Cognitive thought diary in supportive psychology for people undergoing radiotherapy: a feasibility study.

BAC KGROUND: Radiation therapy (RT ) has become one of the most widely-used and efficient treatments for cancer; nevertheless, people who undergo radiotherapy suffer the physical and psychological consequences of this stressful treatment, in addition to the psychosocial distress related to cancer. However, a Radiotherapy Unit is often a place where several patients crowd in from various hospitals with restricted timetables and, for logistic reasons, it is not easy to provide regular psychological sessions for each one. It is important to find a setting that allows us the involvement of the largest number of patients referred to the unit. In this study, we aimed to evaluate the feasibility and the effect of a brief intervention of cognitive-oriented diary on the quality of life, anxiety and depressive symptoms of patients undergoing radiotherapy (RT ), compared to a control group. METH ODS: The sample was constituted of 68 experimental subjects and 78 controls, treated with RT . Both groups were assessed with the Toronto Alexithymia Scale (TAS -20), the Hamilton Anxiety and Depression Scale (HA DS) and the EORTC -QLQ at the beginning and at the end of their RT . Experimental subjects were instructed to report emotions and thoughts before attending the RT sessions in a thought diary. RES ULTS : The experimental group showed a good adherence to the diary, a reduction in mean scores of anxiety (P<0.001), depression (P<0.001), and alexithymia (P<0.001) together with an ameliorative effect on quality of life (P<0.014), compared to control group. CONCLUSI ONS: We observed a reduction in alexithymia scores in the experimental group, together with a significant reduction in anxiety and depression symptoms and an improvement in quality of life, with a moderator role of social disparity in treatment adherence. Our outcomes suggest the opportunity to consider the diary an affordable and effective device for psychologists operating in RT units, able to be extended to the majority of patients, in a simple and replicable setting

Electrophilic nitroalkene-tocopherol derivatives: synthesis, physicochemical characterization and evaluation of anti-inflammatory signaling responses

Inflammation plays a major role in the onset and development of chronic non-communicable diseases like obesity, cardiovascular diseases and cancer. Combined, these diseases represent the most common causes of death worldwide, thus development of novel pharmacological approaches is crucial. Electrophilic nitroalkenes derived from fatty acids are formed endogenously and exert anti-inflammatory actions by the modification of proteins involved in inflammation signaling cascades. We have developed novel nitroalkenes derived from α-tocopherol aiming to increase its salutary actions by adding anti-inflammatory properties to a well-known nutraceutical. We synthesized and characterized an α-tocopherol-nitroalkene (NATOH) and two hydrosoluble analogues derived from Trolox (NATxME and NATx0). We analyzed the kinetics of the Michael addition reaction of these compounds with thiols in micellar systems aiming to understand the effect of hydrophobic partition on the reactivity of nitroalkenes. We studied NATxME in vitro showing it exerts non-conventional anti-inflammatory responses by inducing Nrf2-Keap1-dependent gene expression and inhibiting the secretion of NF-κB dependent pro-inflammatory cytokines. NATxME was also effective in vivo, inhibiting neutrophil recruitment in a zebrafish model of inflammation. This work lays the foundation for the rational design of a new therapeutic strategy for the prevention and treatment of metabolic and inflammation-related disease

Penn classification in acute aortic dissection patients

The objective of this study was to evaluate the effectiveness of the Penn classification in predicting in-hospital mortality after surgery in acute type A aortic dissection patients

Impact of Prosthesis-Patient Mismatch after Mitral Valve Replacement.

Background and aim of the study: The study aim was to determine the impact of prosthesis-patient mismatch (PPM) on early and late clinical outcomes, left atrial and ventricular remodeling, late tricuspid valve regurgitation and pulmonary hypertension (PH) in patients after mitral valve replacement (MVR). Methods: A total of 46 patients (mean age 66 \ub1 9.3 years) with mitral valve diseases and undergoing isolated MVR was enrolled in the study. The mitral valve effective orifice area (EOA) was determined using the continuity equation and indexed for the patient\u2019s body surface area (EOAi). PPM was defined as EOAi 641.2 cm2/m2. PH was defined as a systolic pulmonary artery pressure (sPAP) >40 mmHg. Both, clinical and echocardiographic follow up were performed. Results: PPM was identified in 25% of patients, but no significant differences were observed in baseline and operative characteristics when comparing patients with and without PPM. The NYHA class was improved in most cases after surgery. Indeed, significant decreases in mean transvalvular gradient (from 8.6 \ub1 2.8 mmHg to 5 \ub1 1.3 mmHg, p = 0.001), left atrial dimension (LAD) (from 31.9 \ub1 9.8 mm to 29.5 \ub1 7 mm, p = 0.011), left ventricular end-systolic diameter (from 42.6 \ub1 18.1 mm to 35.5 \ub1 6.6 mm, p = 0.044) and left ventricular end-diastolic diameter (from 55.8 \ub1 19.2 mm to 48.7 \ub1 6.1 mm, p = 0.024) were observed over time when comparing preoperative and postoperative echocardiographic data. In addition, at follow up (mean 6.9 \ub1 1.8 years) there were significant decreases in LAD (from 31.9 \ub1 9.8 mm to 28 \ub1 11.1 mm, p = 0.001), left ventricular enddiastolic volume (from 106.9 \ub1 32.9 ml to 92.3 \ub1 21.9 ml, p = 0.024), tricuspid regurgitation (TR) (from 87% to 27%, p = 0.002) and PH (from 78.3% to 58.7%, p = 0.043) in all patients. No significant differences were observed in hemodynamic, clinical outcome and atrial natriuretic peptide levels of patients with and without PPM. Conclusion: Mitral PPM does not appear to have any negative effect on ventricular and atrial remodeling, TR and PH during the early and late postoperative periods

