Quetiapine for bipolar depression: a systematic review and meta-analysis.

Quetiapine has been proposed for depression in bipolar patients but a quantitative analysis is lacking. In the present paper, we review and meta-analyze available data about the short-term and long-term efficacy and tolerability of quetiapine for the depressive phase of bipolar disorder or bipolar depression. A literature research was carried out using three electronic databases. Studies providing measures of efficacy and tolerability of quetiapine, either as monotherapy or as augmentation, for bipolar depression were considered. Seven short-term studies and four maintenance studies were included. Short-term studies suggested that patients treated with quetiapine monotherapy were significantly more likely than patients treated with placebo and further active comparators to achieve higher response and remission rates as well as more clinical improvements at the endpoint. Such benefits were significant from the first weeks of treatment onward. Maintenance studies suggested that the combination of quetiapine and mood stabilizers was significantly better than placebo plus mood stabilizers for the prevention of both depressive and manic relapses. Quetiapine was generally well tolerated. Furthermore, several clinical variables moderated outcomes under investigation. In conclusion, quetiapine could have some advantages over traditional treatments for the treatment of bipolar depression

Communication, cultural competence and safety in workplaces: A research-action for the application of the C.I.A.O. model (Article) [Comunicazione, competenza culturale e sicurezza nei luoghi di lavoro: Una ricerca-intervento per l'applicazione del modello C.I.A.O.]

Aim: The high frequency of injuries among migrant workers is documented in the international literature and from statistics on a national basis. The management of risk and safety communication in intercultural work contexts must always be at the center of the training promoted by public authorities and companies. To meet these needs we conducted a training project at the construction site Unifimm Tower of Bologna, with the collaboration of the cooperative CMB and the consortium Nuova Agora. Methods: The method C.I.A.O. (Contact, Intended, Alliance, Objectives) has been experimented in a training course addressed to personnel with security responsibilities. The method has been developed specifically to enhance the communication skills in multicultural contexts. The opinion and the ability of officers in relation to risk communication in intercultural environments were evaluated prior to the course and distance of three months from the initiative. Sixteen migrant workers were involved in the evaluation of the safety climate and quality of communication with managers. Results: The training sessions were set on a participatory and interactive teaching methods. A good climate of security and a keen interest in the communication of safety regulations were found. The course has implemented the interest and awareness of the personnel dedicated to the safety in the workplace about the importance of cultural competence in the context of risk communication and provided a application-model of these skills. Conclusion: This pilot experience demonstrated how, even in a work environment security-conscious, cultural competency in risk communication towards migrants is a sensitive issue and implementable. Those training-interventions should be extended and generalized on a national scale

Psychiatric consequences of disasters in Italy: A systematic review

Italy is at high risk of earthquakes, landslides and flood. International literature highlighted the high frequency and severity of mental health consequences following natural disasters. Our review aims to evaluate: 1) the prevalence and risk factors for psychiatric consequences after natural disasters in Italy; 2) variation over time of the prevalence of psychiatric consequences as reported by the Italian studies We conducted a systematic literature review on psychiatric squealae of natural disasters occurred in Italy. We used three electronic databases: MEDLINE, PsychINFO and PILOTS. We found 25 studies reporting disease prevalence and/or symptoms measures. PTSD is the most frequently reported disorder, with a prevalence ranging from 0.3% to 41.3%. Only one study did not find an higher prevalence of mental disorders compared to non-exposed populations. Others reported disorders were depression, somatization and anxiety. The most frequently reported predictors of mental suffering were female gender, social and economic damage and direct involvement in the disaster. This review found a severe consequences on mental health following natural disasters occurred in Italy. There is a need of specific and ad hoc intervention plans not only for the immediate aftermath, but also for the medium-long-term period after natural disasters

Mental health disorders and summer temperature-related mortality: A case crossover study

Identifying the most vulnerable subjects is crucial for the effectiveness of health interventions aimed at limiting the adverse consequences of high temperatures. We conducted a case crossover study aimed at assessing whether suffering from mental health disorders modifies the effect of high temperatures on mortality. We included all deaths occurred in the area of Bologna Local Health Trust during the summers 2004\u20132017. Subjects with mental disorders were identified by using the local Mental Health Registry. A conditional logistic model was applied, and a z-test was used to study the effect modification. Several models were estimated stratifying by subjects\u2019 characteristics. For every 1\u25e6C above 24\u25e6C, mortality among people without mental disorders increased by 1.9% (95% CI 1.0\u20132.6, p < 0.0001), while among mental health service users, mortality increased by 5.5% (95% CI 2.4\u20138.6, p < 0.0001) (z-test equal to p = 0.0259). The effect modification varied according to gender, residency and cause of death. The highest probability of dying due to an increase in temperature was registered in patients with depression and cognitive decline. In order to reduce the effects of high temperatures on mortality, health intervention strategies should include mental health patients among the most vulnerable subjects taking account of their demographic and clinical characteristics

Cancer mortality in Common Mental Disorders: A 10-year retrospective cohort study

