The interplay among psychopathology, personal resources, context-related factors and real-life functioning in schizophrenia: stability in relationships after 4 years and differences in network structure between recovered and non-recovered patients

Improving real-life functioning is the main goal of the most advanced integrated treatment programs in people with schizophrenia. The Italian Network for Research on Psychoses previously explored, by using network analysis, the interplay among illness-related variables, personal resources, context-related factors and real-life functioning in a large sample of patients with schizophrenia. The same research network has now completed a 4-year follow-up of the original sample. In the present study, we used network analysis to test whether the pattern of relationships among all variables investigated at baseline was similar at follow-up. In addition, we compared the network structure of patients who were classified as recovered at follow-up versus those who did not recover. Six hundred eighteen subjects recruited at baseline could be assessed in the follow-up study. The network structure did not change significantly from baseline to follow-up, and the overall strength of the connections among variables increased slightly, but not significantly. Functional capacity and everyday life skills had a high betweenness and closeness in the network at follow-up, as they had at baseline, while psychopathological variables remained more peripheral. The network structure and connectivity of non-recovered patients were similar to those observed in the whole sample, but very different from those in recovered subjects, in which we found few connections only. These data strongly suggest that tightly coupled symptoms/dysfunctions tend to maintain each other's activation, contributing to poor outcome in schizophrenia. Early and integrated treatment plans, targeting variables with high centrality, might prevent the emergence of self-reinforcing networks of symptoms and dysfunctions in people with schizophrenia

The interplay among psychopathology, personal resources, context-related factors and real-life functioning in schizophrenia: stability in relationships after 4 years and differences in network structure between recovered and non-recovered patients

Improving real-life functioning is the main goal of the most advanced integrated treatment programs in people with schizophrenia. The Italian Network for Research on Psychoses previously explored, by using network analysis, the interplay among illness-related variables, personal resources, context-related factors and real-life functioning in a large sample of patients with schizophrenia. The same research network has now completed a 4-year follow-up of the original sample. In the present study, we used network analysis to test whether the pattern of relationships among all variables investigated at baseline was similar at follow-up. In addition, we compared the network structure of patients who were classified as recovered at follow-up versus those who did not recover. Six hundred eighteen subjects recruited at baseline could be assessed in the follow-up study. The network structure did not change significantly from baseline to follow-up, and the overall strength of the connections among variables increased slightly, but not significantly. Functional capacity and everyday life skills had a high betweenness and closeness in the network at follow-up, as they had at baseline, while psychopathological variables remained more peripheral. The network structure and connectivity of non-recovered patients were similar to those observed in the whole sample, but very different from those in recovered subjects, in which we found few connections only. These data strongly suggest that tightly coupled symptoms/dysfunctions tend to maintain each other's activation, contributing to poor outcome in schizophrenia. Early and integrated treatment plans, targeting variables with high centrality, might prevent the emergence of self-reinforcing networks of symptoms and dysfunctions in people with schizophrenia

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Changes of evening exposure to electronic devices during the COVID-19 lockdown affect the time course of sleep disturbances

Study objectives: During the coronavirus disease 2019 (COVID-19) lockdown, there was a worldwide increase in electronic devices' daily usage. Prolonged exposure to backlit screens before sleep influences the circadian system leading to negative consequences on sleep health. We investigated the relationship between changes in evening screen exposure and the time course of sleep disturbances during the home confinement period due to COVID-19. Methods: 2,123 Italians (mean age ± standard deviation, 33.1 ± 11.6) were tested longitudinally during the third and the seventh week of lockdown. The web-based survey evaluated sleep quality and insomnia symptoms through the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. The second assessment survey inquired about intervening changes in backlit screen exposure in the two hours before falling asleep. Results: Participants who increased electronic device usage showed decreased sleep quality, exacerbated insomnia symptoms, reduced sleep duration, prolonged sleep onset latency, and delayed bedtime and rising time. In this subgroup, the prevalence of poor sleepers and individuals reporting moderate/severe insomnia symptoms increased. Conversely, respondents reporting decreased screen exposure exhibited improved sleep quality and insomnia symptoms. In this subgroup, the prevalence of poor sleepers and moderate/severe insomniacs decreased. Respondents preserving screen time habits did not show variations of the sleep parameters. Conclusions: Our investigation demonstrated a strong relationship between modifications of evening electronic device usage and time course of sleep disturbances during the lockdown period. Monitoring the potential impact of excessive evening exposure to backlit screens on sleep health is recommendable during the current period of restraining measures due to COVID-19

DEMOGRAPHICAL, VIRO-IMMUNOLOGICAL, CLINICAL AND THERAPEUTICAL CHARACTERISTICS OF HIV INFECTED PATIENTS IN A “EPIDEMIOLOGICALLY UNEXPLORED” REGION OF ITALY (CALABRIA REGION): THE CALABRHIV COHORT.

