These findings provide epidemiologic evidence of an inverse correlation between coffee intake and ALS risk.

Published
2011

15. Etiopathogenic, clinical-diagnostic and therapeutic aspects of the burning mouth syndrome. Research and treatment protocols in a patient group

Author

Dorina Lauritano, Spadari F, Formaglio F, Zambellini Artini M, Salvato A, Lauritano, D, Spadari, F, Formaglio, F, Zambellini Artini, M, and Salvato, A

Subjects
Adult, Male, Analgesics, Mouth Mucosa, Peripheral Nervous System Diseases, MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, Burning Mouth Syndrome, Middle Aged, Benzodiazepines, Polyneuropathies, Tongue, Burning mouth syndrome, neuropathy, Humans, Female, Capsaicin, Aged
Abstract

Burning mouth syndrome (BMS) is a frequently seen pathology characterised by burning tongue and oral pain without macroscopic structural lesions to the mucose. BMS etiopathology isn't known and therapy is merely empirical and unsatisfactory. METHODS: To evaluate the hypothesis that this syndrome would originate by a small diameter peripheral neuropathy combined to a mucosal trophic lesion, 37 patients, (7 male, 30 female, between 36 and 79 years, mean 54 years) affected by BMS, consecutively observed in our dispensary were submitted to a series of examinations and to therapeutical approach used in neuropathic painful syndromes. All patients were submitted to a complete stomatological exam and X-ray pantomography to exclude mucosal macroscopical lesions and dentistry illnesses. All patients executed sierological exams (glycemia, etc.), neurological exam, tongue and foot dorsum quantitative sensory examination, tongue and face telethermography. A few patients (3 male, 10 female; age 34 to 53, mean 49) were submitted to mucosal tongue biopsy, analyzed by optic microscopy and immunofluorescency following treatment with anticytoplasmatic neuronal proteins antibodies (protein gene product 9.5). RESULTS: These examinations showed subclinical polyneuropathy in 50% of patients. In particular, a loss of function in small diameter nervous fibres in about 50% of patients was observed. Histological examination of tongue mucose revealed a moderate atrophy in 70% patients. CONCLUSIONS: All patients were submitted to an antalgic therapy, with non-antiflammatory drugs used in neuropathic painful syndromes (quercetine, antiepileptic drugs benzodyazepinein and gabaergic, topical application of capsaicine solutions).

Published
1998

16. Trauma and amyotrophic lateral sclerosis: a case-control study from a population-based registry

Author

Pupillo, E, Messina, P, Logroscino, G, Zoccolella, S, Chiò, A, Calvo, A, Corbo, M, Lunetta, C, Micheli, A, Millul, A, Vitelli, E, Beghi, E, Bissolati, M, Formaglio, F, Gerardi, F, Giussani, G, Maestri, E, Prelle, A, Protti, A, Riva, N, Santoro, D, Al Chalabi, A, Berro, A, De Mercanti, S, Giacone, S, Ilardi, A, Hardiman, O, Capozzo, R, Ludolph, A, Mitchell, D, Preux, P, Swingler, R, van den Berg, L, Alvisi, E, Cereda, C, Ceroni, M, Citterio, A, di Poggio, M, Caponnetto, C, Buzzi, P, Colombo, I, Cotelli, M, Filosto, M, Padovani, A, De Lodovici, L, Ferrarese, C, Tremolizzo, L, Fetoni, V, Palazzini, E, Guaita, M, Perrone, P, Secchi, P, Lorusso, L, Sidoti, V, Perini, M, Tavernelli, F, Rigamonti, A, Berro, AC, Mitchell, Dl, Preux, P. M, di Poggio, MB, Cotelli, MS, Guaita, MC, Rigamonti, A., FERRARESE, CARLO, TREMOLIZZO, LUCIO, Pupillo, E, Messina, P, Logroscino, G, Zoccolella, S, Chiò, A, Calvo, A, Corbo, M, Lunetta, C, Micheli, A, Millul, A, Vitelli, E, Beghi, E, Bissolati, M, Formaglio, F, Gerardi, F, Giussani, G, Maestri, E, Prelle, A, Protti, A, Riva, N, Santoro, D, Al Chalabi, A, Berro, A, De Mercanti, S, Giacone, S, Ilardi, A, Hardiman, O, Capozzo, R, Ludolph, A, Mitchell, D, Preux, P, Swingler, R, van den Berg, L, Alvisi, E, Cereda, C, Ceroni, M, Citterio, A, di Poggio, M, Caponnetto, C, Buzzi, P, Colombo, I, Cotelli, M, Filosto, M, Padovani, A, De Lodovici, L, Ferrarese, C, Tremolizzo, L, Fetoni, V, Palazzini, E, Guaita, M, Perrone, P, Secchi, P, Lorusso, L, Sidoti, V, Perini, M, Tavernelli, F, Rigamonti, A, Berro, AC, Mitchell, Dl, Preux, P. M, di Poggio, MB, Cotelli, MS, Guaita, MC, Rigamonti, A., FERRARESE, CARLO, and TREMOLIZZO, LUCIO

