Papers by CINZIA MARINARO
Prognostic role of KRAS in the treatment of colorectal liver metastases
Mutations at KRAS gene have been identified as effective predictive biomarker against treatment o... more Mutations at KRAS gene have been identified as effective predictive biomarker against treatment of colorectal liver metastases (CLM) with anti EGFR monoclonal antibodies. On the other hand its value as considerable prognostic biomarker is still unclear. Thus we examined this issue in a cohort of patients with colorectal liver metastases.KRAS mutation status was assessed in sixty-two resected liver metastases and in forty corresponding primitive colorectal cancers. Genotypes of KRAS were analysed by cycleave PCR. We examined the association of KRAS mutation with clinic-pathological features, recurrence rate and survival. Median follow-up after liver resection was 42.9 months. KRAS mutations in CLM were detected in 18 patients (29%); the most frequent mutation was G12D (34%). A high concordance of mutations has been demonstrated between the primary and LM (90%, p=0.0001). No significant marker correlation has been revealed with clinic-pathological features. Biomarker mutations were slightly associated with extra-hepatic metastases either discovered at the time of diagnosis (p=0.07) or during the follow-up (p=0.09). The 5-years survival was not influenced by the presence of mutations in KRAS (55% Vs 59%). At regard to these little differences, is important to stress that 55% of KRAS mutated patients underwent anti-VEGF target therapy KRAS is not significantly associated with an aggressive metastatic behaviour of colorectal liver metastases. These results are consistent with the majority of data in literature suggesting in the target therapy era offering multiple effective weapons even in KRAS mutated, it s really hard to determine plain prognostic value of KRAS
Archives of Physical Medicine and Rehabilitation, 2021
Re: Hutchinson M, Fox RJ, Havrdova E, et al. Efficacy and safety of BG-12 (dimethyl fumarate) and... more Re: Hutchinson M, Fox RJ, Havrdova E, et al. Efficacy and safety of BG-12 (dimethyl fumarate) and other disease modifying therapies for the treatment of relapsing-remitting multiple sclerosis: a systematic review and mixed treatment comparison. Curr Med Res Opin 2014;30:613-27
NeuroRehabilitation, Dec 22, 2020
BACKGROUND: Primary lateral sclerosis (PLS) is an upper motor neurons disease that on rare occasi... more BACKGROUND: Primary lateral sclerosis (PLS) is an upper motor neurons disease that on rare occasions may determine bradykinesia and motor fatigue. To date, no rehabilitative treatment has been described as useful for these patients. CASE PRESENTATION: A 68-year-old male developed dysarthria, spastic laugh, impairments of handwriting and fine motor, gait and dysphagia disorders for both solids and liquids over the period from 2015 to December 2018, with normal DaT scans and no clinical benefits from therapy with levodopa, pramipexole and baclofen. The patient underwent exercises for gait training and balance control with sensory treadmill and stabilometric platform and kinesiotherapy to improve fine motor skills of both hands and postural changes, five days a week for two weeks. Based on our data, the patient showed an improvement in balance and gait parameters in T2 compared to T1. CONCLUSION: Thanks to the synergistic action of a combined treatment of physical and instrumental therapy, despite the rare pathology and complex disability, the patient had important benefits in terms of performance and independence in daily activity.
Complementary Therapies in Clinical Practice, Nov 1, 2020
Background and purpose: This study aims to determine the best choice of breathing exercises (BE) ... more Background and purpose: This study aims to determine the best choice of breathing exercises (BE) for patients with chronic obstructive pulmonary disease (COPD) via a network meta-analysis. Methods: We searched randomized controlled trials (RCTs) of adults with COPD investigating any BEs in MED-LINE, Embase, Cochrane Library, and ClinicalTrials.gov databases. The effects of comparative treatment on the St. George Respiratory Questionnaire as the outcome were analysed and ranked according to a surface under the cumulative classification curve (SUCRA) analysis. Results: The network meta-analysis included six RCTs involving 280 patients with four intervention groups, comprising control, diaphragmatic breathing training (DBT), yoga, and singing course. Performing SUCRA, we reported that yoga is 75% likely to be the best treatment available as DBT with 66%, instead of 35% for singing and 21% for control. Conclusion: DBT and yoga seem to be the best choices for breathing exercises in people with COPD.
