66 research outputs found

    Pea Albumin 1 Subunit b (PA1b), a Promising Bioinsecticide of Plant Origin

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    PA1b (Pea Albumin 1, subunit b) is a peptide extract from pea seeds showing significant insecticidal activity against certain insects, such as cereal weevils (genus Sitophilus), the mosquitoes Culex pipiens and Aedes aegyptii, and certain species of aphids. PA1b has great potential for use on an industrial scale and for use in organic farming: it is extracted from a common plant; it is a peptide (and therefore suitable for transgenic applications); it can withstand many steps of extraction and purification without losing its activity; and it is present in a seed regularly consumed by humans and mammals without any known toxicity or allergenicity. The potential of this peptide to limit pest damage has stimulated research concerning its host range, its mechanism of action, its three-dimensional structure, the natural diversity of PA1b and its structure-function relationships

    Support management in schizophrenia: a systematic review of current literature

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    Maurizio Pompili,1 Franco Montebovi,1 Alberto Forte,1 Mario Palermo,1 Henry Stefani,1 Ludovica Telesforo,1 Sandra Campi,1 Gloria Giordano,1 Lucia Longo,1 Dorian A Lamis,2 Gianluca Serafini,1 Paolo Girardi11Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; 2Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USABackground: Schizophrenia is generally considered a chronic disorder characterized by psychotic symptoms and relatively stable neurocognitive and interpersonal deficits. Antipsychotic medication has proven beneficial in reducing psychotic symptoms, but is often not enough to treat cognitive or functional impairments. Residual cognitive impairments are barriers to a patient's full recovery from schizophrenia. Rehabilitation is an alternative and important approach which may be useful, and encompasses a variety of treatments including social skills training and psychoeducational and cognitive behavioral treatments.Objective: To investigate the efficacy of psychosocial treatments in schizophrenia, evaluating its effects in the short and long term, comparing psychosocial treatments with pharmacotherapy, and assessing the effects of treatment and the main indications for use in patients with schizophrenia.Methods: A careful MEDLINE®, Excerpta Medica, PsycLIT®, PsycINFO®, and Index Medicus search was performed to identify all papers and book chapters in English for the period 1970–2012.Results: Findings from the studies included in this qualitative analysis suggest that social skills therapy, cognitive behavioral therapy, family intervention therapy, cognitive remediation therapy, and other nonpharmacological therapeutic strategies may be beneficial for patients with significant functional and symptomatic impairments.Conclusion: Schizophrenic patients treated with nonpharmacological techniques have more rapid remission and relapse less frequently than patients treated only pharmacologically.Keywords: schizophrenia, support management, nonpharmacological treatment, cognitive behavioral therap

    Mediators in the Association Between Affective Temperaments and Suicide Risk Among Psychiatric Inpatients

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    BACKGROUND: Affective temperaments have been shown to be related to psychiatric disorders and suicidal behaviors. Less is known about the potential contributory role of affective temperaments on suicide risk factors. In the present study, we investigated whether the effect of affective temperaments on suicide risk was mediated by other variables, such as hopelessness, mentalization deficits, dissociation, psychological pain, and depressive symptoms. METHODS: Several assessment instruments, including the Mini International Neuropsychiatric Interview (MINI); the Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A); the Beck Hopelessness Scale (BHS); the Gotland Male Depression Scale (GMDS); the Dissociative Experiences Scale (DES); the Psychological Pain Assessment Scale (PPAS); and the Mentalization Questionnaire (MZQ), were administered to 189 psychiatrically hospitalized patients (103 women, 86 men) in Rome, Italy. RESULTS: In single-mediator models, hopelessness, depressive symptoms, and mentalization, but not psychological pain or dissociation, were significant mediators in the association between prevalent temperament and suicide risk. In a multiple-mediator model, a significant indirect effect was found only for depression. Results demonstrated that patients with negative temperaments reported higher suicide risk, psychological pain, hopelessness, and depression, and less mentalization than patients with no prevalent temperament or hyperthymic temperaments. CONCLUSIONS: Hopelessness, depression, and mentalization are all factors that mediate the relation between affective temperaments and suicide risk. Identifying factors that mediate the effects of affective temperamental makeup on suicide risk should enhance screening and intervention efforts

    Global Retinoblastoma Presentation and Analysis by National Income Level.

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    Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

    Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

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    BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral

    The association between physical illness/medical conditions and suicide risk

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    Physical diseases and mental disorders often present together increasing the risk of suicidal thoughts and behaviors. Several studies have documented high rates of suicidal behavior among patients suffering from a variety of medical conditions (Berman & Pompili, 2011; Mackenzie, Popkin, & Blumenthal, 1990), and several authors have identified medical conditions as a risk factor for suicide (Berman, Silverman, & Bongar, 2000). Medical conditions are also frequently associated with anxiety, depression, and substance use disorders, which are all related to suicidal thoughts (Scott et al., 2007).The International Handbook of Suicide Prevention, 2nd Edition, presents a series of readings that consider the individual and societal factors that lead to suicide, it addresses ways these factors may be mitigated, and presents the most up-to-date evidence for effective suicide prevention approaches. An updated reference that shows why effective suicide prevention can only be achieved by understanding the many reasons why people choose to end their lives. Gathers together contributions from more than 100 of the world's leading authorities on suicidal behavior-many of them new to this edition. Considers suicide from epidemiological, psychological, clinical, sociological, and neurobiological perspectives, providing a holistic understanding of the subject. Describes the most up-to-date, evidence-based research and practice from across the globe, and explores its implications across countries, cultures, and the lifespan

    DIFFERENCES IN CLINICAL CHARACTERISTICS BETWEEN BIPOLAR PATIENTS WITH CURRENT PSYCHOTIC SYMPTOMS AND THOSE WHO HAVE NEVER BEEN PSYCHOTIC

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    Background: Psychotic symptoms are common in bipolar disorder (BD). Data suggest that BD patients with or without psychotic symptoms may differ from each other with regards to some clinical features of BD (e.g., age at onset, suicidality, psychiatric comorbidity, number of hospitalizations). However, the literature in this area is relatively scarce and not always conclusive. Therefore, the objective of the current study was to investigate whether the presence of psychotic symptoms is associated with clinical characteristics of patients with BD. Subjects and methods: We enrolled 365 hospitalized patients who were diagnosed with BD according to the ICD-10 criteria. After we excluded 196 patients without current psychotic symptoms but psychotic mood episodes in their medical history, our final sample consisted of 169 patients (i.e., 89 BD patients presenting with current psychotic symptoms and 80 BD patients who were hospitalized in the same period, but who did not have psychotic symptoms either currently or during their previous hospitalizations). Clinically available data were collected, systematized and statistically processed according to the aims of the study. Results: Early age of onset, bipolar-I diagnosis, comorbid personality disorder, number of hospitalizations and suicidality were significantly more common in the psychotic group compared to the never-psychotic group. On the contrary, sedative/hypnotics dependence was more frequent in the never-psychotic group. Conclusions: Our results support the notion that the presence of psychotic symptoms in the context of BD may be associated with various other clinical features of this disease
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