Abstract

BACKGROUND AND PURPOSE: Published reports on the association between amyotrophic lateral sclerosis (ALS) and trauma are controversial suggesting the need for a new case-control study done in a large population. METHODS: A case-control study was undertaken in Italy to assess this association. Cases were patients with newly diagnosed ALS from four population-based registries. For each case, two hospital controls were selected, matched for age, sex, and province of residence, one with a neurological (non-degenerative) disease and one with a non-neurological disease (other than orthopedic or surgical). Traumatic events (defined as accidental events causing injuries requiring medical care) were recorded with details on type, site, timing, severity, and complications. The risks were assessed as odds ratios (ORs) with 95% confidence intervals (CI), crude and adjusted for age, sex, education, interviewee (patient or surrogate), physical activity, smoking, alcohol, and coffee. RESULTS: The study population comprised 377 patients in each of the three groups. One or more traumatic events were reported by 225 cases (59.7%), 191 neurological controls (50.7%), and 179 non-neurological controls (47.5%) (P < 0.01) (OR 1.63; 95% CI 1.25-2.14) (P < 0.01). The ORs were 3.07 (95% CI 1.86-5.05) for patients reporting 3+ traumatic events and 2.44 (95% CI 1.36-4.40) for severe traumatic events. The ORs remained significant when the analysis was limited to events occurred 5+ and 10+ years before ALS onset, to incident ALS, and direct informant. CONCLUSION: Antecedent trauma, repeated trauma, and severe trauma may be risk factors for ALS.

Published
2012

21. Etiopathogenic, clinical-diagnostic and therapeutic aspects of the burning mouth syndrome. Research and treatment protocols in a patient group

Author

Lauritano, D, Spadari, F, Formaglio, F, Zambellini Artini, M, Salvato, A, LAURITANO, DORINA, Salvato, A., Lauritano, D, Spadari, F, Formaglio, F, Zambellini Artini, M, Salvato, A, LAURITANO, DORINA, and Salvato, A.

Abstract

Burning mouth syndrome (BMS) is a frequently seen pathology characterised by burning tongue and oral pain without macroscopic structural lesions to the mucose. BMS etiopathology isn't known and therapy is merely empirical and unsatisfactory. METHODS: To evaluate the hypothesis that this syndrome would originate by a small diameter peripheral neuropathy combined to a mucosal trophic lesion, 37 patients, (7 male, 30 female, between 36 and 79 years, mean 54 years) affected by BMS, consecutively observed in our dispensary were submitted to a series of examinations and to therapeutical approach used in neuropathic painful syndromes. All patients were submitted to a complete stomatological exam and X-ray pantomography to exclude mucosal macroscopical lesions and dentistry illnesses. All patients executed sierological exams (glycemia, etc.), neurological exam, tongue and foot dorsum quantitative sensory examination, tongue and face telethermography. A few patients (3 male, 10 female; age 34 to 53, mean 49) were submitted to mucosal tongue biopsy, analyzed by optic microscopy and immunofluorescency following treatment with anticytoplasmatic neuronal proteins antibodies (protein gene product 9.5). RESULTS: These examinations showed subclinical polyneuropathy in 50% of patients. In particular, a loss of function in small diameter nervous fibres in about 50% of patients was observed. Histological examination of tongue mucose revealed a moderate atrophy in 70% patients. CONCLUSIONS: All patients were submitted to an antalgic therapy, with non-antiflammatory drugs used in neuropathic painful syndromes (quercetine, antiepileptic drugs benzodyazepinein and gabaergic, topical application of capsaicine solutions).

