Alexander Salerno | University of Genova (original) (raw)

Papers by Alexander Salerno

Healthcare

The National Institutes of Health Stroke Scale (NIHSS) is commonly used to triage and monitor the... more The National Institutes of Health Stroke Scale (NIHSS) is commonly used to triage and monitor the evolution of stroke victims. Data regarding NIHSS knowledge in nurses and physicians working with stroke patients are scarce, and a progressive decline in specific knowledge regarding this challenging scale is to be expected even among NIHSS certified personnel. This protocol was designed according to the CONSORT-eHealth (Consolidated Standards of Reporting Trials) guidelines. It describes the design of a randomized controlled trial whose primary objective is to determine if nurses and physicians who work in stroke units improve their NIHSS knowledge more significantly after following a highly interactive e-learning module than after following the traditional didactic video. Univariate and multivariable linear regression will be used to analyze the primary outcome, which will be the difference between the score on a 50-question quiz answered before and immediately after following the al...

Introduction: Inflammatory bowel diseases (IBD) are a group of affections characterized by a chro... more Introduction: Inflammatory bowel diseases (IBD) are a group of affections characterized by a chronic inflammation of the mucosae of the digestive tract and primarily include Crohn's Disease (CD) and Ulcerative Colitis (UC). Although much has already been studied, aetiology and pathomechanisms are still unclear. IBD patients are at risk of many complications including the risk of thromboembolic events. Thrombotic complications in this kind of patients have already been recognised and demonstrated although further considerations have to be made regarding the incidence of such kind of events.

Neurology - Neuroimmunology Neuroinflammation

ObjectiveCoronavirus disease (COVID-19) has been associated with a large variety of neurologic di... more ObjectiveCoronavirus disease (COVID-19) has been associated with a large variety of neurologic disorders. However, the mechanisms underlying these neurologic complications remain elusive. In this study, we aimed at determining whether neurologic symptoms were caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) direct infection or by either systemic or local proinflammatory mediators.MethodsIn this cross-sectional study, we checked for SARS-CoV-2 RNA by quantitative reverse transcription PCR, SARS-CoV-2–specific antibodies, and 49 cytokines/chemokines/growth factors (by Luminex) in the CSF +/− sera of a cohort of 22 COVID-19 patients with neurologic presentation and 55 neurologic control patients (inflammatory neurologic disorder [IND], noninflammatory neurologic disorder, and MS).ResultsWe detected anti–SARS-CoV-2 immunoglobulin G in patients with severe COVID-19 with signs of intrathecal synthesis for some of them. Of the 4 categories of tested patients, the CSF ...

International Journal of Stroke

Background Posterior circulation and anterior circulation strokes share many clinical, pathogenet... more Background Posterior circulation and anterior circulation strokes share many clinical, pathogenetic and radiological features, although some clinical signs are highly specific to posterior circulation strokes. Arterial stenosis and occlusions occur in significant numbers in both acute posterior circulation and anterior circulation strokes, making them good candidates for endovascular treatment. Among posterior circulation strokes, basilar artery occlusions stand out because of the diagnostic and acute treatment challenges. Methods We reviewed the literature on clinical stroke syndromes and neuroimaging findings and systematically describe for each anatomical site of stroke the detailed clinical and radiological information (anatomical representation, diffusion weighted imaging and angiographic sequences). The principles of neuroimaging of posterior circulation strokes and the prognosis for each stroke localization are also discussed. Review summary Stroke syndromes in the territorie...

Molecular and Clinical Oncology

Schwannomas are benign tumours that originate from the myelin sheath of peripheral nerves. They a... more Schwannomas are benign tumours that originate from the myelin sheath of peripheral nerves. They are characterised by a slow growth tendency. Benign schwannomas represent 35% of the head and neck district tumours. Hypoglossal schwannomas account for 5% of non-vestibular schwannomas, and malignant schwannomas occur very rarely. In the present case report, the case of a 49-year-old man who presented with paraesthesias in the left parotid and submandibular region, associated with sensation of foreign bodies and dysphagia for solids, is described. A clinical examination revealed the presence of an ovoid palpable mass in the lateral-cervical region of the neck. The patient subsequently underwent excisional surgery, and neuropathological evaluation of the specimen confirmed the diagnosis of benign schwannoma with Antoni areas A and B. Despite the rarity of schwannomas, this condition should be considered in differential diagnoses for masses localised in the neck, as in cases where they reach considerable sizes (>3 cm in diameter). Surgery therefore represents the first-choice treatment.

