Casa di Cura Villa Margherita

Santa Margherita di Belice, Italy

Casa di Cura Villa Margherita

Santa Margherita di Belice, Italy
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PubMed | Casa di Cura Villa Margherita, Monash University, Parkinsons Center Pelascini Riuniti Hospital and University of Padua
Type: | Journal: Gait & posture | Year: 2016

Although hydrotherapy is one of the physical therapies adopted to optimize gait rehabilitation in people with Parkinson disease, the quantitative measurement of gait-related outcomes has not been provided yet. This work aims to document the gait improvements in a group of parkinsonians after a hydrotherapy program through 2D and 3D underwater and on land gait analysis. Thirty-four parkinsonians and twenty-two controls were enrolled, divided into two different cohorts. In the first one, 2 groups of patients underwent underwater or land based walking training; controls underwent underwater walking training. Hence pre-treatment 2D underwater and on land gait analysis were performed, together with post-treatment on land gait analysis. Considering that current literature documented a reduced movement amplitude in parkinsonians across all lower limb joints in all movement planes, 3D underwater and on land gait analysis were performed on a second cohort of subjects (10 parkinsonians and 10 controls) who underwent underwater gait training. Baseline land 2D and 3D gait analysis in parkinsonians showed shorter stride length and slower speed than controls, in agreement with previous findings. Comparison between underwater and on land gait analysis showed reduction in stride length, cadence and speed on both parkinsonians and controls. Although patients who underwent underwater treatment exhibited significant changes on spatiotemporal parameters and sagittal plane lower limb kinematics, 3D gait analysis documented a significant (p<0.05) improvement in all movement planes. These data deserve attention for research directions promoting the optimal recovery and maintenance of walking ability.


PubMed | Parkinsons Center, Casa di Cura Villa Margherita and University of Genoa
Type: | Journal: Clinical rehabilitation | Year: 2016

To compare the efficacy of two physiotherapy protocols (water-based vs. non-water-based) on postural deformities of patients with Parkinsons disease.A single blind, randomized controlled pilot study.Inpatient (Rehabilitative Department).A total of 30 patients with idiopathic Parkinsons disease.Participants were randomly assigned to one of two eight-week treatment groups: Water-based (n=15) or non-water-based physiotherapy exercises (n=15).Changes in the degree of cervical and dorsal flexion and in the angle of lateral inclination of the trunk (evaluated by means of a posturographic system) were used as primary outcomes. Unified Parkinson Disease Rating Scale section III, Time Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence, Falls Efficacy Scale and the Parkinsons disease quality of life questionnaire (39 items) were the secondary outcomes. All outcomes were assessed at baseline, at the end of training and eight weeks after treatment. Patients were always tested at the time of their optimal antiparkinsonian medication (on phase).After the treatment, only Parkinsons disease subjects randomized to water-based treatment showed a significant improvement of trunk posture with a significant reduction of cervical flexion (water-based group: -65.2; non-water-based group: +1.7) and dorsal flexion (water-based group: -22.5; non-water-based group: -6.5) and lateral inclination of the trunk (water-based group: -2.3; non-water-based group: +0.3). Both groups presented significant improvements in the secondary clinical outcomes without between-group differences.Our results show that water-based physiotherapy was effective for improving postural deformities in patients with Parkinsons disease.


Piacentino M.,San Bortolo Hospital | Zambon G.,San Bortolo Hospital | Pilleri M.,Casa di Cura Villa Margherita | Bartolomei L.,San Bortolo Hospital
Journal of Neurosurgical Sciences | Year: 2013

Aim. Intracranial hemorrhage is an infrequent but potentially devastating complication associated with the placement of electrodes for deep brain stimulation (DBS). The objective of this retrospective review is to compare the risk of hemorrhage before and after the introduction of image-guided neuronavigation for the implant of electrodes for DBS. Methods. We reviewed all DBS implant performed at our Institute between 1998 and 2010. In 63 of the 106 patients, the targeting was based on ventriculography and merge of CT/MRI. After 2006, in the latter 43 procedures, we introduced targeting based on the merging of angio CT and MRI.. In both implant techniques, microelectrode recording (MER) was used to better define the target. All DBS procedures were performed by a single surgeon (M.P.). Patients had postoperative imaging (MRI or CT) 4-24 h following surgery. Results. In the group of patients implanted with the first targeting technique, 3 hematomas occurred and all of them solved with sequelae (one residual weakness and two hemiplegias.) After the introduction of neuronavigator, 2 hemorrhages occurred, one solved without sequelae while the second resulted in epileptic seizures. Conclusion. Although the incidence of hemorrhage occurred before and after the use of neuronavigation is the same, the severity is lower in the neuronavigated procedures. Targeting based on the merging of CT angiography and MRI T1/T2 seemed to increase the safety of the lead placement reducing the risk of sequelae related to bleeding. The use of MER was not found to be correlated with an increased hemorrhage rate.


