Azienda Ospedaliera Carlo Poma

Mantova, Italy

Azienda Ospedaliera Carlo Poma

Mantova, Italy
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Bolognini N.,University of Milan Bicocca | Bolognini N.,Instituto Auxologico Italiano | Olgiati E.,University of Milan Bicocca | Xaiz A.,University of Milan Bicocca | And 3 more authors.
Cerebral Cortex | Year: 2012

The observation of touch can be grounded in the activation of brain areas underpinning direct tactile experience, namely the somatosensory cortices. What is the behavioral impact of such a mirror sensory activity on visual perception? To address this issue, we investigated the causal interplay between observed and felt touch in right brain-damaged patients, as a function of their underlying damaged visual and/or tactile modalities. Patients and healthy controls underwent a detection task, comprising visual stimuli depicting touches or without a tactile component. Touch and No-touch stimuli were presented in egocentric or allocentric perspectives. Seeing touches, regardless of the viewing perspective, differently affects visual perception depending on which sensory modality is damaged: In patients with a selective visual deficit, but without any tactile defect, the sight of touch improves the visual impairment; this effect is associated with a lesion to the supramarginal gyrus. In patients with a tactile deficit, but intact visual perception, the sight of touch disrupts visual processing, inducing a visual extinction-like phenomenon. This disruptive effect is associated with the damage of the postcentral gyrus. Hence, a damage to the somatosensory system can lead to a dysfunctional visual processing, and an intact somatosensory processing can aid visual perception. © The Author 2011. Published by Oxford University Press. All rights reserved.

Bolognini N.,University of Milan Bicocca | Bolognini N.,IRCCS Instituto Auxologico Italiano | Olgiati E.,University of Milan Bicocca | Maravita A.,University of Milan Bicocca | And 2 more authors.
Pain | Year: 2013

Limb amputation may lead to chronic painful sensations referred to the absent limb, ie phantom limb pain (PLP), which is likely subtended by maladaptive plasticity. The present study investigated whether transcranial direct current stimulation (tDCS), a noninvasive technique of brain stimulation that can modulate neuroplasticity, can reduce PLP. In 2 double-blind, sham-controlled experiments in subjects with unilateral lower or upper limb amputation, we measured the effects of a single session of tDCS (2 mA, 15 min) of the primary motor cortex (M1) and of the posterior parietal cortex (PPC) on PLP, stump pain, nonpainful phantom limb sensations and telescoping. Anodal tDCS of M1 induced a selective short-lasting decrease of PLP, whereas cathodal tDCS of PPC induced a selective short-lasting decrease of nonpainful phantom sensations; stump pain and telescoping were not affected by parietal or by motor tDCS. These findings demonstrate that painful and nonpainful phantom limb sensations are dissociable phenomena. PLP is associated primarily with cortical excitability shifts in the sensorimotor network; increasing excitability in this system by anodal tDCS has an antalgic effect on PLP. Conversely, nonpainful phantom sensations are associated to a hyperexcitation of PPC that can be normalized by cathodal tDCS. This evidence highlights the relationship between the level of excitability of different cortical areas, which underpins maladaptive plasticity following limb amputation and the phenomenology of phantom limb, and it opens up new opportunities for the use of tDCS in the treatment of PLP. © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Franchini M.,Azienda Ospedaliera Carlo Poma | Bonfanti C.,Azienda Ospedaliera Carlo Poma
Clinica Chimica Acta | Year: 2015

The antigens of the ABO blood group system (A, B and H determinants) are complex carbohydrate molecules expressed on red blood cells and on a variety of other cell lines and tissues. Growing evidence is accumulating that ABO antigens, beyond their key role in transfusion medicine, may interplay with the pathogenesis of many human disorders, including infectious, cardiovascular and neoplastic diseases. In this narrative review, after succinct description of the current knowledge on the association between ABO blood groups and the most severe diseases, we aim to elucidate the particularly intriguing issue of the possible role of ABO system in successful aging. In particular, focus will be placed on studies evaluating the ABO phenotype in centenarians, the best human model of longevity. © 2015 .

