D'Amico, A., Russo, C., Ugga, L., Mazio, F., Capone, E., D'Arco, F., Mankad, K., Caranci, F., Marano, E., Brunetti, A.
Can pontine trigeminal T2-hyperintensity suggest herpetic etiology of trigeminal neuralgia?
(2016) Quantitative Imaging in Medicine and Surgery, 6 (5), pp. 490-495.
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84994884887&partnerID=40&md5=2fdd743482a13368be8211db3120995e
DOI: 10.21037/qims.2016.01.07
AFFILIATIONS: Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Naples, Italy;
Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom;
Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
ABSTRACT: Background: Trigeminal neuralgia (TN) is usually classified into two different categories: idiopathic and secondary. We have investigated the frequency of brainstem pontine lesions in patients with idiopathic TN without multiple sclerosis (MS) or stroke, and their association with herpes zoster (HZ) infection. Methods: Brain magnetic resonance imaging (MRI) studies of 28 patients with TN were retrospectively reviewed. Results: We found seven patients with clinical suspicion of HZ infection and pontine T2 hyperintense lesions, associated with nerve atrophy in one case. Fifteen patients had a neurovascular conflict (NVC) without brainstem involvement, two of them associated with trigeminal atrophy, while four patients had only volumetric reduction of the nerve. In all patients MRI findings were ipsilateral to the side of TN. Conclusions: Pontine T2 hyperintensities could be considered as a MRI sign of TN in patients without NVCs. This "trigeminal pontine sign" (TPS) is frequently found in association with herpetic infections. © Quantitative Imaging in Medicine and Surgery. All rights reserved.
CORRESPONDENCE ADDRESS: D'Amico, A.; Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Italy; email: doctoralex@hotmail.it
D'Arco, F., Ugga, L., Caranci, F., Riccio, M.P., Figliuolo, C., Mankad, K., D'Amico, A.
Isolated macrocerebellum: Description of six cases and literature review
(2016) Quantitative Imaging in Medicine and Surgery, 6 (5), pp. 496-503.
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84994845888&partnerID=40&md5=35ac344c9b639a7bb48fcc8b82974f91
DOI: 10.21037/qims.2016.06.10
AFFILIATIONS: Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom;
Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy;
Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Psychiatry Division, Second University of Naples, Caserta, Italy;
Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
ABSTRACT: Background: Macrocerebellum is a rare entity described as an isolated and abnormal increase of the cerebellum (CB) size without morphological or signal abnormalities. There have been only eleven patients with macrocerebellum reported in the literature so far. Methods: From December 2011 to March 2014, among 950 paediatric patients that underwent a magnetic resonance scan of the brain in our department, in six subjects an abnormal increase of the cerebellar volume was suspected. A volumetric analysis was performed in all patients on T1-weighted 3D imaging to confirm the diagnosis of macrocerebellum. The ratios between (I) volume of the CB and volume of the supratentorial structures (STB) and (II) volume of the CB and the sum of CB and STB (WB) were calculated in order to normalize the absolute values obtained and compared with the normal values present in literature. Results and Discussion: Quantitative analysis confirmed an increased cerebellar volume relatively to the STB volume ("t": 6.9518; P<0.001) and to the WB ("t": 7.1415; P<0.001) volume in comparison to the normal controls available in literature. Clinical characteristics and other neuroradiological findings of the patients are described. We also describe the differential features between isolated macrocerebellum and other pathological conditions that are characterized by cerebellar enlargement such as Lhermitte-Duclos, Sotos syndrome, Costello syndrome, Williams syndrome, Alexander disease and fucosidosis. Furthermore a detailed literature review is provided. Macrocerebellum is always associated with an abnormal mental and motor development. Conclusion: Macrocerebellum is a neuroradiological entity that can be identified qualitatively and confirmed quantitatively through volumetric analysis. This is the largest cohort of patients with macrocerebellum described so far. The data available in literature on this entity show that macrocerebellum is not a specific disease but an epiphenomenon found in heterogeneous brain disorders. © Quantitative Imaging in Medicine and Surgery. All rights reserved.
