Publications by authors named "Martina Locatelli"
Article Synopsis
- A significant portion of spontaneous intracerebral hemorrhages (ICH) arise from macrovascular causes, necessitating a swift diagnosis, often through invasive procedures like digital subtraction angiography (DSA), which aren't suitable for all patients.
- This study aimed to develop a new risk stratification score, the MACRO score, incorporating MRI findings to improve the identification of macrovascular causes of ICH.
- The MACRO score successfully incorporates various patient factors and MRI markers, demonstrating better predictive capabilities than current CT-based scores, validating its effectiveness in a diverse patient population.
Insights Into Perioperative Hypertension Management in Europe: Results From a Survey Endorsed by the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC).
J Cardiothorac Vasc Anesth
December 2024
Article Synopsis
- The study aimed to understand how perioperative hypertension is managed in Europe, given the lack of agreement on blood pressure targets.
- An online survey involving 339 participants (mostly anesthesiologists) revealed most aim for systolic blood pressure (SBP) between 120-140 mmHg during surgeries.
- Common medications used include α-adrenoreceptor antagonists, nitrates, and calcium channel blockers, with a preference for those that allow titratable control; less than 20% of procedures experienced treatment failures.
Article Synopsis
- This study investigates how atrial compression plays a role in CPR rather than focusing solely on the ventricles, specifically looking at the "atrial pump mechanism."
- A cohort of 40 patients who experienced cardiac arrest was analyzed with techniques like transesophageal echocardiography to measure the mechanical characteristics of atrial compression and its effects on blood flow.
- Results showed that 12.5% of patients had significant atrial compression, which correlated with better outcomes in terms of successful CPR, suggesting that this mechanism is important for maintaining blood flow and brain perfusion during resuscitation efforts.
Objectives: Cerebral amyloid angiopathy (CAA)-associated lobar intracerebral hemorrhage (ICH) has a high risk of recurrence, but the underlying mechanisms remain uncertain. We, therefore, aimed to characterize patterns of recurrent ICH.
Methods: We investigated early recurrent ICH (≥1 recurrent ICH event within 90 days of the index event) and ICH clusters (≥2 ICH events within 90 days at any time point) in 2 large cohorts of consecutive patients with first-ever ICH and available MRI.
Article Synopsis
- * Two genetic diseases, Menkes and Wilson's, highlight the importance of copper transport in neurological health, along with its links to other disorders like Alzheimer's and Parkinson's.
- * The review examines how copper imbalances impact brain function, explores animal models of related diseases, and discusses potential therapies aimed at correcting copper levels to improve health.
Background And Objectives: Chronic kidney disease (CKD) may be associated with the pathogenesis and phenotype of cerebral small vessel disease (SVD), which is the commonest cause of intracerebral hemorrhage (ICH). The purpose of this study was to investigate the associations of CKD with ICH neuroimaging phenotype, volume, and location, total burden of small vessel disease, and its individual components.
Methods: In 2 cohorts of consecutive patients with ICH evaluated with MRI, we investigated the frequency and severity of CKD based on established Kidney Disease Improving Global Outcomes criteria, requiring estimated glomerular filtration rate (eGFR) measurements <60 mL/min/1.
Prone positioning with continuous positive airway pressure (CPAP) is widely used for respiratory support in awake patients with COVID-19-associated acute respiratory failure. We aimed to assess the respiratory mechanics and distribution of ventilation in COVID-19-associated ARDS treated by CPAP in awake prone position. We studied 16 awake COVID-19 patients with moderate-to-severe ARDS.
View Article and Find Full Text PDFArticle Synopsis
- The study explores the impact of vaccination on the severity of COVID-19 in patients with neurological disorders, comparing outcomes between vaccinated and unvaccinated individuals admitted to a specialized unit.
- Among 232 hospitalized COVID-19 patients, 32% were fully vaccinated, with breakthrough cases being older and having higher comorbidity compared to unvaccinated patients, but similar disease progression and mortality rates.
- The analysis highlighted age and a specific early warning score as significant predictors of mortality, emphasizing the need to identify vulnerable neurological patients at greater risk during COVID-19 outbreaks.
Article Synopsis
- Cerebral small vessel disease (SVD) is a key cause of intracerebral hemorrhage (ICH), and researchers created a new MRI-based classification system, known as CADMUS, to categorize ICH subtypes associated with SVD.
- A retrospective study analyzed data from two patient cohorts to classify ICH types based on MRI findings, assessing reliability and tracking subsequent strokes or hemorrhages.
- The findings revealed a diverse distribution of ICH phenotypes among patients, with the CADMUS classification showing good reliability and potential for enhancing clinical and research practices in identifying SVD-related ICH types.
Article Synopsis
- There's a growing need in biomedicine to thoroughly evaluate experimental data against existing information to validate results and gauge the novelty of findings.
- BQsupports is a new web tool that uses a vast database of over 1000 biomedical descriptors to analyze observations, providing support scores that summarize the reliability of the data across diverse biomedical areas.
- This tool not only measures the support for individual observations but also suggests features useful for future machine learning applications, making it a valuable resource for researchers.
Article Synopsis
- Biomedical data is rapidly growing, making it difficult to integrate different perspectives on biological events; the Bioteque aims to address this issue.
- The Bioteque is a comprehensive resource featuring over 450,000 biological entities and 30 million relationships derived from a vast knowledge graph, consolidating data from more than 150 sources.
- It enables easier analysis of protein interactions, predicts drug responses, and supports machine learning applications without sacrificing performance compared to using raw data.