Mazziotti G.,University of Brescia | Porcelli T.,University of Brescia | Patelli I.,University of Brescia | Vescovi P.P.,Azienda Ospedaliera Carlo Poma | Giustina A.,University of Brescia
Bone | Year: 2010

Introduction: There is evidence that variations of thyrotropin (TSH) even in its reference range may influence bone mineral density (BMD). In fact, low-normal TSH values have been associated with high prevalence of osteoporosis in post-menopausal women. However, data associating TSH and risk of fractures are scanty and limited to subjects with subclinical thyrotoxicosis. Materials and methods: In this observational study, we investigated the correlation between serum TSH and prevalence of radiological vertebral fractures in a cohort of 130 post-menopausal women with normal thyroid function. Results: Osteoporosis was observed in 80 women (61.5%), whereas 49 women (37.7%) had osteopenia. Vertebral fractures were found in 49 women (37.7%), who were significantly older, with higher prevalence of osteoporosis and with lower serum TSH values as compared with women who did not fracture. Stratifying the patients according to serum TSH values, vertebral fractures were found to be significantly (p= 0.004) more prevalent in first tertile (56.8%) of TSH values as compared with the second (23.3%) and third tertiles (32.6%). Multivariate logistic regression analysis demonstrated that low serum TSH maintained a significant correlation with vertebral fractures (odds ratio 2.8, C.I. 95% 1.20-6.79) even after correction for age, BMD, BMI and serum free-thyroxine values. Discussion: Low-normal TSH values are associated with high prevalence of vertebral fractures in women with post-menopausal osteoporosis or osteopenia, independently of thyroid hormones, age and BMD. © 2009 Elsevier Inc.

Franchini M.,Azienda Ospedaliera Carlo Poma | Crestani S.,Azienda Ospedaliera Carlo Poma | Frattini F.,Azienda Ospedaliera Carlo Poma | Sissa C.,Azienda Ospedaliera Carlo Poma | Bonfanti C.,Azienda Ospedaliera Carlo Poma
Seminars in Thrombosis and Hemostasis | Year: 2015

A rapid restoration of hemostasis should be regarded as a primary goal for management of critical bleeding, which often represents a life-threatening condition. Among the various therapeutic strategies available in this clinical setting, we aim to summarize in this narrative review the current status on the use of recombinant-activated factor VII and prothrombin complex concentrates. The safety and effectiveness of these hemostatic agents in reversal of the anticoagulant effects of vitamin K antagonists will be also explored. In addition, their role in the management of acute bleeding associated with the newer direct oral anticoagulants dabigatran, rivaroxaban, and apixaban will be analyzed in a dedicated section. © 2015 by Thieme Medical Publishers, Inc.

Franchini M.,Azienda Ospedaliera Carlo Poma | Liumbruno G.M.,San Giovanni Calibita Fatebenefratelli Hospital
Clinical Chemistry and Laboratory Medicine | Year: 2013

Human blood group antigens are glycoproteins and glycolipids expressed on the surface of red blood cells and a variety of human tissues, including the epithelium, sensory neurons, platelets and the vascular endothelium. Accumulating evidence indicate that ABO blood type is implicated in the development of a number of human diseases, including cardiovascular and neoplastic disorders. In this review, beside its physiologic role in immunohematology and transfusion medicine, we summarize the current knowledge on the association between the ABO blood group and the risk of developing thrombotic events and cancers. © 2013 by Walter de Gruyter Berlin Boston 2013.

Lippi G.,Academic Hospital of Parma | Danese E.,University of Verona | Favaloro E.J.,Westmead Hospital | Montagnana M.,University of Verona | Franchini M.,Azienda Ospedaliera Carlo Poma
Seminars in Thrombosis and Hemostasis | Year: 2015

Venous thromboembolism (VTE) is a prevalent and life-threatening condition that requires an accurate and timely diagnosis. The current diagnostic approach to this condition, entailing an efficient integration of clinical judgment, diagnostic imaging, and laboratory testing, is the result of decades of scientific and medical research. This article aims to present and discuss the major breakthroughs that have occurred in the diagnostic imaging of both deep vein thrombosis and pulmonary embolism, along with the various biological markers that have emerged from the laboratory bench and which have only marginally migrated to the bedside. Despite decades of research, the current diagnostic armamentarium for an efficient diagnosis of VTE remains suboptimal, and some wiggle room remains for the development of more efficient diagnostic tools, which may include thrombus-targeted molecular imaging, infrared thermal imaging, thrombin generation, and proteomics. Copyright © 2015 by Thieme Medical Publishers, Inc.

