Effect of COVID-19 pandemic on utilisation of community-based mental health care in North-East of Italy: A psychiatric case register study

Aims: WHO declared that mental health care should be considered one essential health service to be maintained during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to describe the effect of lockdown and restrictions due to the COVID-19 pandemic in Italy on mental health services' utilisation, by considering psychiatric diagnoses and type of mental health contacts. Methods: The study was conducted in the Verona catchment area, located in the Veneto region (northeastern Italy). For each patient, mental health contacts were grouped into: (1) outpatient care, (2) social and supportive interventions, (3) rehabilitation interventions, (4) multi-professional assessments, (5) day care. A 'difference in differences' approach was used: difference in the number of contacts between 2019 and 2020 on the weeks of lockdown and intermediate restrictions was compared with the same difference in weeks of no or reduced restrictions, and such difference was interpreted as the effect of restrictions. Both a global regression on all contacts and separate regressions for each type of service were performed and Incidence Rate Ratios (IRRs) were calculated. Results: In 2020, a significant reduction in the number of patients who had mental health contacts was found, both overall and for most of the patients' characteristics considered (except for people aged 18-24 years for foreign-born population and for those with a diagnosis of schizophrenia. Moreover, in 2020 mental health contacts had a reduction of 57 096 (-33.9%) with respect to 2019; such difference remained significant across the various type of contacts considered, with rehabilitation interventions and day care showing the greatest reduction. Negative Binomial regressions displayed a statistically significant effect of lockdown, but not of intermediate restrictions, in terms of reduction in the number of contacts. The lockdown period was responsible of a 32.7% reduction (IRR 0.673; p-value <0.001) in the overall number of contacts. All type of mental health contacts showed a reduction ascribable to the lockdown, except social and supportive interventions. Conclusions: Despite the access to community mental health care during the pandemic was overall reduced, the mental health system in the Verona catchment area was able to maintain support for more vulnerable and severely ill patients, by providing continuity of care and day-by-day support through social and supportive interventions

How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study

Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI

Cephalopod-omics: emerging fields and technologies in cephalopod biology

Few animal groups can claim the level of wonder that cephalopods instill in the minds of researchers and the general public. Much of cephalopod biology, however, remains unexplored: the largest invertebrate brain, difficult husbandry conditions, complex (meta-)genomes, among many other things, have hindered progress in addressing key questions. However, recent technological advancements in sequencing, imaging, and genetic manipulation have opened new avenues for exploring the biology of these extraordinary animals. The cephalopod molecular biology community is thus experiencing a large influx of researchers, emerging from different fields, accelerating the pace of research in this clade. In the first post-pandemic event at the Cephalopod International Advisory Council (CIAC) conference in April 2022, over 40 participants from all over the world met and discussed key challenges and perspectives for current cephalopod molecular biology and evolution. Our particular focus was on the fields of comparative and regulatory genomics, gene manipulation, single cell transcriptomics, metagenomics and microbial interactions. This article is a result of this joint effort, summarizing the latest insights from these emerging fields, their bottlenecks and potential solutions. The article highlights the interdisciplinary nature of the cephalopod -omics community and provides an emphasis on continuous consolidation of efforts and collaboration in this rapidly evolving field

Cephalopod-omics: emerging fields and technologies in cephalopod biology

14 pages, 1 figure.-- This is an Open Access article distributed under the terms of the Creative Commons Attribution LicenseFew animal groups can claim the level of wonder that cephalopods instill in the minds of researchers and the general public. Much of cephalopod biology, however, remains unexplored: the largest invertebrate brain, difficult husbandry conditions, and complex (meta-)genomes, among many other things, have hindered progress in addressing key questions. However, recent technological advancements in sequencing, imaging, and genetic manipulation have opened new avenues for exploring the biology of these extraordinary animals. The cephalopod molecular biology community is thus experiencing a large influx of researchers, emerging from different fields, accelerating the pace of research in this clade. In the first post-pandemic event at the Cephalopod International Advisory Council (CIAC) conference in April 2022, over 40 participants from all over the world met and discussed key challenges and perspectives for current cephalopod molecular biology and evolution. Our particular focus was on the fields of comparative and regulatory genomics, gene manipulation, single-cell transcriptomics, metagenomics, and microbial interactions. This article is a result of this joint effort, summarizing the latest insights from these emerging fields, their bottlenecks, and potential solutions. The article highlights the interdisciplinary nature of the cephalopod-omics community and provides an emphasis on continuous consolidation of efforts and collaboration in this rapidly evolving fieldPeer reviewe