Published
1998

24. Time for a consensus conference on pain in neurorehabilitation

Author

Sandrini, G, Tamburin, S, Paolucci, S, Boldrini, P, Saraceni, V, Smania, N, Italian Consensus Conference on Pain in Neurorehabilitation, Agostini, M, Alfonsi, E, Aloisi, A, Alvisi, E, Aprile, I, Armando, M, Avenali, M, Azicnuda, E, Barale, F, Bartolo, M, Bergamaschi, R, Berlangieri, M, Berlincioni, V, Berliocchi, L, Berra, E, Berto, G, Bonadiman, S, Bonazza, S, Bressi, F, Brugnera, A, Brunelli, S, Buzzi, M, Cacciatori, C, Calvo, A, Cantarella, C, Caraceni, A, Carone, R, Carraro, E, Casale, R, Castellazzi, P, Castelnuovo, G, Castino, A, Cella, M, Cerbo, R, Chiò, A, Ciotti, C, Cisari, C, Coraci, D, Dalla Toffola, E, Defazio, G, De Icco, R, Del Carro, U, Dell’Isola, A, De Tanti, A, D’Ippolito, M, Fazzi, E, Federico, A, Ferrari, A, Ferrari, S, Ferraro, F, Formaglio, F, Formisano, R, Franzoni, S, Gajofatto, F, Gandolfi, M, Gardella, B, Geppetti, P, Giammò, A, Gimigliano, R, Giusti, E, Greco, E, Ieraci, V, Invernizzi, M, Jacopetti, M, Jedrychowska, I, Lacerenza, M, La Cesa, S, Lobba, D, Magrinelli, F, Mandrini, S, Manera, U, Manzoni, G, Marchettini, P, Marchioni, E, Mariotto, S, Martinuzzi, A, Masciullo, M, Mezzarobba, S, Miotti, D, Modenese, A, Molinari, M, Monaco, S, Morone, G, Nappi, R, Negrini, S, Pace, A, Padua, L, Pagliano, E, Palmerini, V, Pazzaglia, C, Pecchioli, C, Pietrabissa, G, Picelli, A, Polli, A, Porro, C, Porru, D, Romano, M, Roncari, L, Rosa, R, Saccavini, M, Sacerdote, P, Saviola, D, Schenone, A, Schweiger, V, Scivoletto, G, Solaro, C, Spallone, V, Springhetti, I, Tassorelli, C, Tinazzi, M, Togni, R, Torre, M, Torta, R, Traballesi, M, Trabucco, E, Tramontano, M, Truini, A, Tugnoli, V, Turolla, A, Valeriani, M, Vallies, G, Verzini, E, Vottero, M, Mario, P, Sandrini, Giorgio, Tamburin, Stefano, Paolucci, Stefano, Boldrini, Paolo, Saraceni, Vincenzo M., Smania, Nicola, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto Tommaso, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castelnuovo, Gianluca, Castino, Adele, Cella, Monica, Cerbo, Rosanna, Chiò, Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'Isola, Andrea, De Tanti, Antonio, D'Ippolito, Mariagrazia, Fazzi, Elisa, Federico, Angela, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammò, Alessandro, Gimigliano, Raffaele, Giusti, Emanuele Maria, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, Jedrychowska, Iwona, Lacerenza, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Manzoni, Gian Mauro, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marcella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Pietrabissa, Giada, Picelli, Alessandro, Polli, Andrea, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Saviola, Donatella, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Torta, Riccardo, Traballesi, Marco, Trabucco, Erika, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Valeriani, Massimiliano, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, and Zerbinati, Paolo

Subjects
Male, peripheral neuropathy, Time Factors, Physical Therapy, consensus conference, Consensus Development Conferences as Topic, Sports Therapy and Rehabilitation, Settore M-PSI/08 - PSICOLOGIA CLINICA, pain, diabetic neuropathy, neurorehabilitation, neuropathic pain, Settore MED/13 - Endocrinologia, Humans, Pain Management, Randomized Controlled Trials as Topic, Physical Therapy, Sports Therapy and Rehabilitation, Rehabilitation, Female, Italy, Neurological Rehabilitation, neurorehabilitation, pain, consensus conference, Settore MED/34 - Medicina Fisica e Riabilitativa, Settore MED/26 - Neurologia, Human

25. Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

Author

Castelnuovo, Gianluca, Giusti, Emanuele M., Manzoni, Gian Mauro, Saviola, Donatella, Gatti, Arianna, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Spatola, Chiara A. M., Corti, Stefania, Novelli, Margherita, Villa, Valentina, Cottini, Andrea, Lai, Carlo, Pagnini, Francesco, Castelli, Lorys, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Capodaglio, Paolo, D'aniello, Guido E., Scarpina, Federica, Brioschi, Andrea, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan G., Wiederhold, Brenda, Tamburin, Stefano, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiã², Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'isola, Andrea, De Tanti, Antonio, D'ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammã², Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Castelnuovo, Gianluca, Giusti, Emanuele M., Manzoni, Gian Mauro, Saviola, Donatella, Gatti, Arianna, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Spatola, Chiara A. M., Corti, Stefania, Novelli, Margherita, Villa, Valentina, Cottini, Andrea, Lai, Carlo, Pagnini, Francesco, Castelli, Lory, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Capodaglio, Paolo, D'Aniello, Guido E., Scarpina, Federica, Brioschi, Andrea, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan G., Wiederhold, Brenda, Tamburin, Stefano, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiã², Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'Isola, Andrea, De Tanti, Antonio, D'Ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammã², Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Castelnuovo G., Giusti E.M., Manzoni G.M., Saviola D., Gatti A., Gabrielli S., Lacerenza M., Pietrabissa G., Cattivelli R., Spatola C.A.M., Corti S., Novelli M., Villa V., Cottini A., Lai C., Pagnini F., Castelli L., Tavola M., Torta R., Arreghini M., Zanini L., Brunani A., Capodaglio P., D'Aniello G.E., Scarpina F., Brioschi A., Priano L., Mauro A., Riva G., Repetto C., Regalia C., Molinari E., Notaro P., Paolucci S., Sandrini G., Simpson S.G., Wiederhold B., Tamburin S., Agostini M., Alfonsi E., Aloisi A.M., Alvisi E., Aprile I., Armando M., Avenali M., Azicnuda E., Barale F., Bartolo M., Bergamaschi R., Berlangieri M., Berlincioni V., Berliocchi L., Berra E., Berto G., Bonadiman S., Bonazza S., Bressi F., Brugnera A., Brunelli S., Buzzi M.G., Cacciatori C., Calvo A., Cantarella C., Caraceni A., Carone R., Carraro E., Casale R., Castellazzi P., Castino A., Cerbo R., Chio A., Ciotti C., Cisari C., Coraci D., Toffola E.D., Defazio G., De Icco R., Del Carro U., Dell'Isola A., De Tanti A., D'Ippolito M., Fazzi E., Ferrari A., Ferrari S., Ferraro F., Formaglio F., Formisano R., Franzoni S., Gajofatto F., Gandolfi M., Gardella B., Geppetti P., Giammo A., Gimigliano R., Greco E., Ieraci V., Invernizzi M., Jacopetti M., La Cesa S., Lobba D., Magrinelli F., Mandrini S., Manera U., Marchettini P., Marchioni E., Mariotto S., Martinuzzi A., Masciullo M., Mezzarobba S., Miotti D., Modenese A., Molinari M., Monaco S., Morone G., Nappi R., Negrini S., Pace A., Padua L., Pagliano E., Palmerini V., Pazzaglia C., Pecchioli C., Picelli A., Porro C.A., Porru D., Romano M., Roncari L., Rosa R., Saccavini M., Sacerdote P., Schenone A., Schweiger V., Scivoletto G., Smania N., Solaro C., Spallone V., Springhetti I., Tassorelli C., Tinazzi M., Togni R., Torre M., Traballesi M., Tramontano M., Truini A., Tugnoli V., Turolla A., Vallies G., Verzini E., Vottero M., Zerbinati P., Giusti, Emanuele M, and Simpson, Susan G

Subjects
medicine.medical_specialty, lcsh:BF1-990, Psychological intervention, Settore M-PSI/08 - PSICOLOGIA CLINICA, Review, 03 medical and health sciences, 0302 clinical medicine, psychological distress, health psychology, Chronic pain, Clinical psychology, Health psychology, Neurorehabilitation, Pain management, Psychology (all), medicine, Psychology, psychology (all), 030212 general & internal medicine, General Psychology, neurorehabilitation, business.industry, chronic pain, clinical psychology, pain management, medicine.disease, depression, pain Treatment, Settore MED/34 - Medicina Fisica e Riabilitativa, lcsh:Psychology, Migraine, Physical therapy, Anxiety, Pain catastrophizing, medicine.symptom, business, Psychosocial, 030217 neurology & neurosurgery, clinical psychology, health psychology
Abstract

Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions. Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions.

Published
2016
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26. Evidence of peripheral axonal neuropathy in primary restless legs syndrome

Author

Luigi Ferini-Strambi, Salvatore Smirne, Raffaello Nemni, Angelo Quattrini, Marco Lacerenza, Sandro Iannaccone, Paolo Marchettini, S. Palazzi, Fabio Formaglio, Marco Zucconi, Iannaccone, S, Zucconi, M, Marchettini, P, FERINI STRAMBI, Luigi, Nemni, R, Quattrini, A, Palazzi, S, Lacerenza, M, Formaglio, F, and Smirne, S.

Subjects
Adult, Male, medicine.medical_specialty, Polysomnography, Sural nerve, Neurological examination, Neurological disorder, Nerve conduction velocity, Restless Legs Syndrome, mental disorders, medicine, Humans, Peripheral Nerves, Restless legs syndrome, Age of Onset, Axon, Aged, medicine.diagnostic_test, Electromyography, Peripheral Nervous System Diseases, Thermal Conductivity, Middle Aged, medicine.disease, Axons, Surgery, Electrophysiology, medicine.anatomical_structure, Peripheral neuropathy, Neurology, Sensory Thresholds, Anesthesia, Peripheral nervous system, Female, Neurology (clinical), Psychology
Abstract

Restless legs syndrome (RLS) is a well-defined clinical entity characterized by an unpleasant creeping sensation arising in the legs with an irresistible need to move them. The trouble is more pronounced when the affected people lie in a prolonged rest position and try to fall asleep. It is known that RLS may be consequent to systemic disorders and to diseases affecting the central or peripheral nervous system. The International Classification of Sleep Disorders states that peripheral neuropathy should be ruled out by medical history and clinical grounds before diagnosing primary RLS (pRLS). The present study extended peripheral nerve investigation in eight consecutive pRLS patients with normal neurological examination results and showed that all patients exhibited two or more electrical, psychophysiological, and/or morphological features of peripheral axonal neuropathy. Morphometric analysis of sural nerve showed a significant reduction in myelinated fiber density and g ratio (axon diameter/fiber diameter) in the pRLS group compared with eight control biopsy specimens. These results suggest that axonal neuropathy is often present in patients with RLS. A comprehensive peripheral nerve investigation should be considered in RLS patients.