Muscles, ligaments and tendons journal, Mar 1, 2020
Objective. To investigate RCTs that reported the effects of Radial ShockWave Therapy (RSWT) versu... more Objective. To investigate RCTs that reported the effects of Radial ShockWave Therapy (RSWT) versus traditional physiotherapy on pain, shoulder articular function and quality of life of patients suffering by tendinopathy of the shoulder. Data sources. Studies were comprehensively searched, without language restrictions, on PubMed, Embase, PEdro, Cochrane Controlled Trials Register, the Cochrane. Possible studies from reference lists of articles and review were cross-checked. Study selection. Randomized controlled trials from 2006 to present were included. Two reviewers conducted the selection independently. Data extraction. Two reviewers assessed the quality of data. Disagreements in extraction were settled by consulting a third and fourth reviewers to reach a consensus. Data synthesis. Five studies with 475 participants were included in the network meta-analysis that used a random-effect model to investigate the mean difference of pooled effect sizes of the visual analog scale, Constant-Murley score combined with UCLA, and SPADI score. Conclusions. Compared to control groups, RSWT resulted an improvement in pain-0.24 (95% CI:-0.43 to-0.05 Z=2.45 p<0.05), an increase of Constant/UCLA score 4.72 (95% CI: 4.03 to 5.4 Z=13.5 p<0.05) and a decrease in SPADI scale-6.76 (95% CI:-13.3 to-0.48 Z=2.11 p<0.05). Despite the small number of the studies, seems that RSWT can be more effective in pain, shoulder articular function and quality of life of patients with tendinopathy of the shoulder.
Acta bio-medica : Atenei Parmensis, Jan 21, 2020
Background: Stroke is the third cause of long term disability worldwide and its rehabilitation pr... more Background: Stroke is the third cause of long term disability worldwide and its rehabilitation program must to have into account all aspects of disability. International research and politics increasingly study the relationship between disability and the direct costs associated with living with a disability. Objective: Using the ICF, this article provides a correlation between financial assets and disability in participation and activities, in a context such as the Italian one where there is a twenty-year decentralization of the national health system Methods. At the University of Catanzaro, in southern Italy, n=130 ICF checklists of stroke patients were analyzed at 6 months from the end of the rehabilitation treatment. Financial assets domains in environment and nine domains in participation and activities were correlated, in order to evaluate the relationship between familiar economic condition and disability. Results: Pearson's r test (t = -6.6515, df = 25, p-value<0.05) showed a significant correlation of 0.79. Multiple R-squared was 0.639 and an we reported an Adjusted R-squared of 0.6245 (p<0.05). Thus, about 62% of the increase of the all considered disability qualifiers in participation and activities in ICF checklist can be explained by a lower financial income. Conclusions: In a regional context (Calabria) of an European country (Italy) with a national health system, thanks to the ICF it can be assumed that with the decrease of the financial income, the gap in participation of activities increases.
Cerebral Cortex, Nov 17, 2011
The canonical Wnt/Wingless pathway is implicated in regulating cell proliferation and cell differ... more The canonical Wnt/Wingless pathway is implicated in regulating cell proliferation and cell differentiation of neural stem/progenitor cells. Depending on the context, b-Catenin, a key mediator of the Wnt signaling pathway, may regulate either cell proliferation or differentiation. Here, we show that b-Catenin signaling regulates the differentiation of neural stem/progenitor cells in the presence of the b-Catenin interactor Homeodomain interacting protein kinase-1 gene (Hipk1). On one hand, Hipk1 is expressed at low levels during the entire embryonic forebrain development, allowing b-Catenin to foster proliferation and to inhibit differentiation of neural stem/progenitor cells. On the other hand, Hipk1 expression dramatically increases in neural stem/progenitor cells, residing within the subventricular zone (SVZ), at the time when the canonical Wnt signaling induces cell differentiation. Analysis of mouse brains electroporated with Hipk1, and the active form of b-Catenin reveals that coexpression of both genes induces proliferating neural stem/progenitor cells to escape the cell cycle. Moreover, in SVZ derive neurospheres cultures, the overexpression of both genes increases the expression of the cell-cycle inhibitor P16Ink4. Therefore, our data confirm that the b-Catenin signaling plays a dual role in controlling cell proliferation/ differentiation in the brain and indicate that Hipk1 is the crucial interactor able to revert the outcome of b-Catenin signaling in neural stem/progenitor cells of adult germinal niches.
