Publications by authors named "Alessandra D"

5 Publications

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Stroke management during the coronavirus disease 2019 (COVID-19) pandemic: experience from three regions of the north east of Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige).

Neurol Sci 2021 Nov 4;42(11):4599-4606. Epub 2021 Mar 4.

Stroke Unit, Azienda Ospedaliera Università di Padova, Padova, Italy.

Background: Efficiency of care chain response and hospital reactivity were and are challenged for stroke acute care management during the pandemic period of coronavirus disease 2019 (COVID-19) in North-Eastern Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige), counting 7,193,880 inhabitants (ISTAT), with consequences in acute treatment for patients with ischemic stroke.

Methods: We conducted a retrospective data collection of patients admitted to stroke units eventually treated with thrombolysis and thrombectomy, ranging from January to May 2020 from the beginning to the end of the main first pandemic period of COVID-19 in Italy. The primary endpoint was the number of patients arriving to these stroke units, and secondary endpoints were the number of thrombolysis and/or thrombectomy. Chi-square analysis was used on all patients; furthermore, patients were divided into two cohorts (pre-lockdown and lockdown periods) and the Kruskal-Wallis test was used to test differences on admission and reperfusive therapies.

Results: In total, 2536 patients were included in 22 centers. There was a significant decrease of admissions in April compared to January. Furthermore, we observed a significant decrease of thrombectomy during the lockdown period, while thrombolysis rate was unaffected in the same interval across all centers.

Conclusions: Our study confirmed a decrease in admission rate of stroke patients in a large area of northern Italy during the lockdown period, especially during the first dramatic phase. Overall, there was no decrease in thrombolysis rate, confirming an effect of emergency care system for stroke patients. Instead, the significant decrease in thrombectomy rate during lockdown addresses some considerations of local and regional stroke networks during COVID-19 pandemic evolution.
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http://dx.doi.org/10.1007/s10072-021-05066-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930104PMC
November 2021

Basal forebrain metabolism in Alzheimer's disease continuum: relationship with education.

Neurobiol Aging 2020 03 27;87:70-77. Epub 2019 Nov 27.

Faculty of Medicine, Geneva University, Geneva, Switzerland; NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland; Department of Radiology and Medical informatics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. Electronic address:

We analyzed education, as a proxy of cognitive reserve, and the cholinergic pathway in Alzheimer's disease (AD), to test the hypothesis that education might modulate the relationship between clinical symptoms and metabolic and structural changes in AD. We included 84 subjects and compared between diagnostic groups and different educational levels the glucose metabolism of basal forebrain (BFM) and volume of the basal forebrain, the major cholinergic structure, and hippocampus (HM) (and hippocampal volume), a relevant projection site for the basal forebrain. Correlations with the global cognitive status and education in the whole sample were also performed. Patients with AD dementia showed reduced basal forebrain volume, hippocampal volume, and HM compared with controls. In the whole group, the global cognitive status was positively correlated with BFM and HM. Among high-educated subjects, mild cognitive impairment showed higher BFM and HM in comparison to other diagnostic groups. Our results suggest that in mild cognitive impairment subjects with a higher educational level, cholinergic activity is upregulated and this appears to have a compensatory effect, which may be lost in later symptomatic stages.
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http://dx.doi.org/10.1016/j.neurobiolaging.2019.11.013DOI Listing
March 2020

Impact of Joint Involvement on Patients Reported Outcomes in Systemic Lupus Erythematosus.

Curr Rheumatol Rev 2018 ;14(2):188-192

Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Objective: Joint involvement is common among patients with systemic lupus erythematosus (SLE). Aim of this work was to evaluate the correlation between the presence of joint involvement and patient-reported pain, perception of disease activity, general health and quality of life.

Methods: Fifty consecutive SLE patients were enrolled in the study. All patients underwent a complete clinical evaluation including a 44-joint count; in addition, an ultrasound evaluation of joint involvement of hands and wrists was performed. The following patients reported outcomes (PROs) were completed: Visual Analog Scales 0-100 mm (VAS) evaluating patients reported pain, patient's perception of global disease activity and general health (GH) and a validated Italian version of the Health Assessment Questionnaire (HAQ).

Results: Fourteen patients (28%) reported a significant morning stiffness lasting for more than 30 minutes; hand or wrist arthritis was clinically detectable in 10 (20%) patients, while the US evaluation exhibited at least one joint or tendon pathology in 18 patients (36%). The mean VAS score for pain and disease activity perception was 27 (±27.7) mm and 25.3 (±25.2) mm, respectively, the mean of GH score was 33.2 (±24.3) mm, and the mean HAQ score was 0.34 (±0.5). A significant correlation was observed between VAS score for pain, patient's perception of disease activity and GH and the presence of arthritis.

Conclusion: PROs may play an important role in guiding therapeutic decisions and suggest the utility of ultrasound evaluation in patients reporting articular symptoms.
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http://dx.doi.org/10.2174/1573397113666170314110022DOI Listing
October 2018

Short-term effect of whole-body vibration training on balance, flexibility and lower limb explosive strength in elite rhythmic gymnasts.

Hum Mov Sci 2014 Feb 20;33:149-58. Epub 2013 Sep 20.

University of Athens, Hippokratio Hospital, Greece.

The purpose of this study was to examine whether whole-body vibration (WBV) training results in short-term performance improvements in flexibility, strength and balance tests in comparison to an equivalent exercise program performed without vibration. Eleven elite rhythmic gymnasts completed a WBV trial, and a control, resistance training trial without vibration (NWBV). The vibration trial consisted of eccentric and concentric squatting exercises on a vibration platform that was turned on, whereas the NWBV involved the same training protocol with the platform turned off. Balance was assessed using the Rhythmic Weight Shift (RWS) based on the EquiTest Dynamic Posturography system; flexibility was measured using the sit & reach test, and lower limb explosive strength was evaluated using standard exercises (squat jump, counter movement jump, single leg squat). All measurements were performed before (pre) immediately after the training program (post 1), and 15 minutes after the end of the program (post 15). Data were analyzed using repeated measures ANOVA was used with condition (WBV-NWBV) as the primary factor and time (pre, post 1, post 15) as the nested within subjects factor, followed by post-hoc pairwise comparison with Bonferroni corrections. Results confirmed the hypothesis of the superiority of WBV training, especially in the post 15 measurement, in all flexibility and strength measures, as well as in a number of balance tests.
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http://dx.doi.org/10.1016/j.humov.2013.07.023DOI Listing
February 2014

Mycophenolate mofetil treatment in two children with severe polyarteritis nodosa refractory to immunosuppressant drugs.

Rheumatol Int 2012 Jul 24;32(7):2215-9. Epub 2011 Jul 24.

Department of BioMedicine, Rheumatology Section, Transition Clinic, University of Florence, Viale Pieraccini 18, 50139 Florence, Italy.

Polyarteritis nodosa (PAN) is a necrotizing vasculitis of small- and medium-sized arteries with multiorgan involvement, rarely reported in childhood. Despite aggressive treatment with the combination of corticosteroids and cytotoxic agents, the overall prognosis is poor in most patients. We report on two siblings, now 15- and 14-year-old, affected with childhood onset PAN, refractory to multiple therapies, who showed rapid clinical and laboratory improvement when mycophenolate mofetil was introduced. The relationship between the administration of this immunosuppressant agent and the reduced disease activity is confirmed by the sustained absence of disease flares over 4 years of treatment.
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http://dx.doi.org/10.1007/s00296-011-2003-yDOI Listing
July 2012
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