Oncology Letters, 2015

Extra-abdominal fibromatosis is a rare, benign disease that is characterized by a local but not m... more Extra-abdominal fibromatosis is a rare, benign disease that is characterized by a local but not metastatic invasivity. In particular, desmoid tumors of the chest wall represent only 10-20% of all deep fibromatoses. The disease occurs more often in females and has a higher incidence between puberty and the fourth decade of life. The present study reports the case of a 34-year-old female who came to our attention due to a voluminous mass in the right subcostal region. The magnetic resonance imaging of the upper abdomen confirmed the presence of a neoplasm localized between the anterior hepatic margin and the right costal plane. Through a right subcostal laparotomy, the voluminous 95x45x94-mm neoplasm was excised. Histological examination showed evidence consistent with extra-abdominal fibromatosis. The patient has not shown recurrence of the disease for 4 years since the surgery. Overall, radical surgery with disease-free resection margins is the prime treatment option for this disease. Other therapeutic options, such as radiotherapy, hormonal therapy or treatment with imatinib mesylate, can also be considered in certain cases.

Journal of the Peripheral Nervous System

The increasing interest around the role of glycosylation in disease has uncovered the existence o... more The increasing interest around the role of glycosylation in disease has uncovered the existence of nearly 30 genetic disorders affecting N−linked and O−linked pathways. Moreover, mutations introducing new or removing constitutive N−linkage sites are more frequent than expected. We have recently identified different mutations in the Myelin Protein Zero (MPZ) gene, encoding P0, causing a gain or loss of glycosylation. In particular we proved that four mutations (N93S, T95A, T95M and T95K) cause a loss-of-glycosylation, while other mutations (D32N, D80N, D89N and K109N) create a new glycosylation consensus sequence. Iminosugars, a class of drugs interfering with the N-glycosylation pathway, are an intriguing group of molecules that might complement mutations causing misglycosylation. Therefore, we investigated the effect of selected iminosugars on transfected cells expressing the fusion protein P0K109N-EGFP corresponding to a hyperglycosylated P0 mutant. We preliminary selected, in HeL...

BACKGROUND-AIM: Crohn's disease (CD)and Ulcerative colitis (UC) are inflammatory bowel diseas... more BACKGROUND-AIM: Crohn's disease (CD)and Ulcerative colitis (UC) are inflammatory bowel disease (IBD) with a chronic course and a strong impact on the patient's condition, leading to a reduced quality of life. METHODS: We carry out an update of the literature of the last two-three decades with the focus to analyze the current role of the surgeon in the management of IBD. RESULTS: Surgery is fundamental in the treatment of IBD.70% of patients with CD and 30%-40% of patients with UC require surgery in their lifetime. In CD, surgery is often followed by recurrence while, in UC, surgery may be curative. For this reason in patients with CD surgery is indicated when medical therapies fail, or when patients develop one of several complications such as obstruction, fistula, abscess or malnutrition. As regards UC, patients undergo surgery to have an improvement of the quality of life. According to the current surgical approach to CD, the surgeon should follow "the principle of bo...

Oncology Letters, Sep 8, 2015

Extra-abdominal fibromatosis is a rare, benign disease that is characterized by a local but not m... more Extra-abdominal fibromatosis is a rare, benign disease that is characterized by a local but not metastatic invasivity. In particular, desmoid tumors of the chest wall represent only 10-20% of all deep fibromatoses. The disease occurs more often in females and has a higher incidence between puberty and the fourth decade of life. The present study reports the case of a 34-year-old female who came to our attention due to a voluminous mass in the right subcostal region. The magnetic resonance imaging of the upper abdomen confirmed the presence of a neoplasm localized between the anterior hepatic margin and the right costal plane. Through a right subcostal laparotomy, the voluminous 95x45x94-mm neoplasm was excised. Histological examination showed evidence consistent with extra-abdominal fibromatosis. The patient has not shown recurrence of the disease for 4 years since the surgery. Overall, radical surgery with disease-free resection margins is the prime treatment option for this disease. Other therapeutic options, such as radiotherapy, hormonal therapy or treatment with imatinib mesylate, can also be considered in certain cases.

