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排序方式: 共有791条查询结果,搜索用时 15 毫秒
781.
Silvia Cipriani Marta Guerrero-Valero Stefano Tozza Edward Zhao Veith Vollmer Danique Beijer Matt Danzi Cristina Rivellini Dejan Lazarevic Giovanni Battista Pipitone Bianca Rose Grosz Costanza Lamperti Stefania Bianchi Marzoli Paola Carrera Marcella Devoto Chiara Pisciotta Davide Pareyson Marina Kennerson Stefano C. Previtali Stephan Zuchner Steven S. Scherer Fiore Manganelli Martin Bähler Alessandra Bolino 《European journal of neurology》2023,30(2):511-526
782.
Nuccia Morici MD PhD Simone Frea MD Maurizio Bertaina MD Alice Sacco MD Elena Corrada MD Carlotta Sorini Dini MD Martina Briani MD Michele Tedeschi MD Francesco Saia MD Costanza Colombo MD Matteo Rota Fabrizio Oliva MD Mario Iannaccone MD Gaetano M. De Ferrari MD Alessandro Sionis MD Navin K. Kapur MD Guido Tavazzi MD Federico Pappalardo MD 《Catheterization and cardiovascular interventions》2023,101(1):22-32
Background
Cardiogenic shock (CS) includes several phenotypes with heterogenous hemodynamic features. Timely prognostication is warranted to identify patients requiring treatment escalation. We explored the association of the updated Society for Cardiovascular Angiography and Interventions (SCAI) stages classification with in-hospital mortality using a prospective national registry.Methods
Between March 2020 and February 2022 the Altshock-2 Registry has included 237 patients with CS of all etiologies at 11 Italian Centers. Patients were classified according to their admission SCAI stage (assigned prospectively and independently updated according to the recently released version). In-hospital mortality was evaluated for association with both admission and 24-h SCAI stages.Results
The overall in-hospital mortality was 38%. Of the 237 patients included and staged according to the updated SCAI classification, 20 (8%) had SCAI shock stage B, 131 (55%) SCAI stage C, 61 (26%) SCAI stage D and 25 (11%) SCAI stage E. In-hospital mortality stratified according to the SCAI classification at 24 h was 18% for patients in SCAI stage B, 27% for SCAI stage C, 63% for SCAI stage D and 100% for SCAI stage E. Both the revised SCAI stages on admission and at 24 h were associated with in-hospital mortality, but the classification potential slightly increased at 24-h. After adjusting for age, sex, lactate level, eGFR, CVP, inotropic score and mechanical circulatory support [MCS], SCAI classification at 24 h was an independent predictor of in-hospital mortality.Conclusions
In the Altshock-2 registry the utility of SCAI shock stages to identify risk of in-hospital mortality increased at 24 h after admission. Escalation of treatment (either pharmacological or with MCS) should be tailored to achieve prompt clinical improvement within the first 24 h after admission. Registration: http://www.clinicaltrials.gov ; Unique identifier: NCT04295252. 相似文献783.