Published
1995
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27. Acute myelopathy selectively involving lumbar anterior horns following intranasal insufflation of ecstasy and heroin

Author

U. Del Carro, Mauro Comola, Paolo Morana, Nilo Riva, Federica Cerri, Stefano Amadio, Giancarlo Comi, Simonetta Gerevini, Fabio Formaglio, Riva, N, Morana, P, Cerri, F, Gerevini, S, Amadio, S, Formaglio, F, Comi, Giancarlo, Comola, M, and DEL CARRO, U.

Subjects
medicine.medical_specialty, Past medical history, Nerve root, Lumbar plexus, business.industry, Stupor, Poison control, medicine.disease, Surgery, Psychiatry and Mental health, Lumbar, Anesthesia, medicine, Letters, Neurology (clinical), medicine.symptom, Paraplegia, business, Rhabdomyolysis
Abstract

We report a patient who developed acute myelopathy after intranasal insufflation of amphetamines and heroin. The functional prognosis was very poor; after 4 months, she remained paraplegic. MRI imaging showed selective T2 hyperintensity and intense enhancement confined to the spinal anterior horns and lumbar nerve roots and plexus. This unique MRI pattern, together with neurophysiological data, suggests that the pathological process at the first primary affected spinal anterior horns (SAH), conditioning motoneuron cell death, and then nerve roots and lumbar plexus as a consequence of wallerian degeneration A 17-year-old girl was admitted to the emergency department in a drowsy state and unable to walk after an overdose of intranasal insufflated heroin and amphetamines. After a few hours, drowsiness progressed to stupor, and progressive weakness in all four limbs, mainly involving the lower limbs, developed. At that time, laboratory data showed massive rhabdomyolysis (creatine phosphokinase 36 880 mg/dl) with acute renal failure (ARF), and hepatic failure; medical therapy was promptly started. The patient’s past medical history was unremarkable except for habitual use of amphetamines (ecstasy) and cannabinoids since the age of 12 years. The previous week she had insufflated heroin about once a day; the previous night she reported a double dose of heroin consumption, and a high dose (approximately 1 g) of intranasal insufflation of amphetamines. The next day the …

Published
2007
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29. Management model of caregiver's grief in a tertiary oncological center Hospice, from anticipatory mourning to condolence conversation: preliminary observations.

Author

Gallio I, Lorusso M, Moscato M, Miranti C, Pasalic M, Formaglio F, Feltrin A, and Ruggiero E

Subjects
Humans, Male, Female, Middle Aged, Aged, Adult, Qualitative Research, Tertiary Care Centers organization & administration, Adaptation, Psychological, Hospices methods, Communication, Aged, 80 and over, Grief, Caregivers psychology
Abstract

Background: Bereavement is a crucial physiological process in palliative care; grief-processing disorders can be diagnosed at least 6 months after death and can have severe clinical or psychological consequences. This study aims to verify how adequate management of anticipatory mourning and condolence conversations can be protective in the early stages of grief., Methods: Patients and caregivers are supported by a multidisciplinary team through semi-structured interviews. In condolence conversations within one month of the death, we identify signs of psychological fragility that require support for adequate processing of the loss., Results: From the condolence conversations, only 2-4% of caregivers who had received psychological support during the hospital stay and showed a good level of acceptance of their relative's end of life exhibited grief problems within 1 month of death; none showed excessive avoidance of memories, difficulties with trust, or feelings of emotional loneliness., Conclusions: Despite the limitations, the preliminary data of our study clearly suggest the protective potential of multidisciplinary support, particularly in reducing the risk of developing grief processing disorders. These considerations encourage us to implement our model of clinical and psychological support systems and develop pathways dedicated to caregivers experiencing greater difficulty., Competing Interests: Declarations. Ethics approval and consent to partecipate: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of Veneto Institute of Oncology IOV–IRCCS, Padua, Italy (L04P10 - cod. int. CET ANV 2024-19). Informed consent was obtained from all subjects and/or their legal guardian(s). Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Published
2024
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30. Case report: The lesson from opioid withdrawal symptoms mimicking paraganglioma recurrence during opioid deprescribing in cancer pain.

