Clinical presentation of strokes confined to the insula: a systematic review of literature

BACKGROUND AND PURPOSE: The insular cortex serves a wide variety of functions in humans, ranging from sensory and affective processing to high-level cognition. Hence, insular dysfunction may result in several different presentations. Ischemic strokes limited to the insular territory are rare and deserve a better characterization, to be quickly recognized and to receive the appropriate treatment (e.g. thrombolysis). METHODS: We reviewed studies on patients with a first-ever acute stroke restricted to the insula. We searched in the Medline database the keywords "insular stroke" and "insular infarction", to identify previously published cases. Afterwards, the results were divided depending on the specific insular region affected by the stroke: anterior insular cortex (AIC), posterior insular cortex (PIC) or total insula cortex (TIC). Finally, a review of the clinical correlates associated with each region was performed. RESULTS: We identified 25 reports including a total of 49 patients (59.7 ± 15.5 years, 48% male) from systematic review of the literature. The most common clinical phenotypes were motor and somatosensory deficits, dysarthria, aphasia and a vestibular-like syndrome. Atypical presentations were also common and included dysphagia, awareness deficits, gustatory disturbances, dysautonomia, neuropsychiatric or auditory disturbances and headache. CONCLUSIONS: The clinical presentation of insular strokes is heterogeneous; however, an insular stroke should be suspected when vestibular-like, somatosensory, speech or language disturbances are combined in the same patient. Further studies are needed to improve our understanding of more atypical presentations

ELSA Italy

In the last 50 years, Italy has experienced a relevant transformation, starting from an emigrant nation (according to the last statistics from the Ministry of the Interior, there are more than 4.636.647 Italians still living abroad) to become an immigrant destination. From 1970 until now, migrant citizens with regular residence permits in Italy have increased, with a rate of growth that looks almost unstoppable: at the beginning of 2017, there were more than 5,047,028 foreign nationals resident in Italy. This numbers, added to the illegal immigrants whose numbers are difficult to define, outline a complex situation, characterized by immigrant flows from almost 200 different countries, especially Central Eastern Europe (Albania, Romania and Ukraine), Northern Africa (Morocco), China and the Indian subcontinent (Pakistan, India, and Sri Lanka). This historically important phenomenon requires in-depth analysis in order to evaluate the effectiveness of the Italian legislation and intervention policies, and to find concrete solutions to help immigrants settling in our country

Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead

There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data – emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine

Short porous implants in the rehabilitation of the mandible: a 3-years report of a prospective study.

l'obiettivo dello studio è stato quello di presentare a distanza di 3 anni dal carico protesico i risultati ottenuti con impianti corti a superficie sinterizzata posizionati nei settori posteriori della mandibol

Short porous implants in the rehabilitation of the maxilla: a 3-years report of a prospective study.

Scopo del presente lavoro \ue8 stato quello di valutare a distanza di 3 anni dal carico protesico impianti corti a superficie sinterizzata posizionati nei settori atrofici del mascellare posterior

Analysis of survival rate and peri-implant tissue stability of implants placed in revascularized fibula free flap for the reconstruction of maxillo-mandibula defects. A long term study.

Il lavoro ha avuto come obiettivo quello di valutare la sopravvivenza a lungo termine di impianti posizionati in osso rigenerato con lembo di fibula rivascolarizzato nel mascellare superiore e nella mandibol

Peri-implant tissue in patients treated with revascularized free flaps. Clinical consideration.

Il lavoro ha avuto come obiettivo quello di valutare la salute e la stabilit\ue0 dei tessuti perimplantari attorno a impianti posizionati in osso di fibula rivascolarizzato

Clinical evaluation of locking-taper implants placed

This study updates the esthetic results of locking-taper implants, placed in fresh extraction site of anterior areas of the maxill

Evaluation of compliance to telehomecare (THC) in a group of patients with Cystic Fibrosis (CF) in a period of 2 years

Objectives. In the present study, we examined data related to adherence to telemonitoring in our CF patients followed at home for a period of 2 years, in the aim to improve the follow-up in terms of efficiency and appropriateness. Materials and Methods. We kept electronic records of transmissions, in spreadsheet format. For each transmission, the main parameters and any action taken were collected. We carried out automatically a monthly summary of activities, a monthly average percentage of adherence to prescribed frequency of transmissions, monitored the contacts and phone calls. Results. We received in the period from February 15, 2010 to February 15, 2012 overall 1364 transmissions in 515 days (1817 spirometry, 414 nocturnal pulse-oximetry and 398 questionnaires on symptoms) The average compliance in the reporting period was 10,16%, with an increasing trend. Conclusions. The improvement of outcome in FC necessarily passes through an improvement of the adherence to treatment. More psychological and behavioural studies are needed in order to gradually remove the obstacles which still prevent a further improvement in long-term outcome