125 research outputs found
The Clinical Efficacy of Mindfulness-Based Treatments for Alcohol and Drugs Use Disorders: A Meta-Analytic Review of Randomized and Nonrandomized Controlled Trials
Introduction: The current study aims to evaluate if and to what extent mindfulness-based interventions (MBIs) could promote an incremental effectiveness compared to interventions usually provided in clinical practice to treat Alcohol and Drugs Use Disorders. In line with this aim, we accomplished a meta-analytic review of randomized and nonrandomized controlled trials, considering primary and secondary outcomes that comprehensively operationalize treatment efficacy. Methods: We conducted the online research up to August 31st 2017. Adequate procedures for Cohen's d computation were applied. Heterogeneity indexes, moderators, bias of publication, and Orwin's fail-safe number were also estimated. Results: Thirty-seven studies were included (n = 3,531 patients). We observed null effect sizes for attrition rate and overall mental health. Small effect sizes were detected in abstinence, levels of perceived stress, and avoidance coping strategies. Moderate effect sizes were revealed in anxiety and depressive symptoms. Large effect sizes were associated to levels of perceived craving, negative affectivity, and post-traumatic symptoms. Conclusion: MBIs seemed to show clinically significant advantages compared to other clinical approaches in relation to specific primary and secondary outcomes. Conversely, treatment retention was independent of the therapeutic approach
Emotion Dysregulation in Borderline Personality Disorder: A Literature Review
The goal of this literature review is to describe the state of art related to emotion dysregulation in BPD and to illustrate a possible descriptive model. As of today, no consensus in literature is reached, but, from a conceptual point of view, most of the authors agrees with Linehan’s theory in understanding emotion dysregulation both as affective instability and as a frequent recourse to dysfunctional regulation strategies. The latter is what emotion dysregulation is from an operational point of view. The descriptive model explained in this paper is a possible way to bridge the conceptual and operative views of emotion dysregulation in BPD
Post Traumatic Reactions as Individual Differences: Latent Structure Analysis of the International Trauma Questionnaire in Italian Trauma-Exposed and Non-Trauma Exposed Adults
To evaluate the internal consistency and factor structure of the Italian translation of the 12-item International Trauma Questionnaire (ITQ), 382 trauma-exposed and 366 non-trauma exposed Italian community-dwelling Italian adults from a total group of 748 volunteers completed the ITQ. The ITQ Post-traumatic Stress Disorder and Disorder of Self-Organization scales showed adequate Cronbach’s as in both trauma-exposed and non-trauma-exposed participants. Confirmatory factor analyses showed that the a priori model of item-to-scale assignment of the ITQ items was consistently reproduced in both trauma-exposed and non-trauma-exposed participants, even when measurement invariance was formally assessed. Finally, taxometric analyses showed that the latent distribution of the six ITQ PTSD symptom items should be conceived as a latent dimension rather than a categorical latent construct. As a whole, our findings supported to the cross-cultural validity of the ITQ while extending its clinical usefulness
kinematic elicitation of basic emotions a validation study in an italian sample
Video clips proved to effectively elicit different emotions. Hewig and colleagues (2005) developed a comprehensive set collecting 20 emotional film clips and investigated the basic emotions elicited in a German sample. In this study, we tested the reproducibility of their findings in Italian nonclinical adult subjects (N = 32) examined individually in an ecological setting; moreover, the differences between presentation modalities (with and without sound) were examined. Clips were rated on 10 emotional states (serene, amused, happy, surprised, sad, scared, angry, disgusted, indignant, tense) and on two bipolar dimensions of valence and intensity. Only little differences between presentation modalities were found; stories depicted proved to be clear enough. Film clips elicited the expected emotional profiles, and their rank order for each emotion is almost comparable with the German ones. However, all the clips elicited more than one emotion: ANCOVA proved that emotions were not fully independent and specific association patterns were found. Implications are discussed in the light of the complexity of emotional activation
Photon-Counting Computed Tomography in Atherosclerotic Plaque Characterization
Atherosclerotic plaque buildup in the coronary and carotid arteries is pivotal in the onset of acute myocardial infarctions or cerebrovascular events, leading to heightened levels of illness and death. Atherosclerosis is a complex and multistep disease, beginning with the deposition of low-density lipoproteins in the arterial intima and culminating in plaque rupture. Modern technology favors non-invasive imaging techniques to assess atherosclerotic plaque and offer insights beyond mere artery stenosis. Among these, computed tomography stands out for its widespread clinical adoption and is prized for its speed and accessibility. Nonetheless, some limitations persist. The introduction of photon-counting computed tomography (PCCT), with its multi-energy capabilities, enhanced spatial resolution, and superior soft tissue contrast with minimal electronic noise, brings significant advantages to carotid and coronary artery imaging, enabling a more comprehensive examination of atherosclerotic plaque composition. This narrative review aims to provide a comprehensive overview of the main concepts related to PCCT. Additionally, we aim to explore the existing literature on the clinical application of PCCT in assessing atherosclerotic plaque. Finally, we will examine the advantages and limitations of this recently introduced technology