CORRESPONDENCE ADDRESS: D'Arco, F.; Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation TrustUnited Kingdom; email: darcofel@gmail.com
Rengo, G., Pagano, G., Filardi, P.P., Femminella, G.D., Parisi, V., Cannavo, A., Liccardo, D., Komici, K., Gambino, G., D'Amico, M.L., De Lucia, C., Paolillo, S., Trimarco, B., Vitale, D.F., Ferrara, N., Koch, W.J., Leosco, D.
Prognostic value of lymphocyte G protein-coupled receptor kinase-2 protein levels in patients with heart failure
(2016) Circulation Research, 118 (7), pp. 1116-1124.
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84994571224&partnerID=40&md5=c040107e0a990576873a37b9e36f8191
DOI: 10.1161/CIRCRESAHA.115.308207
AFFILIATIONS: Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy;
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, Naples, Italy;
Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy;
SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy;
Department of Pharmacology, Center of Translational Medicine, Temple University School of Medicine, 3500 N Broad St., Philadelphia, PA, United States
ABSTRACT: Rationale: Sympathetic nervous system hyperactivity is associated with poor prognosis in patients with heart failure (HF), yet routine assessment of sympathetic nervous system activation is not recommended for clinical practice. Myocardial G protein-coupled receptor kinase-2 (GRK2) is upregulated in HF patients, causing dysfunctional β-adrenergic receptor signaling. Importantly, myocardial GRK2 levels correlate with levels found in peripheral lymphocytes of HF patients. Objective: The independent prognostic value of blood GRK2 measurements in HF patients has never been investigated; thus, the purpose of this study was to evaluate whether lymphocyte GRK2 levels predict clinical outcome in HF patients. Methods and Results: We prospectively studied 257 HF patients with mean left ventricular ejection fraction of 31.4±8.5%. At the time of enrollment, plasma norepinephrine, serum NT-proBNP, and lymphocyte GRK2 levels, as well as clinical and instrumental variables were measured. The prognostic value of GRK2 to predict cardiovascular (CV) death and all-cause mortality was assessed using the Cox proportional hazard model including demographic, clinical, instrumental, and laboratory data. Over a mean follow-up period of 37.5±20.2 months (range, 3-60 months), there were 102 CV deaths. Age, left ventricular ejection fraction, New York Heart Association class, chronic obstructive pulmonary disease, chronic kidney disease, N-terminal-pro brain natriuretic peptide, and lymphocyte GRK2 protein levels were independent predictors of CV mortality in HF patients. GRK2 levels showed an additional prognostic and clinical value over demographic and clinical variables. The independent prognostic value of lymphocyte GRK2 levels was also confirmed for all-cause mortality. Conclusions: Lymphocyte GRK2 protein levels can independently predict prognosis in patients with HF. © 2016 American Heart Association, Inc.
CORRESPONDENCE ADDRESS: Koch, W.J.; Department of Pharmacology, Center of Translational Medicine, Temple University School of Medicine, 3500 N Broad St., United States; email: walter.koch@temple.edu
Corbi, G., Conti, V., Davinelli, S., Scapagnini, G., Filippelli, A., Ferrara, N.
Dietary phytochemicals in neuroimmunoaging: A new therapeutic possibility for humans?
(2016) Frontiers in Pharmacology, 7, art. no. 364, .
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84994323063&partnerID=40&md5=b54358b70025787c6be6ef1df3dbef65
DOI: 10.3389/fphar.2016.00364
AFFILIATIONS: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy;
Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy;
Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy;
Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese, Telese Terme, Italy
ABSTRACT: Although several efforts have been made in the search for genetic and epigenetic patterns linked to diseases, a comprehensive explanation of the mechanisms underlying pathological phenotypic plasticity is still far from being clarified. Oxidative stress and inflammation are two of the major triggers of the epigenetic alterations occurring in chronic pathologies, such as neurodegenerative diseases. In fact, over the last decade, remarkable progress has been made to realize that chronic, low-grade inflammation is one of the major risk factor underlying brain aging. Accumulated data strongly suggest that phytochemicals from fruits, vegetables, herbs, and spices may exert relevant immunomodulatory and/or anti-inflammatory activities in the context of brain aging. Starting by the evidence that a common denominator of aging and chronic degenerative diseases is represented by inflammation, and that several dietary phytochemicals are able to potentially interfere with and regulate the normal function of cells, in particular neuronal components, aim of this review is to summarize recent studies on neuroinflammaging processes and proofs indicating that specific phytochemicals may act as positive modulators of neuroinflammatory events. In addition, critical pathways involved in mediating phytochemicals effects on neuroinflammaging were discussed, exploring the real impact of these compounds in preserving brain health before the onset of symptoms leading to inflammatory neurodegeneration and cognitive decline.
