The Relationship between Compulsive Behaviour and Internet Addiction

A variety of behavioural and emotional problems among university students is due to Internet Addiction (Alavi et al. 2012, Rusconi et al. 2012). In 2013 a survey is conducted on a sample of 532 students of University of L’Aquila. The purpose is to investigate Internet use patterns and the correlation between Internet Addiction disorder and compulsive behaviour. Two self-administered questionnaires are used: the Internet Addiction Test and the Cognitive Behavioural Assessment 2.0. 517 students show signs of Internet Addiction, which is moderate for 31% of respondents and severe for 1% of them. 5% shows intrusive thoughts and compulsive behaviours. The symptoms of obsessive-compulsive disorder are statistically associated with Internet Addiction (chi² test=23.53, p=0.000). Among young people there is a relationship between compulsive behaviour and Internet Addiction. This relationship has significant effects on treatment of Internet Addiction

Direct CD32 T-cell cytotoxicity: implications for breast cancer prognosis and treatment

The FcγRII (CD32) ligands are IgFc fragments and pentraxins. The existence of additional ligands is unknown. We engineered T cells with human chimeric receptors resulting from the fusion between CD32 extracellular portion and transmembrane CD8α linked toCD28/ζ chain intracellular moiety (CD32-CR). Transduced T cells recognized three breast cancer (BC) and one colon cancer cell line among 15 tested in the absence of targeting antibodies. Sensitive BC cell conjugation with CD32-CR T cells induced CD32 polarization and down-regulation, CD107a release, mutual elimination, and proinflammatory cytokine production unaffected by human IgGs but enhanced by cetuximab. CD32-CR T cells protected immunodeficient mice from subcutaneous growth of MDA-MB-468 BC cells. RNAseq analysis identified a 42 gene fingerprint predicting BC cell sensitivity and favorable outcomes in advanced BC. ICAM1 was a major regulator of CD32-CR T cell–mediated cytotoxicity. CD32-CR T cells may help identify cell surface CD32 ligand(s) and novel prognostically relevant transcriptomic signatures and develop innovative BC treatments

Prevention of infections and fever to improve outcome in older patients with acute stroke (PRECIOUS): a randomised, open, phase III, multifactorial, clinical trial with blinded outcome assessment

BackgroundInfections and fever after stroke are associated with poor functional outcome or death. We assessed whether prophylactic treatment with anti-emetic, antibiotic, or antipyretic medication would improve functional outcome in older patients with acute stroke. MethodsWe conducted an international, 2∗2∗2-factorial, randomised, controlled, open-label trial with blinded outcome assessment in patients aged 66 years or older with acute ischaemic stroke or intracerebral haemorrhage and a score on the National Institutes of Health Stroke Scale ≥ 6. Patients were randomly allocated (1:1) to metoclopramide (oral, rectal, or intravenous; 10 mg thrice daily) vs. no metoclopramide, ceftriaxone (intravenous; 2000 mg once daily) vs. no ceftriaxone, and paracetamol (oral, rectal, or intravenous; 1000 mg four times daily) vs. no paracetamol, started within 24 h after symptom onset and continued for four days. All participants received standard of care. The target sample size was 3800 patients. The primary outcome was the score on the modified Rankin Scale (mRS) at 90 days analysed with ordinal logistic regression and reported as an adjusted common odds ratio (an acOR 1 harm). This trial is registered (ISRCTN82217627). FindingsFrom April 2016 through June 2022, 1493 patients from 67 European sites were randomised to metoclopramide (n = 704) or no metoclopramide (n = 709), ceftriaxone (n = 594) or no ceftriaxone (n = 482), and paracetamol (n = 706) or no paracetamol (n = 739), of whom 1471 were included in the intention-to-treat analysis. Prophylactic use of study medication did not significantly alter the primary outcome at 90 days: metoclopramide vs. no metoclopramide (adjusted common odds ratio [acOR], 1.01; 95% CI 0.81–1.25), ceftriaxone vs. no ceftriaxone (acOR 0.99; 95% CI 0.77–1.27), paracetamol vs. no paracetamol (acOR 1.19; 95% CI 0.96–1.47). The study drugs were safe and not associated with an increased incidence of serious adverse events. InterpretationWe observed no sign of benefit of prophylactic use of metoclopramide, ceftriaxone, or paracetamol during four days in older patients with a moderately severe to severe acute stroke. FundingThis project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No: 634809

The Relationship between Compulsive Behaviour and Internet Addiction

A variety of behavioural and emotional problems among university students is due to Internet Addiction (Alavi et al. 2012, Rusconi et al. 2012). In 2013 a survey is conducted on a sample of 532 students of University of L’Aquila. The purpose is to investigate Internet use patterns and the correlation between Internet Addiction disorder and compulsive behaviour. Two self-administered questionnaires are used: the Internet Addiction Test and the Cognitive Behavioural Assessment 2.0. 517 students show signs of Internet Addiction, which is moderate for 31% of respondents and severe for 1% of them. 5% shows intrusive thoughts and compulsive behaviours. The symptoms of obsessive-compulsive disorder are statistically associated with Internet Addiction (chi² test=23.53, p=0.000). Among young people there is a relationship between compulsive behaviour and Internet Addiction. This relationship has significant effects on treatment of Internet Addiction