Mioni G.,University of Padua | Stablum F.,University of Padua | Prunetti E.,Casa di Cura Villa Margherita | Grondin S.,UniversiteLavalQC
Journal of Affective Disorders | Year: 2016

Several studies reported temporal dysfunctions in anxious and depressed patients. In particular, compared to controls, anxious patients report that time is passing fast whereas depressed patients report that time passes slowly. However, in some studies, no differences between patients and controls are reported. Direct comparison between studies may be complex because of methodological differences, including the fact of conducting investigations with different temporal ranges. In the present study, we tested a group of anxious patients, a group of depressed patients, and a control group with two temporal tasks (time reproduction and time production) with the same temporal intervals (500, 1000 and 1500 ms) to further investigate the presence and cause of patient's temporal dysfunctions. Results showed that, compared to controls, anxious patients under-reproduced temporal intervals and depressed patients over-produced temporal intervals. The results suggest that time dysfunction in anxious patients would be mainly due to an attentional dysfunction whereas temporal dysfunction in depressed patients would be mainly due to variations in the pulse's emission rate of the pacemaker. © 2016 Elsevier B.V. All rights reserved.


Piacentino M.,San Bortolo Hospital | Pilleri M.,Casa di Cura Villa Margherita | Bartolomei L.,San Bortolo Hospital
Acta Neurochirurgica | Year: 2011

Background: Device-related infection is a common occurrence after deep brain stimulation (DBS) surgery, and may result in additional interventions and a loss of efficacy of therapy. This retrospective review aimed to evaluate the incidence, severity and management of device-related infections in 212 DBS procedures performed in our institute. Methods: Data on 106 patients, in whom 212 DBS procedures were performed between 2001 and 2011 at our institute by a single neurosurgeon (M.P.), were reviewed to assess the incidence, severity, management and clinical characteristics of infections in the first year after the implantation of a DBS system. Results: Infections occurred in 8.5% of patients and 4.2% of procedures. Of the nine infections, eight involved the neurostimulator and extensions, and one the whole system. The infections occurred 30.7 days after implantation: 7 within 30 days and 2 within 6 months. Infected and uninfected patients were comparable in terms of age, sex, indication for DBS implantation and neurostimulator location. In eight cases, the system components involved were removed and re-implanted after 3 months, while in one case the complete hardware was removed and not re-implanted. Conclusion: The overall incidence of postoperative infections after DBS system implantation was 4.2%; this rate decreased over time. All infections required further surgery. Correct and timely management of partial infections may result in successful salvage of part of the system. © 2011 Springer-Verlag.


Piacentino M.,San Bortolo Hospital | D'Andrea G.,Casa di Cura Villa Margherita | Perini F.,San Bortolo Hospital | Volpin L.,San Bortolo Hospital
World Neurosurgery | Year: 2014

Objective: On the basis of recent findings about the pathophysiology of cluster headache and through the experience reported in recent literature, we have reviewed the outcome of four patients affected by drug-resistant cluster headache treated in our department by posterior hypothalamic deep brain stimulation with a follow-up of more than 5 years. Methods: Between 2004 and 2006, we selected four patients affected by cluster headache. The diagnosis was based on the International Classification of Headache Disorders II criteria, and all patients were refractory to drug therapy. Under local anesthesia they underwent stereotactic positioning of a stimulation electrode within the posterior hypothalamus, ipsilateral to the site of pain. An intraoperative neurophysiological test stimulation was performed to assess possible side effects and symptoms related to hypothalamic neuronal activity. A second surgery was then performed with the patient under general anesthesia to implant the extension cable and the implantable pulse generator. Results: After 5 years of follow up, all patients had a valuable benefit with a reduction in episode frequency from 90% to 50% associated with a decrease in pain intensity perception. Conclusion: The long-lasting pain reduction and the improvement in the patients' symptoms should be considered a real positive prospective, not only because there was uncertainty about the persistence of the beneficial effects at a long-term follow-up, but also for the improvement of the quality of life. The stimulation can restore important aspects concerning the psychic condition that very often constitutes an important limiting factor in normal daily life for this type of patient.