Journal of International Medical Research, Aug 1, 2020
Rehabilitation is important for patients with coronavirus disease 2019 (COVID-19) infection. Give... more Rehabilitation is important for patients with coronavirus disease 2019 (COVID-19) infection. Given the lack of guidelines in English on the rehabilitation of these patients, we conducted a review of the most recent reports. We performed this literature review using the principal research databases and included randomized trials, recommendations, quasi-randomized or prospective controlled clinical trials, reports, guidelines, field updates, and letters to the editor. We identified 107 studies in the database search, among which 85 were excluded after screening the full text or abstract. In total, 22 studies were finally included. The complexity of the clinical setting and the speed of spread of the severe acute respiratory syndrome coronavirus 2, which leads to rapid occupation of beds in the intensive care unit, make it necessary to discharge patients with COVID-19 who have mild symptoms as soon as possible. For these reasons, it is necessary to formulate rehabilitation programs for these patients, to help them restore physical and respiratory function and to reduce anxiety and depression, particularly patients with comorbidities and those who live alone or in rural settings, to restore a good quality of life.
Comprehensive genetic analysis of laryngeal leiomyosarcoma by next generation sequencing: a case report
Otorhinolaryngology, Mar 1, 2023
Effects of rehabilitation on reducing dyskinesias in a Parkinson's disease patient abusing therapy with levodopa-carbidopa intestinal gel: a paradigmatic case report and literature review
Journal of Biological Regulators and Homeostatic Agents, Aug 2, 2021
International Journal of Molecular Sciences, May 27, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of Electromyography and Kinesiology, Feb 1, 2021
Introduction: Anaemia is common in haemodialysis patients and treating it with erythropoiesis-sti... more Introduction: Anaemia is common in haemodialysis patients and treating it with erythropoiesis-stimulating agents (ESAs) is complex due to many factors. Objectives: To assess the usefulness of the anaemia control model (ACM) in the treatment of anaemia in haemodialysis. Methods: ACM is a software that predicts the optimal dose of darbepoetin and iron sucrose to achieve target haemoglobin (Hb) and ferritin levels, and makes prescription suggestions. Study conducted in dialysis clinics lasting 18 months with two intervention phases (IPs) with ACM (IP1, n: 213; IP2, n: 218) separated by a control phase (CP, n: 219). The primary outcome was the percentage of Hb in range and the median dose of ESAs, and the secondary outcomes were transfusion, hospitalisation and cardiovascular events. Clinical and patient analyses were performed. Hb variability was assessed by the standard deviation (SD) of the Hb. We also analysed the patients with most of the suggestions confirmed (ACM compliant group). Results: ACM increased the percentage of Hb in range: 80.9% in IP2, compared with 72.7% in the CP and reduced the intake of darbepoetin (IP1: 20 [70]; CP 30 [80] g, p = 0.032) with less Hb fluctuation (0.91 ± 0.49 in the CP to 0.82 ± 0.37 g/dl in IP2, p < 0.05), improving in the ACM compliant group. The secondary outcomes decreased with the use of ACM. Conclusions: ACM helps to obtain better anaemia results in haemodialysis patients, minimising the risks of treatment with ESAs and reducing costs.
Journal of Clinical Medicine, Jun 17, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Comprehensive genetic analysis of laryngeal leiomyosarcoma by next generation sequencing: a case report
Otorhinolaryngology
Journal of Physical Education and Sport, 2019
The aim of this study was to compare effectiveness of two programs of APA in patients with neurol... more The aim of this study was to compare effectiveness of two programs of APA in patients with neurological disability in order to reduce the risk of fall and to improve state of global health. Forty-six patients with MS, PD and Stroke, divided in APA group (adapted physical exercises) and APA-D group (with devices). Each group participated in two 60-minute weekly sessions for 2 months, they were tested at T0, T1 and at follow-up 6 months about: FIM, Tinetti, Berg Balance, TUG, 6MWT, Hads, EuroQol, Cop, Walking Analysis. Both groups, in the T1 phase, showed an increase level of performance and health status, though the APA_D group presented a more pronounced decrease in the risk of fear of fall for balance variable (T0_T1:Tinetti: 30%; Berg: 30%; Tug: 18,3%; Cop: 52,1%). Results demonstrate fall risks relationship with "functional tests" currently used to measure dynamic balance, and its accuracy in predicting falls in neurologic subjects.
