"Tele-riabilitazione in Sclerosi Multipla: Continuità Terapeutica Domiciliare Dopo Trattamento Di Neuro-riabilitazione Intensiva, Studio Randomizzato Controllato Con Piattaforma Integrata Per La Riabilitazione Del Disequilibrio"

RCT pilot study to evaluate adherence, satisfaction and feasibility in the use of a telemedicine station for balance rehabilitation in patients with multiple sclerosis.
The platform is designed as a tool for maintenance rehabilitation in a home setting and not as an alternative to intensive treatment in hospital, and is therefore compared to maintenance treatment as usual (TAU) after intensive treatment.

开始日期2024-11-06

申办/合作机构

Fondazione IRCCS Istituto Neurologico Carlo Besta

[+2]

NCT06229171 / Not yet recruitingN/AIIT

InTake Care: Development and Validation of an Innovative, Personalized Digital Health Solution for Medication Adherence Support in Cardiovascular Prevention

Inadequate medication adherence (MA) in chronic conditions, including cardiovascular prevention, represents an important risk factor. The use of new IT technologies in this setting is supposed to be useful to improve patients' adherence, but currently available solutions have significant limitations, including lack of personalization and reliance on expensive ad hoc systems.
This interdisciplinary project aims to verify the hypothesis that in patients on chronic antihypertensive treatment MA can be improved through the implementation of a novel digital health solution for MA monitoring and support, based on inexpensive and user-friendly, commercially available technology (voice assistant), connected with web interface for the physician. The intervention will be personalized based on the creation of Personas, intended as multidisciplinary-based representations of different user types. This approach will be tested in a randomized clinical trial.

开始日期2024-10-01

申办/合作机构

Istituto Auxologico Italiano

[+2]

NCT06309537 / Not yet recruitingN/AIIT

Chemoreflex Sensitivity in Heart Failure With Preserved Ejection Fraction

Patients with heart failure and a preserved left ventricular ejection fraction (HFpEF) almost invariably complain of exertional breathlessness. Abnormal cardiac hemodynamics with pulmonary congestion are believed to trigger dyspnea in this patients. However, some patients may complain of exertional breathlessness which seems to be out of proportion as compared with hemodynamic abnormalities.
Chemoreflex sensitivity accounts for the ventilatory responses to a variety of chemical stimuli, including carbon dioxide produced by the organism during exercise. Chemoreflex sensitivity can be augmented in heart failure with reduced left ventricular ejection fraction, and an increased chemoreflex sensitivity has been linked to symptoms, neurohumoral activation, breathing disturbances, and adverse prognosis.
However, the clinical correlates and implications of chemoreflex sensitivity in HFpEF have not been accurately studied.
We aim to characterize chemoreflex sensitivity in patients with a diagnosis of HFpEF, and to correlate chemoreflex sensitivity with clinical and hemodynamic characteristics.

开始日期2024-10-01

申办/合作机构

Istituto Auxologico Italiano

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项与 Istituto Auxologico Italiano 相关的文献（医药）

2025-01-01·PARKINSONISM & RELATED DISORDERS

Association of Amyotrophic Lateral Sclerosis and Dopa-responsive dystonia in a Tunisian patient

Letter

作者: Ratti, Antonia ; Sghaier, Ikram ; Ben Rhouma, Hanene ; RATTI, Antonia ; Ticozzi, Nicola ; Kacem, Imen ; TICOZZI, Nicola ; Silani, V.I.N.C.E.N.Z.O. ; GOUIDER-KHOUJA, Neziha ; Silani, Vincenzo ; Gouider-Khouja, Neziha ; Gouider, Riadh ; GOUIDER, Riadh ; SGHAIER, Ikram ; KACEM, Imen ; BEN RHOUMA, Hanene

Dopa-responsive dystonia (DRD) is an autosomal dominant disease with parkinsonian and dystonic symptoms caused by GCH1 gene pathogenic variants affecting dopamine synthesis. The present case report is the first to link DRD with childhood-onset with ALS, suggesting that complex inheritance patterns in the North African population may contribute to multiple disorders.

2025-01-01·JOURNAL OF NEUROLOGY

Diagnosing primary lateral sclerosis: a clinico-pathological study

Article

作者: Ingre, Caroline ; Mühlebner, Angelika ; Vandenberghe, Wim ; Van Damme, Philip ; Pijnenburg, Yolande A L ; Ticozzi, Nicola ; Morris, Huw R ; Seelaar, Harro ; van Rheenen, Wouter ; Corcia, Philippe ; Veldink, Jan H ; Mol, Christian P ; Westeneng, Henk-Jan ; de Vries, Bálint S ; van Es, Michael A ; Vincken, Koen L ; van den Berg, Leonard H ; Höglinger, Günter U ; Van Hecke, Wim ; Litvan, Irene ; de Boer, Eva M J ; Raaphorst, Joost ; van de Warrenburg, Bart P C

BACKGROUND:

Primary lateral sclerosis (PLS) is a rare motor neuron disease characterized by upper motor neuron degeneration, diagnosed clinically due to the absence of a (neuropathological) gold standard. Post-mortem studies, particularly TDP-43 pathology analysis, are limited.

METHODS:

This study reports on 5 cases in which the diagnostic criteria for PLS were met, but in which neuropathology findings showed (partially) conflicting results. These discrepancies prompted us to perform a clinico-pathology study focussing on diagnostic challenges and accuracy in PLS. To this end, all cases were reviewed by an international panel of 11 experts using an e-module and structured questionnaires.