Correlation among periodontal health status, maternal age and pre-term low birth weight

Purpose: To assess correlations between periodontal status, maternal age and adverse pregnancy outcomes, such as pre-term and low birth weight in a sample of pregnant women. Methods: Study population was represented by outpatient pregnant women, gestational age &gt; 26 weeks. Medical history questionnaires were administered to all participants who underwent clinical evaluation; clinical obstetric outcome records were collected after delivery. A questionnaire was administered regarding personal information, socio-economic status, oral hygiene habits, and oral health conditions. A clinical oral examination was performed to collect Simplified Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI). Pregnancy outcome records included: delivery week, kind and causes of delivery, any relevant complications, and birth weight. Descriptive statistics were used to depict the data from the questionnaire while the relationship between delivery week, birth weight, maternal age and periodontal status was evaluated through multivariate tests of significance. Results: 88 pregnant women were enrolled in the study. The results showed a statistically significant correlation (P&lt;0.001) among participants older than 40 years of age, between periodontal disease and adverse pregnancy outcomes. No statistical correlation was found among pre-term and low birth weight, smoking, ethnicity and educational level of mothers. The results highlight the importance of including a routine oral and periodontal health examination in pregnant women older than 40 years of age

Better social but worse academic premorbid adjustment in cannabis-users psychotic patients across Europe

Background: Several studies report that patients with psychosis who used cannabis have a better cognitive performance than those whodid not (Rabin et al. 2011). In a previous study we found out a higher premorbid IQ, and a better IQ in psychotic patients who smoked cannabis in their lifetime, and our findings were consistent with the idea that this association is due to a better premorbid functioning rather than to an ameliorative effect of cannabis use on cognitive performance (Ferraro et al., 2013). A number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage in illegal drug consumption, than non-using patients (Compton et al., 2011; L\uf8berg et al., 2014; Arnold et al., 2015). Given that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to test the hypothesis of a better premorbid functioning in First Episode Psychosis (FEP) cannabis-using and non-using patients coming from different European countries (England, Italy, Spain, France, the Netherlands) as part of the EUGEI-STUDY. Methods: 1.745 people (746 cases; 999 controls) completed the assessment for Intellectual Quotient (IQ) (WAIS-brief version) premorbid adjustment (Premorbid Adjustment Scale \u2013 PAS) and cannabis use (CEQ-Revised). We first performed a factor analysis on PAS components, by obtaining two main factors: \u201cPremorbid Social Adjustment\u201d (PSA) and \u201cPremorbid Academic Adjustment\u201d (PAA). We therefore performed linear mixed models with IQ, PSA, and PAA as dependent variables and cannabis lifetime (Yes/No), subject status (Cases/Controls), gender and age as independent variables. Results: Across all countries, IQ was higher in those patients who smoked cannabis in their lifetime compared to those who did not (P = 0.027). This IQ difference was only 3 points and was the same for cases and healthy controls (P = 0.949). Similarly, patients who had smoked cannabis in their lifetime showed better PSA scores than non users (P = 0.009). The difference in PSA score between cannabis-users and non-users was significantly greater in cases than controls (P = 0.038). Conversely, across all countries, PAA resulted worst in patients who smoked cannabis lifetime than patients who did not (Po0.001) and this PAA score difference was the same for cases and controls (P = 0.693). Discussion: Our cannabis-using FEP patients have higher IQ, better PSA and lower PAA than non user patients across 5 different European countries. Starting from these preliminary results, we can conclude that a better PSA is significantly associated with cannabis use in FEP patients. Nevertheless, in an exploratory analysis, a better IQ resulted related to a better PAA (o0.001) but not to PSA (P = 0.260); thus indicating an independent relationship of IQ and PSA with cannabis use. Further analysis are required in order to model these multivariate relationships

What does augment the risk to use cannabis on an everyday-basis in psychotic patients?

