Giovanni Paternò

Istituto di Sessuologia Clinica

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Mattéo Riva

IRCCS Ospedale San Raffaele

Davide Carone

University of Oxford

Carlo Ferrarese

Azienda Ospedaliera San Gerardo

Alessandro Versace

Azienda Ospedaliera San Gerardo

Simone Beretta

University of Milano-Bicocca

Erik P. Sganzerla

Prince Charles Hospital

Carlo Giussani

Istituti di Ricovero e Cura a Carattere Scientifico

Giada Padovano

University of Milano-Bicocca

Ruiyao Cai

Helmholtz Zentrum München

L Monza

University of Milano-Bicocca

Cooperative Institutions

Istituti di Ricovero e Cura a Carattere Scientifico

195

University of Milano-Bicocca

141

University of Brescia

Azienda Ospedaliera San Gerardo

University of Milan

Sapienza University of Rome

Istituto Nazionale di Riposo e Cura per Anziani

University of Florence

Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia

University of Turin

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Intraventricular Ectopic Cerebellum

World Neurosurgery (2020)

Alessandro De Benedictis Maria Camilla Rossi Espagnet Francesca Diomedi Camassei Sabrina Rossi Elena Fontana

Pia mater

Fourth ventricle

10.1016/j.wneu.2020.01.127

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Citations (3)

Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era

European Heart Journal (2020)

Salvatore De Rosa Carmen Spaccarotella Cristina Basso Maria Pia Calabrò Antonio Curcio

Abstract Aims To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs). Methods and Results We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7–32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3–70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7–6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1–2.8; P = 0.009). Conclusion Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.

2019-20 coronavirus outbreak

10.1093/eurheartj/ehaa409

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Intraoperative Ultrasound-Assisted Extent of Resection Assessment in Pediatric Neurosurgical Oncology

Frontiers in Oncology (2021)

Andrea Carai Alessandro De Benedictis Tommaso Calloni Nicola Onorini Giovanni Paternò

Central nervous system tumors represent the most frequent solid malignancy in the pediatric population. Maximal safe surgical resection is a mainstay of treatment, with significant prognostic impact for the majority of histotypes. Intraoperative ultrasound (ioUS) is a widely available tool in neurosurgery to assist in intracerebral disease resection. Despite technical caveats, preliminary experiences suggest a satisfactory predictive ability, when compared to magnetic resonance imaging (MRI) studies. Most of the available evidence on ioUS applications in brain tumors derive from adult series, a scenario that might not be representative of the pediatric population. We present our preliminary experience comparing ioUS-assisted resection assessment to early post-operative MRI findings in 154 consecutive brain tumor resections at our pediatric neurosurgical unit. A high concordance was observed between ioUS and post-operative MRI. Overall ioUS demonstrated a positive predictive value of 98%, a negative predictive value of 92% in assessing the presence of tumor residue compared to postoperative MRI. Overall, sensibility and specificity were 86% and 99%, respectively. On a multivariate analysis, the only variable significantly associated to unexpected tumor residue on postoperative MRI was histology. Tumor location, patient positioning during surgery, age and initial tumor volume were not significantly associated with ioUS predictive ability. Our data suggest a very good predictive value of ioUS in brain tumor resective procedures in children. Low-grade glioma, high-grade glioma and craniopharyngioma might represent a setting deserving specific endeavours in order to improve intraoperative extent of resection assessment ability.

Concordance

Neuroradiology

Brain tumor

10.3389/fonc.2021.660805

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Citations (17)

Zenodo (CERN European Organization for Nuclear Research) (2022)

Simone Beretta Alessandro Versace Bortolo Martini M Viganò Susanna Diamanti

The database contains animal models MRI in DICOM and NIfTI file format

Head-Down Tilt

10.5281/zenodo.6280694

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Cerebral collateral therapeutics in acute ischemic stroke: A randomized preclinical trial of four modulation strategies

Journal of Cerebral Blood Flow & Metabolism (2017)