Journal of Digestive Diseases, 2015

Ulcerative colitis (UC) is a chronic inflammatory disease of the mucosa of the large intestine. T... more Ulcerative colitis (UC) is a chronic inflammatory disease of the mucosa of the large intestine. The treatment of UC depends on the severity of symptoms and on the extent of the disease. Acute Severe Colitis (ASC) occurs in 12-25%. Patients with Acute Severe Colitis must be managed by a multidisciplinary team. A medical or surgical aggressive treatment is carried out with the final aim of reducing mortality. Intravenous corticosteroids are the mainstay of the therapy. Medical rescue therapy based on Cyclosporine or Infliximab should be considered if there is no response to corticosteroids after 3 days. In the event that there has been no response to medical rescue therapy after 4-7 days, the patient must undergo a colectomy surgery in urgency. Prolonged observation is counterproductive, as over time it increases the risk of toxic megacolon and of perforation, burdened with a very high mortality rate. The best possible treatment is a subtotal colectomy with ileostomy and preservation of the rectum. Emergency surgery in UC should not be seen as a last chance, but can be considered as a life-saving procedure. Colectomy in an emergency setting is characterized by high morbidity rates but the mortality is low.

Journal of the Peripheral Nervous System

The increasing interest around the role of glycosylation in disease has uncovered the existence o... more The increasing interest around the role of glycosylation in disease has uncovered the existence of nearly 30 genetic disorders affecting N−linked and O−linked pathways. Moreover, mutations introducing new or removing constitutive N−linkage sites are more frequent than expected. We have recently identified different mutations in the Myelin Protein Zero (MPZ) gene, encoding P0, causing a gain or loss of glycosylation. In particular we proved that four mutations (N93S, T95A, T95M and T95K) cause a loss-of-glycosylation, while other mutations (D32N, D80N, D89N and K109N) create a new glycosylation consensus sequence. Iminosugars, a class of drugs interfering with the N-glycosylation pathway, are an intriguing group of molecules that might complement mutations causing misglycosylation. Therefore, we investigated the effect of selected iminosugars on transfected cells expressing the fusion protein P0K109N-EGFP corresponding to a hyperglycosylated P0 mutant. We preliminary selected, in HeL...

Healthcare

The National Institutes of Health Stroke Scale (NIHSS) is commonly used to triage and monitor the... more The National Institutes of Health Stroke Scale (NIHSS) is commonly used to triage and monitor the evolution of stroke victims. Data regarding NIHSS knowledge in nurses and physicians working with stroke patients are scarce, and a progressive decline in specific knowledge regarding this challenging scale is to be expected even among NIHSS certified personnel. This protocol was designed according to the CONSORT-eHealth (Consolidated Standards of Reporting Trials) guidelines. It describes the design of a randomized controlled trial whose primary objective is to determine if nurses and physicians who work in stroke units improve their NIHSS knowledge more significantly after following a highly interactive e-learning module than after following the traditional didactic video. Univariate and multivariable linear regression will be used to analyze the primary outcome, which will be the difference between the score on a 50-question quiz answered before and immediately after following the al...

Introduction: Inflammatory bowel diseases (IBD) are a group of affections characterized by a chro... more Introduction: Inflammatory bowel diseases (IBD) are a group of affections characterized by a chronic inflammation of the mucosae of the digestive tract and primarily include Crohn's Disease (CD) and Ulcerative Colitis (UC). Although much has already been studied, aetiology and pathomechanisms are still unclear. IBD patients are at risk of many complications including the risk of thromboembolic events. Thrombotic complications in this kind of patients have already been recognised and demonstrated although further considerations have to be made regarding the incidence of such kind of events.

Neurology - Neuroimmunology Neuroinflammation

ObjectiveCoronavirus disease (COVID-19) has been associated with a large variety of neurologic di... more ObjectiveCoronavirus disease (COVID-19) has been associated with a large variety of neurologic disorders. However, the mechanisms underlying these neurologic complications remain elusive. In this study, we aimed at determining whether neurologic symptoms were caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) direct infection or by either systemic or local proinflammatory mediators.MethodsIn this cross-sectional study, we checked for SARS-CoV-2 RNA by quantitative reverse transcription PCR, SARS-CoV-2–specific antibodies, and 49 cytokines/chemokines/growth factors (by Luminex) in the CSF +/− sera of a cohort of 22 COVID-19 patients with neurologic presentation and 55 neurologic control patients (inflammatory neurologic disorder [IND], noninflammatory neurologic disorder, and MS).ResultsWe detected anti–SARS-CoV-2 immunoglobulin G in patients with severe COVID-19 with signs of intrathecal synthesis for some of them. Of the 4 categories of tested patients, the CSF ...

