Publications by authors named "Maria Guarino"
Objective: The STEPPER (Status Epilepticus in Emilia-Romagna) study aimed to investigate the clinical characteristics, prognostic factors, and treatment approaches of status epilepticus (SE) in adults of the Emilia-Romagna region (ERR), Northern Italy.
Methods: STEPPER, an observational, prospective, multicentric cohort study, was conducted across neurology units, emergency departments, and intensive care units of the ERR over 24 months (October 2019-October 2021), encompassing incident cases of SE. Patients were followed up for 30 days.
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- The Itel-MMSE is an easy-to-use telephone screening tool for dementia that gained traction during COVID-19 but needed validation and faced issues like a ceiling effect.
- This study standardized and validated the Itel-MMSE, recruiting 707 healthy participants and 368 individuals with Mild Cognitive Impairment and Alzheimer's Disease to establish new cut-off scores.
- Results indicated that the Itel-MMSE is effective in identifying dementia, with strong performance metrics in distinguishing between normal conditions and cognitive impairments, supporting its use in remote screenings.
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- * The study focused on identifying brain-specific DNA methylation profiles to track brain-derived cfDNA (bcfDNA) through comparisons of brain and non-brain tissues and validated these findings on autopsy samples.
- * The developed assay showed higher levels of bcfDNA in patients experiencing neurotoxicity after CAR-T therapy, indicating its potential for early detection of neuronal loss in neurodegenerative diseases.
Obesity is a chronic, complex and multi-factorial condition with an increasing prevalence worldwide. Irregular eating schedules might be a contributing factor to these numbers through the dysregulation of the circadian system. Time-restricted eating (TRE), an approach that limits eating windows, has been studied as a strategy to treat obesity, aligning eating occasions with metabolic circadian rhythms.
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- - Short-term dual antiplatelet treatment (DAPT) shows better effectiveness compared to single antiplatelet treatment (SAPT) for preventing secondary strokes in patients with mild to moderate strokes and high-risk TIAs, according to a study of 2016 patients.
- - Patients treated with DAPT had a higher likelihood of regaining pre-stroke neurological function within 90 days and showed more early neurological improvement compared to those on SAPT.
- - The study suggests that DAPT might be a safer and more effective option than SAPT in real-world settings, even for patients not fitting the criteria of major clinical trials.
Clinical Course of Neurologic Adverse Events Associated With Immune Checkpoint Inhibitors: Focus on Chronic Toxicities.
Neurol Neuroimmunol Neuroinflamm
November 2024
Article Synopsis
- This study investigates the clinical characteristics of neurologic immune-related adverse events (n-irAEs) linked to immune checkpoint inhibitors (ICIs) and their potential to become chronic.
- A total of 66 patients were analyzed, with findings showing that a significant portion experienced chronic n-irAEs, particularly affecting the peripheral nervous system and leading to various neurological impairments.
- The study highlights that patients with concurrent myocarditis had a higher risk of fatal outcomes, and chronic n-irAEs often required ongoing treatment or resulted in persistent neurological issues like ataxia and cognitive impairment.
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- - The study analyzes the short-term outcomes of patients with minor ischemic stroke from small artery occlusion (SAO-MIS) treated with dual antiplatelet therapy (DAPT) and compares them to patients with other causes of minor strokes.
- - In a sample of 678 minor ischemic stroke patients, SAO-MIS showed low rates of primary outcomes (1.2% had major cardiovascular events) and a high proportion achieving excellent functional outcomes (75.5%) within 90 days.
- - Results indicate that SAO-MIS patients have a significantly lower risk of recurrent vascular events compared to non-SAO-MIS patients, while showing similar safety outcomes, suggesting that DAPT is beneficial for SAO-M
Acute-on-chronic liver failure (ACLF) is a severe clinical syndrome characterized by acute liver decompensation in patients with chronic liver disease, marked by systemic inflammation and systemic organ failure. In this review, we discussed sex-related disparities in the incidence, prognosis, and access to liver transplantation (LT) for patients with ACLF, particularly during Intensive Care Unit (ICU) management. Some studies have suggested that ACLF is more prevalent among male patients admitted to the ICU, and they have higher mortality rates than females.
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- * A case study involved a woman in her 70s who experienced neck issues due to a CCF, which affected her cranial nerve and led to cervical myelopathy.
- * A detailed search of medical literature revealed that CCFs presenting with cervical myelopathy are quite rare, offering insights that could aid doctors in diagnosing and treating this complex condition.
Osimertinib, a third-generation EGFR tyrosine kinase inhibitor, is the standard of care for patients with advanced NSCLC and EGFR-sensitizing mutations. Both in osimertinib pivotal trials and in the post-marketing phase, asymptomatic creatinine phosphokinase elevation and clinically relevant muscle damage have been reported. However, the mechanisms underlying these conditions remain unclear.
