Enucleation and development of cluster headache: a retrospective study

BACKGROUND: Cluster headache (CH) is a neurovascular, primary headache disorder. There are, however, several case reports about patients whose CH started shortly after a structural brain disease or trauma. Motivated by a patient who developed CH 3 weeks after the removal of an eye and by similar case reports, we tested the hypothesis that the removal of an eye is a risk factor for CH. METHODS: A detailed headache questionnaire was filled out by 112 patients on average 8 years after enucleation or evisceration of an eye. RESULTS: While 21 % of these patients experienced previously unknown headaches after the removal of an eye, no patient fulfilled the diagnostic criteria for CH. CONCLUSION: Our data does not suggest that the removal of an eye is a major risk factor for the development of CH

Risk of SARS-CoV-2 infection, hospitalization, and death for COVID-19 in people with Parkinson disease or parkinsonism over a 15-month period: A cohort study

Background and purpose: The patterns of long-term risk of SARS-CoV-2 infection, hospitalization for COVID-19, and related death are uncertain in people with Parkinson disease (PD) or parkinsonism (PS). The aim of the study was to quantify these risks compared to a control population cohort, during the period March 2020–May 2021, in Bologna, Northern Italy. Methods: ParkLink Bologna cohort (759 PD, 192 PS) and controls (9226) anonymously matched (ratio = 1:10) for sex, age, district, and comorbidity were included. Data were analysed in the whole period and in the two different pandemic waves (March–May 2020 and October 2020–May 2021). Results: Adjusted hazard ratio of SARS-CoV-2 infection was 1.3 (95% confidence interval [CI] = 1.04–1.7) in PD and 1.9 (95% CI = 1.3–2.8) in PS compared to the controls. The trend was detected in both the pandemic waves. Adjusted hazard ratio of hospitalization for COVID-19 was 1.1 (95% CI = 0.8–1.7) in PD and 1.8 (95% CI = 0.97–3.1) in PS. A higher risk of hospital admission was detected in PS only in the first wave. The 30-day mortality risk after hospitalization was higher (p = 0.048) in PS (58%) than in PD (19%) and controls (26%). Conclusions: Compared with controls, after adjustment for key covariates, people with PD and PS showed a higher risk of SARS-CoV-2 infection throughout the first 15 months of the pandemic. COVID-19 hospitalization risk was increased only in people with PS and only during the first wave. This group of patients was burdened by a very high risk of death after infection and hospitalization

New variable sources revealed by DECam toward the LMC: The first 15 deg2

The Dark Energy Camera (DECam) is a sensitive, wide field instrument mounted at the prime focus of the 4 mV. Blanco Telescope in Chile. Beside its main objectives, i.e. understanding the growth and evolution of structures in the Universe, the camera offers the opportunity to observe a similar to 3 deg2 field of view in one single pointing and, with an adequate cadence, to identify the variable sources contained. In this paper, we present the result of a DECam observational campaign toward the LMC and give a catalogue of the observed variable sources. We considered all the available DECam observations of the LMC, acquired during 32 nights over a period of two years (from February 2018 to January 2020), and set up a specific pipeline for detecting and characterizing variable sources in the observed fields. Here, we report on the first 15 deg2 in and around the LMC as observed by DECam, testing the capabilities of our pipeline. Since many of the observed fields cover a rather crowded region of the sky, we adopted the ISIS subtraction package which, even in these conditions, can detect variables at a very low signal to noise ratio. All the potentially identified variable sources were then analysed and each light curve tested for periodicity by using the Lomb-Scargle and Schwarzenberg-Czerny algorithms. Furthermore, we classified the identified sources by using the UPSILoN neural network. This analysis allowed us to find 70 981 variable stars, 1266 of which were previously unknown. We estimated the period of the variables and compared it with the available values in the catalogues. Moreover, for the 1266 newly detected objects, an attempted classification based on light curve analysis is presented

