Bipolar disorder and peripartum mood episodes: Epidemiology and clinical correlates

INTRODUCTION: It is known that the peripartum period is a high-risk period of recurrence in bipolar disorder (BD). However, data on correlations between reproductive life events, such as age at menarche and peripartum period, are mixed in BD. OBJECTIVES: The aims of this retrospective study are to investigate the lifetime rate of peripartum mood episodes, the clinical correlates and the relationship between age at menarche and peripartum episode in a sample of women with BD. METHODS: The study focused on comparisons between women with vs. without peripartum mood episodes (n = 292). Socio-demographic and clinical characteristics between women with vs without BD peripartum episode were examined through descriptive statistics.Adjusted logistic regression analysis was run to examine the association between variables. RESULTS: In our sample, 30% had at least one BD peripartum episode. Women with peripartum episode had significantly earlier age at menarche, earlier onset of BD and longer duration of untreated disorder compared to women without peripartum episode. After adjustment, the late menarche (>15 years) was associated with lower probability of BD episodes during the peripartum period compared to normal menarche (12-14 years). CONCLUSIONS: Peripartum mood episodes are common in BD and are correlated with early onset of BD and long duration of untreated disorder. Moreover, age at menarche may be related to the risk of peripartum mood episodes. The results deserve to be deepened in further studies

WebGIS as boundary tools between scientific geoinformation and disaster risk reduction action in volcanic areas

As the amount of spatial data is growing, there is increased interest in developing tools to explore, visualize and interpret them, with the final aim of informing decision making efficiently. Within the European MIAVITA project, we examined this issue in the case of volcanic areas, where existing geospatial databases are particularly complex due to the number of threats to be considered, including volcanic (e.g. lava flows, ash fall) and non-volcanic hazards, such as landslides or tsunamis. We involved a group of hazard and risk analysts and managers, civil security officers, GIS analysts and system developers to design a Web-based geographical information system (WebGIS). We tested the system at the Mount Cameroon volcano, taking advantage of a complex hazard and risk geographical database. This study enabled identifying key requirements for such tools in volcanic areas, such as the need to manage user privileges differently according to their profile and the status of the volcano. This work also highlights that, in addition to the development of large geoinformation clearinghouses, there is a need for site-specific information systems focused on working procedures of users, in order to fill the last gap between data producers and users

Obestatin induced recovery of myocardial dysfunction in type 1 diabetic rats: underlying mechanisms.

BACKGROUND: The aim of this study was to investigate whether obestatin (OB), a peptide mediator encoded by the ghrelin gene exerting a protective effect in ischemic reperfused heart, is able to reduce cardiac dysfunctions in adult diabetic rats. METHODS: Diabetes was induced by STZ injection (50 mg/kg) in Wistar rats (DM). OB was administered (25 μg/kg) twice a day for 6 weeks. Non-diabetic (ND) rats and DM rats were distributed into four groups: untreated ND, OB-treated ND, untreated DM, OB-treated DM. Cardiac contractility and ß-adrenergic response were studied on isolated papillary muscles. Phosphorylation of AMPK, Akt, ERK1/2 and GSK3ß as well ß-1 adrenoreceptors levels were detected by western blot, while α-MHC was measured by RT-PCR. RESULTS: OB preserved papillary muscle contractility (85 vs 27% of ND), ß-adrenergic response (103 vs 65% of ND), as well ß1-adrenoreceptors and α-MHC levels in diabetic myocardial tissue. Moreover, OB up-regulated the survival kinases Akt and ERK1/2, and enhanced AMPK and GSK3ß phosphorylation. OB corrected oxidative unbalance, reduced pro-inflammatory cytokine TNF-α plasma levels, NFkB translocation and pro-fibrogenic factors expression in diabetic myocardium. CONCLUSIONS: OB displays a significant beneficial effect against the alterations of contractility and ß-adrenergic response in the heart of STZ-treated diabetic rats, which was mainly associated with the ability of OB to up-regulate the transcription of ß1-adrenergic receptors and α-MHC; this protective effect was accompanied by the ability to restore oxidative balance and to promote phosphorylation/modulation of AMPK and pro-survival kinases such as Akt, ERK1/2 and GSK3ß

