Emotional Health and Mental Coaching: Safeguarding Oncological Patients' Mental Health in the COVID-19 Era

The new Coronavirus infection, called COVID-19, has appeared on the world stage with significant implications for patients suffering from cancer and their caregivers. Patients with oncological diseases are particularly at risk, both for morbidity and lethality related to respiratory virus infections and are exposed to a higher risk of severe events. The assistance to these types of patients had to deal with the consequences and damage that arise from a state of health emergency and has therefore undergone a remodeling. While the threat of slowdowns threatens patients and all people who risk being diagnosed late, many oncologists face severe occupational burnout. This situation has repercussions on an emotional level: a shared path is desirable to protect the patient himself and the health professionals who take responsibility for the therapeutic care process of such fragile patients. Our model of assistance is based on coaching pointed towards patients affected by cancer, their caregivers and healthcare professionals with the aim of addressing the crisis through an operational process aimed at helping to integrate the experience of illness in order to rebuild the continuity of the existence and give it an evolutionary sense

Age-dependent modifications of expression level of VEGF and its receptors in the inner ear

The mechanisms responsible for age-associated hearing loss are still incompletely characterized. In this study, we used a murine model of age-dependent hearing loss and evaluated whether this condition is associated with vascular modifications of the structures of the inner ear. We used old C57BL/6J mice that are affected by rapid and severe age-related hearing loss, and analyzed the expression pattern of vascular endothelial growth factor (VEGF), a prototypical angiogenic cytokine, and its receptors Flt-1 and Flk-1 in the inner ear. We report for the first time morphological and quantitative data about the expression of these crucial angiogenic molecules in the murine cochlea. We also show that in this animal model, cochlear VEGF expression is significantly reduced as a function of age. Our findings provide new evidence of possible interdependent relationships between aging, VEGF, and presbycusis, suggesting that vascular abnormalities might play a role in aging-associated hearing loss, with potentially important fundamental and clinical implications. (C) 2004 Elsevier Inc. All rights reserved

Antithrombotic Therapy in Hereditary Hemorrhagic Telangiectasia: Real-World Data from the Gemelli Hospital HHT Registry

Although Hereditary Hemorrhagic Telangiectasia (HHT) is characterized by an overwhelming bleeding propensity, patients with this disease may also present medical conditions that require antithrombotic therapy (AT). However, precise information on indications, dosage, duration, effectiveness, and safety of AT in HHT patients is lacking. We performed a retrospective analysis of the HHT Registry of our University Hospital and found 26 patients who received AT for a total of 30 courses (19 courses of anticoagulant therapy and 11 courses of antiplatelet therapy). Indications to treatments included: atrial fibrillation, venous thrombosis and pulmonary embolism, heart valve replacement, retinal artery occlusion, secondary prevention after either stroke or myocardial infarction, and thromboprophylaxis for surgery. The total time of exposure to antiplatelet therapy was 385 months and to anticoagulant therapy 169 months. AT was generally well tolerated, with no fatal bleedings and no significant changes in hemoglobin levels. However, we found three major bleedings, with an incidence rate of 6.5 per 100 patients per year. When only patients treated with anticoagulants were considered, the incidence rate of major bleedings increased to 21.6 per 100 patients per year. Our study indicates that major bleeding may occur in HHT patients receiving AT, with a substantially increased rate in those treated with anticoagulants. Further studies are needed to fully estimate the tolerability of antithrombotic drugs in HHT

Sonic Hedgehog Therapy in a Mouse Model of Age-Associated Impairment of Skeletal Muscle Regeneration

Sonic hedgehog (Shh) is a morphogen regulating muscle development during embryogenesis. We have shown that the Shh pathway is postnatally recapitulated after injury and during regeneration of the adult skeletal muscle and regulates angiogenesis and myogenesis after muscle injury. Here, we demonstrate that in 18-month-old mice, there is a significant impairment of the upregulation of the Shh pathway that physiologically occurs in the young skeletal muscle after injury. Such impairment is even more pronounced in 24-month-old mice. In old animals, intramuscular therapy with a plasmid encoding the human Shh gene increases the regenerative capacities of the injured muscle, in terms of Myf5-positive cells, regenerating myofibers, and fibrosis. At the molecular level, Shh treatment increases the upregulation of the prototypical growth factors, insulin-like growth factor-1 and vascular endothelial growth factor. These data demonstrate that Shh increases regeneration after injury in the muscle of 24-month-old mice and suggest that the manipulation of the Shh pathway may be useful for the treatment of muscular diseases associated with aging

Hereditary Haemorrhagic Telangiectasia: a disease not to be forgotten during the COVID-19 pandemic

From November 2019 to date, almost six thousand papers have been published on COVID-19, the disease caused by SARS-CoV-2 infection. As physicians working in a multidisciplinary centre for the cure of Hereditary Haemorrhagic Telangiectasia (HHT) in a country (Italy) that has been severely affected by COVID-19, we are surprised that, among this impressive amount of publications, there is none on HHT. Indeed, we performed our last PubMed search on 22 April 2020, using the keywords "Hereditary Haemorrhagic Telangiectasia" OR "Hereditary Hemorrhagic Telangiectasia" OR "HHT" OR "Rendu-Osler-Weber" AND "COVID-19" OR "coronavirus", and found no papers. This is surprising, because, although HHT is a rare disease, there are many reasons why we believe that it deserves special attention during the COVID-19 pandemic

Nutrition and IBD: Malnutrition and/or Sarcopenia? A Practical Guide

Malnutrition is a major complication of inflammatory bowel disease (IBD). This mini review is focusing on main determinants of malnutrition in IBD, the most important components of malnutrition, including lean mass loss and sarcopenia, as an emerging problem. Each one of these components needs to be well considered in a correct nutritional evaluation of an IBD patient in order to build a correct multidisciplinary approach. The review is then focusing on possible instrumental and clinical armamentarium for the nutritional evaluation