Introduction: Studies on the durability of an intensive, structured education protocol on best insulin injection practice are missing for people with type 2 diabetes mellitus (T2DM). The aim of this study was to assess the durability of an intensive, structured education-based rehabilitation protocol on best insulin injection practice in well-trained subjects from our previous intensive, multimedia intervention study registered as the ISTERP-1 study. A total of 158 subjects with T2DM from the well-trained group of the 6-month-long ISTERP-1 study, all of whom had successfully attained lower glucose levels compared to baseline levels with lower daily insulin doses and with less frequent and severe hypoglycemic episodes, participated in the present investigation involving an additional 6-month follow-up period, called the ISTERP-2 study. Methods: Participants were randomized into an intervention group and a control group, depending on whether they were provided or not provided with further education refresher courses for 6 months. At the end of the 6 months, the two groups were compared in terms of injection habits, daily insulin dose requirement, number of severe or symptomatic hypoglycemic events, and glycated hemoglobin (HbA1c) levels.

The objective of this study was to describe the clinical and demographic features of idiopathic non-task-specific upper limb dystonia compared with the task-specific form. Methods: In this retrospective study, adult patients with idiopathic upper limb dystonia, either focal or as part of a segmental/multifocal dystonia, from the Italian Dystonia Registry were enrolled. In patients with focal upper limb dystonia, dystonia spread was estimated by survival analysis. Results: Of the 1522 patients with idiopathic adult-onset dystonia included in the Italian Dystonia Registry, we identified 182 patients with upper limb dystonia. Nontask-specific dystonia was present in 61.5% of enrolled cases. Women predominated among non-task-specific patients, whereas men predominated in the task-specific group. Peak age of upper limb dystonia onset was in the sixth decade in the non-task-specific group and in the fourth decade in the task-specific group. In both groups, upper limb dystonia started as focal dystonia or as part of a segmental dystonia. Segmental onset was more frequent among non-task-specific patients, whereas focal onset predominated among task-specific patients. Dystonic action tremor was more frequent among non-taskspecific patients. No significant differences between groups emerged in terms of sensory trick frequency, rest tremor, or family history of dystonia. In patients with focal upper limb dystonia, dystonia spread was greater in the non-task-specific group. Conclusion: Novel information on upper limb dystonia patients suggests that non-task-specific and task-specific upper limb dystonia have different demographic and

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Background and aimsTo assess how COVID-19 impacted the clinical practice specialized SCI units. MethodsSurvey circulated to the personnel of specialized SCI centers in Italy. ResultsTwo hundred people answered the survey. Most of them (63%) reported that during the last year there has been a reduction of the number of new SCI and a reduction of the number of beds available for patients with SCI. In 68% of the centers patients with SCI and COVID were admitted, but mostly (47%) after a negative swab. In all units COVID screening is regularly performed. Almost all the visit of relatives to the patients were suspended. Despite all these precautions, 52% of the respondents reported that some patients were found positive during their stay in the unit. Most of them (58%) (depending on the clinical situation) were transferred to COVID units. 95% of the respondents reported that the precautions adopted against the virus changed working modalities, halting some aspects of the clinical practice (e.g. outdoors activities, formal meetings with the relatives, caregivers training, evaluation of architectural barriers at patients home) and causing an increased length of stay, also due to the difficulties to transfer the patients to nursing home, and to the difficulties experienced by the patients to obtain all the necessary equipment. However, none of the respondents reported an impact on patients outcomes, especially in daily living independence. ConclusionsThe outpatients activities have been impacted too and this reflected in an increase of complications related to SCI, in particular pressure ulcers, pain, spasticity, anxiety and depression.

Background Identifying late epileptic seizures (LS) following cerebral venous thrombosis (CVT) can be useful for prognosis and management. We systematically reviewed the literature to identify risk factors for LS due to CVT. Methods We systematically searched PubMed, Scholar, and Scopus databases (May 2021) to identify studies reporting data on prevalence and risk factors for CVT-LS. The methodological quality was assessed with the Ottawa-Newcastle Scale. The risk of developing CVT-LS was summarized in meta-analyses and expressed as odds ratio (OR) and corresponding 95% confidence intervals (CIs) using random-effects models. Results Out of the 332 records retrieved, four studies were eventually included with a total of 1309 patients with CVT and 142 (11%) with CVT-LS. The most relevant predictors of CVT-LS were symptomatic seizures (OR 5.66, 95% CI 3.83–8.35), stupor/coma (OR 6.81, 95% CI 1.18–39.20), focal neurologic signs (OR 6.81, 95% CI 1.18–39.2), hemorrhagic component (OR 3.52, 95% CI 2.45–5.06), and superior sagittal sinus involvement (OR 1.52, 95% CI 1.04–2.21). Conclusion There are several risk factors for CVT-LS that should be considered in clinical practice. Further high-quality studies are warranted to develop predictive models for individualized risk stratification and prediction of CVT-LS. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-022-06148-y.