CORRESPONDENCE ADDRESS: Corbi, G.; Department of Medicine and Health Sciences, University of MoliseItaly; email: graziamaria.corbi@unimol.it
Buonocore, M., Amarelli, C., Scardone, M., Caiazzo, A., Petrone, G., Majello, L., Santé, P., Nappi, G., Della Corte, A.
Cerebral perfusion issues in acute type A aortic dissection without preoperative malperfusion: How do surgical factors affect outcomes?
(2016) European Journal of Cardio-thoracic Surgery, 50 (4), pp. 652-659.
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84994125586&partnerID=40&md5=581169a08d7a8119bbf95f6b81e538fa
DOI: 10.1093/ejcts/ezw152
AFFILIATIONS: Department of Cardiac Surgery, AZ Sint Jan, Brugge, Belgium;
Department of Cardiovascular Surgery and Transplants, Monaldi Hospital, Azienda dei Colli, Naples, Italy;
Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy;
Unit of Neurology, Monaldi Hospital, Azienda dei Colli, Naples, Italy
ABSTRACT: OBJECTIVES: Both preoperative (disease-related) and operative (management-related) variables make the assessment of the outcomes of acute type A aortic dissection (ATAAD) surgery a difficult task. Our aim was to evaluate the impact of operative factors, including arterial cannulation site, route of cerebral perfusion and surgeon's specific experience with ATAAD ('aortic surgeon'), on the early results of surgical management, with particular attention to neurological injury. METHODS: Penn classification was used to identify clinically homogeneous risk groups of ATAAD patients undergoing surgery. Between January 2007 and June 2014, 111 of 183 ATAAD patients treated with open surgery in a single centre were in Penn Class Aa (no ischaemic complications at presentation). They were divided in two groups depending on the arterial cannulation site: femoral artery (FemA; 56 patients) or right axillary artery (RAxA; 55 patients). Study outcomes included: 30-day mortality, major adverse cardiac and cerebrovascular events at 30 days, neurological complications and in particular, patterns of stroke as defined by Bamford classification. RESULTS: No significant differences in preoperative variables were observed between cannulation-site groups, except for myocardial ischaemic time (60.9 ± 30.4 min in the RAxA group vs 81.7 ± 52.3 in the FemA group, P = 0.014) and cerebral perfusion time (42.1 ± 25.5 min in the RAxA group vs 52.9 ± 32.6 in the FemA group, P = 0.048). Outcomes in terms of mortality and neurological injury did not differ except for a higher incidence of lacunar cerebral infarction (LACI) in the RAxA group (14.5 vs 3.6%, P = 0.043), mainly but not exclusively explained by a higher incidence of LACI in unilateral (17.2%) than in bilateral cerebral perfusion (6.9%) within the RAxA group. The 'non-aortic surgeon' was associated instead with 30-day mortality and composite outcome in multivariable analysis (respectively, OR 6.40, P = 0.002 and OR 4.68, P = 0.001). CONCLUSIONS: The RAxA cannulation and FemA cannulation are associated with comparable 30-day mortality following surgery for aortic dissection. However, the possible higher risk of LACI-type strokes in the RAxA group, especially when associated with unilateral brain perfusion, should be considered when RAxA cannulation is performed in ATAAD. The hypothesis that more experienced surgeons may produce better earlier outcomes warrants further investigation. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
CORRESPONDENCE ADDRESS: Buonocore, M.; Department of Cardiac Surgery, AZ Sint Jan, Ruddershove 10, Belgium; email: mariannabuonocore@gmail.com