Tako-Tsubo cardiomyopathy and psychiatric disorders: Review of comorbidity

Background: In recent times, the connections between mental health and cardiac outcomes have been under increasing investigation. Tako-Tsubo Cardiomyopathy (TTC) is also called “broken heart syndrome”, since it has been described to occur after emotionally stressful events; it presents as an acute reversible coronary syndrome due to a transient failure of the left ventricle, in the absence of obstructive coronary heart disease. It has a 10-timehigher prevalence in postmenopausal women and may have a strong correlation with biopsycho- social stress. Aim: To review existing studies on TTC in comorbidity with psychiatric disorders. Method: Four PubMed literature searches performed during January 2015 (search terms: tako-tsubo AND psy*; tako-tsubo AND anxiety; tako-tsubo AND depression; tako-tsubo AND mania) provided 9 references: 4 case reports, 2 reviews, 2 prospective studies and 1 case–control study. Results: Not only chronic psychological stress (present in 2/3 of these patients, on average), but also a high co-occurrence of anxiety and depression (from 50 to 70% of patients with this cardiopathy), panic attacks (diagnosed in almost 20% of women with tako-tsubo), subthreshold and full-blown PTSD (co-morbid in almost 40% of patients according to a 2-year prospective study) were associated with TTC. It has been suggested that changes in circulating levels of catecholamines combined to heart's abnormal response to these hormones could be at the pathophysiological basis for such associations. Conclusion: The present literature review confirms a high cooccurrence of comorbid conditions with increased sympathetic activity (in particular anxiety, depression and panic disorder), which could be risk factors for TTC. More studies, especially longitudinal ones, are needed to better clarify the causative pathways of this usually reversible, but potentially lethal, syndrome, especially among post-menopausal women

Impact of anxiety-depressive symptoms on outpatients\u2019 quality of life: Preliminary results from an Italian observational study

Introduction Several studies have shown an association between the Short-Form 36 (SF36) scores and anxiety-depressive symptoms, suggesting that depression in particular could reduce Quality of Life (QoL) to the same, and even greater, extent than chronic noncommunicable diseases, such as diabetes and hypertension. Aims To explore the relationshipamongQoL and anxiety, depressive and anxiety-depressive symptoms in an outpatient sample. Methods Cross-sectional study. Inclusion criteria: outpatients aged 6540 years, without history for cancer, attending colonoscopy after positive faecal occult blood test. Collected data: blood pressure, blood glucose, lipid profile. Psychometric test: Hospital Anxiety and Depression Scale (HADS). QoL was assessed with SF36. Statistics performed with STATA13. Results 54 patients enrolled (27 females). Sixteen patients (30.2%) were positive for anxiety symptoms, ten (18.9%) for depressive symptoms and five (9.4%) for anxiety-depressive symptoms. The perceived QoL was precarious in twelve subjects (22.2%): eight (15.9%) had low score ( 64 42) at \u201cMental Component Summary\u201d (MCS) subscale, three (5.7%) at the \u201cMental Health\u201d item and one patient (1.9%) at the \u201cVitality\u201d one. At the multiple regression analysis, depressive (OR = 28.63; P = 0.01) and anxiety-depressive symptoms (OR = 11.16; P = 0.02) were associated with MCS. Conclusions The association emerging from the present study between depressive/anxiety symptoms and the MCS component of SF36 is consistent with available literature. Study design and small sample size do not allow to generalize results, that need further studies to be confirmed

“It’s always good to ask”: a mixed methods study on the perceived role of sexual health practitioners asking gay and bisexual men about experiences of domestic violence and abuse

Development of joint displays is a valued approach to merging qualitative and quantitative findings in mixed methods research. This study aimed to illustrate a case series mixed methods display and the utility of using mixed methods for broadening our understanding of domestic violence and abuse. Using a convergent design, 532 gay and bisexual men participated in a Health and Relationship Survey in a U.K. sexual health service and 19 in an interview. Quantitative and qualitative data were analyzed separately and integrated at the level of interpretation and reporting. There were inconsistencies in perceptions and reports of abuse. Men were supportive of selective enquiry for domestic violence and abuse by practitioners (62.6%; 95% confidence interval = 58.1% to 66.7%) while being mindful of contextual factors

Association of blood pressure with anxiety and depression in a sample of primary care patients

Introduction According to international scientific literature, and as summarized in the guidelines of the International Society of Hypertension, lowering of blood pressure can prevent cardiovascular accidents. Some studies suggest that hypertension, anxiety, and depression might be inversely correlated. Objective To investigate whether blood pressure is associated with anxiety and depression. Methods Cross-sectional design. Male and female primary care patients were enrolled, aged 40–80. Criteria of exclusion adopted: use of antidepressants or antipsychotics; previous major cardiovascular event; psychosis or major depression; Type 1-DM; pregnancy and hereditary disease associated to obesity. Anxiety and depression symptoms were assessed using HADS. Waist circumference, hip circumference, blood pressure, HDL, triglycerides, blood sugar, hypertension, albumin concentrations and serum iron were also assessed. Results Of the 210 subjects, 84 were men (40%), mean age was 60.88 (SD ± 10.88). Hypertension was found to correlate significantly to anxiety (OR = 0.38; 95% CI = 0.17–0.84), older age (OR = 3.96; 95% CI = 1.88–8.32), cigarette smoking (OR = 0.35; 95%CI = 0.13–0.94), high Body Mass Index (OR = 2.50; 95% CI = 1.24–5.01), Waist-hip ratio (OR = 0.09; 95% CI = 0.02–0.46) and the Index of comorbidity (OR = 16.93; 95% CI = 3.71–77.29). Conclusions An inverse association was found between anxiety and hypertension, suggesting the need to clinically manage these two dimensions in a coordinated way. Other findings are well known and already included in prevention campaigns. Further research is needed, also to better understand and explain the causative pathways of this correlation

