Cancer and severe mental illness: Bi‐directional problems and potential solutions

ObjectiveGiven the reported increased rates of physical morbidity and higher mortality rates among people with severe mental illness (SMI) (schizophrenia and severe mood disorders), with a life expectancy shorter of 15‐20 years with respect to the general population, the aim of this paper was to call attention to the problem of cancer in SMI.MethodsWe conducted a narrative review of the most significant papers published in the areas of cancer screening, incidence, mortality and palliative care in SMI.ResultsData from the literature confirm disparities in screening (eg, mammography; pap‐smear test; colorectal cancer screening) and prevention (eg, clinical breast examination; smoking cessation). The incidence of cancer was found to be variable with a portion of the studies reporting a higher prevalence while others a similar or a lower prevalence of cancer compared to the general population. A lower percentage of patients with SMI received proper cancer treatment resulting in survival after cancer diagnosis significantly worse than people without SMI. Likewise, end‐of‐life care has been shown to be lacking with poorer levels of physical, psychological and spiritual care.ConclusionsThe problems of stigma and discrimination, poorer dignity, poorer health behavior, lack of integration in health‐care services for people with SMI needs to be addressed and solved in cancer care. Psycho‐oncology has a very specific and mandatory role in integrating the recommendation of the World Health Organization to improve the links between oncology and mental health settings for more specific psycho‐oncology programs addressed for this vulnerable segment of the population.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163408/2/pon5534.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163408/1/pon5534_am.pd

Horizontal and vertical growth of S. cerevisiae metabolic network

<p>Abstract</p> <p>Background</p> <p>The growth and development of a biological organism is reflected by its metabolic network, the evolution of which relies on the essential gene duplication mechanism. There are two current views about the evolution of metabolic networks. The retrograde model hypothesizes that a pathway evolves by recruiting novel enzymes in a direction opposite to the metabolic flow. The patchwork model is instead based on the assumption that the evolution is based on the exploitation of broad-specificity enzymes capable of catalysing a variety of metabolic reactions.</p> <p>Results</p> <p>We analysed a well-studied unicellular eukaryotic organism, <it>S. cerevisiae</it>, and studied the effect of the removal of paralogous gene products on its metabolic network. Our results, obtained using different paralog and network definitions, show that, after an initial period when gene duplication was indeed instrumental in expanding the metabolic space, the latter reached an equilibrium and subsequent gene duplications were used as a source of more specialized enzymes rather than as a source of novel reactions. We also show that the switch between the two evolutionary strategies in <it>S. cerevisiae </it>can be dated to about 350 million years ago.</p> <p>Conclusions</p> <p>Our data, obtained through a novel analysis methodology, strongly supports the hypothesis that the patchwork model better explains the more recent evolution of the <it>S. cerevisiae </it>metabolic network. Interestingly, the effects of a patchwork strategy acting before the Euascomycete-Hemiascomycete divergence are still detectable today.</p

The risk and the course of cancer among people with Severe Mental Illness

The paucity of data regarding patients with Serious Mental Illness (SMI) and cancer is alarming given the fact that people with SMI, especially schizophrenia, bipolar disorders and severe depressive disorders, have in general poorer access to physical health care and higher morbidity and mortality because of physical illnesses. The aims of this review were to examine the current evidence from existing literature on the risk of developing cancer and its course among people with SMI. Equivocal results emerge regarding the risk of developing some kind of cancer among people with SMI, with contrasting data on a possible higher, similar or lower risk in comparison with the general population. In contrast, a series of studies have pointed out that patients with SMI who develop cancer are less likely to receive standard levels of cancer care, both in terms of screening, diagnosis and treatment. Also, the mortality for cancer has been confirmed to be higher than the general population. A global sensitization about these problems is mandatory in an era in which community psychiatry has been developed in all countries and that policies of prevention, treatment, follow up, and palliative care should regard all the segments of the population, including people with SMI, through an interdisciplinary approach

Clinical Implications of Cancer Related Inflammation and Depression: A Critical Review

Neuropsychiatric symptoms are problematic in cancer settings. In addition to poor quality of life, depression is associated with worsened survival. Patients who develop depression that responds to treatment have the same cancer-related survival as those patients who never had depression. Although depression in patients with cancer is common, it is often unrecognized, untreated, or at best, undertreated. There remains untapped potential for underlying cancer-related biology associated with depression to help clinicians correctly identify depressed cancer patients and orchestrate appropriate treatments to address cancer-related depression. Biologically, inflammation has been most vigorously described in its association with depression in otherwise healthy patients and to a significant extent in patients with medical illness. This association is especially relevant to patients with cancer since so many aspects of cancer induce inflammation. In addition to cancer itself, its treatments (e.g., surgery, radiation, chemotherapy, and systemic therapies) and associated factors (e.g., smoking, obesity, aging) are all associated with increased inflammation that can drive immunological changes in the brain followed by depression. This critical review investigates the relationship between depression and cancer-related inflammation. It investigates several hypotheses that support these relationships in cancer patients. Special attention is given to the data that support certain inflammatory markers specific to both cancer and depression, the neurobiological mechanisms by which inflammation can impact neurotransmitters and neurocircuits in the brain, and the data addressing interventions that reduce inflammation and depression in cancer patients, and future directions

bipolar disorder preceding the onset of multiple sclerosis

Multiple sclerosis (MS) is the most common inflammatory demyelinating brain disease. The occurrence of psychiatric disorders, especially for major depression, in the course of MS is high. Reports concerning bipolar disorder (BD) remain rather scarce although early descriptions were found in the old neurological literature. The purpose of this article is to provide a critical review of the epidemiology, comorbidity, and treatment findings regarding BD preceding the onset of MS