Author

Ruggiero E, Pambuku A, Caccese M, Lombardi G, Gallio I, Brunello A, Ceccato F, and Formaglio F

Abstract

Pain is one of the predominant and troublesome symptoms that burden cancer patients during their whole disease trajectory: adequate pain management is a fundamental component of cancer care. Opioid are the cornerstone of cancer pain relief therapy and their skillful management must be owned by physicians approaching cancer pain patients. In light of the increased survival of cancer patients due to advances in therapy, deprescription should be considered as a part of the opioid prescribing regime, from therapy initiation, dose titration, and changing or adding drugs, to switching or ceasing. In clinical practice, opioid tapering after pain remission could be challenging due to withdrawal symptoms' onset. Animal models and observations in patients with opioid addiction suggested that somatic and motivational symptoms accompanying opioid withdrawal are secondary to the activation of stress-related process (mainly cortisol and catecholamines mediated). In this narrative review, we highlight how the lack of validated guidelines and tools for cancer patients can lead to a lower diagnostic awareness of opioid-related disorders, increasing the risk of developing withdrawal symptoms. We also described an experience-based approach to opioid withdrawal, starting from a case-report of a symptomatic patient with a history of metastatic pheochromocytoma-paraganglioma., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Ruggiero, Pambuku, Caccese, Lombardi, Gallio, Brunello, Ceccato and Formaglio.)

Published
2023
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31. Advanced Adrenocortical Carcinoma: From Symptoms Control to Palliative Care.

Author

Ruggiero E, Tizianel I, Caccese M, Lombardi G, Pambuku A, Zagonel V, Scaroni C, Formaglio F, and Ceccato F

Abstract

The prognosis of patients with advanced adrenocortical carcinoma (ACC) is often poor: in the case of metastatic disease, five-year survival is reduced. Advanced disease is not a non-curable disease and, in referral centers, the multidisciplinary approach is the standard of care: if a shared decision regarding several treatments is available, including the correct timing for the performance of each one, overall survival is increased. However, many patients with advanced ACC experience severe psychological and physical symptoms secondary to the disease and the cancer treatments. These symptoms, combined with existential issues, debase the quality of the remaining life. Recent strong evidence from cancer research supports the early integration of palliative care principles and skills into the advanced cancer patient's trajectory, even when asymptomatic. A patient with ACC risks quickly suffering from symptoms/effects alongside the disease; therefore, early palliative care, in some cases concurrent with oncological treatment (simultaneous care), is suggested. The aims of this paper are to review current, advanced ACC approaches, highlight appropriate forms of ACC symptom management and suggest when and how palliative care can be incorporated into the ACC standard of care.

Published
2022
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32. Simultaneous Care in Oncology: A 7-Year Experience at ESMO Designated Centre at Veneto Institute of Oncology, Italy.

Author

Brunello A, Galiano A, Schiavon S, Nardi M, Feltrin A, Pambuku A, De Toni C, Dal Col A, Lamberti E, Pittarello C, Bergamo F, Basso U, Maruzzo M, Finotto S, Bolshinsky M, Stragliotto S, Procaccio L, Rizzato MD, Formaglio F, Lombardi G, Lonardi S, and Zagonel V

Abstract

Benefits of early palliative care referral in oncology are well-validated. At the Veneto Institute of Oncology-IRCCS, a simultaneous-care outpatient clinic (SCOC) has been active since 2014, where patients with advanced cancer are evaluated by an oncologist together with a palliative care team. We prospectively assessed SCOC patients’ characteristics and SCOC outcomes through internal procedure indicators. Data were retrieved from the SCOC prospectively maintained database. There were 753 eligible patients. The median age was 68 years; primary tumor sites were gastrointestinal (75.2%), genitourinary (15.0%) and other sites (9.8%). Predominant symptoms were psychological issues (69.4%), appetite loss (67.5%) and pain (65.9%). Dyspnea was reported in 53 patients (7%) in the referral form, while it was detected in 226 patients (34.2%) during SCOC visits (p < 0.0001). Median survival of patients after the SCOC visit was 7.3 months. Survival estimates by the referring oncologist were significantly different from the actual survival. Psychological intervention was deemed necessary and undertaken in 34.6% of patients, and nutritional support was undertaken in 37.9% of patients. Activation of palliative care services was prompted for 77.7% of patients. Out of 357 patients whose place of death is known, 69.2% died at home, in hospice or residential care. With regard to indicators’ assessment, the threshold was reached for 9 out of 11 parameters (81.8%) requested by the procedure. This study confirmed the importance of close collaboration between oncologists and palliative care teams in responding properly to cancer patients’ needs. The introduction of a procedure with indicators allowed punctual assessment of a team’s performance.

Published
2022
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33. Neuropathic pain: clinical classification and assessment in patients with pain due to cancer.