International Journal of Stroke

Background Posterior circulation and anterior circulation strokes share many clinical, pathogenet... more Background Posterior circulation and anterior circulation strokes share many clinical, pathogenetic and radiological features, although some clinical signs are highly specific to posterior circulation strokes. Arterial stenosis and occlusions occur in significant numbers in both acute posterior circulation and anterior circulation strokes, making them good candidates for endovascular treatment. Among posterior circulation strokes, basilar artery occlusions stand out because of the diagnostic and acute treatment challenges. Methods We reviewed the literature on clinical stroke syndromes and neuroimaging findings and systematically describe for each anatomical site of stroke the detailed clinical and radiological information (anatomical representation, diffusion weighted imaging and angiographic sequences). The principles of neuroimaging of posterior circulation strokes and the prognosis for each stroke localization are also discussed. Review summary Stroke syndromes in the territorie...

Molecular and Clinical Oncology

Schwannomas are benign tumours that originate from the myelin sheath of peripheral nerves. They a... more Schwannomas are benign tumours that originate from the myelin sheath of peripheral nerves. They are characterised by a slow growth tendency. Benign schwannomas represent 35% of the head and neck district tumours. Hypoglossal schwannomas account for 5% of non-vestibular schwannomas, and malignant schwannomas occur very rarely. In the present case report, the case of a 49-year-old man who presented with paraesthesias in the left parotid and submandibular region, associated with sensation of foreign bodies and dysphagia for solids, is described. A clinical examination revealed the presence of an ovoid palpable mass in the lateral-cervical region of the neck. The patient subsequently underwent excisional surgery, and neuropathological evaluation of the specimen confirmed the diagnosis of benign schwannoma with Antoni areas A and B. Despite the rarity of schwannomas, this condition should be considered in differential diagnoses for masses localised in the neck, as in cases where they reach considerable sizes (>3 cm in diameter). Surgery therefore represents the first-choice treatment.

Oncology Letters, 2015

Extra-abdominal fibromatosis is a rare, benign disease that is characterized by a local but not m... more Extra-abdominal fibromatosis is a rare, benign disease that is characterized by a local but not metastatic invasivity. In particular, desmoid tumors of the chest wall represent only 10-20% of all deep fibromatoses. The disease occurs more often in females and has a higher incidence between puberty and the fourth decade of life. The present study reports the case of a 34-year-old female who came to our attention due to a voluminous mass in the right subcostal region. The magnetic resonance imaging of the upper abdomen confirmed the presence of a neoplasm localized between the anterior hepatic margin and the right costal plane. Through a right subcostal laparotomy, the voluminous 95x45x94-mm neoplasm was excised. Histological examination showed evidence consistent with extra-abdominal fibromatosis. The patient has not shown recurrence of the disease for 4 years since the surgery. Overall, radical surgery with disease-free resection margins is the prime treatment option for this disease. Other therapeutic options, such as radiotherapy, hormonal therapy or treatment with imatinib mesylate, can also be considered in certain cases.

Journal of the Peripheral Nervous System

The increasing interest around the role of glycosylation in disease has uncovered the existence o... more The increasing interest around the role of glycosylation in disease has uncovered the existence of nearly 30 genetic disorders affecting N−linked and O−linked pathways. Moreover, mutations introducing new or removing constitutive N−linkage sites are more frequent than expected. We have recently identified different mutations in the Myelin Protein Zero (MPZ) gene, encoding P0, causing a gain or loss of glycosylation. In particular we proved that four mutations (N93S, T95A, T95M and T95K) cause a loss-of-glycosylation, while other mutations (D32N, D80N, D89N and K109N) create a new glycosylation consensus sequence. Iminosugars, a class of drugs interfering with the N-glycosylation pathway, are an intriguing group of molecules that might complement mutations causing misglycosylation. Therefore, we investigated the effect of selected iminosugars on transfected cells expressing the fusion protein P0K109N-EGFP corresponding to a hyperglycosylated P0 mutant. We preliminary selected, in HeL...