Percutaneous endoscopic gastrostomy, body weight loss and survival in amyotrophic lateral sclerosis: a population-based registry study

Objective: To assess the role of percutaneous endoscopic gastrostomy (PEG) insertion, and its timing, on ALS survival, and to study prognostic factors of survival before and after PEG placement in a population-based setting. Methods: In this observational population-based, registry study, we enrolled patients with newly- diagnosed ALS, according to the El Escorial revised criteria, who were resident in the Emilia Romagna Region, and who developed severe dysphagia needing enteral nutritional support. The primary outcome measure was tracheostomy-free survival after PEG recommendation. Results: There were 210 patients needing PEG, out of an incident cohort of 545 patients from the Emilia Romagna Registry for ALS, who were diagnosed between 2009 and 2013. One hundred and ninety-three patients were included in the study, and 17 were excluded because they were already tracheostomized at the time of PEG placement. Of the 193 patients included in the study, 152 underwent PEG, whereas 41 did not undergo the procedure. Patients who did not undergo PEG, among the eligible ones, had the same tracheostomy-free survival from onset as patients who did (25 vs. 32 months, p = 0.21). Tracheostomy-free survival from PEG recommendation was greater in patients who underwent PEG placement than in patients who did not (6 vs. 2 months, p = 0.008). Median tracheostomy-free survival from PEG insertion was eight months (95% CI5–12); 30 days after PEG placement, survival was 89.60%. At Cox multivariable analysis, the hazard of death or tracheostomy after PEG insertion was significantly influenced by the difference between BMI at the time of the PEG procedure and BMI at diagnosis (HR 1.05, 95% CI 1.02–1.08; p = 0.002). The hazard of death or tracheostomy was not affected by the timing of PEG insertion. Conclusions: The present study, although it has some limitations, suggests a gain of tracheostomy-free survival from the time of PEG recommendation for patients who undergo PEG placement, and, among patients who undergo PEG, a greater survival if PEG is inserted before a significant weight loss occurs, and if nutritional support avoids further weight loss. Should this association between prevention of weight loss and better clinical outcome be confirmed by further studies, it would have important implications for disease management

Amyotrophic lateral sclerosis: a comparison of two staging systems in a population-based study

Background and purpose: To compare two recently developed staging systems for amyotrophic lateral sclerosis (ALS) [King's College and Milano-Torino staging (MITOS) systems] in an incident, population-based cohort of patients with ALS. Methods: Since 2009, a prospective registry has been recording all incident cases of ALS in the Emilia Romagna region in Italy. For each patient, detailed clinical information, including the ALS functional rating scale score, is collected at each follow-up. Results: Our study on 545 incident cases confirmed that King's College stages occurred at predictable times and were quite evenly spaced out throughout the disease course (occurring at approximately 40%, 60% and 80% of the disease course), whereas MITOS stages were mostly skewed towards later phases of the disease. In the King's College system there was a decrease in survival and an increase in deaths with escalating stages, whereas in the MITOS system survival curves pertaining to intermediate stages overlapped and the number of deaths was fairly homogenous throughout most stages. Conclusions: The King's College staging system had a higher homogeneity (i.e. smaller differences in survival among patients in the same stage) and a higher discriminatory ability (i.e. greater differences in survival among patients in different stages), being more suitable for individualized prognosis and for measuring efficacy of therapeutic interventions

A further Rasch study confirms that ALSFRS-R does not conform to fundamental measurement requirements