Muscle Ligaments and Tendons Journal, 2020
Objective. To investigate RCTs that reported the effects of Radial ShockWave Therapy (RSWT) versu... more Objective. To investigate RCTs that reported the effects of Radial ShockWave Therapy (RSWT) versus traditional physiotherapy on pain, shoulder articular function and quality of life of patients suffering by tendinopathy of the shoulder. Data sources. Studies were comprehensively searched, without language restrictions, on PubMed, Embase, PEdro, Cochrane Controlled Trials Register, the Cochrane. Possible studies from reference lists of articles and review were cross-checked. Study selection. Randomized controlled trials from 2006 to present were included. Two reviewers conducted the selection independently. Data extraction. Two reviewers assessed the quality of data. Disagreements in extraction were settled by consulting a third and fourth reviewers to reach a consensus. Data synthesis. Five studies with 475 participants were included in the network meta-analysis that used a random-effect model to investigate the mean difference of pooled effect sizes of the visual analog scale, Constant-Murley score combined with UCLA, and SPADI score. Conclusions. Compared to control groups, RSWT resulted an improvement in pain-0.24 (95% CI:-0.43 to-0.05 Z=2.45 p<0.05), an increase of Constant/UCLA score 4.72 (95% CI: 4.03 to 5.4 Z=13.5 p<0.05) and a decrease in SPADI scale-6.76 (95% CI:-13.3 to-0.48 Z=2.11 p<0.05). Despite the small number of the studies, seems that RSWT can be more effective in pain, shoulder articular function and quality of life of patients with tendinopathy of the shoulder.
Effects of rehabilitation on reducing dyskinesias in a Parkinson's disease patient abusing therapy with levodopa-carbidopa intestinal gel: a paradigmatic case report and literature review
Journal of biological regulators and homeostatic agents, 2021
Journal of Electromyography and Kinesiology, 2021
Introduction: Anaemia is common in haemodialysis patients and treating it with erythropoiesis-sti... more Introduction: Anaemia is common in haemodialysis patients and treating it with erythropoiesis-stimulating agents (ESAs) is complex due to many factors. Objectives: To assess the usefulness of the anaemia control model (ACM) in the treatment of anaemia in haemodialysis. Methods: ACM is a software that predicts the optimal dose of darbepoetin and iron sucrose to achieve target haemoglobin (Hb) and ferritin levels, and makes prescription suggestions. Study conducted in dialysis clinics lasting 18 months with two intervention phases (IPs) with ACM (IP1, n: 213; IP2, n: 218) separated by a control phase (CP, n: 219). The primary outcome was the percentage of Hb in range and the median dose of ESAs, and the secondary outcomes were transfusion, hospitalisation and cardiovascular events. Clinical and patient analyses were performed. Hb variability was assessed by the standard deviation (SD) of the Hb. We also analysed the patients with most of the suggestions confirmed (ACM compliant group). Results: ACM increased the percentage of Hb in range: 80.9% in IP2, compared with 72.7% in the CP and reduced the intake of darbepoetin (IP1: 20 [70]; CP 30 [80] g, p = 0.032) with less Hb fluctuation (0.91 ± 0.49 in the CP to 0.82 ± 0.37 g/dl in IP2, p < 0.05), improving in the ACM compliant group. The secondary outcomes decreased with the use of ACM. Conclusions: ACM helps to obtain better anaemia results in haemodialysis patients, minimising the risks of treatment with ESAs and reducing costs.
Journal of International Medical Research, 2020
Rehabilitation is important for patients with coronavirus disease 2019 (COVID-19) infection. Give... more Rehabilitation is important for patients with coronavirus disease 2019 (COVID-19) infection. Given the lack of guidelines in English on the rehabilitation of these patients, we conducted a review of the most recent reports. We performed this literature review using the principal research databases and included randomized trials, recommendations, quasi-randomized or prospective controlled clinical trials, reports, guidelines, field updates, and letters to the editor. We identified 107 studies in the database search, among which 85 were excluded after screening the full text or abstract. In total, 22 studies were finally included. The complexity of the clinical setting and the speed of spread of the severe acute respiratory syndrome coronavirus 2, which leads to rapid occupation of beds in the intensive care unit, make it necessary to discharge patients with COVID-19 who have mild symptoms as soon as possible. For these reasons, it is necessary to formulate rehabilitation programs for...
Journal of Clinical Medicine
Transcranial direct current stimulation (tDCS) has emerged as an appealing rehabilitative approac... more Transcranial direct current stimulation (tDCS) has emerged as an appealing rehabilitative approach to improve brain function, with promising data on gait and balance in people with multiple sclerosis (MS). However, single variable weights have not yet been adequately assessed. Hence, the aim of this pilot randomized controlled trial was to evaluate the tDCS effects on balance and gait in patients with MS through a machine learning approach. In this pilot randomized controlled trial (RCT), we included people with relapsing–remitting MS and an Expanded Disability Status Scale >1 and <5 that were randomly allocated to two groups—a study group, undergoing a 10-session anodal motor cortex tDCS, and a control group, undergoing a sham treatment. Both groups underwent a specific balance and gait rehabilitative program. We assessed as outcome measures the Berg Balance Scale (BBS), Fall Risk Index and timed up-and-go and 6-min-walking tests at baseline (T0), the end of intervention (T1)...
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Papers by CINZIA MARINARO