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- Short-term dual antiplatelet therapy (DAPT) has been shown to be effective in preventing recurrent strokes after minor ischemic stroke or high-risk transient ischemic attack (TIA) in controlled trials, prompting a need to evaluate its real-world efficacy and safety.
- The READAPT study observed 1,920 patients in a real-world setting, finding that only a small percentage followed strict research protocols; however, the overall rates of stroke or death due to vascular causes were low (3.9%) and serious bleeding events were rare (0.6%).
- Most patients did not meet the strict criteria of randomized controlled trials, yet DAPT proved to be both effective and safe, especially in patients with lower NIHSS scores and delayed treatment
BACKGROUNDPredicting immune effector cell-associated neurotoxicity syndrome (ICANS) in patients infused with CAR T cells is still a conundrum. This complication, thought to be consequent to CAR T cell activation, arises a few days after infusion, when circulating CAR T cells are scarce and specific CAR T cell-derived biomarkers are lacking.METHODSCAR+ extracellular vesicle (CAR+EV) release was assessed in human CD19.
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- - Vulvar carcinoma, especially vulvar squamous cell carcinoma (VSCC), is a rare type of cancer that makes up 4% of gynecological tumors; diagnosis typically involves biopsy during vulvoscopy along with imaging techniques like MRI, USG, and PET.
- - A study conducted with data from multiple databases analyzed the effectiveness of imaging for diagnosing and staging VSCC, revealing high sensitivity but lower specificity in identifying malignant lesions, particularly with a mean SUV value of 8.4 in PET scans for tumors.
- - MRI was effective for evaluating lymph node involvement, showing significant accuracy rates, while USG measurements (cortical thickness and short axis length) proved crucial for distinguishing between cancerous and non-cancer
Recently, metabolic associated steatotic liver disease (MASLD) became the leading cause of chronic liver disease worldwide and one of the most frequent causes of hepatocellular carcinoma (HCC). Nonetheless, in this epidemiological trend, viral hepatitis remains the major driver in hepatic carcinogenesis. Globally, hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma, with an overall attributable risk of approximately 40%, followed by hepatitis C virus (HCV), which accounts for 28-30% of cases, with significant geographic variations between the Eastern and Western world.
View Article and Find Full Text PDFBioelectronic medicine are an emerging class of treatments aiming to modulate body nervous activity to correct pathological conditions and restore health. Recently, it was shown that the high frequency electrical neuromodulation of the carotid sinus nerve (CSN), a small branch of the glossopharyngeal nerve that connects the carotid body (CB) to the brain, restores metabolic function in type 2 diabetes (T2D) animal models highlighting its potential as a new therapeutic modality to treat metabolic diseases in humans. In this manuscript, we review the current knowledge supporting the use of neuromodulation of the CSN to treat T2D and discuss the future perspectives for its clinical application.
View Article and Find Full Text PDFIntroduction: Seizures may occur in up to 30% of non-Hodgkin lymphoma patients who received anti-CD19 CAR T-cell therapy, yet the optimal anti-seizure medication (ASM) prevention strategy has not been thoroughly investigated.
Methods: Consecutive patients affected by refractory non-Hodgkin lymphoma who received anti-CD19 CAR T-cells were included. Patients were selected and assessed using similar internal protocols.
Introduction: Tacrolimus-associated neurotoxicity (TAN) manifests with wide clinical spectrum, ranging from mild tremors to severe encephalopathy. The isolated involvement of the brainstem is a rarely documented presentation of TAN, and its clinical and diagnostic characteristics are unclear.
Methods: We report two cases of brainstem-isolated TAN (bi-TAN).
Background & Aims: Chronic hepatitis D virus (HDV) often leads to end-stage liver disease and hepatocellular carcinoma (HCC). Comprehensive data pertaining to large populations with HDV and HCC are missing, therefore we sought to assess the characteristics, management, and outcome of these patients, comparing them to patients with hepatitis B virus (HBV) infection.
Methods: We analysed the Italian Liver Cancer database focusing on patients with positivity for HBV surface antigen and anti-HDV antibodies (HBV/HDV, n = 107) and patients with HBV infection alone (n = 588).
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- The study investigates the impact of the COVID-19 pandemic on rapid outpatient TIA (transient ischemic attack) clinics, aiming to understand effects on TIA incidence and hospital services.
- Data from six medical centers over three years (pre- and intra-COVID) were analyzed for TIA and ischemic stroke presentations, as well as treatments like IV thrombolysis and endovascular thrombectomy.
- Results showed stable TIA clinic activity during the pandemic, but a decrease in the proportion of ischemic strokes treated with IV thrombolysis, indicating potential delays in patients seeking urgent treatment that need addressing in public health strategies.