Franchini M.,Azienda Ospedaliera Carlo Poma
Clinical Chemistry and Laboratory Medicine | Year: 2015

There are a growing number of studies documenting that, similarly to patients with solid cancers, also patients with hematological malignancies (i.e., acute leukemia, lymphoproliferative and myeloproliferative neoplasms and plasma cell disorders) are at increased risk of thrombosis. The pathogenesis of the hypercoagulable state associated with hematological cancers is often multifactorial. Contributor factors include tumor cell-derived procoagulants, antineoplastic therapies, central venous catheters, concomitant infections and advanced age. In this narrative review, the epidemiology, pathogenesis and management of thrombosis in patients with hematological malignancies are reviewed. © 2015 by De Gruyter 2015.

Antoniazzi F.,University of Verona | Monti E.,University of Verona | Venturi G.,University of Verona | Franceschi R.,University of Verona | And 4 more authors.
European Journal of Endocrinology | Year: 2010

Objective: To verify the effects of bisphosphonates (Bps) in combination with recombinant human GH (rGH) in pediatric osteogenesis imperfecta (OI) patients; we focused on possible improvement of bone mineral density (BMD), projected bone areas, growth velocity, and fractures risk. Design: A randomized controlled 1-year clinical trial on 30 prepubertal children (M:F=14:16) affected by OI (type I, IV, and III) being treated with neridronate. Methods: Following an observational period of 12 months during ongoing neridronate treatment, the patients were randomly divided into two groups: 15 were treated for 12 months with rGH and neridronate (group Bp+rGH) and 15 continued neridronate alone (group Bp). We evaluated auxological parameters, number of fractures, bone age (BA), bone metabolic parameters, and bone mass measurements (at lumbar spine and radius by dual-energy X-ray absorptiometry). Results: The mean variation in percentage of BMD (Δ%BMD) - at lumbar spine (L2-L4), at distal and ultradistal radius - and the projected area of lumbar spine increased significantly in group Bp+rGH (P<0.05). Growth velocity was significantly higher during rGH treatment in group Bp+rGH versus group Bp and versus pretreatment (P<0.05), with no difference in increase in BA or fracture risk rate. Patients with quantitative (-qt) collagen synthesis defects had a higher, although not significant, response to rGH in terms of growth velocity and BMD. Conclusions: In OI patients, the combined rGH-Bp treatment may give better results than Bp treatment alone, in terms of BMD, lumbar spine projected area and growth velocity, particularly in patients with quantitative defects. © 2010 European Society of Endocrinology.

Agency: European Commission | Branch: H2020 | Program: RIA | Phase: PHC-17-2014 | Award Amount: 5.99M | Year: 2015

Every year, 1.3 million Europeans have a stroke and one million ultimately die of stroke. One third of stroke patients remain dependent on the help of others. The annual costs for stroke care in Europe are estimated at 64.1 billion. Stroke incidence increases almost exponentially with age, and the personal, societal, and economic burden of stroke is therefore largely driven by its frequent occurrence in the elderly. The elderly have been strongly underrepresented in previous stroke trials and treatment guidelines have no recommendations specific to this important group. Elderly patients are at the highest risk of complications after stroke, such as infections, fever, and dysphagia. These complications are strongly and independently associated with a higher risk of death or dependency. We will perform a pragmatic, randomised, open clinical trial with blinded outcome assessment in 3800 patients with acute stroke aged 66 years or older, to assess whether pharmacological prevention of infections and fever, and early management of dysphagia, will reduce the risk of death, poor functional outcome, and poor quality of life, and lead to reductions in the costs of stroke care throughout Europe. Patients will be randomised using a factorial design to preventive treatment for 4 days with ceftriaxone, paracetamol, and/or metoclopramide, or to standard care alone. The primary outcome is functional outcome at 3 months, assessed with the modified Rankin Scale (mRS), and analysed with ordinal logistic regression. The study will have 90% power to detect a statistically significant shift towards a favourable outcome, assuming a 5% absolute increase in the proportion of patients with a good outcome (mRS 0 to 2) in the intervention group, compared with controls. This simple, safe, and generally available treatment strategy has the potential to lead to an annual reduction of over 25 000 elderly Europeans being dead or dependent as a result of stroke, at very low costs.

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