Prevalence and risk factors for microalbuminuria in children and adolescents with type 1 diabetes: long-term experience of a single centre

Objectives: Diabetic nephropathy is a late complication of type 1 diabetes mellitus (T1DM) and microalbuminuria (MA) is an early and reversible sign of diabetic renal disease. Aims of this longitudinal study were: to define the prevalence of MA in children and adolescents with T1DM; to identify which risk factors are predictive for the development of MA. Methods: Seventy children and adolescents with T1DM [57% male; age at T1DM onset (T0) 5.95 3.16 yrs] were enrolled. The mean follow-up (FU) period was 7.18 1.89 yrs. Blood and urinary tests were performed once a year from the T0. MA screening was evaluated by urinary albumin concentration (UAC) or by timed urine collections for urinary albumin/creatinine ratio (ACR). MA was considered persistent (PMA) when at least 2 out of 3 consecutive evaluation of UAC and/or ACR were found positive. Results: PMA was found in 13% of patients. Subjects with PMA compared to normoalbuminuric ones had both significantly higher GFR at T0 (p = 0.025) and UAC at 1-year FU (T1) (p = 0.045). Predictive cut-off values for PMA development were 160 ml/min/1.73 m2 for GFR at T0 (sensitivity: 57%, specificity: 75%) and 8.5 mg/L for UAC at T1 (sensitivity:75%, specificity:80%). Relative risk for PMA was 23-times higher when UAC was >8.5 mg/L (p = 0.004). Kaplan- Meier survival curves as a function of age at T0 showed an increased probability of developing PMA among children in which T1DM onset occured between 5 and 11 years of age compared to those with younger onset (p = 0.014) and a pubertal diabetes duration >5 years was also a significant risk factor for PMA (p < 0.0005). Conclusions: Age at T1DM onset, pubertal timing, high UAC, and hyperfiltration predispose to PMA development and increase the risk for diabetic nephropathy. Specific cut-off values at T1DM onset and during first years of FU could provide indications to avoid disease progression

MALATTIA PARODONTALE IN BAMBINI ED ADOLESCENTI CON DIABETE DI TIPO 1: EFFICACIA DELLA SOMMINISTRAZIONE ORALE DI LACTOBACILLUS REUTERI

OBIETTIVI Nei soggetti con diabete di tipo 1 (DM1) il rischio di sviluppare malattia parodontale è fi no a 5-volte maggiore rispetto ai soggetti sani; tuttavia, in età evolutiva, le prove a sostegno dell’associazione tra queste due malattie sono controverse. La somministrazione orale di probiotici crea un biofi lm e protegge i tessuti orali contro l’azione dei batteri patogeni parodontali. Scopo di questo studio longitudinale è stato quello di valutare gli effetti della somministrazione di probiotici (Lactobacillus reuteri) sulla salute orale di bambini ed adolescenti con DM1. METODI Sono stati reclutati 43 pazienti con DM1 (11.3±2.77 anni; durata DM1 58.2±38.0 mesi) randomizzati nel Gruppo A (probiotico - 10^8 CFU/die per 3 mesi) e nel Gruppo B (senza probiotico). Al baseline (T0) e dopo 3 mesi (T1) sono stati valutati i seguenti parametri: Full Mouth Plaque Score (FMPS), Full Mouth Bleeding Score (FMBS), dose di insulina (UI/kg/die) e HbA1c. RISULTATI FMPS al T1 è migliorato sia nel Gruppo A che nel Gruppo B (p<0.05). Nel Gruppo B dal T0 al T1 abbiamo riscontrato un aumento della dose di insulina (0.77±0.17 vs. 0.83±0.18 UI/kg/die; p=0.01) ed un miglioramento dell’HbA1c (82.1±21.4 vs. 69.9±19.1 mmol/mmol; p<0.001). Il controllo metabolico non si è modifi cato nel Gruppo A. Per valutare l’aderenza alla somministrazione del probiotico nei pazienti del Gruppo A abbiamo eseguito un sondaggio telefonico: 13 pazienti su 22 hanno riferito un’assunzione regolare (Gruppo A1), mentre negli altri la compliance è risultata sporadica (Gruppo A2). Confrontando i dati di questi 2 gruppi, al T0 non abbiamo riscontrato differenze nei valori di FMPS e FMBS; al T1 entrambi gli indici sono risultati signifi cativamente inferiori (p<0.05) nel Gruppo A1 rispetto al Gruppo A2. La riduzione longitudinale di FMPS e FMBS è stata dimostrata nel Gruppo A1 (p<0.05) ma non nel Gruppo A2. Nessuna modifi ca signifi cativa della dose di insulina e di HbA1c è stata dimostrata. CONCLUSIONI I nostri dati preliminari suggeriscono che la regolare somministrazione orale di probiotici potrebbe migliorare la salute orale dei bambini e adolescenti con DM1 e confermano l’importante ruolo del controllo glicemico