Purpose Individuals with Common Mental Disorders (CMDs) may have a higher cancer mortality. The purpose of this study was to examine cancer-related mortality among patients with CMDs and verify which cancer types are predominantly involved. Methods We used the Regional Mental Health Registry of the Emilia-Romagna region, in Northern Italy to identify patients aged >= 18 years who received an ICD 9-CM diagnosis of CMDs (i.e., depressive and neurotic disorders) over a 10 year period (2008-2017). Information on cause of death was retrieved from the Regional Cause of Death Registry. Comparisons were made with data from the regional population without CMDs. Results Among 101,487 patients suffering from CMDs (55.7% depression; 44.3% neurotic disorders), 3,087 (37.8%) died from neoplasms. The total standardized mortality ratio (SMR) was 1.82 (95% CI 1.78-1.86) while the SMR for all neoplasms was 2.08 (95% CI 2.01-2.16). Individuals of both genders, with both depressive and neurotic disorders had a higher risk of death from almost all cancers compared with the regional population. Conclusion Patients with CMDs have considerably higher cancer mortality risk than the general population. Higher mortality was observed for a broad range of cancers associated with different aetiologies. It is imperative to promote cancer awareness, prevention and treatment for people with CMDs

Axonal regeneration in adult CNS neurons - Signaling molecules and pathways

10.1111/j.1471-4159.2006.03663.xJournal of Neurochemistry9661501-1508JONR

A Novel Mouse Model of Traumatic Optic Neuropathy Using External Ultrasound Energy to Achieve Focal, Indirect Optic Nerve Injury

Abstract Traumatic optic neuropathy (TON) is a devastating cause of permanent visual loss following blunt injury to the head. Animal models for TON exist, but most fail to recapitulate the clinical scenario of closed head indirect trauma to the nerve and subsequent neurodegeneration. Thus, we developed a clinically-relevant animal model for TON using a novel ultrasonic pulse injury modality (sonication-induced TON; SI-TON). To trigger TON, a microtip probe sonifier was placed on the supraorbital ridge directly above the entrance of the optic nerve into the bony canal. An ultrasonic pulse was then delivered to the optic nerve. After injury, the number of RGCs in the retina as well as visual function measured by PERG steadily decreased over a two-week period. In the optic nerve, pro-inflammatory markers were upregulated within 6 hours following injury. Immunohistochemistry showed activation of microglia and infiltration of CD45-positive leukocytes in the optic nerve and initiation of a gliotic response. The SI-TON model is capable of delivering a non-contact concussive injury to the optic nerve and induce TON in mice. Thus, our data indicate that the SI-TON model reliably recapitulates the pathophysiology and progressive neurodegeneration seen in the human manifestation

Identifying gene-environment interactions in schizophrenia: Contemporary challenges for integrated, large-scale investigations

Recent years have seen considerable progress in epidemiological and molecular genetic research into environmental and genetic factors in schizophrenia, but methodological uncertainties remain with regard to validating environmental exposures, and the population risk conferred by individual molecular genetic variants is small. There are now also a limited number of studies that have investigated molecular genetic candidate gene-environment interactions (G 7 E), however, so far, thorough replication of findings is rare and G 7 E research still faces several conceptual and methodological challenges. In this article, we aim to review these recent developments and illustrate how integrated, large-scale investigations may overcome contemporary challenges in G 7 E research, drawing on the example of a large, international, multi-center study into the identification and translational application of G 7 E in schizophrenia. While such investigations are now well underway, new challenges emerge for G 7 E research from late-breaking evidence that genetic variation and environmental exposures are, to a significant degree, shared across a range of psychiatric disorders, with potential overlap in phenotype. \ua9 2014 The Author

Glaucoma-Induced Degeneration of Retinal Ganglion Cells Prevented by Hypoxic Preconditioning: A Model of Glaucoma Tolerance

Like all cells, neurons adapt to stress by transient alterations in phenotype, an epigenetic response that forms the basis for preconditioning against acute ischemic injury in the central nervous system. We recently showed that a modified repetitive hypoxic preconditioning (RHP) regimen significantly extends the window of ischemic tolerance to acute retinal ischemic injury from days to months. The present study was undertaken to determine if this uniquely protracted neuroprotective phenotype would also confer resistance to glaucomatous neurodegeneration. Retinal ganglion cell death at somatic and axonal levels was assessed after both 3 and 10 wks of sustained intraocular hypertension in an adult mouse model of inducible, open-angle glaucoma, with or without RHP before intraocular pressure elevation. Loss of brn3-positive ganglion cell soma after 3 wks of experimental glaucoma, along with increases in several apoptotic endpoints, were all significantly and robustly attenuated in mice subjected to RHP. Soma protection by RHP was also confirmed after 10 wks of intraocular hypertension by brn3 and SMI32 immunostaining. In addition, quantification of axon density in the postlaminar optic nerve documented robust preservation in RHP-treated mice, and neurofilament immunostaining also revealed preconditioning-induced improvements in axon integrity/survival in both retina and optic nerve after 10 wks of experimental glaucoma. This uniquely protracted period of phenotypic change, established in retinal ganglion cells by the activation of latent antiapoptotic, prosurvival mechanisms at both somatic and axonal levels, reflects a novel form of inducible neuronal plasticity that may provide innovative therapeutic targets for preventing and treating glaucoma and other neurodegenerative diseases