Introduction There are strong enough evidences of the fact that risk of psychosis is augmented by cannabis use. In a recent analysis, the strongest predictor of case-control status was daily-skunk use, i.e. the ORs for skunk users increase with the frequency of use5. We know also that FEP who smoked cannabis in their lifetime are less neuropsychologically impaired i.e. they have better premorbid and current IQ6. In this study we wanted to test what augments the probability to be everyday users, taking into account premorbid social and academic adjustment and cognition as predictors, along with age at first cannabis-use and % of THC in cannabis used. Methods The sample was made of 834 First Episode Psychosis (FEP) cannabis-using and non-using patients from different European countries and 1.061 healthy controls, as part of the EUGEI-STUDY. A logistic regression was computed, using frequency of cannabis use among those who reported to have used cannabis in their lifetime, as an outcome variable in order to estimate the risk to be an everyday-user (heavy user) or a less-than-everyday user (recreational user), taking into account a list of predictors: sociodemographics, age at first cannabis-use, % of THC, premorbid social factor (PSF), premorbid academic factor (PAF), extracted from the Premorbid Adjustment Scale (PAS) and the four scales of WAIS-brief version. Results The risk to be an everyday-smoker was higher for cases, in interaction with age at first use, i.e. while the risk of controls diminishes when age at first use increases, this is not true for cases, whose risk stay higher even when age at first use increases (OR=1.2, p=0.001, CI 95% 1.09, 1.45). THC absolute concentration >10% augmented almost 2 folds the risk to be an everyday-smoker (OR=1.8, p=0.001, CI 95% 1.29, 2.60). A lower premorbid academic adjustment (OR=0.8, p=0.040, CI 95% 0.68, 0.99) and higher premorbid social adjustment before 16 years (OR=1.6, p=0.019, CI 95% 1.08, 2.60) increased the risk to be a heavy cannabis user, along with having a lower education level and being unemployed (all p<0.05). Higher scores of working memory reduced the risk related to education and premorbid adjustment. Conclusions The predictors of everyday cannabis-\uaduse were lower premorbid academic adjustment but higher sociability before 16 years, the latter moderated by a higher working memory. An earlier age at first use was the most relevant risk factor for being cannabis everyday-\uadusers in both psychotic subjects and healthy controls

Premorbid social adjustment is better in cannabis-using than non-using psychotic patients across Europe:Abstracts of the 24rd European Congress of Psychiatry

Introduction A number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage inillegal drug consumption, than non-using patients. Objectives Given that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to study First Episode Psychosis (FEP) cannabis-using and non-using patients coming from different European countries as part of the EUGEI-STUDY. Aims We tested the hypothesis of better premorbid social adjustment in cannabis using FEP patients, by comparing them to FEP non cannabis users and to their respective healthy controls. Methods 1.745 people (746 cases; 999 controls) completed the assessment for premorbid adjustment (Premorbid Adjustment Scale \u2013 PAS) and cannabis use (CEQ-Revised). We first extracted the Premorbid Social Adjustment Factor (PSA) from PAS and then performedlinear mixed models with PSA as dependent variable and cannabis lifetime (Yes/No) and subject status (Cases/Controls) as independent variables. We then considered \u201cCountry\u201d as random intercept. Results Across all countries, PSA scores were better in patients who had smoked cannabis in their lifetime than patients who had not (p=0.009). The difference in PSA score between cannabis users and non users was significantly greater in cases than controls (p=0.038). The relationship between PSA, cannabis lifetime (Yes/No) and subject status among nations (random intercept) is shown in Figure 1. Conclusions Cannabis-using psychotic patients show better premorbid social adjustment than non-using patients, across 5 European countries

Low incidence of psychosis in Italy:confirmation from the first epidemiological study in Sicily

PURPOSE: The incidence of psychotic disorders varies in different geographical areas. As there have been no reports from Southern Italy, this study aimed to determine the incidence rate of first-episode psychosis in Palermo, Sicily. METHODS: All patients, aged 18-65 years, presenting with a first episode of psychosis (FEP) (ICD-10 F20-29, F30-33) to mental health services in Palermo, were recorded over a 3-year period. Incidence rates of psychotic disorders and their 95% confidence intervals (95% CI) were estimated. Poisson regression was applied to estimate the differences in incidence rate ratio (IRR) by age, sex and migrant status. RESULTS: Two hundred and four FEP participants were identified during the 3 years; 183 (89.7%, males n = 112) participants were native Italians and 21 were migrants (10.3%, males n = 14). The crude incidence of all psychoses was 15.9 (95% CI 13.7-18.1). As predicted, the risk of schizophrenia F20 was higher in males compared to females (adjusted IRR = 1.99, 95% CI 1.36-2.88) and in migrants compared to native Italians (adjusted IRR = 4.02, 95% CI 2.39-6.75). CONCLUSIONS: This study, the first from Sicily, confirms previous findings from Northern Italy that the risk of schizophrenia and other psychoses is much lower in Italian cities than those reported from cities in Northern Europe; the reasons for this disparity may provide important clues to the aetiology of psychosis