Author

Shkodra M, Brunelli C, Zecca E, Formaglio F, Bracchi P, Lo Dico S, Caputo M, Kaasa S, and Caraceni A

Subjects
Humans, Pain Measurement, Retrospective Studies, Surveys and Questionnaires, Neoplasms complications, Neuralgia diagnosis, Neuralgia epidemiology, Neuralgia etiology
Abstract

Abstract: Neuropathic cancer pain (NcP) is associated with worse treatment responses and specific therapy indications, but a standardized clinical diagnosis of NcP is still lacking. This is a prospective observational study on outpatients with cancer, comparing different clinical approaches with NcP evaluation. A three-step assessment of NcP was performed using DN4 (cutoff of 4), palliative care physician Clinical Impression, including etiology and pain syndrome identification, and Retrospective Clinical Classification by a board of specialists with the IASP Neuropathic Pain Special Interest Group criteria. Neuropathic cancer pain classification was specifically referred to pain directly due to cancer. Three hundred fifty patients were assessed, and NcP prevalence was 20% (95% confidence interval [CI] 15.9%-24.6%), 36.9%, (95% CI 31.6%-42.1%), and 28.6% (95% CI 23.8%-33.9%) according to DN4, Clinical Impression, and Retrospective Clinical Classification, respectively. Cohen's kappa concordance coefficient between DN4 and Retrospective Clinical Classification was 0.57 (95% CI 0.47-0.67), indicating moderate concordance. Higher percentages of discordance were found for specific pain syndromes such as pain due to deep soft tissue infiltration and pain associated with tenesmus. Disagreement among clinicians accounted also for different NcP diagnoses and highlighted lack of homogeneous clinical criteria. Rigorous application of etiological and syndrome diagnosis to explain pain cause, associated with standardized diagnostic criteria and assessment of pain characteristics, that is also specific for the cancer pain condition could improve clinical classification of NcP., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.)

Published
2021
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34. Pharmacological and non-pharmacological strategies in the integrated treatment of pain in neurorehabilitation. Evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation.

Author

Tamburin S, Lacerenza MR, Castelnuovo G, Agostini M, Paolucci S, Bartolo M, Bonazza S, Federico A, Formaglio F, Giusti EM, Manzoni GM, Mezzarobba S, Pietrabissa G, Polli A, Turolla A, and Sandrini G

Subjects
Evidence-Based Medicine, Female, Humans, Italy, Male, Neuralgia diagnosis, Pain Management methods, Physical Therapy Modalities standards, Prognosis, Psychotherapy methods, Risk Assessment, Treatment Outcome, Analgesics, Opioid administration & dosage, Neuralgia drug therapy, Neuralgia rehabilitation, Practice Guidelines as Topic standards
Abstract

The interplay between pain and neurorehabilitation is very complex, in that pain may be a target for treatment, but can also have negative effects on neurorehabilitation procedures. Moreover, side effects of drugs, which are currently used to treat pain, may negatively influence rehabilitation outcomes. Because of the lack of guidelines or consensus, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) was aimed to answer some open questions on the treatment of pain in this setting. To this aim, we collected evidence on the pharmacological and non-pharmacological strategies and their role in the integrated approach to pain. Despite the lack of studies in patients undergoing neurorehabilitation, current guidelines on the pharmacological treatment of nociceptive and neuropathic pain may be applied in this setting. Non-pharmacological strategies include physical therapy, invasive procedures, psychological treatments and psychotherapy, which together with pharmacological therapies play a key role in the integrated approach to pain. The ICCPN recommendations offer information to ameliorate the current treatment of pain in neurorehabilitation, and to design future studies to answer the still open questions on this topic.

Published
2016

35. Persistent vegetative state: an ethical reappraisal.

Author

Tarquini D, Congedo M, Formaglio F, Gasparini M, Marcello N, Porteri C, Pucci E, Zullo S, and Defanti CA

Subjects
Consciousness physiology, Humans, Longitudinal Studies, Morals, Persistent Vegetative State physiopathology, Consciousness ethics, Ethical Analysis, Persistent Vegetative State diagnosis
Abstract

New knowledge from scientific research on vegetative state (VS) and its consequences in clinical practice are reviewed. The ambiguity of the concept of consciousness and the difficult issue of its moral significance are then examined. The Authors stress the need for longitudinal prognostic studies, the promotion of an expert widespread use of standardized behavioural scales, and recommend that the ethical debate about VS rely upon the widest consensus of the scientific community.

Published
2012
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36. Acute myelopathy selectively involving lumbar anterior horns following intranasal insufflation of ecstasy and heroin.

Author

Riva N, Riva N, Morana P, Cerri F, Gerevini S, Amadio S, Formaglio F, Comi G, Comola M, and Del Carro U

Abstract

We report a patient who developed acute myelopathy after intranasal insufflation of amphetamines and heroin. The functional prognosis was very poor; after 4 months, she remained paraplegic. MRI imaging showed selective T2 hyperintensity and intense enhancement confined to the spinal anterior horns and lumbar nerve roots and plexus. This unique MRI pattern, together with neurophysiological data, suggests that the pathological process at the first primary affected spinal anterior horns (SAH), conditioning motoneuron cell death, and then nerve roots and lumbar plexus as a consequence of wallerian degeneration.

Published
2009
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37. The Lindblom roller.