Associations between serum gamma-globulin concentration, enzyme activities, growth and survival in preweaning Alpine goat kids

Colostral immunity is crucial for young ruminants, but the individual factors that may affect passive transfer status and its effects on preweaning growth performance have not been widely investigated in goats. The methods to quantify immunoglobulins G can be expensive. Colostrum enzymes, though, pass the intestinal barrier and might be suitable as markers of passive transfer status, as demonstrated in other ruminant species. This study aimed to investigate the effect of sex, litter size, dam parity, and birth body weight on passive transfer status and the relationship between gamma-globulin concentration (GG) and pre-weaning growth performance in Alpine goat kids. The association between serum GG, serum total protein concentration and serum activity of colostrum enzymes including γ-glutamyltransferase (GGT), alkaline phosphatase (ALP), aspartate aminotrans- ferase (AST), and lactate dehydrogenase (LDH) was examined for their use as predictors of passive transfer status in neonatal goat kids. Sixty-six Alpine goat kids (39 males, 27 females), born to 28 does at one dairy goat farm during two delivery seasons, were enrolled. Kids nursed their dams in group housing until weaned at 50 days of age. Blood samples were collected 24 h after birth. Body weights (BW) were taken at birth and weaning. Serum enzyme activities and total protein concentration were measured using a clinical biochemical analyser. Serum GG was determined by gel electrophoresis. Statistical analysis was performed using GraphPad Prism (v. 8.2.1). No significant differences in serum GG between males and females, singlets and twins, multiparous’ and pri- miparous’ kids were found. No association was detected between birth BW and GG. Serum GG was strongly and significantly associated with TP (R2 =0.85; p 0.0001) and moderately associated with GGT (R2 =0.47; p 0.0001). No correlation was found with ALP, AST, and LDH. Although partial failure of passive transfer (FPT) was diagnosed in 23% of kids, no effects on morbidity (3%), mortality (0%) and pre-weaning growth performance were observed. Our results confirm that serum total proteins can be used to indirectly estimate immunoglobulin concentration. Contrarily, passive transfer status can be predicted with little success by measuring the activity of serum GGT. It is not advisable to use ALP, AST and LDH as indicators of passive transfer status. Finally, FTP is not necessarily associated with the health and preweaning growth performance of Alpine goat kids reared in non- intensive breeding systems that follow good farming practices

Multiple primary melanomas: Is there a correlation between dermoscopic features and germline mutations?

No abstract availabl

18F-Fluorocholine PET/CT, Tc-99m-MIBI and TC-99m-MDP SPECT/CT in Tertiary Hyperparathyroidism with Renal Osteodystrophy

Tertiary hyperparathyroidism (HPT) is a metabolic disorder characterized by the semi-autonomous hypersecretion of parathyroid hormone (PTH), leading to hypercalcemia. It can be the end result of persistent secondary hyperparathyroidism and is most commonly observed in patients with long-standing chronic kidney disease (CKD) and often after renal transplantation. Untreated HPT can lead to progressive bone disease, fibrocystic osteitis, and soft-tissue calcifications, along with other severe complications. In the 2009 Kidney Disease Improving Global Outcomes (KDIGO) guidelines, CKD-Mineral and Bone Disorder (CKD-MBD) is used to describe the broader clinical syndrome encompassing mineral, bone, and calcific cardiovascular abnormalities that develop as a complication of CKD. We report a 62-year-old female with a severe HPT evolved from advanced chronic kidney disease (stage 5D, KDIGO). Patient was evaluated with multimodality nuclear medicine functional imaging to assess hyperfunctioning parathyroid glands and bone lesions. Tc-99m-methoxyisobutylisonitrile (MIBI) dual-phase scintigraphy, Tc-99m-methylenediphosphonate (MDP) bone scan and 18F-Fluorocholine positron emission tomography/computed tomography ( 18F-FCH PET/CT) were performed before surgery

Users' choice and change of allocated primary mental health professional in community-based mental health services: A scoping review

Background. The recovery model in mental health care emphasizes users\u2019 right to be involved in key decisions of their care, including choice of one\u2019s primary mental health professional (PMHP). Aims. The aim of this paper was to provide a scoping review of the literature on the topic of users\u2019 choice, request of change and preferences for the PMHP in community mental health services. Method. A search of Pubmed, Cochrane Library, Web of Science and PsycINFO for papers in English was performed. Additional relevant research articles were identified through authors\u2019 personal bibliography. Results. 2774 articles were screened and 38 papers were finally included. Four main aspects emerged: 1) the importance, for users, to be involved in the choice of their PMHP; 2) the importance, for users, of the continuity of care in the relationship with their PMHP; 3) factors of the user/PMHP dyad influencing users\u2019 preferences; 4) the effect of choice on treatments\u2019 outcomes. Conclusions. While it is generally agreed that it is important to consider users\u2019 preferences in choosing or requesting to change their PMHP, little research on this topic is available. PMHPs\u2019 and other stakeholders\u2019 views should also be explored in order to discuss ethical and practical issues