Il ruolo dei fattori psicologici nel determinismo degli incidenti stradali

Gli incidenti stradali sono, nella società odierna, una delle principali cause di decesso. Il parziale insuccesso dei tentativi di eludere questo problerma lascia pensare che si è sottovalutato l’insieme dei fattori fisiologici nel detreminare il comportamento dei conducenti considerando che nel 90% degli incidenti stradali il responsabile era il conducente mentre solo nel 6% il veicolo, nel 3% l’ambiente e nell’1% il sistema. Nel 1982 Wielde riporta che il livello di rischio che le persone sono disposte a correre è visto come l’unico fattore determinante del tasso degli incidenti. Lo sforzo preventivo che non è utile a ridurre questo livello, fallirà nel ridurre il tasso di incidenti. Vengono quindi riportati altri lavori per comprendere il ruolo dei fattori psicologici nel determinismo degli incidenti considerando come questi studi siano molto complessi e lunghi da effettuare, ma sicuramente è di grande interesse approfondire le ricerche in questo senso

La stabilità psico-percettiva dell’automobilista

La sensibilità pervcettiva è indispensabile all’automobilista per la sicurezza sua e del prossimo. Una condizione percettiva fluttuante, incerta ma soprattutto alternata, pone il conducente su un piano di guida pericoloso in quanto non solo ha un modo percettivo precario ma presenta anche un approccio psicologico con l’ambiente incerto, confuso, rischioso, …. La domanda che ci si è posti per lo scopo del lavoro è stata la seguente: può il ristabilimento o il miglioramento della performance visiva spiegare la sfera psicologica verso un miglioramento ed una stabilità? Dai risultati ottenuti emerge che gli uomini ametropi elevati, passando da una lente a tempiale ad una a contatto, possono affrontare la guida con più sicurezza e preparazione, anche se il significato dell’automobile rimane per loro sempre lo stesso. Le donne, invece, non solo migliorano le loro performance cognitive nei confronti dell’auto, ma essa acquista veramente il significato di mezzo di comunicazione con cui muoversi

Sacral meningocele in a military pilot, presenting during flight

This study describes an unusual case of a military pilot with sacral meningocele that contained cerebrospinal fluid and presented as episodes of gluteal neuralgia during flight. The patient, a 38-yr-old male pilot, had complained of a dull and mild low lumbar pain over the previous 10 mo. These pains were exacerbated and radiated to the left gluteal region during flight. The patient's history, clinical examination, imaging findings, and treatment are reported. CT and MRI imaging revealed an unusual case of sacral meningocele (2.2 cm x 3.6 cm x 5.8 cm). These lesions can progress steadily in size, leading to worsening symptoms and potentially requiring surgical management. However, surgery is not indicated for stable and asymptomatic lesions not associated with tumors. In our case, tactical monitoring was suggested, since no other symptoms appeared. There are currently no other reported cases involving pilots, so an individual approach to treatment should be taken in accordance with their military health service, the potential risk factors, and depending on the level of acceleration experienced. We discuss the pathogenesis, the clinical and radiological findings of this rare condition, and note that a spinal cyst is of special interest when occurring in pilots since they are exposed to intense accelerations and spinal strain. Copyright © by the Aerospace Medical Association

Psychosis or simply a new manifestation of neurosyphilis?

The widespread use of antibiotics in recent years has caused a significant reduction in the incidence of neurosyphilis and changes in its clinical features. We present a case that initially presented as persistent headache and untreatable psychosis. Neurosyphilis was diagnosed during the clinical evaluation. Blood serum analyses for syphilis were positive for rapid plasma reagin titres, the Venereal Disease Research Laboratories test and fluorescent treponemal antibody absorption. A lumbar puncture was performed and cerebrospinal fluid analysis resulted in the diagnosis of neurosyphilis. The patient completed a 2-week course of treatment with aqueous crystalline penicillin G and his symptoms subsequently improved. We suggest that neurosyphilis should always be included in the differential diagnosis of untreatable psychosis. Copyright © 2006 Cambridge Medical Publications

Influence of anxiety and reported stressful life events on relapses in multiple sclerosis: a prospective study

Objective Self-reported stressful life events and infections have been associated with relapses in multiple sclerosis. Also, anxiety has been reported to influence other diseases of unpredictable course. To study relation of self-reported stressful life events, levels of anxiety, and episodes of infection, with relapses of the disease in women with multiple sclerosis. Methods This is a one-year prospective study. Thirty seven women with multiple sclerosis were regularly seen every four weeks, for one year. They were keeping diaries of events they considered stressful. These events were ranked according to the Holmes and Rahe Social Readjustment Rating Scale. Their anxiety levels were assessed with the Hamilton rating scale for anxiety. Relapses and episodes of infection were verified at additional visits. Results were studied using a survival analysis model adapted for several recurrent events. Results A total of 291 stressful events, 37 episodes of infection, and 48 relapses, were registered. High level of anxiety were stongly related to the number and the severity of reported stressful events during the preceding period and with the advent of a relapse in the following period (Hamilton score greater than 18 is associated with 4.2 times the rate of relapsing and three or more reported stressful events with 5.7 times the rate of relapsing). Conclusions Anxiety and self-reported stressful events may in fact be two measures of the same underlying emotional factor, which plays an important role on the course of the disease, in addition to episodes of infection. Multiple Sclerosis 2008; 14: 1262-1268. http://msj.sagepub.co

Headache as a first manifestation of Vogt-Koyanagi-Harada disease

Objectives: To describe headache as an initial presentation of Vogt-Koyanagi-Harada (VKH) disease. Clinical Presentation and Intervention: A 56-year-old man initially presented with a 6-month duration of a continuous, diffuse headache of mild to moderate and sometimes of severe intensity. A CT of the brain was normal. Neurological examination was normal, including absence of symptoms and signs of meningismus. During the last 2 months, an intermittent eye pain, redness, and gradual loss of vision in both eyes was detected and subsequently he had tinnitus, malaise, nausea and mild meningismus. He was diagnosed as having VKH disease. Ophthalmologic examination revealed high intraocular pressure, requiring trabeculectomy with surgical iridectomy. The patient is now being treated with systemic steroids. Conclusion: VKH disease may initially present as sustained headache, without specific ophthalmologic symptoms and it should be considered in the differential diagnosis in patients with atypical but relentless headache. Copyright © 2008 S. Karger AG

Complex Interplay Between Health and Successful Aging: Role of Perceived Stress, Resilience, and Social Support

Psychological and psychosocial resources, including resilience and social support, have traditionally been studied in the context of the stress paradigm and, more recently, in the context of successful aging. This study used moderated mediation analyses to examine the role of perceived stress in the relationships between physical and mental health functioning and self-rated successful aging (SRSA), and whether differences between people in level of resilience and social support changes the role of perceived stress in these relationships. A cross-sectional study of 1,006 older adults (Mean=77 years) completed scales addressing SRSA, physical and mental health functioning, perceived stress, resilience, and social support. Results indicated that the strength of relationships between both physical and mental health functioning and SRSA were reduced after accounting for variation in level of perceived stress. The role of perceived stress in the association between mental health functioning and SRSA was found to be stronger among participants with the highest levels of resilience, and the influence of perceived stress on the degree of relationship between physical health functioning and SRSA was stronger among those with greatest social support. These findings suggest that interventions to reduce perceived stress may help break the link between disability and poor well-being in older adults. The findings further suggest that the impact of such interventions might differ depending on psychological resources (i.e., resilience) for mental health disabilities and external resources (i.e., social support) for those with physical health problems. The complex interplay of these factors should be taken into account in clinical settings