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Milano, Italy

Donetti E.,University of Milan | Gualerzi A.,University of Milan | Ricceri F.,University of Florence | Pescitelli L.,University of Florence | And 2 more authors.
Experimental Dermatology | Year: 2012

Tumor Necrosis Factor-α (TNF-α) plays a pivotal role in psoriasis, an immuno-mediated and genetic skin disease. Anti-TNF-α inhibitors, such as etanercept, are widely used in clinical practice. By immunofluorescence, we investigated the expression of junctional transmembrane proteins in desmosomes (desmocollin-1, Dsc1; desmoglein-1, Dsg1), adherens junctions (E-cadherin), tight junctions (occludin), biomarkers of keratinocyte differentiation (keratin-10, K10; keratin-14, K14; keratin-16, K16; involucrin), epithelial proliferation and apoptosis in psoriatic skin before/after etanercept treatment (n = 5) and in control skin samples (n = 5). Occludin, K14, K16 and involucrin expressions were altered in psoriatic epidermis, while Dsc1, Dsg1, E-cadherin and K10 localisations were comparable to controls. Etanercept promoted the restoration of the physiological condition as suggested by a more differentiated keratinocyte phenotype and a reduced epidermal proliferation rate. © 2012 John Wiley & Sons A/S.


Caliandro P.,Catholic University of the Sacred Heart | Ferrarin M.,Polo Tecnologico | Cioni M.,University of Catania | Bentivoglio A.R.,Catholic University of the Sacred Heart | And 4 more authors.
Gait and Posture | Year: 2011

Previous studies have reported that patients with Parkinson's disease (PD) show, in the " off medication" state, a reduced activation of tibialis anterior (TA) in the late swing-early stance phase of the gait cycle. In PD patients the pathophysiological picture may cause differences among the stride cycles. Our aims were to evaluate how frequently TA activity is reduced in the late swing-early stance phase and if there is a relationship between the TA pattern and the clinical picture.Thirty PD patients were studied 2. h after Levodopa administration (" on-med" ) and 12. h after Levodopa wash-out (" off-med" ). They were evaluated by the Unified Parkinson's Disease Rating Scale (UPDRS III) and surface electromyography of TA and gastrocnemius medialis (GM). The root mean square (RMS) of the TA activity in late swing-early stance phase (RMS-A) was normalized as a percent of the RMS of the TA activity in late stance-early swing (RMS-B).RMS-A was reduced in 30% of patients in the " off-med" condition. Within these patients, the percentage of stride cycles with reduced RMS-A, ranged between 28% and 83%. After Levodopa intake, no stride cycle showed reduced RMS-A. Patients with reduced RMS-A had a lower UPDRS III total score in the " on-med" rather than in the " off-med" condition (p=0.02).Our data confirm and extend previous observations indicating that, in " off-med" the function of TA is impaired in those patients clinically more responsive to Levodopa. TA activation is reduced in a relatively high percent of gait cycles in the " off-med" state. Since the variability of TA activation disappears after Levodopa administration, this phenomenon could be the expression of an abnormal dopaminergic drive. © 2010 Elsevier B.V.


Lombardi C.,S.Luca Hospital | Lombardi C.,University of Washington | Meriggi P.,Polo Tecnologico | Meriggi P.,University of Washington | And 26 more authors.
Journal of Sleep Research | Year: 2013

