Publications by authors named "Carlo Grigioni"
Article Synopsis
- The study compares patients with degenerative mitral regurgitation (DMR) from Asian institutions (AsIs) and European/American institutions (EAIs) to understand differences in their presentation, management, and outcomes.
- AsI patients were generally younger, had fewer symptoms, and presented with smaller heart dimensions, yet underwent fewer interventions and experienced higher mortality rates compared to EAI patients.
- The findings suggest that imaging may not accurately reflect the severity of DMR in AsI patients due to their smaller body size, indicating a potential issue with under-treatment in this population.
Aims: In patients with degenerative mitral regurgitation (DMR), left ventricular (LV) dysfunction is associated with increased risk of heart failure and excess mortality. LV end-systolic diameter (LVESD) is an established trigger for intervention, yet recommended LVESD thresholds apply poorly to patients with small body size. Whether LV normalization to body surface area (BSA) may be used as a trigger for DMR correction is unknown.
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- The study evaluated the long-term survival outcomes of 2833 patients with severe degenerative mitral regurgitation (DMR) who underwent surgical correction, guided by various surgical indications.
- Results indicated that patients classified under Class-I triggers experienced significantly lower postoperative survival rates compared to those under Class-IIa triggers or no triggers, with a median follow-up of 8.5 years showing a stark difference in survival percentages.
- Overall, operating on patients with Class-I criteria resulted in a considerable loss of postoperative survival time, suggesting that immediate surgery based on these guidelines may not be the best approach for improving long-term outcomes in DMR patients.
Background: Stent implantation represents the standard of care in coronary intervention. While a short stent implanted on a focal lesion located on the left anterior descending artery (LAD) seems a reasonable alternative to an internal mammary implant, the same for long stents is still debated.
Methods: We reported the long-term data of 531 consecutive patients who underwent Percutaneous Coronary Intervention (PCI) with long stents in two highly specialized centres.
Background: Balance impairment is a common disability in post-stroke survivors, leading to reduced mobility and increased fall risk. Robotic gait training (RAGT) is largely used, along with traditional training. There is, however, no strong evidence about RAGT superiority, especially on balance.
View Article and Find Full Text PDFBackground: Robot-based treatments are developing in neurorehabilitation settings. Recently, the Italian National Health Systems recognized robot-based rehabilitation as a refundable service. Thus, the Italian neurorehabilitation community promoted a national consensus on this topic.
View Article and Find Full Text PDFBackground: Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has been considered only in a few recent studies.
Objective: To verify whether, in the current state of the literature, cognitive measures are used as inclusion or exclusion criteria and/or outcomes measures in robotic upper limb rehabilitation in stroke patients.
Background: Robot-assisted arm therapy (RAT) has been used mainly in stroke rehabilitation in the last 20 years with rising expectations and growing evidence summarized in systematic reviews (SRs).
Objective: The aim of this study is to provide an overview of SRs about the effectiveness, within the ICF domains, and safety of RAT in the rehabilitation of adult with stroke compared to other treatments.
Methods: The search strategy was conducted using search strings adapted explicitly for each database.
Background: Many robots are available for gait rehabilitation (BWSTRT and ORET) and their application in persons with SCI allowed an improvement of walking function.
Objective: The aim of the study is to compare the effects of different robotic exoskeletons gait training in persons with different SCI level and severity.
Methods: Sixty-two studies were included in this systematic review; the study quality was assessed according to GRADE and PEDro's scale.
Background: The recovery of walking after stroke is a priority goal for recovering autonomy. In the last years robotic systems employed for Robotic Assisted Gait Training (RAGT) were developed. However, literature and clinical practice did not offer standardized RAGT protocol or pattern of evaluation scales.
View Article and Find Full Text PDFBackground: Gait impairments are common disabling symptoms of Parkinson's disease (PD). Among the approaches for gait rehabilitation, interest in robotic devices has grown in recent years. However, the effectiveness compared to other interventions, the optimum amount of training, the type of device, and which patients might benefit most remains unclear.
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- The review investigates the use of robotic-assisted arm training (RAT) and electromechanical devices for improving motor and functional recovery in patients with cervical spinal cord injuries, highlighting their importance in neurorehabilitation.