Objective: To explore the impact of antithrombotic therapy discontinuation in the postacute phase of cervical artery dissection (CeAD) on the mid-term outcome of these patients.
Methods: In a cohort of consecutive patients with first-ever CeAD, enrolled in the setting of the multicentre Italian Project on Stroke in Young Adults Cervical Artery Dissection, we compared postacute (beyond 6 months since the index CeAD) outcomes between patients who discontinued antithrombotic therapy and patients who continued taking antithrombotic agents during follow-up. Primary outcome was a composite of ischaemic stroke and transient ischaemic attack.
Article Synopsis
- Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease mainly affecting motor neurons, with only 10% of cases being inherited.
- The study analyzed microRNA (miRNA) expression in motor neurons and exosomes from both familial ALS patients and healthy controls, revealing specific miRNAs (miR-34a, miR-335, and miR-625-3p) that were dysregulated and linked to the disease's progression.
- Additionally, significant changes in the levels of miR-34a-3p and miR-625-3p were found in the cerebrospinal fluid of patients, suggesting that examining miRNA across different biological samples could enhance our understanding of ALS and support
Objective: The aim of this study is to evaluate the differences in clinical presentations and the impact of healthcare organization on outcomes of neurological COVID-19 patients admitted during the first and second pandemic waves.
Methods: In this single-center cohort study, we included all patients with SARS-CoV-2 infection admitted to a Neuro-COVID Unit. Demographic, clinical, and laboratory data were compared between patients admitted during the first and second waves of the COVID-19 pandemic.
Background: Subclinical vascular brain lesions are highly prevalent in elderly patients with stroke. Little is known about predisposing factors and their impact on long-term outcome of patients with stroke at a young age.
Methods: We quantified magnetic resonance-defined subclinical vascular brain lesions, including lacunes and white matter hyperintensities, perivascular spaces and cerebral microbleeds, and assessed total small-vessel disease (SVD) score in patients with first-ever acute ischemic stroke aged 18 to 45 years, and followed them up, as part of the multicentre Italian Project on Stroke in Young Adults.
Article Synopsis
- The study aimed to explore how traditional stroke risk factors affect the likelihood of intracerebral hemorrhage (ICH) based on age.
- Researchers conducted a case-control analysis involving 3,492 ICH patients and an equal number of stroke-free controls from a multi-center study in Italy.
- Results indicated that untreated hypertension significantly increases ICH risk more in younger individuals, while untreated hypercholesterolemia's impact decreases with age; untreated diabetes and high alcohol intake were only risky for older adults.
Objective: To characterize patients with acute ischemic stroke related to SARS-CoV-2 infection and assess the classification performance of clinical and laboratory parameters in predicting in-hospital outcome of these patients.
Methods: In the setting of the STROKOVID study including patients with acute ischemic stroke consecutively admitted to the ten hub hospitals in Lombardy, Italy, between March 8 and April 30, 2020, we compared clinical features of patients with confirmed infection and non-infected patients by logistic regression models and survival analysis. Then, we trained and tested a random forest (RF) binary classifier for the prediction of in-hospital death among patients with COVID-19.
Whether and how SARS-CoV-2 outbreak affected in-hospital acute stroke care system is still matter of debate. In the setting of the STROKOVID network, a collaborative project between the ten centers designed as hubs for the treatment of acute stroke during SARS-CoV-2 outbreak in Lombardy, Italy, we retrospectively compared clinical features and process measures of patients with confirmed infection (COVID-19) and non-infected patients (non-COVID-19) who underwent reperfusion therapies for acute ischemic stroke. Between March 8 and April 30, 2020, 296 consecutive patients [median age, 74 years (interquartile range (IQR), 62-80.
View Article and Find Full Text PDFCervical artery dissection (CeAD) is the most common cause of ischemic stroke in young and middle-aged adults. Over the last decade, a relation between CeAD and fibromuscular dysplasia (FMD), an idiopathic, segmental, non-atherosclerotic and non-inflammatory arterial disease, has been suggested based on a number of epidemiologic observations, while preliminary data support the idea that the two conditions may share common biologic mechanisms. In this article, we review the literature on the relation between CeAD and FMD, focus on the potential pathogenetic mechanisms common to the two conditions, summarize clinical features, management and outcome, and provide support to the hypothesis that the coexistence of the two diseases in one individual might be conceptualized as a distinct non-atherosclerotic non-inflammatory arteriopathy.
View Article and Find Full Text PDFBackground And Purpose: Observational studies have suggested a link between fibromuscular dysplasia and spontaneous cervical artery dissection (sCeAD). However, whether patients with coexistence of the two conditions have distinctive clinical characteristics has not been extensively investigated.
Methods: In a cohort of consecutive patients with first-ever sCeAD, enrolled in the setting of the multicenter IPSYS CeAD study (Italian Project on Stroke in Young Adults Cervical Artery Dissection) between January 2000 and June 2019, we compared demographic and clinical characteristics, risk factor profile, vascular pathology, and midterm outcome of patients with coexistent cerebrovascular fibromuscular dysplasia (cFMD; cFMD+) with those of patients without cFMD (cFMD-).
Objective: To report clinical and laboratory characteristics, treatment, and clinical outcomes of patients admitted for neurologic diseases with and without coronavirus disease 2019 (COVID-19).
Methods: In this retrospective, single-center cohort study, we included all adult inpatients with confirmed COVID-19 admitted to a neuro-COVID unit beginning February 21, 2020, who had been discharged or died by April 5, 2020. Demographic, clinical, treatment, and laboratory data were extracted from medical records and compared (false discovery rate corrected) to those of neurologic patients without COVID-19 admitted in the same period.