L'impiego dei farmaci antidepressivi nel puerperio

none4Riassunto. Il puerperio, così come la gravidanza, è associato ad un maggior rischio di disturbi d’ansia e/o disturbi depressivi. La depressione post-partum (DPP), frequentemente in comorbilità con sintomi d’ansia, è il disturbo che si manifesta più frequentemente dopo il parto, con tassi di prevalenza compresi tra il 5 e il 15%. Tra gli antidepressivi (AD), gli inibitori selettivi della ricaptazione della serotonina (SSRI) sono considerati farmaci di prima scelta nel trattamento dei disturbi depressivi puerperali e in particolare della DPP. È quindi fondamentale stabilire, per quelle madri che necessitino di un trattamento con SSRI, il profilo di sicurezza di questi farmaci durante l’allattamento. I vantaggi dell’allattamento al seno, sia per la madre che per il bambino, sono infatti ben documentati. Se, da un lato, tutti gli AD, compresi gli SSRI, passano nel latte, è comunque vero che il rapporto tra concentrazioni ematiche del farmaco e concentrazioni nel latte, proposto per valutare il rischio di una determinata molecola durante l’allattamento, appare un parametro che non è in grado di predire in modo accurato la sicurezza di questi farmaci. Da un’analisi delle evidenze presenti nella letteratura si può concludere che, tra gli SSRI, paroxetina e sertralina offrono il miglior profilo di sicurezza, non essendo fino ad oggi stati segnalati effetti collaterali per il neonato in corso di allattamento con tali AD. Nonostante questi risultati rassicuranti, appaiono comunque necessari ulteriori studi che permettano di definire meglio il profilo di sicurezza. Come regola generale, è importante monitorare con molta attenzione le condizioni di un neonato la cui madre assuma un AD in corso di allattamento, in modo da poter riconoscere precocemente eventuali effetti collaterali farmaco-indotti. Parole chiave. Depressione post-partum, allattamento, antidepressivi, inibitori selettivi della ricaptazione della serotonina, tossicità neonatale.BELLANTUONO C.; MIGLIARESE G.; MAGGIONI F.; IMPERADORE G.Bellantuono, Cesario; Migliarese, G.; Maggioni, F.; Imperadore, G

L'impiego dei farmaci antidepressivi nel puerperio

Riassunto. Il puerperio, così come la gravidanza, è associato ad un maggior rischio di disturbi d’ansia e/o disturbi depressivi. La depressione post-partum (DPP), frequentemente in comorbilità con sintomi d’ansia, è il disturbo che si manifesta più frequentemente dopo il parto, con tassi di prevalenza compresi tra il 5 e il 15%. Tra gli antidepressivi (AD), gli inibitori selettivi della ricaptazione della serotonina (SSRI) sono considerati farmaci di prima scelta nel trattamento dei disturbi depressivi puerperali e in particolare della DPP. È quindi fondamentale stabilire, per quelle madri che necessitino di un trattamento con SSRI, il profilo di sicurezza di questi farmaci durante l’allattamento. I vantaggi dell’allattamento al seno, sia per la madre che per il bambino, sono infatti ben documentati. Se, da un lato, tutti gli AD, compresi gli SSRI, passano nel latte, è comunque vero che il rapporto tra concentrazioni ematiche del farmaco e concentrazioni nel latte, proposto per valutare il rischio di una determinata molecola durante l’allattamento, appare un parametro che non è in grado di predire in modo accurato la sicurezza di questi farmaci. Da un’analisi delle evidenze presenti nella letteratura si può concludere che, tra gli SSRI, paroxetina e sertralina offrono il miglior profilo di sicurezza, non essendo fino ad oggi stati segnalati effetti collaterali per il neonato in corso di allattamento con tali AD. Nonostante questi risultati rassicuranti, appaiono comunque necessari ulteriori studi che permettano di definire meglio il profilo di sicurezza. Come regola generale, è importante monitorare con molta attenzione le condizioni di un neonato la cui madre assuma un AD in corso di allattamento, in modo da poter riconoscere precocemente eventuali effetti collaterali farmaco-indotti. Parole chiave. Depressione post-partum, allattamento, antidepressivi, inibitori selettivi della ricaptazione della serotonina, tossicità neonatale