View at Publisher| Export | Download | Add to List | More... Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration Volume 16, Issue 5-6, 27 August 2015, Pages 331-337 A further Rasch study confirms that ALSFRS-R does not conform to fundamental measurement requirements (Article) Franchignoni, F.aefghijklmnopqrstuvwx, Mandrioli, J.b , Giordano, A.c, Ferro, S.d, Mandrioli, J.e, Fini, N.e, Georgoulopoulou, E.e, Nichelli, P.e, Biguzzi, S.f, Venturini, E.f, Passarin, M.G.f, Guidi, C.g, Neri, W.g, Sette, E.h, Tugnoli, V.h, Tola, M.R.h, Terlizzi, E.i, Guidetti, D.i, Curro Dossi, M.j, Pasquinelli, M.j, Andruccioli, J.j, Ravasio, A.j, Casmiro, M.k, Rasi, F.k, Salvi, F.l, Bartolomei, I.l, Michelucci, R.l, \ud Avoni, P.m, De Pasqua, S.m, Liguori, R.m, Rizzi, R.n, Canali, E.n, Marcello, N.n, Grassi, A.o, Delay, L.o, Pietrini, V.o, Aiello, M.p, Chierici, E.q, Montanari, E.q, Santangelo, M.r, Amidei, S.r, Greco, G.r, Casetta, I.s, Groppo, E.s, Granieri, E.s, De Massis, P.t, Mussuto, V.t, Borghi, A.u, Gabellini, A.u, Sacquegna, T.u, Rinaldi, R.v, Cirignotta, F.v, Ferro, S.d, D'Alessandro, R.w Hide additional authors a Unit of Occupational Rehabilitation and Ergonomics, Salvatore Maugeri Foundation, Scientific Institute of Veruno (NO), Italy b Department of Neuroscience, University of Modena and Reggio Emilia and Nuovo Ospedale Civile, S. Agostino-Estense di Modena, Via Pietro Giardini n. 1355, Modena, Italy c Unit of Bioengineering, Salvatore Maugeri Foundation, Scientific Institute of Veruno (NO), Italy View additional affiliations View references (25) Abstract Our objective was to verify and expand previous evidence of psychometric inadequacies in the ALSFRS-R, in a different sample of subjects suffering from ALS. Since 2009, a prospective registry records all incident cases of ALS in Emilia Romagna Region, Italy (4.4 million inhabitants) referred to its 17 neurological departments. For each patient, demographic and clinical information is collected by the physician in charge, including compilation of the ALSFRS-R at each clinical follow-up. Results showed that a confirmatory factor analysis on the three-factor model previously found (bulbar, motor, respiratory function) showed a good fit. Rasch analysis on the whole scale showed the need to collapse some rating categories, confirmed the multidimensionality of the ALSFRS-R, and demonstrated the presence of differential item functioning between patients with spinal versus bulbar onset. Moreover, some items included in the three ALSFRS-R subscales showed a problematic fit to the respective construct they were intended to measure. In conclusion, the interpretation of a total raw score of ALSFRS-R is hampered by ambiguities due to the different metric properties of the three domains the scale aggregates, and their content and structure. This study confirms that a refinement of ALSFRS-R is warranted, pointing to the need to revise its whole structure, and providing detailed guidelines for its revision.Our objective was to verify and expand previous evidence of psychometric inadequacies in the ALSFRS-R, in a different sample of subjects suffering from ALS. Since 2009, a prospective registry records all incident cases of ALS in Emilia Romagna Region, Italy (4.4 million inhabitants) referred to its 17 neurological departments. For each patient, demographic and clinical information is collected by the physician in charge, including compilation of the ALSFRS-R at each clinical follow-up. Results showed that a confirmatory factor analysis on the three-factor model previously found (bulbar, motor, respiratory function) showed a good fit. Rasch analysis on the whole scale showed the need to collapse some rating categories, confirmed the multidimensionality of the ALSFRS-R, and demonstrated the presence of differential item functioning between patients with spinal versus bulbar onset. Moreover, some items included in the three ALSFRS-R subscales showed a problematic fit to the respective construct they were intended to measure. In conclusion, the interpretation of a total raw score of ALSFRS-R is hampered by ambiguities due to the different metric properties of the three domains the scale aggregates, and their content and structure. This study confirms that a refinement of ALSFRS-R is warranted, pointing to the need to revise its whole structure, and providing detailed guidelines for its revision