Simone Beretta Alessandro Versace Davide Carone Mattéo Riva Valentina Dell’Era

Cerebral collaterals are dynamically recruited after arterial occlusion and highly affect tissue outcome in acute ischemic stroke. We investigated the efficacy and safety of four pathophysiologically distinct strategies for acute modulation of collateral flow (collateral therapeutics) in the rat stroke model of transient middle cerebral artery (MCA) occlusion. A composed randomization design was used to assign rats (n = 118) to receive phenylephrine (induced hypertension), polygeline (intravascular volume load), acetazolamide (cerebral arteriolar vasodilation), head down tilt (HDT) 15° (cerebral blood flow diversion), or no treatment, starting 30 min after MCA occlusion. Compared to untreated animals, treatment with collateral therapeutics was associated with lower infarct volumes (62% relative mean difference; 51.57 mm3 absolute mean difference; p < 0.001) and higher chance of good functional outcome (OR 4.58, p < 0.001). Collateral therapeutics acutely increased cerebral perfusion in the medial (+40.8%; p < 0.001) and lateral (+19.2%; p = 0.016) MCA territory compared to pretreatment during MCA occlusion. Safety indicators were treatment-related mortality and cardiorespiratory effects. The highest efficacy and safety profile was observed for HDT. Our findings suggest that acute modulation of cerebral collaterals is feasible and provides a tissue-saving effect in the hyperacute phase of ischemic stroke prior to recanalization therapy.

Collateral circulation

Stroke

10.1177/0271678x16688705

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Citations (34)

Intracranial Collateral flow defines the boundaries of molecular penumbra in experimental ischemic stroke

Simone Beretta Elisa Cuccione Alessandro Versace Davide Carone Mattéo Riva

Penumbra

Stroke

Collateral circulation

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Zenodo (CERN European Organization for Nuclear Research) (2022)

Simone Beretta Alessandro Versace Bortolo Martini M Viganò Susanna Diamanti

The database contains animal models MRI in DICOM and NIfTI file format

Head-Down Tilt

10.5281/zenodo.6280695

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Citations (0)

The Cerebellum

Elsevier eBooks (2024)

Jorge Ojeda Giovanni Paternò Sergio Juica

10.1016/b978-0-12-822404-5.00008-5

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Therapeutic modulation of intracranial collateral flow improves outcome in experimental ischemic stroke

Davide Carone Simone Beretta Elisa Cuccione Alessandro Versace Mattéo Riva

Stroke

Collateral circulation

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Use of combination therapy is associated with improved LDL cholesterol management: 1-year follow-up results from the European observational SANTORINI study

European Journal of Preventive Cardiology (2024)

Kausik K. Ray Carlos Aguíar Marcello Arca Derek Connolly Mats Eriksson

Abstract Aims To assess whether implementation of the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) dyslipidaemia guidelines observed between 2020 and 2021 improved between 2021 and 2022 in the SANTORINI study. Methods and results Patients with high or very high cardiovascular (CV) risk were recruited across 14 European countries from March 2020 to February 2021, with 1-year prospective follow-up until May 2022. Lipid-lowering therapy (LLT) and 2019 ESC/EAS risk-based low-density lipoprotein (LDL) cholesterol (LDL-C) goal attainment (defined as <1.4 mmol/L for patients at very high CV risk and <1.8 mmol/L for patients at high CV risk) at 1-year follow-up were compared with baseline. Of 9559 patients enrolled, 9136 (2626 high risk and 6504 very high risk) had any available follow-up data, and 7210 (2033 high risk and 5173 very high risk) had baseline and follow-up LDL-C data. Lipid-lowering therapy was escalated in one-third of patients and unchanged in two-thirds. Monotherapy and combination therapy usage rose from 53.6 and 25.6% to 57.1 and 37.9%, respectively. Mean LDL-C levels decreased from 2.4 to 2.0 mmol/L. Goal attainment improved from 21.2 to 30.9%, largely driven by LLT use among those not on LLT at baseline. Goal attainment was greater with combination therapy compared with monotherapy at follow-up (39.4 vs. 25.5%). Conclusion Lipid-lowering therapy use and achievement of risk-based lipid goals increased over 1-year follow-up particularly when combination LLT was used. Nonetheless, most patients remained above goal; hence, strategies are needed to improve the implementation of combination LLT.

10.1093/eurjpc/zwae199

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Citations (5)