Publications by authors named "Maurizio Melis"

Background: Antibody-mediated rejection is a significant cause of kidney transplant failure. Recent studies have shown that the MHC class I gene influences the transplantation outcome. However, the role of the primary receptor, NKG2D, has yet to be explored.

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  • The study investigates the incidence and prevalence of aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder (AQP4-IgG+NMOSD) in Sardinia over a ten-year period (2013-2022), where 45 cases were identified to capture this rare central nervous system disease.
  • Results show an increase in prevalence from 1.1 to 2.6 per 100,000 from 2013 to 2022, with a predominance of females (9:1 ratio) and a median age of 51 years at diagnosis.
  • Findings suggest that while Sardinia has a high risk for multiple sclerosis, the incidence of AQP4-IgG+
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  • * Researchers analyzed 202 MG patients from 2010 to 2019, finding that the incidence was 32.6/million and prevalence was 55.3/100,000, with the majority testing positive for acetylcholine receptor antibodies.
  • * The findings suggest that Sardinia has a higher prevalence of MG than the European average for rare diseases, highlighting the need to explore environmental and genetic factors contributing to this increased risk.
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  • Fabry disease (FD) is a rare genetic disorder linked to strokes, and there's ongoing debate about when to test for it in stroke patients.
  • This study, part of the Fabry-Stroke Italian Registry, screened nearly 1,906 stroke patients for FD by checking alpha-galactosidase A activity and conducting genetic tests, identifying a small number of affected individuals.
  • The findings suggest that limiting FD screening only to cryptogenic strokes could miss a significant number of cases, highlighting the importance of recognizing clinical signs that may indicate the need for testing.
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  • This study looked at how patients with a minor stroke are treated, comparing two methods: one using a drug called IVT and another method called MT, versus just IVT alone.
  • They analyzed data from patients treated in Italy to see which method led to better health outcomes after a stroke.
  • The results showed that while IVT plus MT had more complications in the short term, both treatment methods had similar long-term recovery outcomes.
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I n the context of an adequate health care organization, the figure of the neurologist as an emergency operator (in the emergency room-ER-and/or in a dedicated outpatient clinic) is crucial for an effective functional connection with the territory (and therefore with general practitioners), a reduction in inappropriate ER accesses, specific diagnostic and therapeutic approaches to neurological emergencies in the ER and a reduction in nonspecific or even unnecessary instrumental investigations. In this position paper of the Italian Association of Emergency Neurology (ANEU: Associazione Neurologia dell'Emergenza Urgenza), these issues are addressed, and two important organizational solutions are proposed: 1) The Neuro Fast Track, as an outpatient organization approach strongly linked to general practitioners and non-neurological specialists and dedicated to cases with deferrable urgency (to be assessed within 72 h) 2) The identification of an emergency neurologist, who is engaged in ER assessments as a consultant and involved in the management of the semi-intensive care unit of the emergency neurology and the stroke unit according to an appropriate rotation, as well as in consultations for patients with neurological emergencies in inpatient wards The possibility of computerizing the screening of patients with deferrable urgency in the Neuro Fast Track is described. A dedicated app represents an important tool that can facilitate the identification of patients for whom deferred assessment is appropriate, the scheduling of neurological examinations and reductions in the booking time through a more rapid approach to specialist assessment and subsequent investigations.

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Efficacy and safety of mechanical thrombectomy (MT) for stroke with posterior circulation large vessel occlusion (LVO) is still under debate. We aimed to compare the outcomes of stroke patients with posterior circulation LVO treated with intravenous thrombolysis (IVT) (< 4.5 h after symptom onset) plus MT < 6 h after symptom onset with those treated with IVT alone (< 4.

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  • Recent studies indicate that host genetic factors, particularly HLA-G molecules, may play a significant role in determining the severity of COVID-19 effects among individuals.
  • The study compared immune-genetic characteristics of 381 COVID-19 patients and 420 healthy controls from Sardinia, revealing that certain gene polymorphisms are associated with varying disease severity.
  • Key findings included a more common extended haplotype in patients with mild symptoms and protective effects from other genetic factors, while the Neanderthal gene variant showed negative implications for disease progression.
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  • The study investigates predictors of hemorrhagic transformation (HT) and cerebral edema (CED) in stroke patients undergoing endovascular treatment after experiencing large vessel occlusion (LVO).
  • It analyzes data from 1,400 patients to find clinical and procedural factors associated with these complications, identifying variables like diabetes, NIHSS scores, and ASPECTS ratings as significant predictors.
  • Results show that HT occurred in 18% of patients and CED in 19.2%, with general anesthesia linked to a lower risk of HT, while factors like longer onset-to-groin times and invasive procedures raised the risk for both complications.
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Background: Heart failure (HF) is the second most important cardiac risk factor for stroke after atrial fibrillation (AF). Few data are available on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with HF.

Methods: The source of data is the multicentre Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS).

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Unlabelled: The immunomodulatory effects of HLA-G expression and its role in cancers, human liver infections and liver transplantation are well documented, but so far, there are only a few reports addressing autoimmune liver diseases, particularly autoimmune hepatitis (AIH).