Josie Carmichael Sarah Abdi Konstantinos Balaskas Enrico Costanza Ann Blandford 《Ophthalmic & physiological optics》2023,43(6):1510-1523
Purpose
Ophthalmic services are currently under considerable stress; in the UK, ophthalmology departments have the highest number of outpatient appointments of any department within the National Health Service. Recognising the need for intervention, several approaches have been trialled to tackle the high numbers of false-positive referrals initiated in primary care and seen face to face within the hospital eye service (HES). In this mixed-methods narrative synthesis, we explored interventions based on their clinical impact, cost and acceptability to determine whether they are clinically effective, safe and sustainable. A systematic literature search of PubMed, MEDLINE and CINAHL, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), was used to identify appropriate studies published between December 2001 and December 2022.Recent Findings
A total of 55 studies were reviewed. Four main interventions were assessed, where two studies covered more than one type: training and guidelines (n = 8), referral filtering schemes (n = 32), asynchronous teleophthalmology (n = 13) and synchronous teleophthalmology (n = 5). All four approaches demonstrated effectiveness for reducing false-positive referrals to the HES. There was sufficient evidence for stakeholder acceptance and cost-effectiveness of referral filtering schemes; however, cost comparisons involved assumptions. Referral filtering and asynchronous teleophthalmology reported moderate levels of false-negative cases (2%–20%), defined as discharged patients requiring HES monitoring.Summary
The effectiveness of interventions varied depending on which outcome and stakeholder was considered. More studies are required to explore stakeholder opinions around all interventions. In order to maximise clinical safety, it may be appropriate to combine more than one approach, such as referral filtering schemes with virtual review of discharged patients to assess the rate of false-negative cases. The implementation of a successful intervention is more complex than a ‘one-size-fits-all’ approach and there is potential space for newer types of interventions, such as artificial intelligence clinical support systems within the referral pathway. 相似文献784.
Martina Paola Zanaboni Ludovica Pasca Stefania Maria Bova Matteo Alessio Chiappedi Melissa Filippini Lucio Giordano Serena Grumi Serena Micheletti Francesca F. Operto Dario Pruna Francesca Ragona Federico Raviglione Martina Totaro Costanza Varesio Aglaia Vignoli Valentina De Giorgis The EpilEpsyIt study group 《Epileptic Disord》2023,25(2):160-172
785.
Costanza Calamai Oumaima Ammar Sara Marchiani Selene Degl'Innocenti Marisa Fino Lorenzo Righi Sara Dabizzi Mario Maggi Elisabetta Baldi Linda Vignozzi Monica Muratori 《Environmental and molecular mutagenesis》2023,64(3):148-158
In March 2020, the Italian government imposed a national lockdown which was almost completely removed in June 2020. Due to the abrupt stop of human activities, emissions of air pollutants decreased. Air pollution is an environmental risk factor for noncommunicable disease and mortality. Emerging evidence also suggests a role in male infertility. In this study, we compared sperm DNA fragmentation (sDF) levels and conventional semen parameters between subjects undergoing sDF determination and routine semen analysis in a single Italian centre, during about 6 months before (N = 119) and after lockdown (N = 105). After lockdown, we found an improvement of sperm progressive motility (48.00[38.50–58.00]% vs. 42.00[33.00–53.00]%) and sDF levels (as total: 24.79[18.33–33.97]% vs. 35.02[25.04–45.73]%, p < .001; brighter: 14.02[10.69–17.93]% vs 18.54[13.58–25.82]%, p < .001 and dimmer sDF: 9.24[5.64–15.78]% vs. 12.24[8.08–19.10]%, p < .01), mirrored by a decrease of leukocyte semen concentration (p < .01). The improvement of sperm motility and DNA quality was maintained after adjusting for leukocyte concentration and several conditions known to affect sperm motility and/or sDF levels. With a significant decrease in air pollution observed in Tuscany during and after lockdown, associated improvement in sperm motility and DNA quality in patients referred to the infertility clinic is suggestive of the potential role of air pollution in male infertility. 相似文献
786.
