Publications by authors named "SACCO S"

The Pacific banana slug, Ariolimax columbianus, is endemic to the forests of the Pacific Northern West. Found throughout coastal foothills and mountains of California, the hermaphroditic molluscs Ariolimax spp. are niche-constrained, hyper-localized, and phenotypically diverse.

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Background: The term "aura" refers to a well-defined pattern of usually positive, progressive, and reversible neurological symptoms, with spreading depolarization as the underlying mechanism. While commonly associated with migraine, aura can also occur in other neurological disorders (i.e.

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Background: Although mechanical thrombectomy (MT) represents the standard of care for ischemic stroke due to large-vessel occlusion (LVO), the impact of sex on outcomes in tandem occlusions remains unclear. We investigated sex-based differences in outcomes after MT for tandem occlusions.

Methods: This multicenter observational study included consecutive patients with tandem occlusion treated with MT across three stroke centers (2021-2023).

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Background: Mechanical thrombectomy (MT) is the standard of care for eligible acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) since 2015.

Aim: Our aim was to determine the key challenges for MT implementation and access worldwide.

Methods: We conducted an international online survey consisting of 37 questions, distributed through the World Stroke Organization network, and as invited by co-authors between December 2022 and March 2023.

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Background: Sex may impact clinical outcomes in patients with stroke treated with dual antiplatelet therapy (DAPT). We aimed to investigate the sex differences in the short-term outcomes of DAPT within a real-world population of patients with noncardioembolic mild-to-moderate ischemic stroke or high-risk transient ischemic attack.

Methods: We performed a propensity score-matched analysis from a prospective multicentric cohort study (READAPT [Real-Life Study on Short-Term Dual Antiplatelet Treatment in Patients With Ischemic Stroke or Transient Ischemic Attack]) by including patients with noncardioembolic mild-to-moderate stroke (National Institutes of Health Stroke Scale score of 0-10) or high-risk transient ischemic attack (age, blood pressure, clinical features, duration of transient ischemic attack, presence of diabetes [ABCD] ≥4) who initiated DAPT within 48 hours of symptom onset.

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Article Synopsis
  • * In the study, 689 participants were categorized into three groups based on migraine resistance, with significant differences in the number and type of comorbidities found among them.
  • * The findings suggest that higher comorbidity rates may contribute to the worsening of migraines, potentially making them harder to treat over time.
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The use of antiplatelet therapy (APT) is prevalent among the general population, sometimes without clear indications. We provided updated figures on the incidence and prognosis of first-ever intracerebral hemorrhage occurring on APT (APT-ICH) over 10 years in a population-based stroke registry and investigated the rates of inappropriate APT prescription. We included all cases of first-ever ICH not on anticoagulants from January 2011 to December 2020 in the district of L'Aquila (Southern Italy).

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  • Migraine with aura (MwA) is a painful disorder marked by neurological symptoms, predominantly visual, with unclear causes involving the trigeminovascular system and cortical spreading depression.* -
  • The study analyzed data from 272 MwA patients, finding that most experienced typical aura symptoms, especially visual auras, and some reported relapses within 24 hours.* -
  • Common treatments for aura included triptans, non-steroidal anti-inflammatory drugs, and nutraceuticals, which may help improve clinical management and understanding of MwA.*
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Background: Cerebral venous thrombosis (CVT) accounts for 0.5-1% of all strokes. The role of endovascular therapy (EVT) in the management of CVT remains controversial and variations in practice patterns are not well known.

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Background: According to the literature, about one third of patients with brain ischemic symptoms lasting <24 h, which are classified as Transient ischemic attacks (TIAs) according to the traditional "time-based" definition, show the presence of acute ischemic lesions at neuroimaging. Recent evidence has shown that the presence of acute ischemic lesions at neuroimaging may impact on the outcome of patients with transient ischemic symptoms treated with dual antiplatelet treatment (DAPT). This uncertainty is even more compelling in recent years as short-term DAPT has become the standard treatment for any non-cardioembolic TIA or minor ischemic stroke.

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Article Synopsis
  • - 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.
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The migraine treatment landscape has seen significant advancements in recent years, including the introduction of novel preventive agents specifically targeting the disease. These new treatments offer improved efficacy and tolerability, potentially addressing the issue of poor treatment adherence commonly observed with conventional preventatives. In this context, pragmatic trials emerge as a critical tool for advancing migraine care, offering a real-world approach to evaluating open clinical questions at the same time as avoiding the biases of real-world observational evidence.