Endothelial and heart dysfunction in children and adolescents with type 1 diabetes

Background/Objectives: Type 1 diabetes (T1D) is an important risk factor for cardiovascular disease (CVD). Even if CVD become mainly manifest in adulthood, the process of atherosclerosis starts in childhood. Ultrasound is a reliable and noninvasive method for detecting early structural and functional atherosclerotic changes in arterial wall and heart. Aim of this study was to determine early ultrasound signs of atherosclerosis and of left ventricular (LV) systolic and diastolic dysfunction in children and adolescents with T1D. Methods: Ninety-four subjects with T1D [12.3±3.53 yrs.; males 59.6%; T1D duration 5.14±3.53 years) were enrolled into the study. Carotid intima-media thickness (cIMT), systolic and diastolic function indices were determined according to standardized scanning protocol and were performed by the same investigator blinded to subjects’ anthropometric (Ht, Wt, BMI, pubertal status, WC, SBP/DBP) and laboratory data (HbA1c, TC, LDL-C, HDL-C, TG). Results: cIMT, LV systolic and diastolic function indices were all in the normal range defined for healthy population. Pubertal subjects, respect to pre-pubertal ones, had significantly higher values of cIMT (0.60±0.09 vs. 0.49±0.08 mm; p&lt;0.001), interventricular septal end-diastole (IVSd) (7.27±1.27 vs. 6.61±1.00 mm; p=0.027), deceleration time (DT) (138.3±31.7 vs. 112.6±20.9 ms; p&lt;0.001), and isovolumetric relaxation time (IVRT) (60.8±14.1 vs. 53.1±9.58 ms; p=0.006). Patients with DKA at T1D onset had significantly higher values of IVSd respect to subjects without DKA 7.40±1.22 vs. 6.80±1.17 mm; p=0.018). Moreover, DBP (Chi-Square=6.13; p=0.047), LV internal dimension at end-iastole (LVIDd) (Chi-Square=7.25; p=0.027), A wave peak (Chi-Square=6.11; p=0.047), and IVRT (Chi-Square=7.29; p=0.026) were significantly different according to mean HbA1c value in the last year. cIMT was higher in subjects with a worse glycemic control (HbA1c ≥9%) (Chi-Square=5.07; p=0.079) and cIMT was significantly correlated with age (R=0.51, p&lt;0.001), WC (R=0.39, p&lt;0.001), SBP (R=0.41, p&lt;0.001), mean HbA1c values of the first 5 years of T1D (R=0.24, p=0.021), TG (R=0.23, p=0.029), and TG/HDL-C ratio (R=0.22, p=0.034). The multivariate regression model was statistically significant for cIMT (R2=0.44, p&lt;0.001) and identify T1D duration (β= -0.23; p=0.024) and LDL-C levels (β=0.20, p=0.031) as predictor factors. Conclusions: cIMT were within normal range but, despite the good glycemic and lipid control, mean values were significantly higher respect to published ones in healthy and T1D children and adolescents. Moreover, LV diastolic function was slightly abnormal. Ultrasound is useful for early detection of subjects with a greater cardiovascular risk who can benefit from targeted therapeutic interventions

Health-Related Quality of Life and Metabolic Control in Immigrant and Italian Children and Adolescents with Type 1 Diabetes and in their Parents

Objective: To determine if the diabetes-specific health-related quality of life (D-HRQOL) of young people with type 1 diabetes (T1D) and their parents is influenced by migrant status. Subjects and methods: One hundred and twenty-five patients (12.4±3.55 years, males 53.6%) with T1D and their parents (102 mothers, 37 fathers) were enrolled and categorized into: Group A (both foreign parents) and Group B (both native Italian parents). The Pediatric Quality of Life Inventory™ 3.0 Diabetes Module (PedsQL™ 3.0 DM) was used to evaluate the D-HRQOL. Data on diabetic ketoacidosis (DKA) at T1D onset, insulin therapy, and glycosylate hemoglobin (HbA1c) were also collected. Results: Group A (n=40), compared to Group B (n=85), had higher frequency of DKA at T1D onset (p&lt;0.001) and a lower use of sensor augmented insulin pump (p=0.015). HbA1c values were higher in Group A than in Group B (p&lt;0.001). Patients' "Diabetes symptoms" (p=0.004), "Treatment barriers" (p=0.001), and "Worry" (p=0.009) scales scores were lower in Group A than in Group B. Mothers of Group A had lower scores in "Diabetes symptoms" (p=0.030), "Treatment barriers" (p&lt;0.001), "Treatment adherence" (p=0.018), "Communication" (p=0.009) scales, and total score (p=0.011) compared to the Group B ones. High PedsQL™ 3.0 DM was significantly associated with being Italian, being pre-pubertal, and having lower HbA1c mean levels. Conclusions: Being a migrant confers disadvantages in terms of D-HRQOL and metabolic control in children and adolescents with T1D. Specific educational interventions should be considered in the clinical care of patients with migration background, to improve D-HRQOL and health status