Anna Ardissone Giulia Ferrera Costanza Lamperti Valeria Tiranti Daniele Ghezzi Isabella Moroni Eleonora Lamantea 《European journal of neurology》2023,30(7):2079-2091
Background and purpose
Mitochondrial diseases (MDs) are heterogeneous disorders caused by mutations in nuclear DNA (nDNA) or mitochondrial DNA (mtDNA) associated with specific syndromes. However, especially in childhood, patients often display heterogeneity. Several reports on the biochemical and molecular profiles in children have been published, but studies tend not to differentiate between mtDNA- and nDNA-associated diseases, and focus is often on a specific phenotype. Thus, large cohort studies specifically focusing on mtDNA defects in the pediatric population are lacking.Methods
We reviewed the clinical, metabolic, biochemical, and neuroimaging data of 150 patients with MDs due to mtDNA alterations collected at our neurological institute over the past 20 years.Results
mtDNA impairment is less frequent than nDNA impairment in pediatric MDs. Ocular involvement is extremely frequent in our cohort, as is classical Leber hereditary optic neuropathy, especially with onset before 12 years of age. Extraneurological manifestations and isolated myopathy appear to be rare, unlike adult phenotypes. Deep gray matter involvement, early disease onset, and specific phenotypes, such as Pearson syndrome and Leigh syndrome, represent unfavorable prognostic factors. Phenotypes related to single large scale mtDNA deletions appear to be very frequent in the pediatric population. Furthermore, we report for the first time an mtDNA pathogenic variant associated with cavitating leukodystrophy.Conclusions
We report on a large cohort of pediatric patients with mtDNA defects, adding new data on the phenotypical characterization of mtDNA defects and suggestions for diagnostic workup and therapeutic approach. 相似文献787.
Marta Bellofatto Alessandro Bertini Irene Tramacere Fiore Manganelli Gian Maria Fabrizi Angelo Schenone Lucio Santoro Tiziana Cavallaro Marina Grandis Stefano C. Previtali Yuri Falzone Isabella Allegri Luca Padua Costanza Pazzaglia Daniela Calabrese Paola Saveri Aldo Quattrone Paola Valentino Stefano Tozza Luca Gentile Massimo Russo Anna Mazzeo Giuseppe Vita Sylvie Piacentini Chiara Pisciotta Davide Pareyson for the Italian CMT Network 《European journal of neurology》2023,30(3):710-718
Background and purpose
Fatigue, a disabling symptom in many neuromuscular disorders, has been reported also in Charcot–Marie–Tooth disease (CMT). The presence of fatigue and its correlations in CMT was investigated.Methods
The Modified Fatigue Impact Scale (MFIS) was administered to CMT patients from the Italian Registry and a control group. An MFIS score >38 indicated abnormal fatigue. The correlation with disease severity and clinical characteristics, the Hospital Anxiety and Depression Scale and Epworth Sleepiness Scale scores, and drug use was analysed.Results
Data were collected from 251 CMT patients (136 women) and 57 controls. MFIS total (mean ± standard deviation 32 ± 18.3, median 33), physical (18.9 ± 9.7, 20) and psychosocial (2.9 ± 2.4, 3) scores in CMT patients were significantly higher than controls. Abnormal fatigue occurred in 36% of the patients who, compared to patients with normal scores, had more severe disease (median CMT Examination Score 9 vs. 7), more frequent use of foot orthotics (22% vs. 11%), need of support for walking (21% vs. 8%), hand disability (70% vs. 52%) and positive sensory symptoms (56% vs. 36%). Patients with abnormal fatigue had significantly increased frequency of anxiety/depression/general distress (Hospital Anxiety and Depression Scale), somnolence (Epworth Sleepiness Scale), obesity (body mass index ≥ 30) and use of anxiolytic/antidepressant or anti-inflammatory/analgesic drugs.Conclusions
Fatigue is a relevant symptom in CMT as 36% of our series had scores indicating abnormal fatigue. It correlated with disease severity but also with anxiety, depression, sleepiness and obesity, indicating different components in the generation of fatigue. CMT patients' management must include treatment of fatigue and of its different generators, including general distress, sleepiness and obesity. 相似文献788.
789.
Maia De Luca Carmen D'Amore Lorenza Romani Costanza Tripiciano Vitangelo Clemente Stefania Mercadante Daniela Perrotta Joseph Nunziata Corrado Cecchetti Emanuele Rossetti Roberto Bianchi Carlo Federico Perno Paola Bernaschi Cristina Russo Laura Lancella Massimiliano Raponi Marta Luisa Ciofi degli Atti 《Influenza and other respiratory viruses》2023,17(1):e13038