Delayed Deconfinement and the Hawking-Page Transition

We revisit the confinement/deconfinement transition in $\mathcal{N}=4$ super Yang-Mills (SYM) theory and its relation to the Hawking-Page transition in gravity. Recently there has been substantial progress on counting the microstates of 1/16-BPS extremal black holes. However, there is presently a mismatch between the Hawking-Page transition and its avatar in $\mathcal{N}=4$ SYM. This led to speculations about the existence of new gravitational saddles that would resolve the mismatch. Here we exhibit a phenomenon in complex matrix models which we call "delayed deconfinement". It turns out that when the action is complex, due to destructive interference, tachyonic modes do not necessarily condense. We demonstrate this phenomenon in ordinary integrals, a simple unitary matrix model, and finally in the context of $\mathcal{N}=4$ SYM. Delayed deconfinement implies a first-order transition, in contrast to the more familiar cases of higher-order transitions in unitary matrix models. We determine the deconfinement line and find remarkable agreement with the prediction of gravity. On the way, we derive some results about the Gross-Witten-Wadia model with complex couplings. Our techniques apply to a wide variety of (SUSY and non-SUSY) gauge theories though in this paper we only discuss the case of $\mathcal{N}=4$ SYM.Comment: 47 pages, 9 figure

Sales of antidepressants, suicides and hospital admissions for depression in Veneto Region, Italy, from 2000 to 2005: an ecological study

<p>Abstract</p> <p>Background</p> <p>Increased prescription of antidepressants has been consistently associated with a decrease in suicide rates in several countries. The aim of this study is to explore antidepressant consumption, suicide rates and admission for depression in the Veneto Region, Italy, in order to see whether the same pattern could be detected.</p> <p>Methods</p> <p>Data from the Italian Ministry of Health (admissions for depression), the Pharmacy Service of a Local Health Unit (antidepressant prescribing) and from the Epidemiological System of the Veneto region (suicide rates) were collected from 2000 to 2005 for the Veneto region.</p> <p>Results</p> <p>Suicide rates did not show any marked increase but were stable in males and females. Antidepressant prescribing increased exponentially over the period examined, whilst admissions for depression markedly decreased. The trend for an exponential increase in antidepressant prescribing in the Veneto region is shared with other countries and locales.</p> <p>Conclusions</p> <p>It is possible that the increase in antidepressant prescribing might be associated with earlier treatment of depression, thus decreasing the likelihood of aggravation of depression.</p

Ordered structure of the transcription network inherited from the yeast whole-genome duplication

<p>Abstract</p> <p>Background</p> <p>Gene duplication, a major evolutionary path to genomic innovation, can occur at the scale of an entire genome. One such "whole-genome duplication" (WGD) event among the Ascomycota fungi gave rise to genes with distinct biological properties compared to small-scale duplications.</p> <p>Results</p> <p>We studied the evolution of transcriptional interactions of whole-genome duplicates, to understand how they are wired into the yeast regulatory system. Our work combines network analysis and modeling of the large-scale structure of the interactions stemming from the WGD.</p> <p>Conclusions</p> <p>The results uncover the WGD as a major source for the evolution of a complex interconnected block of transcriptional pathways. The inheritance of interactions among WGD duplicates follows elementary "duplication subgraphs", relating ancestral interactions with newly formed ones. Duplication subgraphs are correlated with their neighbours and give rise to higher order circuits with two elementary properties: newly formed transcriptional pathways remain connected (paths are not broken), and are preferentially cross-connected with ancestral ones. The result is a coherent and connected "WGD-network", where duplication subgraphs are arranged in an astonishingly ordered configuration.</p

Long-term outcome of Rockwood capsular shift for recurrent shoulder dislocation

Purpose. To review the long-term outcome of Rockwood capsular shift for recurrent shoulder dislocation secondary to trauma. Methods. Records of 30 males and 4 females who underwent Rockwood capsular shift for recurrent (≥2 episodes) anterior shoulder dislocation were reviewed. An additional Bankart repair with different techniques was performed in 24 of the patients by 2 different surgeons. The outcome was assessed using the Western Ontario Shoulder Instability Index (WOSI) and the Western Ontario Osteoarthritis of the Shoulder (WOOS) index questionnaires, the modified Rowe score, and the Constant-Murley score. Shoulder range of motion (ROM) was measured. Degenerative joint changes were evaluated on radiographs. Results. During a mean follow-up of 13 (range, 10–16) years, 6 (18%) patients had a mean of 1.2 recurrent dislocations. Four of the patients reported a traumatic event during recurrent dislocation. Of the 6 patients, 3 had undergone a Bankart lesion repair. Better Rowe and adjusted Constant scores were associated with lower age at first dislocation, at the index surgical procedure, and at follow-up. Four patients developed glenohumeral osteoarthritis: 2 were mild or moderate and 2 were severe and symptomatic. Glenohumeral osteoarthritis was associated with follow-up duration (p=0.03) and poorer Rowe score (p=0.012), adjusted Constant score (p=0.001), and WOOS score (p=0.006). Conclusion. Rockwood capsular shift can preserve shoulder ROM, with rates of recurrent dislocation and degenerative joint changes comparable with other techniques