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  • - Fasting-mimicking diets (FMD), specifically a low-salt version (LS-FMD), were tested in rats with kidney damage and were found to restore normal kidney function and structure by inducing a nephrogenic gene program.
  • - LS-FMD activated pathways that promote cell reprogramming in the kidney, specifically targeting podocytes, which play a critical role in kidney health.
  • - A pilot study in patients with chronic kidney disease showed that FMD cycles improved kidney function and reduced protein levels in urine, indicating potential for further research in treating progressive kidney diseases.
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  • A study aimed to compare outcomes of general anesthesia (GA) versus non-general anesthesia (non-GA) in patients aged 90 and older undergoing mechanical thrombectomy (MT) for acute ischemic stroke, a group often excluded from previous research.
  • The analysis included 139 patients, with those receiving non-GA showing significantly worse outcomes in 90-day modified Rankin Scale (mRS) scores and higher mortality rates.
  • The findings suggest that nonagenarians treated with MT without GA have poorer prognoses, highlighting the need for further research on anesthesia techniques for this age group.
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  • The European Stroke Organisation recommends using tenecteplase (TNK) as an alternative to alteplase (TPA) for treating acute ischemic stroke within 4.5 hours, based on previous studies establishing its noninferiority.
  • An updated systematic review and meta-analysis assessed the efficacy and safety of TNK compared to TPA, using data from 11 randomized controlled trials involving nearly 7,600 patients.
  • Results showed that TNK was linked to better chances of achieving excellent functional outcomes and reduced disability at 3 months, while maintaining similar safety profiles for symptomatic intracranial hemorrhage when compared to TPA.
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Inclusion of adaptive design features in a clinical trial provides preplanned flexibility to dynamically modify a trial during its conduct while preserving validity and integrity. Adaptive trials are needed to accelerate the conduct of more efficient, informative, and ethical clinical research in the field of neurology. Stroke is a natural candidate for adoption of these innovative approaches to trial design.

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Article Synopsis
  • Over one-third of patients with migraines experience inadequate relief from acute medications, highlighting the need for more effective treatments.
  • Sumatriptan-naproxen sodium, a combined medication, was studied in 14 clinical trials to assess its effectiveness for migraine relief among adults and adolescents.
  • The results showed that sumatriptan-naproxen sodium provided significantly superior pain relief within 2 hours and sustained pain freedom for up to 24 hours compared to other treatments, demonstrating its potential in enhancing acute migraine care.
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Background And Purpose: Although there is extensive evidence about the safety of monoclonal antibodies against calcitonin gene-related peptide (anti-CGRP mAbs) in combination with traditional drugs, scarce data are available on the safety of their combination with other mAbs. This study aimed to evaluate the 6-month effectiveness and tolerability of anti-CGRP mAbs in combination with other mAbs for different diseases.

Methods: Patients included in the Italian Headache Registry and treated concomitantly with an anti-CGRP mAb and another mAb were included.

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Background: Infants with Down syndrome (DS) are at high risk of obstructive sleep apnoea (OSA) which is associated with neurocognitive dysfunction and behaviour problems. The aim of our study was to evaluate the effect of early OSA treatment in infants with DS on neurocognitive development and behaviour.

Methods: In this prospective, interventional, non-randomised study, 40 infants with DS underwent polysomnography (PSG) every 6 months in room air between 6 and 36 months of age () and were compared to a control group of 40 infants with DS receiving standard of care and a single, systematic PSG in room air at 36 months of age ().

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Article Synopsis
  • - 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
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Background And Purpose: Guidelines help physicians to provide optimal care for stroke patients, but implementation is challenging due to the quantity of recommendations. Therefore a practical overview related to applicability of recommendations can be of assistance.

Methods: A systematic review was performed on ischaemic stroke guidelines published in scientific journals, covering the whole acute care process for patients with ischaemic stroke.

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Somatic variant detection is an integral part of cancer genomics analysis. While most methods have focused on short-read sequencing, long-read technologies now offer potential advantages in terms of repeat mapping and variant phasing. We present DeepSomatic, a deep learning method for detecting somatic SNVs and insertions and deletions (indels) from both short-read and long-read data, with modes for whole-genome and exome sequencing, and able to run on tumor-normal, tumor-only, and with FFPE-prepared samples.

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The Global Burden of Disease (GBD) study is pivotal in shaping health policies by providing comprehensive data on mortality and disability. An updated GBD2021 analysis, published in on 14 March 2024, expands the scope of neurological disorders to include 37 conditions, revealing their significant impact on global health. Neurological disorders affect 3.

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Background: The superiority of endovascular thrombectomy (EVT) over medical management was not established in two early basilar artery occlusion (BAO) randomized controlled trials. Despite this, many clinicians recommended EVT for acute BAO under certain circumstances. This paper aims to compare physicians' diagnostic and management strategies of BAO according to gender.

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