Background and Objectives   HIV epidemics may differ among epidemiological contexts. We aimed at constructing an HIV clinical cohort whose main epidemiological, clinical and therapeutical characteristics are described (the CalabrHIV cohort, Calabria Region, Southern Italy).   Methods   The CalabrHIV cohort includes all HIV patients on active follow-up in all infectious disease centers in the Calabria Region as at October 2014. All information were recorded in a common electronic database. Not-infectious co-morbidities (such as cardiovascular diseases, bone fractures, diabetes, renal failure and hypertension) were also studied.   Results   548 patients (68% males; 63% aged 50 years-old patients than in <50 years-old ones (30% vs. 6%; p<0.0001). Co-morbidity was more frequent in HCV and/or HBV co-infected than in HIV mono-infected patients (46.6% vs. 31.7%: p=0.0006).   Conclusion   This cohort presentation study sheds light, for the first time, on HIV patients’ characteristics in the Calabria Region. Despite a small number of officially reported cases, the size of the cohort was substantial. We showed that HIV infected patients with chronic hepatites, were affected by concomitant not-infectious co-morbidities more than the HIV mono-infected individuals. New HCV treatments are eagerly awaited

Materiali e tecnologie odontostomatologiche

Questa terza edizione nasce per rispondere alle crescenti esigenze, dopo l’ottima ricezione, da parte degli studenti e cultori della materia. È dedicata alla Prof.ssa Elettra Dorigo De Stefano, primo docente di Materiali Dentari, Past President del Collegio dei Docenti di Odontoiatria, sotto il cui patrocinio è iniziato il nostro progetto; i suoi consigli sono stati fondamentali per la sua produzione collegiale. Il carisma e la dedizione della prof.ssa Dorigo nei confronti della disciplina sono di esempio per tutte le generazioni future che intendono intraprendere la carriera accademica. Ventuno sedi universitarie, oggi ventisette, hanno aderito a questo progetto; tutte hanno collaborato attivamente fornendo il proprio materiale didattico. Il risultato è questo volume, che rimane sotto il Patrocinio del presidente del Collegio dei Docenti, oggi il prof. Roberto di Lenarda, a cui va il mio ringraziamento. La nuova edizione è stata implementata con nuovi argomenti quali: materiali per l’ingegneria cranio-facciale, per l’igiene orale, per lo sbiancamento, per lo studio e il trattamento dell’alitosi e dispositivi LED in odontoiatria. Inoltre è stato inserito un capitolo apposito per quanto riguarda la ricerca ed analisi al microscopio. Includendo questi nuovi argomenti si creano i fondamenti e si fornisce il know-how agli studenti sia di Odontoiatria che di Igiene Dentale per mettere in dialogo i professionisti del “dentale”. L’indice di questo testo riflette i programmi condivisi dai docenti di disciplina, senza entrare nelle tematiche specialistiche in modo approfondito, per lasciare così al singolo docente spazio per gli approfondimenti che riterrà necessari. Inoltre, per facilitare la comprensione del testo, i diversi argomenti sono stati raggruppati per aree tematiche, caratterizzate da diversi colori. Sono personalmente convinto che molto è ancora da fare e da correggere e pertanto spero, con l’arrivo di suggerimenti, di poter migliorare e aggiornare il testo. Giuseppe Spoto Coordinatore dei Docenti di questo Lavoro Collegiale già Referente della Disciplina “Materiali Dentari e Tecnologie Protesiche di Laboratorio” già Professore ordinario di Materiali Dentari, Prof. inc. di Chimica Medica, Referente Nazionale della sede di Chieti per il Collegio dei Docenti di Odontoiatria, Università “G. d’Annunzio” di Chieti, Dipartimento di Scienze Mediche Orali e Biotecnologiche (via dei Vestini 31, Chieti)