Method And Materials: We analyzed the genetic and phenotypic characteristics of HLA-G in 205 type 1 AIH patients (AIH-1) and a population of 210 healthy controls from Sardinia (Italy).

Results: Analysis of the HLA-G locus showed no substantial differences in allele frequencies between patients and the healthy control population.

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Background: Recently in the field neurodegenerative diseases increasing attention has been pointed to CSF biomarkers and their integration with neuroimaging (1). Frontotemporal lobar degeneration (FTLD) refers to a heterogeneous group of clinical syndromes with different underlying proteinopathies including tau pathology. CSF biomarkers have been proposed as diagnostic and prognostic factors.

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Purpose: The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.

Methods: We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke.

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Background: Symptomatic intracerebral hemorrhage (sICH) and major bleeding can be fatal complications of intravenous thrombolysis (IVT) for acute ischemic stroke. We investigated the impact of early fibrinogen depletion after IVT on major bleeding events.

Methods: This multicenter observational prospective cohort study enrolled 1678 consecutive patients receiving IVT for acute ischemic stroke at 6 Italian centers, undergoing fibrinogen concentration assessment at baseline, 2 hours and 6 hours after IVT.

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Objective: to investigate the responses to mRNA COVID-19 vaccines in a cohort of immunosuppressed patients affected by immune-mediated inflammatory diseases (IMID).

Methods: we have measured humoral and cellular immunity using quantitative IgG anti-SARS-CoV-2 Spike antibody (anti-S-IgG), neutralization assays and specific interferon-gamma (IFN-g) release assay (IGRA) before and after the third dose of BNT162b2. The response of those on anti-CD20 (n = 18) was then compared with healthy controls (HC, n = 18) and IMID naïve to anti-CD20 drugs (n = 13).

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Background And Purpose: We sought to investigate whether there are gender differences in clinical outcome after stroke due to large vessel occlusion (LVO) after mechanical thrombectomy (EVT) in a large population of real-world patients.

Methods: From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke due to large vessel occlusion. We compared clinical and safety outcomes in men and women who underwent EVT alone or in combination with intravenous thrombolysis (IVT) in the total population and in a Propensity Score matched set.

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  • The study analyzed the relationship between the Careggi Collateral Score (CCS) and radiological outcomes in 1,785 patients who underwent thrombectomy for middle cerebral artery (MCA) occlusions, revealing significant findings.* -
  • CCS scores range from 0 (no retrograde filling) to 4 (extensive collateral flow), with higher scores indicating better radiological outcomes related to infarct growth, cerebral bleeding, and edema at 24 hours post-treatment.* -
  • Ordinal regression analysis showed that lower CCS scores (0-4) were associated with worse outcomes, suggesting that CCS may serve as a useful predictor in assessing the effectiveness of thrombectomy treatments in stroke patients.*
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Purpose: To study for the first time the incidence of adult-onset CNS tumors in Southern Sardinia, Italy.

Methods: Clinical records of patients > 18 years old who were diagnosed with primary CNS tumors during 2016-2019 in the study area were reviewed. Meningiomas, cranial/paraspinal nerve tumors, lymphomas, and pituitary tumors were excluded.

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  • The study examines how variations in KIR genes and their interactions with HLA Class I ligands affect the severity of COVID-19 in 396 Sardinian patients.
  • Researchers divided patients into two groups: symptomatic or mildly symptomatic (Group A) and hospitalized patients with severe disease (Group S).
  • Findings showed significant genetic differences, with Group S having a higher frequency of the KIR A/A haplotype and less representation of the KIR2DS2/HLA C1 combination, indicating these factors may correlate with more severe disease outcomes.
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Objectives: Epidemiological investigations and mathematical models have revealed that the rapid diffusion of Covid-19 can mostly be attributed to undetected infective individuals who continue to circulate and spread the disease: finding their number would be of great importance in the control of the epidemic.

Methods: The dynamics of an infection can be described by the SIR model, which divides the population into susceptible (S), infective I, and removed R subjects. In particular, we exploited the Kermack-McKendrick epidemic model, which can be applied when the population is much larger than the fraction of infected subjects.

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Giant hydronephrosis in adults is a rare entity. It is defined as an extensive dilatation of the pyelocaliceal cavities occupying a large part of the abdominal cavity. Giant hydronephrosis is usually due to pelvi-ureteric junction obstruction and is usually diagnosed in children and infants.

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Aim: SARS-CoV-2 infection is a world-wide public health problem. Several aspects of its pathogenesis and the related clinical consequences still need elucidation. In Italy, Sardinia has had very low numbers of infections.

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Background And Purpose: Recent data suggest that imbalances in the composition of the gut microbiota (GM) could exacerbate the progression of Parkinson disease (PD). The effects of levodopa (LD) have been poorly assessed, and those of LD-carbidopa intestinal gel (LCIG) have not been evaluated so far. The aim of this study was to identify the effect of LD and LCIG, in particular, on the GM and metabolome.

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