PubMed | University of Padua, UniversiteLaval and Casa di Cura Villa Margherita
Type: | Journal: Journal of affective disorders | Year: 2016

Several studies reported temporal dysfunctions in anxious and depressed patients. In particular, compared to controls, anxious patients report that time is passing fast whereas depressed patients report that time passes slowly. However, in some studies, no differences between patients and controls are reported. Direct comparison between studies may be complex because of methodological differences, including the fact of conducting investigations with different temporal ranges. In the present study, we tested a group of anxious patients, a group of depressed patients, and a control group with two temporal tasks (time reproduction and time production) with the same temporal intervals (500, 1000 and 1500ms) to further investigate the presence and cause of patients temporal dysfunctions. Results showed that, compared to controls, anxious patients under-reproduced temporal intervals and depressed patients over-produced temporal intervals. The results suggest that time dysfunction in anxious patients would be mainly due to an attentional dysfunction whereas temporal dysfunction in depressed patients would be mainly due to variations in the pulses emission rate of the pacemaker.


PubMed | Casa di Cura Villa Margherita, La Trobe University and University of Limerick
Type: | Journal: Complementary therapies in medicine | Year: 2016

As the number of people diagnosed with Parkinsons disease increases, there is a need to develop initiatives that promote health and wellbeing and support self-management. Additionally, as exercise may slow physical decline, there is a need to develop methods that facilitate greater engagement with community-based exercise. The aim of this study is to examine the needs of (1) people with Parkinsons disease and (2) set dancing teachers to enable the development of participant-centred community set dance classes.A mixed methods study design was used. Two consensus group discussions using nominal group technique were held to (1) identify factors pertaining to the needs of people with Parkinsons disease from a set dance class and (2) the educational needs of set dancing teachers to enable them to teach set dancing to people with Parkinsons disease. Group discussions began with silent generation of ideas. A round-robin discussion and grouping of ideas into broader topic areas followed. Finally, participants ranked, by order of priority (1-5), the topic areas developed. Final data analysis involved summation of participants ranking scores for each topic area.Rich information on the needs of people with Parkinsons disease from a dance class and the educational guidance sought by set dancing teachers was gathered. Topic areas developed include teaching method for set dances and class environment.Accessing community exercise programmes is important for this population. The results of this study will inform the development of an educational resource on Parkinsons disease for set dancing teachers. This resource may facilitate a larger number of teachers to establish sustainable community set dancing classes for people with Parkinsons disease.


Shanahan J.,University of Limerick | Morris M.E.,La Trobe University | Bhriain O.N.,University of Limerick | Volpe D.,Casa di Cura Villa Margherita | And 2 more authors.
Complementary Therapies in Clinical Practice | Year: 2015

Objective: To investigate if community-based Irish set dancing is feasible in Irish adults with Parkinson's disease. Methods: Over an eight week period, ten participants attended one set dancing class per week and completed a home programme in parallel. Feasibility was assessed by monitoring adverse effects, participants' verbal feedback, compliance rates and feedback from an exit questionnaire. Participants were assessed using the Berg balance scale, 6-min walk test, UPDRS-3 and PDQ-39, before and after the intervention. Results: No adverse effects were detected. Attendance at classes was 86%. Compliance with the home programme was 67%. Findings from the exit questionnaire showed participants enjoyed participating and reported improvements in aspects of health including balance. Quality of life improved with the dance programme and there was a trend toward improvement on the UPDRS-3. Conclusion: These findings suggest community-based Irish set dancing is a feasible form of exercise that can positively influence quality of life. © 2014 Elsevier Ltd.


Bolner A.,Casa di Cura Villa Margherita | Pilleri M.,Casa di Cura Villa Margherita | De Riva V.,Casa di Cura Villa Margherita | Nordera G.P.,Casa di Cura Villa Margherita
Clinical Laboratory | Year: 2011

Background: Oxidative stress may be directly or indirectly involved in the pathogenesis of Parkinson's disease (PD). 8-hydroxy-2′deoxyguanosine (8-OHdG) is the major product of DNA oxidative damage but its determination in plasma or urine may have controversial significance. The concentration of 8-OHdG not only depends on its oxidation rate but also on the efficacy of the DNA repairing systems. Methods: We studied the ratio between 8-OHdG and 2-dG (the corresponding not hydroxylated base 2′-deoxyguanosine) in plasma and urine as a marker of oxydative stress in PD. This enabled the determination of the real DNA damage in terms of oxidation rate regardless of the efficacy of the DNA repairing mechanisms. Results: We optimized two different analytical methods: one for 8-OHdG and the other for 2-dG, both based on a common preliminary solid-phase extraction step (SPE) followed by two different HPLC analytical separations with electrochemical detection (HPLC-ED). The reliability of these methods was confirmed by analysing plasma and urine samples collected in parkinsonian patients and in age-matched healthy control subjects. Conclusions: In urine samples, the measurement of 8-OHdG alone as well as the ratio 8-OHdG/2-dG were significantly different in healthy controls and PD patients. In plasma samples, only the ratio 8-OHdG/2-dG was significantly higher in PD compared to healthy controls showing that the ratio 8-OHdG/2-dG is a reliable diagnostic tool in studies on DNA oxydative damage.

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