Author

Marchettini P, Marangoni C, Lacerenza M, and Formaglio F

Subjects
Aged, Cold Temperature adverse effects, Female, Hemangioma diagnosis, Humans, Hypesthesia diagnosis, Hypesthesia etiology, Meningeal Neoplasms diagnosis, Meningioma diagnosis, Middle Aged, Point-of-Care Systems, Spinal Cord Neoplasms diagnosis, Hemangioma complications, Meningeal Neoplasms complications, Meningioma complications, Pain diagnosis, Pain etiology, Pain Measurement instrumentation, Spinal Cord Neoplasms complications
Abstract

Neuropathic pain is caused by injury of the peripheral or central nervous system. The neurological examination of the sensory system in neuropathic pain patients guides the anatomical localization of the injury. Among the sensory modalities to be tested, priority should be given to those subserved by small peripheral sensory fibers or by the spinothalamic tract that most commonly are abnormal in neuropathic pain patients. Testing of cold and warm perception was traditionally carried out in the clinic using tubes filled with water at different temperatures, a cumbersome method that has limited the routine examination of these sensory modalities. The Lindblom roller offers a practical and effective method of readily testing temperature perception and is among the best available clinical tools for delineating the anatomical boundaries of a sensory abnormality. Routinely use of the Lindblom roller shall be standard bedside clinical assessment of neuropathic pain patients. To exemplify this statement we describe two patients affected by complex and fluctuating painful sensory abnormalities caused by an extradural mass compressing the spinal cord. The level of the injury was readily localized with a roller kept at room temperature.

Published
2003
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38. Sympathetically maintained pain.

Author

Marchettini P, Lacerenza M, and Formaglio F

Subjects
Adolescent, Adult, Aged, Female, Guanethidine administration & dosage, Guanethidine therapeutic use, Humans, Male, Pain diagnosis, Pain Management, Sympathectomy, Sympatholytics administration & dosage, Sympatholytics therapeutic use, Pain etiology, Reflex Sympathetic Dystrophy psychology
Abstract

Reflex sympathetic dystrophy (RSD) is a controversial condition, redefined in 1996 by an ad hoc International Association for the Study of Pain (IASP) task force. One of the strongest critiques against the entire concept of sympathetic-dependent pain is that patients labeled as having RSD harbor in reality a somatoform disorder. Here clinical cases are described to prove that other organic medical conditions may exist other than RSD and still present the clinical picture of pain, sensory, and vasomotor disorders and trophic changes. The analysis of each patient illustrates how the inappropriate diagnosis of RSD may lead to increased worsening of pain intensity, or delay the proper diagnosis, and consequently the appropriate treatment.

Published
2000
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39. [Etiopathogenic, clinical-diagnostic and therapeutic aspects of the burning mouth syndrome. Research and treatment protocols in a patient group].

Author

Lauritano D, Spadari F, Formaglio F, Zambellini Artini M, and Salvato A

Subjects
Adult, Aged, Analgesics therapeutic use, Benzodiazepines therapeutic use, Burning Mouth Syndrome diagnosis, Burning Mouth Syndrome drug therapy, Capsaicin therapeutic use, Female, Humans, Male, Middle Aged, Mouth Mucosa innervation, Peripheral Nervous System Diseases diagnosis, Peripheral Nervous System Diseases drug therapy, Polyneuropathies complications, Polyneuropathies diagnosis, Tongue innervation, Burning Mouth Syndrome etiology, Peripheral Nervous System Diseases complications
Abstract

Background: Burning mouth syndrome (BMS) is a frequently seen pathology characterised by burning tongue and oral pain without macroscopic structural lesions to the mucose. BMS etiopathology isn't known and therapy is merely empirical and unsatisfactory., Methods: To evaluate the hypothesis that this syndrome would originate by a small diameter peripheral neuropathy combined to a mucosal trophic lesion, 37 patients, (7 male, 30 female, between 36 and 79 years, mean 54 years) affected by BMS, consecutively observed in our dispensary were submitted to a series of examinations and to therapeutical approach used in neuropathic painful syndromes. All patients were submitted to a complete stomatological exam and X-ray pantomography to exclude mucosal macroscopical lesions and dentistry illnesses. All patients executed sierological exams (glycemia, etc.), neurological exam, tongue and foot dorsum quantitative sensory examination, tongue and face telethermography. A few patients (3 male, 10 female; age 34 to 53, mean 49) were submitted to mucosal tongue biopsy, analyzed by optic microscopy and immunofluorescency following treatment with anticytoplasmatic neuronal proteins antibodies (protein gene product 9.5)., Results: These examinations showed subclinical polyneuropathy in 50% of patients. In particular, a loss of function in small diameter nervous fibres in about 50% of patients was observed. Histological examination of tongue mucose revealed a moderate atrophy in 70% patients., Conclusions: All patients were submitted to an antalgic therapy, with non-antiflammatory drugs used in neuropathic painful syndromes (quercetine, antiepileptic drugs benzodyazepinein and gabaergic, topical application of capsaicine solutions).

Published
1998

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