BACKGROUND-AIM: Crohn's disease (CD)and Ulcerative colitis (UC) are inflammatory bowel diseas... more BACKGROUND-AIM: Crohn's disease (CD)and Ulcerative colitis (UC) are inflammatory bowel disease (IBD) with a chronic course and a strong impact on the patient's condition, leading to a reduced quality of life. METHODS: We carry out an update of the literature of the last two-three decades with the focus to analyze the current role of the surgeon in the management of IBD. RESULTS: Surgery is fundamental in the treatment of IBD.70% of patients with CD and 30%-40% of patients with UC require surgery in their lifetime. In CD, surgery is often followed by recurrence while, in UC, surgery may be curative. For this reason in patients with CD surgery is indicated when medical therapies fail, or when patients develop one of several complications such as obstruction, fistula, abscess or malnutrition. As regards UC, patients undergo surgery to have an improvement of the quality of life. According to the current surgical approach to CD, the surgeon should follow "the principle of bo...

Oncology Letters, Sep 8, 2015

Extra-abdominal fibromatosis is a rare, benign disease that is characterized by a local but not m... more Extra-abdominal fibromatosis is a rare, benign disease that is characterized by a local but not metastatic invasivity. In particular, desmoid tumors of the chest wall represent only 10-20% of all deep fibromatoses. The disease occurs more often in females and has a higher incidence between puberty and the fourth decade of life. The present study reports the case of a 34-year-old female who came to our attention due to a voluminous mass in the right subcostal region. The magnetic resonance imaging of the upper abdomen confirmed the presence of a neoplasm localized between the anterior hepatic margin and the right costal plane. Through a right subcostal laparotomy, the voluminous 95x45x94-mm neoplasm was excised. Histological examination showed evidence consistent with extra-abdominal fibromatosis. The patient has not shown recurrence of the disease for 4 years since the surgery. Overall, radical surgery with disease-free resection margins is the prime treatment option for this disease. Other therapeutic options, such as radiotherapy, hormonal therapy or treatment with imatinib mesylate, can also be considered in certain cases.

Journal of Digestive Diseases, 2015

Ulcerative colitis (UC) is a chronic inflammatory disease of the mucosa of the large intestine. T... more Ulcerative colitis (UC) is a chronic inflammatory disease of the mucosa of the large intestine. The treatment of UC depends on the severity of symptoms and on the extent of the disease. Acute Severe Colitis (ASC) occurs in 12-25%. Patients with Acute Severe Colitis must be managed by a multidisciplinary team. A medical or surgical aggressive treatment is carried out with the final aim of reducing mortality. Intravenous corticosteroids are the mainstay of the therapy. Medical rescue therapy based on Cyclosporine or Infliximab should be considered if there is no response to corticosteroids after 3 days. In the event that there has been no response to medical rescue therapy after 4-7 days, the patient must undergo a colectomy surgery in urgency. Prolonged observation is counterproductive, as over time it increases the risk of toxic megacolon and of perforation, burdened with a very high mortality rate. The best possible treatment is a subtotal colectomy with ileostomy and preservation of the rectum. Emergency surgery in UC should not be seen as a last chance, but can be considered as a life-saving procedure. Colectomy in an emergency setting is characterized by high morbidity rates but the mortality is low.

Journal of the Peripheral Nervous System

The increasing interest around the role of glycosylation in disease has uncovered the existence o... more The increasing interest around the role of glycosylation in disease has uncovered the existence of nearly 30 genetic disorders affecting N−linked and O−linked pathways. Moreover, mutations introducing new or removing constitutive N−linkage sites are more frequent than expected. We have recently identified different mutations in the Myelin Protein Zero (MPZ) gene, encoding P0, causing a gain or loss of glycosylation. In particular we proved that four mutations (N93S, T95A, T95M and T95K) cause a loss-of-glycosylation, while other mutations (D32N, D80N, D89N and K109N) create a new glycosylation consensus sequence. Iminosugars, a class of drugs interfering with the N-glycosylation pathway, are an intriguing group of molecules that might complement mutations causing misglycosylation. Therefore, we investigated the effect of selected iminosugars on transfected cells expressing the fusion protein P0K109N-EGFP corresponding to a hyperglycosylated P0 mutant. We preliminary selected, in HeL...