Transcriptome-wide selection and validation of a solid set of reference genes for gene expression studies in the cephalopod mollusk Octopus vulgaris

Octopus vulgaris is a cephalopod mollusk and an active marine predator that has been at the center of a number of studies focused on the understanding of neural and biological plasticity. Studies on the machinery involved in e.g., learning and memory, regeneration, and neuromodulation are required to shed light on the conserved and/or unique mechanisms that these animals have evolved. Analysis of gene expression is one of the most essential means to expand our understanding of biological machinery, and the selection of an appropriate set of reference genes is the prerequisite for the quantitative real-time polymerase chain reaction (qRT-PCR). Here we selected 77 candidate reference genes (RGs) from a pool of stable and relatively high-expressed transcripts identified from the full-length transcriptome of O. vulgaris, and we evaluated their expression stabilities in different tissues through geNorm, NormFinder, Bestkeeper, Delta-CT method, and RefFinder. Although various algorithms provided different assemblages of the most stable reference genes for the different kinds of tissues tested here, a comprehensive ranking revealed RGs specific to the nervous system (Ov-RNF7 and Ov-RIOK2) and Ov-EIF2A and Ov-CUL1 across all considered tissues. Furthermore, we validated RGs by assessing the expression profiles of nine target genes (Ov-Naa15, Ov-Ltv1, Ov-CG9286, Ov-EIF3M, Ov-NOB1, Ov-CSDE1, Ov-Abi2, Ov-Homer2, and Ov-Snx20) in different areas of the octopus nervous system (gastric ganglion, as control). Our study allowed us to identify the most extensive set of stable reference genes currently available for the nervous system and appendages of adult O. vulgaris

Periprocedural management of anticoagulation therapy and in-hospital outcomes in patients with warfarin indication undergoing percutaneous coronary intervention. Data from the WAR-STENT registry

BACKGROUND: In patients with an indication for oral anticoagulation (OAC) with warfarin, the management of OAC peri-procedure of percutaneous coronary intervention (PCI) is still not fully defined. To investigate clinical practice and outcomes associated with continuation vs interruption of OAC, with or without bridging with low-molecular-weight heparin (LMWH), we examined the database of the observational, prospective, multicenter Italian WAR-STENT registry. METHODS: The WAR-STENT registry was conducted in 2008-2010 in 37 Italian centers and included 411 consecutive patients in 157 of whom the peri-procedural international normalized ratio (INR) value was available. In relation to the continuation vs interruption of OAC, patients were divided into group 1 (n = 106) and group 2 (n = 51) respectively, and compared. RESULTS: The basal characteristics of the two groups were similar. The most frequent indication for OAC was atrial fibrillation and for PCI acute coronary syndromes, respectively. The pre-procedural mean value of INR was significantly different in group 1 vs group 2 (2.3 ± 0.4 vs 1.5 ± 0.2; p <0.001), while the use of antithrombotic drugs did not differ, except for LMWH which, albeit limited to only 14% of cases, was used significantly more frequently in group 2 (14% vs 2%; p=0.006). The radial approach was used significantly more often in group 1 vs group 2 (72% vs 45%; p=0.002). The in-hospital incidence of major bleeding complications was similar in groups 1 and 2 (4% vs 8%; p=0.27), as well as the occurrence of major adverse cardio-cerebrovascular events, including cardiovascular death, non-fatal myocardial infarction, re-revascularization of the treated vessel, stent thrombosis, stroke and venous thromboembolism (6% vs 6%; p=0.95). There was a tendency towards a higher incidence of minor access-site bleeding complications in group 1 patients treated by the femoral route. CONCLUSIONS: In unselected patients with an indication for OAC with warfarin and undergoing PCI, the continuation vs interruption of OAC (essentially without LMWH bridging) strategies appears similar in terms of efficacy and safety. In consideration of the superior convenience, peri-procedural continuation of OAC should therefore generally be preferred, with the possible exception of patients in whom the femoral approach is required for the procedure