High-altitude exposure is characterized by the appearance of periodic breathing during sleep. Only limited evidence is available, however, on the presence of gender-related differences in this breathing pattern. In 37 healthy subjects, 23 male and 14 female, we performed nocturnal cardio-respiratory monitoring in the following conditions: (1) sea level; (2) first/second night at an altitude of 3400 m; (3) first/second night at an altitude of 5400 m and after a 10 day sojourn at 5400 m. At sea level, a normal breathing pattern was observed in all subjects throughout the night. At 3400 m the apnea-hypopnea index was 40.3 ± 33.0 in males (central apneas 77.6%, central hypopneas 22.4%) and 2.4 ± 2.8 in females (central apneas 58.2%, central hypopneas 41.8%; P < 0.01). During the first recording at 5400 m, the apnea-hypopnea index was 87.5 ± 35.7 in males (central apneas 60.0%, central hypopneas 40.0%) and 41.1 ± 44.0 in females (central apneas 73.2%, central hypopneas 26.8%; P < 0.01), again with a higher frequency of central events in males as seen at lower altitude. Similar results were observed after 10 days. With increasing altitude, there was also a progressive reduction in respiratory cycle length during central apneas in males (26.9 ± 3.4 s at 3400 m and 22.6 ± 3.7 s at 5400 m). Females, who displayed a significant number of central apneas only at the highest reached altitude, were characterized by longer cycle length than males at similar altitude (30.1 ± 5.8 s at 5400 m). In conclusion, at high altitude, nocturnal periodic breathing affects males more than females. Females started to present a significant number of central sleep apneas only at the highest reached altitude. After 10 days at 5400 m gender differences in the apnea-hypopnea index similar to those observed after acute exposure were still observed, accompanied by differences in respiratory cycle length. © 2013 European Sleep Research Society.


Cantagallo A.,Modulo di Neuropsicologia Riabilitativa | Spinazzola L.,University of Turin | Rabuffetti M.,Polo Tecnologico | Della Sala S.,University of Edinburgh
Neuropsychological Rehabilitation | Year: 2010

Patients with anarchic hand (AH) syndrome exhibit involuntary but seemingly purposeful controlesional upper limb movements. Here we report on the case of a patient (AC) presenting with a right AH following a left medial frontal lesion. Previous literature indicated that endogenous movements, particularly in the presence of distractors, are impaired in AH, whereas exogenous movements are spared. In this study we examined exogenous and endogenous (or sequential) movements using a new experimental procedure. Our main aim was to investigate whether the ability to perform sequential movements improves under verbal command as anecdotally observed in patients with AH. Results showed that the performance of AC's right AH was impaired in sequential tasks and that this impairment was improved by verbal command. The observed reduction in errors in sequential tasks under external verbal command was coupled with a compensatory increase in response times. © 2010 Psychology Press.


Caravita S.,Neural and Metabolic science | Caravita S.,University of Milan Bicocca | Faini A.,Neural and Metabolic science | Lombardi C.,Neural and Metabolic science | And 10 more authors.
Chest | Year: 2015

Objective: Nocturnal periodic breathing occurs more frequently in men than in women with various clinical and pathophysiologic conditions. The mechanisms accounting for this sexrelated difference are not completely understood. Acetazolamide effectively counteracts nocturnal periodic breathing, but it has been investigated almost exclusively in men. Our aim was to explore possible determinants of nocturnal periodic breathing in a high-altitude setting both in men and in women. We hypothesized that increased hypoxic chemosensitivity in men could be associated with the development of nocturnal periodic breathing at altitude more frequently than in women, and that acetazolamide, by leftward shifting the CO2 ventilatory response, could improve nocturnal periodic breathing at altitude in a sex-independent manner. Methods: Forty-four healthy lowlanders (21 women), randomized to acetazolamide or placebo, underwent cardiorespiratory sleep studies at sea level offtreatment and under treatment on the first night after arrival at a 4,559-m altitude. Hypoxic and hypercapnic chemosensitivities were assessed at sea level. Results: Men, more frequently than women, exhibited increased hypoxic chemosensitivity and displayed nocturnal periodic breathing at altitude. Acetazolamide leftward shifted the CO2 set point and, at altitude, improved oxygenation and reduced periodic breathing in both sexes, but to a larger extent in men. Hypoxic chemosensitivity directly correlated with the number of apneas/hypopneas at altitude in the placebo group but not in the acetazolamide group. Conclusions: The greater severity of periodic breathing during sleep displayed by men at altitude could be attributed to their increased hypoxic chemosensitivity. Acetazolamide counteracted the occurrence of periodic breathing at altitude in both sexes, modifying the apneic threshold and improving oxygenation. Trial Registry: EU Clinical Trials Register, EudraCT; No.: 2010-019986-27; URL: https://www.clinicaltrialsregister.eu © 2015 American College Of Chest Physicians.

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