- Conducted within the framework of an Italian conference, the study systematically analyzed data from various sources, assessing the quality of included studies using established scales, ultimately reviewing 11 studies of differing research types.
- Results suggest RAT is both feasible and safe, with positive initial effects on arm function, but high variability in treatment methods affects the ability to generalize findings, emphasizing a need for more standardized future research.
Background: Robot-assisted Arm Therapy (RAT) has been increasingly applied in the last years for promoting functional recovery in patients with disabilities related to neurological health conditions. Evidence of a knowledge-to-action gap for applying robot-assisted technologies in the rehabilitation of patients with neurological health conditions and the difficulty to apply and tailor the knowledge to the local contexts solicited the need for a national consensus conference on these interventions.
Aim: The aim of this paper was to explain the methodology used by the working group dedicated to synthesizing evidence on the effectiveness of RAT in neurological health conditions in the context of the CICERONE Italian Consensus Conference.
Introduction: The rapid development of electromechanical and robotic devices has profoundly influenced neurorehabilitation. Growth in the scientific and technological aspects thereof is crucial for increasing the number of newly developed devices, and clinicians have welcomed such growth with enthusiasm. Nevertheless, improving the standard for the reporting clinical, technical, and normative aspects of such electromechanical and robotic devices remains an unmet need in neurorehabilitation.
View Article and Find Full Text PDFIntroduction: Stroke is the third leading cause of adult disability worldwide, and lower extremity motor impairment is one of the major determinants of long-term disability. Although robotic therapy is becoming more and more utilized in research protocols for lower limb stroke rehabilitation, the gap between research evidence and its use in clinical practice is still significant. The aim of this study was to determine the scope, quality, and consistency of guidelines for robotic lower limb rehabilitation after stroke, in order to provide clinical recommendations.
View Article and Find Full Text PDFIntroduction: Postural instability is a cardinal feature of Parkinson's disease, together with rest tremor, rigidity and bradykinesia. It is a highly disabling symptom that becomes increasingly common with disease progression and represents a major source of reduced quality of life in patients with Parkinson's disease. Rehabilitation aims to enable patients with Parkinson's disease to maintain their maximum level of mobility, activity and independence.
View Article and Find Full Text PDFIntroduction: In recent years, robot-assisted gait training (RAGT) has been proposed as therapy for balance and gait dysfunctions in people with multiple sclerosis (PwMS). Through this systematic review, we aimed to discuss the impact of RAGT on balance and gait outcomes. Furthermore, characteristics of the training in terms of robots used, participants characteristics, protocols and combined therapeutic approaches have been described.
View Article and Find Full Text PDFIntroduction: Upper limb motor impairment is one of the most frequent stroke consequences. Robot therapy may represent a valid option for upper limb stroke rehabilitation, but there are still gaps between research evidence and their use in clinical practice. The aim of this study was to determine the quality, scope, and consistency of guidelines clinical practice recommendations for upper limb robotic rehabilitation in stroke populations.
View Article and Find Full Text PDFBackground: Scientific guidelines consider atrial fibrillation (AF) complicating degenerative mitral regurgitation (DMR) a debated indication for surgery.
Objectives: This study analyzed the prognostic/therapeutic implications of AF at DMR diagnosis and long-term.
Methods: Patients were enrolled in the MIDA (Mitral Regurgitation International Database) registry, which reported the consecutive, multicenter, international experience with DMR due to flail leaflets echocardiographically diagnosed.
Article Synopsis
- The study explores how P2X7R signaling influences T cell differentiation, specifically noting that it controls the balance between Th17 and Th2 cells, with NLRP3 acting as a transcriptional factor for Th2 cells.
- A loss-of-function mutation in the intracellular region of P2X7R disrupts this balance, causing an increase in Th17 cells and resulting in poor outcomes for cardiac transplant patients carrying this mutation.
- The research suggests that modifying NLRP3 levels can normalize T cell profiles, and IL-17 blockade could serve as a potential treatment for patients with P2X7R mutations to improve graft outcomes.