Correlates of violent suicide attempts in patients with bipolar disorder

Background: Suicide is one of the leading causes of death in bipolar disorder (BD); violent suicide attempts are associated with the highest level of lethality. We aimed to evaluate factors related to the risk of violent suicide in a large naturalistic sample of patients with BD; in addition, we analyzed the rates of lifetime suicide attempts and the variables associated with suicidal behavior. Methods: We recruited 847 patients with BD. Patients were grouped according to whether they had a lifetime history of suicide attempts and, among suicide attempters, subjects who had used a violent suicide method were compared with those who had attempted suicide with a nonviolent method. Comparisons were performed using \u3c72 tests for categorical variables and ANOVA for continuous variables. Logistic regression (LogReg) was used to identify explanatory variables associated with violent suicide attempts (dependent variable). Results: Two hundred and two patients (24%) had a lifetime history of suicide attempts. Subjects with at least one lifetime suicide attempt showed longer duration of illness (22.4 \ub1 14.1 years vs 19.9 \ub1 14.2 years: p 0.028), more lifetime hypomanic episodes (3.3 \ub1 4.3 vs 2.3 \ub1 3.1: p 0.001), more lifetime depressive episodes (6.0 \ub1 4.4 vs 4.7 \ub1 4.1: p < 0.001), higher rates of lifetime psychiatric comorbidities (50.0% vs 41.3%: p 0.029), higher rates of lifetime medical comorbidities (58.0% vs 48.9%: p 0.028) and higher rates of reduced HDL cholesterol (46.2% vs 36.7%: p 0.030). Among suicide attempters, fifty-two patients (30.6%) attempted suicide with a violent method. We found more men in the group of violent suicide attempters than in the group of nonviolent suicide attempters (65% vs 28%; p: <0.001). Moreover subjects with previous violent attempts showed higher mean values of weight (80.5 \ub1 18.3 vs 69.4 \ub1 14.7: p < 0.001), body mass index (27.8 \ub1 5.6 vs 25.2 \ub1 4.7: p < 0.003) and waist circumference (98.7 \ub1 18.5 vs 92.4 \ub1 14.3: p 0.032). The LogReg analysis confirmed the association of violent attempts with male gender (p: <0.001; Phi: 0.35) and higher waist circumference (p: <0.001; Cohen's d: 0.39). Limitations: In our research we analyzed lifetime suicide attempts, but the sample does not include completed suicides, meaning that we are unable to test whether the results are generalizable to suicide deaths. Moreover, some relevant variables, such as medical comorbidities/metabolic parameters at the time of suicide attempts and previous medication, were not collected. Another limitation concerns the heterogeneity of recruited patients in terms of clinical characteristics (e.g.: medical conditions, drug treatments), with potential confounding factors. Conclusions: The present study confirms the association between male gender and violent suicide and suggests a correlation between obesity and the use of violent suicide methods. The relationship between obesity and suicidal behaviour is worthy of interest and deserves to be explored by further studies

Pharmacological Inhibition of FAK-Pyk2 Pathway Protects Against Organ Damage and Prolongs the Survival of Septic Mice

Sepsis and septic shock are associated with high mortality and are considered one of the major public health concerns. The onset of sepsis is known as a hyper-inflammatory state that contributes to organ failure and mortality. Recent findings suggest a potential role of two non-receptor protein tyrosine kinases, namely Focal adhesion kinase (FAK) and Proline-rich tyrosine kinase 2 (Pyk2), in the inflammation associated with endometriosis, cancer, atherosclerosis and asthma. Here we investigate the role of FAK-Pyk2 in the pathogenesis of sepsis and the potential beneficial effects of the pharmacological modulation of this pathway by administering the potent reversible dual inhibitor of FAK and Pyk2, PF562271 (PF271) in a murine model of cecal ligation and puncture (CLP)-induced sepsis. Five-month-old male C57BL/6 mice underwent CLP or Sham surgery and one hour after the surgical procedure, mice were randomly assigned to receive PF271 (25 mg/kg, s.c.) or vehicle. Twenty-four hours after surgery, organs and plasma were collected for analyses. In another group of mice, survival rate was assessed every 12 h over the subsequent 5 days. Experimental sepsis led to a systemic cytokine storm resulting in the formation of excessive amounts of both pro-inflammatory cytokines (TNF-α, IL-1β, IL-17 and IL-6) and the anti-inflammatory cytokine IL-10. The systemic inflammatory response was accompanied by high plasma levels of ALT, AST (liver injury), creatinine, (renal dysfunction) and lactate, as well as a high, clinical severity score. All parameters were attenuated following PF271 administration. Experimental sepsis induced an overactivation of FAK and Pyk2 in liver and kidney, which was associated to p38 MAPK activation, leading to increased expression/activation of several pro-inflammatory markers, including the NLRP3 inflammasome complex, the adhesion molecules ICAM-1, VCAM-1 and E-selectin and the enzyme NOS-2 and myeloperoxidase. Treatment with PF271 inhibited FAK-Pyk2 activation, thus blunting the inflammatory abnormalities orchestrated by sepsis. Finally, PF271 significantly prolonged the survival of mice subjected to CLP-sepsis. Taken together, our data show for the first time that the FAK-Pyk2 pathway contributes to sepsis-induced inflammation and organ injury/dysfunction and that the pharmacological modulation of this pathway may represents a new strategy for the treatment of sepsis