Spectral Photon-Counting Computed Tomography: Technical Principles and Applications in the Assessment of Cardiovascular Diseases
Spectral Photon-Counting Computed Tomography (SPCCT) represents a groundbreaking advancement in X-ray imaging technology. The core innovation of SPCCT lies in its photon-counting detectors, which can count the exact number of incoming x-ray photons and individually measure their energy. The first part of this review summarizes the key elements of SPCCT technology, such as energy binning, energy weighting, and material decomposition. Its energy-discriminating ability represents the key to the increase in the contrast between different tissues, the elimination of the electronic noise, and the correction of beam-hardening artifacts. Material decomposition provides valuable insights into specific elements’ composition, concentration, and distribution. The capability of SPCCT to operate in three or more energy regimes allows for the differentiation of several contrast agents, facilitating quantitative assessments of elements with specific energy thresholds within the diagnostic energy range. The second part of this review provides a brief overview of the applications of SPCCT in the assessment of various cardiovascular disease processes. SPCCT can support the study of myocardial blood perfusion and enable enhanced tissue characterization and the identification of contrast agents, in a manner that was previously unattainable
Collateral non cardiac findings in clinical routine CT coronary angiography: results from a multi-center registry
Cathepsin K Null Mice Show Reduced Adiposity during the Rapid Accumulation of Fat Stores
Growing evidences indicate that proteases are implicated in adipogenesis and in the onset of obesity. We previously reported that the cysteine protease cathepsin K (ctsk) is overexpressed in the white adipose tissue (WAT) of obese individuals. We herein characterized the WAT and the metabolic phenotype of ctsk deficient animals (ctsk−/−). When the growth rate of ctsk−/− was compared to that of the wild type animals (WT), we could establish a time window (5–8 weeks of age) within which ctsk−/−display significantly lower body weight and WAT size as compared to WT. Such a difference was not observable in older mice. Upon treatment with high fat diet (HFD) for 12 weeks ctsk−/− gained significantly less weight than WT and showed reduced brown adipose tissue, liver mass and a lower percentage of body fat. Plasma triglycerides, cholesterol and leptin were significantly lower in HFD-fed-ctsk−/− as compared to HFD-fed WT animals. Adipocyte lipolysis rates were increased in both young and HFD-fed-ctsk−/−, as compared to WT. Carnitine palmitoyl transferase-1 activity, was higher in mitochondria isolated from the WAT of HFD treated ctsk−/− as compared to WT. Together, these data indicate that ctsk ablation in mice results in reduced body fat content under conditions requiring a rapid accumulation of fat stores. This observation could be partly explained by an increased release and/or utilization of FFA and by an augmented ratio of lipolysis/lipogenesis. These results also demonstrate that under a HFD, ctsk deficiency confers a partial resistance to the development of dyslipidemia
Dupilumab in the treatment of severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP): A multicentric observational Phase IV real-life study (DUPIREAL)
Background
Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with significant morbidity and reduced health-related quality of life. Findings from clinical trials have demonstrated the effectiveness of dupilumab in CRSwNP, although real-world evidence is still limited.
Methods
This Phase IV real-life, observational, multicenter study assessed the effectiveness and safety of dupilumab in patients with severe uncontrolled CRSwNP (n = 648) over the first year of treatment. We collected data at baseline and after 1, 3, 6, 9, and 12 months of follow-up. We focused on nasal polyps score (NPS), symptoms, and olfactory function. We stratified outcomes by comorbidities, previous surgery, and adherence to intranasal corticosteroids, and examined the success rates based on current guidelines, as well as potential predictors of response at each timepoint.
Results
We observed a significant decrease in NPS from a median value of 6 (IQR 5–6) at baseline to 1.0 (IQR 0.0–2.0) at 12 months (p < .001), and a significant decrease in Sino-Nasal Outcomes Test-22 (SNOT-22) from a median score of 58 (IQR 49–70) at baseline to 11 (IQR 6–21; p < .001) at 12 months. Sniffin' Sticks scores showed a significant increase over 12 months (p < .001) compared to baseline. The results were unaffected by concomitant diseases, number of previous surgeries, and adherence to topical steroids, except for minor differences in rapidity of action. An excellent-moderate response was observed in 96.9% of patients at 12 months based on EPOS 2020 criteria.
Conclusions
Our findings from this large-scale real-life study support the effectiveness of dupilumab as an add-on therapy in patients with severe uncontrolled CRSwNP in reducing polyp size and improving the quality of life, severity of symptoms, nasal congestion, and smell
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