RESULTS:

Autopsy exhibited neuropathological findings consistent with amyotrophic lateral sclerosis (ALS) in one case, while two cases exhibited similar, but more limited lower motor neuron involvement, hinting at PLS or ALS overlap. Another case displayed tau-pathology indicative of progressive supranuclear palsy. The final case displayed extensive myelin loss without a proteinopathy or a clear diagnosis. The expert panel identified 24 different ancillary investigations lacking across cases (e.g. genetic testing, DAT scans, neuropsychological evaluation), listed 28 differential diagnoses, and identified 13 different conditions as the most likely diagnosis. Autopsy results led panel members to change their final diagnosis in 42% of the cases.

CONCLUSIONS:

This study underscores the diagnostic challenges posed by diverse underlying pathologies resulting in upper motor neuron phenotypes. Despite adhering to the same diagnostic criteria, consensus amongst experts was limited. Ensuring the diagnostic consistency is crucial for advancing understanding and treatment of PLS. Explicit guidelines for excluding potential mimics along with a neuropathological gold standard are imperative.

2025-01-01·JOURNAL OF HYPERTENSION

Early wave reflection of carotid artery is associated with 18F-FDG PET hypometabolism in Alzheimer's brain areas of cognitively normal adults

Article

作者: Salvi, Paolo ; Verger, Antoine ; Roch, Veronique ; Marie, Pierre-Yves ; Zimmermann, Gaétan ; Grignon, Rachel ; Doyen, Matthieu ; Joly, Laure ; Schoepfer, Pauline ; Benetos, Athanase

Introduction::

Arterial stiffening likely plays a role in Alzheimer disease (AD) pathogenesis. The current study investigated whether inter-individual variations in arterial stiffness and pressure wave parameters were associated with 18F-FDG positron emission tomography (PET) metabolism in AD-associated brain areas throughout adulthood, independently of age and before the onset of any neuropsychological disorders.

Methods::

A prospective, large age-range population of 67 patients (17 young, 16 middle-aged, and 34 older adults; 37 women) underwent a: brain 18F-FDG PET, blood pressure recording, and carotid/femoral pulse wave-based measurements, including the time-to-peak of the reflected backward carotid pulse wave (bT), on the same day. Multivariable and quantitative voxel-to-voxel analyses (P-voxel < 0.005, corrected for cluster volumes) were conducted to assess associations between vascular parameters and 18F-FDG PET metabolism in AD-associated brain areas.

Results::

In the multivariable analysis, only increased age and decreased bT were independently associated with the decline of metabolic activity in AD-associated brain areas (P < 0.001). In the voxel-to-voxel analysis with age as a covariate, bT was strongly associated with the metabolic activity of 40 clusters in AD-associated brain areas (clusters cumulative volume: 63 cm3; T score max: 5.7).

Conclusion::

In a large age-range population of adult patients, who are still unaffected by neuropsychological disorders, an early reflected arterial pressure wave, as evidenced by a decreased bT value, is strongly associated with hypometabolic activity of AD-associated brain areas, independently of age.

项与 Istituto Auxologico Italiano 相关的新闻（医药）

2024-04-11

·mobihealthnews

oVRcome announces pilot program with NHS for autistic individuals

New Zealand-based virtual reality and cognitive behavioral therapy company oVRcome announced it signed an international contract with the U.K.'s National Health Service (NHS) to help autistic individuals navigate hospital environments and social interactions. oVRcome, launched in 2021, utilizes a smartphone and a headset to deliver exposure therapy to adults and children with numerous conditions, including phobias, social anxiety, panic disorder and other ailments. Exposure therapy is a type of cognitive behavioral therapy that helps patients build up their tolerance to their specific phobias through short bursts of exposure. The U.K.-based pilot program aims to reduce the appointment cancellation rate among individuals on the autism spectrum by helping them navigate hospital and social settings via oVRcome's exposure therapy platform. The program will immerse autistic individuals in virtual environments, complete with scripted videos showing ways of behaving in social settings so that they can practice navigating these environments and feel more comfortable. Up to a hundred individuals will participate in the pilot program, scheduled to begin in August. "What we know firsthand is that members of the autistic community experience anxiety around accessing medical services and environments. Often, this anxiety leads to the cancellation of appointments, with many of these being essential to the individual's health and wellbeing," Adam Hutchinson, founder of oVRcome, told MobiHealthNews. "Our goal is to reduce this anxiety through customized virtual reality exposure therapy co-designed with members of the community. This is accessed via the oVRcome smartphone app, with a clinician being able to connect to the VR session remotely via our clinician portal." THE LARGER TREND In 2022, oVRcome released the results of a randomized, controlled trial performed in the Department of Psychological Medicine at the University of Otago. The study aimed to reduce the symptoms of common phobias, including a fear of flying, heights, needles, spiders and dogs. Based on findings, which were published in the Australian and New Zealand Journal of Psychiatry, the app-based CBT program alleviated symptoms of phobias by 75% among participants after six weeks of treatment. Barbara Rothbaum of Emory University is credited as being the inventor of virtual reality exposure therapy, which is now used by numerous researchers globally, including at Stanford University's Virtual Reality and Immersive Technology (VR-IT) lab, the Applied Technology for Neuro-Psychology Laboratory (ATN-P Lab) at Istituto Auxologico Italiano, in Italy, and the University of Barcelona. Another company using VR to teach neurodiverse individuals behavioral, social and life skills is Floreo. It recently received a strategic investment from Cleveland Clinic and acquired Autism EyesTM, an autism-focused diagnostics and assessment company developed by Cleveland Clinic Innovations.